Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112514

Courtney M. Queen, MS, Department of Sociology, University of North Texas, P.O. Box 311157, Denton, TX 76203-1157, 940-565-4914, courtneymqueen@yahoo.com, Susan Eve, PhD, University Honors Program, University of North Texas, P.O. Box 305189, Denton, TX 76203-5189, Ximena Urrutia-Rojas, RN, DrPH, Department of Social and Behavioral Sciences, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2699, Fernando Trevino, PhD, MPH, Health Management and Policy, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, Joane Baumer, MD, Dept. of Family and Community Medicine, JPS Health Network, 1500 South Main, Fort Worth, TX 76104, and Kenneth Koelln, PhD, Department of Economics, University of North Texas, P.O. Box 305457, Denton, TX 76203-5457.

Objectives and theoretical framework. The objectives of this research are to identify problems Hispanic immigrants have accessing health care in a safety-net healthcare system and to suggest public policies that can address the barriers they face. The theoretical framework used is the Behavioral Model for Vulnerable Populations developed by Ronald Andersen, LuAnn Aday, and Lillian Gelberg. The model includes both traditional and vulnerable population variables that measure factors that create a predisposition to use health care service, resources that enable people to use health care services when needed, and perceptions of health needs. Methods. Data on 379 Hispanic immigrants were taken from a random telephone survey of 2034 patients aged 18-60 years of age who used the JPS Health Network in July and August 2000. The JPS Health Network is a tax-supported healthcare network for medically indigent residents of Tarrant County, Texas. The network consists of a comprehensive hospital and 12 health centers located throughout the county. Healthcare services are available to legal residents of the county with incomes up to 200% of the federal poverty level on a sliding fee scale; all other patients must pay the full rate for their care either out-of-pocket or with insurance. Most of the respondents (72.3%)were female. Data were analyzed using cross-tabulated tables, with chi-square tests of significance and gamma as the measure of association. Major findings. One-fourth (23.7%) of the Hispanic immigrants surveyed reported problems getting healthcare they needed in the past year and 16.4% reported difficulty getting prescription medicine that they needed. 38.8% were seen in the emergency department, but only 17.2% had a physician visit and 19.0% had an overnight stay in hospital. 94.2% were not born in the U.S., only 66.2% speak English at home, and 40.9% had been in the U.S. five years or less. 90% of the men but less than 1/3 of the women report being employed although only 10.3% report having health insurance through work. The greatest barrier to accessing healthcare reported is competing needs for food, clothing, and shelter (31.7%) followed by difficulty with transportation (18.2%), not having someone to accompany them to the doctor (14.4%), problems with getting a language interpreter (9.2%), and problems with paperwork (4.4%). Conclusions. Policy changes at the national, state and county levels that could increase access to healthcare services by Hispanic immigrants are discussed.Research support from Texas Higher Education Coordinating Board, Advanced Research Program, #003594-0120-1999.

Learning Objectives:

• List major barriers Hispanic immigrants face in using safety-net providers, including physicians, hospitals, emergency departments, dentists, and pharmacies.
• Discuss public policy issues at national, state, and county levels that can address access barriers identified.

Keywords: Access to Health Care, Hispanic

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation