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APHA Scientific Session and Event Listing

Millicent Fleming-Moran, PhD, Indiana University, Applied Health Science, HPER 116, Bloomington, IN 47405, (812) 855 8361, mfmoran@indiana.edu

Purpose: A community-academic coalition assessed care access, perceptual, and institutional barriers to Hispanics' use of a local Emergency Department, among community members, bi-cultural providers, and advocates during a United Way Hispanic community assessment (Monroe County, Indiana), to provide appropriate care and assist in the county's Pandemic Flu preparation. This population doubled since 1995, half are undocumented, and most are underserved due to limited English proficiency (LEP), financial, and primary care availability barriers. Methods: : One-on-one structured interviews were held with key Latino community members and advocacy and service provider informants, June-August 2005. Transcript themes were analyzed for: 1) whether the ED is frequently used in lieu of PC services? 2) What perceptions /experience hindered appropriate ED use? 3) What community networks and tailored information is needed to increase awareness and use of local health services, and reduce deportation fear during emergency care. Results: : The ED was rarely used by Hispanics, and depended on: patients' perceived severity of presenting condition; cultural- or lack-of-access delayed primary care; threatening ED intake, triage, or payment processes; perceived deportation risk and having a bi-cultural advocate during ED visits. Conclusions: Findings were used to develop hospital staff CE competency, and medical interpreter training. Patients' mistrust of the ED and non-use of community health services will delay appropriate care for emergent diseases, and increase inter-ethnic disparities in the impact of community outbreaks. Community partners are defining specific Hispanic networks to reduce misinformation about emergency care and deportation risk in county emergency planning.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe common perceptions inhibiting undocumented Hispanic community members' use of Emergency Department services.
• Understand the implications of these perceptions for community emergency planning.
• Identify potential gaps in community emergency planning for Limited English Proficiency (LEP), low literacy, and immigrant populations.

Keywords: Barriers to Care, Emergency Department/Room

Presenting author's disclosure statement:

Not Answered