Identifying the gaps: Community member perspectives on Latino health care access in Baltimore, Maryland

The Latin American population in Baltimore has rapidly expanded and diversified within the last 6 years. Latin Americans are most likely to lack health insurance coverage and least likely to access health care services. The aim of this study is to qualitatively explore health care access and obstacles in the lives of Latin American immigrants living in Baltimore.

One focus group and 5 individual unstructured interviews were carried with community members from the local Latin American population in East Baltimore. All conversations were recorded and transcribed. Line-by-line coding was used to analyze transcripts and to identify themes relevant to the study aim. Relevant themes were linked to create concepts for exploring access issues as they appeared in the data.

The main themes that emerged focused on medical bills and their association to feelings of discrimination, linguistic barriers and cultural insensitivity. These themes developed into the concept of medical bills as barriers to health care access for Latinos. In addition, the concept of defining cultural barriers to health care access provided further context for the function of medical bills in the lives of Latin Americans. Latino experiences with medical bill management reveals a lack of support services for Latinos who have little experience in navigating the health care system in a new country.

Latinos need assistance in managing medical bills they receive following receipt of health care services. Given that medical bills are received outside of a health care setting, Latinos have no immediate contact person to help them manage these bills. Community-based organizations within urban settings could potentially offer services to help Latinos cope with bill payment and to reduce fear of accessing health care services, particularly for Latinos who perceive discrimination in health care settings.