Recognizing demographic shifts in rural Nebraska: Examining the increasing need for a culturally and linguistically competent health profession workforce to address the unmet needs of the Hispanic population

Background: Hispanics experience health care disparities by means of poorer access to care, including linguistic and cultural barriers that may contribute to these disparities. Access to culturally competent health care services represents a cornerstone of social justice principles within the present context of health care reform. This study examines implications of the increasing rural Hispanic populations in Nebraska on the availability of culturally competent health care services.

Methods: We used data sets from the U.S. Census Bureau to analyze changes in population demographics between 2000 and 2007, and employed Microsoft Excel to calculate change in total population size and overall percent change in population for each of Nebraska's 93 counties during this time frame. Data from the University Nebraska Medical Center's Health Professions Tracking Service provided us with the numbers of practicing Hispanic, as well as Spanish speaking primary care providers in Nebraska.

Results: Findings reveal that from the year 2000 to 2007 there was a 33% increase among Hispanic populations in rural Nebraska counties, from 43,832 to 58,135 Hispanic individuals. As of January 2010, there are 793 practicing primary health care providers, 7 (0.88%) report being of Hispanic descent, and only 18 (2.27%) convey Spanish speaking ability.

Conclusion: The present shortage of Spanish speaking providers may contribute to health care disparities among Hispanics, which may be exacerbated over time as Hispanic populations continue to increase while the rural workforce becomes reduced. These findings underscore the need for interventions aimed at increasing the number of Hispanic/Spanish speaking primary care providers.