Health Care Experiences of Migrant and Seasonal Farm Workers at Federally Funded Health Centers

Background and Significance: Primary medical care is essential to good health. MSFW are one of the vulnerable subpopulations served by health centers. Heretofore, little information is available regarding their general profile and experience with health center services. This is the first study that includes a representative sample of MSFW. Results of the study would help achieve a better understanding of this sub-population and their experience of health center services. To the extent significant disparities in care exist, policymakers would know where to target effective interventions to address those.

Methods: Data - The 2009 Health Center Patient Survey has a probability sample of 4,562 (with 831 MSFW) patients representing over 13 million health center medical patients seen during 2008. Measures - Measures used in the analyses include patients' demographics (age, gender, race/ethnicity), socioeconomics (poverty status, English speaking), health status, and access to primary (health insurance, usual source of care, unable to get needed medical care, delayed in getting needed medical care, unable to get needed prescription medicine, delayed in getting needed prescription medicine, unable to get needed dental care, delayed in getting needed dental care, rate overall quality of care) and preventive care (last general physical exam, ever had a Pap smear, had a mammogram, had colonoscopy/sigmoidoscopy, had a blood stool test). Analysis - The analyses examine the following three aspects: 1.The characteristics of MSFW patients in terms of demographics, socioeconomics, health status, and access to primary and preventive care. 2. Disparities in access to primary and preventive care among MSFW patients, based on racial/ethnic, insurance, and poverty-level status. 3. Factors associated with access to primary and preventive care employing multivariate logistic regression models. Due to the sampling design, results are weighted to reflect national estimates.

Selected Results: Potential racial/ethnic disparities are only noted in delays in getting medical care and having a general physical exam. No significant racial/ethnic disparities are noted in other 11 measures of access to primary and preventive care. Potential insurance-related disparities are noted in four measures: having a USC, delayed in getting dental care, having a general physical exam, and having a blood stool test. The uninsured are less likely to have a general physical exam and a blood stool test than the insured.

Conclusions: No racial/ethnic disparities are observed among MSFW in accessing primary and preventive care. Targeted efforts are needed at reducing insurance-related disparities in access to care particularly preventive services.