Examining Latino Manufacturing Workers' Utilization of Preventive Health Services: Opportunities for Health Care Reform

Background: Health promotion and disease prevention are health care reform priorities, especially for minority populations across the United States. Disparities in health care access, including utilization of preventive health services, are well documented among minority populations. These disparities are demonstrated in increased risk for preventable causes of morbidity and mortality (i.e., diabetes, cancer, hepatitis) and in poor health outcomes. Latinos in particular, have been identified as having a higher incidence of infections largely preventable with timely immunization or screening services. However, little is known about the preventive service utilization patterns of employed Latinos along the Texas-Mexico border. The purpose of the current study is to examine the relationship between health insurance status and utilization of preventive screening services among Latino manufacturing workers in South Texas. Methods: We conducted cross sectional analysis of data collected from 228 Latino workers in the manufacturing sector in South Texas. The main study variables included demographics, health insurance status, and rates of preventive health service utilization. Chi-square analysis and binary logistic regressions were completed to examine differences in health services utilization by insurance status. Results: Respondents were mostly male (71%), mean age 40, and had completed an average of 11 years of education. Importantly, more than half of participants (54%) did not have health care coverage. Overall, rates of preventive service use in this sample were found to be significantly lower when compared to rates for the state of Texas (e.g., 22% vs. 56%, p<.001, for colorectal cancer screening). Relative to respondents with health care coverage, those without coverage were less likely to engage in preventive and screening services: receipt of a flu vaccine (p<.001), a mammogram (women ≥ 40 years old, p=.063), a pap smear (women ≥ 30 years old, p<.01), and a colonoscopy (participants ≥ 50 years old, p=.078). After controlling for education, income, and health literacy, logistic regression results indicate that those with health care coverage were significantly more likely to access preventive services including flu vaccinations (OR: 4.67, CI:2.16-10.1) and pap smear tests (OR: 4.91, 95% CI:1.31-18.41). Conclusion: Latinos along the Texas-Mexico border, even those who are employed, suffer from high uninsurance rates and, hence, have less access to preventive health screening services. Since it is clear that health care coverage is critical to accessing such services, health care reform efforts could potentially have a significant impact on reducing adverse health outcome disparities that exist in the Latino community.