Initiative and Strategies for engaging immigrant community to seek health care

Background: Nassau county has an estimated 1.3 million residents. Immigration is drastically changing the workforce which is currently comprised of 20% foreign born workers, both documented and undocumented. One in six are estimated to be undocumented. Between 2005-7, the largest immigration to Long Island came from Central America. This study was undertaken to offer health care screening for respiratory disease and to follow-up on whether positive screening impacted on the decision to seek medical care. Methods: The Asthma Coalition of Long Island participated in 5 health fairs located in areas with large numbers of indigent, undocumented and Hispanic residents. Participants were offered asthma education and screening which included symptom based questionnaire and spirometry, which was interpreted onsite by a physician. Only data on Hispanic participants is presented. Onsite physician suggested medical evaluation for the positively screened participants. If primary care provider was not identified, low cost options were discussed. Results: Of the 104 participants 61% screened positive. Of them, 38 % women and 27 % men had positive symptoms, 7 % women and 19 % men had abnormal spirometry and 14 % women and 17 % men had both abnormal symptom profile and spirometry results. At 1 month 61 % of the women and 50 % men who screened positive responded to followup contact; 21 % of the women and 33 % men sought medical evaluation as a result of the screening. Of those who did not seek medical evaluation 75% did not have a primary care provider. Conclusions: Health fairs can be an important venue for immigrants to gain access to healthcare system in United States. High prevalence of positive screens and lack of identified providers suggests that options should be developed to facilitate referral to affordable healthcare.