Barriers to accessing health and mental health services among older rural immigrant Latinos: A five county study

Little research exists on studying on the bi-directional relationship between mental health and chronic disease among rural immigrant Hispanic populations, particularly with regard to trends by age or by acculturation status. Data for this study come from a community mobilization project, funded by the National Association of Chronic Disease Directors (NACDD) which involved the formation of 5 partnerships to conduct a series of community-based participatory action research (CBPAR) projects. The overall aim of the project was to explore the relationships of acculturation and certain mental health conditions (e.g. stress, depression, health-related quality of life) with chronic diseases among a diverse group of rural Hispanic immigrant populations aged 18 to 78 in Illinois. Using the CBPAR approach each community engaged in an assessment phase involving collection of data regarding the relationships between acculturation, mental health and chronic disease, developed small scale mobilization projects to address identified needs for health education/health promotion strategies in these areas, conducted evaluations of these efforts and created materials and programs for dissemination that can be used in other similarly situated communities. Findings suggest that compared to their younger counterparts, older immigrant Hispanics were less likely to identify barriers related to their ethnicity or perceived discrimination from health care providers but were more likely to mention lack of access due to not having insurance or inability to pay for care. Moreover, these findings remain fairly consistent when considering the effect of acculturation as measured by length of residence in the US.