Overcoming barriers to prostate cancer care: Affordable care is not enough

Introduction: Uninsured Latino men face a myriad of barriers when accessing health care to detect, diagnose, treat, and manage their prostate cancer. This study focuses on developing an understanding of the barriers to health care access among these men.

Analysis: Our underlying assumption is that access to health care is a complex interaction among Latino men, U.S. health care providers and institutions, family, and cultural beliefs that are subject to a range of internal and external influences. A descriptive qualitative design employing grounded theory analysis techniques was utilized to identify barriers to care from the perspective of Latinos with prostate cancer. Transcripts of semi-structured interviews with 60 Latinos enrolled in a state-funded public assistance program were analyzed to develop a descriptive framework to understand the barriers to health care access.

Results: The analysis revealed that the same societal (Finances, Work and Insurance), systemic (Care Coordination and Lack of Doctor Continuity), and individual (Communication and Understanding) barriers appear along all major points of the prostate-cancer-care process: screening, diagnosis, treatment, and follow-up care. These function independently and together to bar access to prostate cancer care for Latinos. Participant perceptions illustrate the individual, interpersonal, and macro-level structures that impede access, stressing the need for expanded medical coverage coupled with measures to improve quality care.

Conclusion: A multifaceted approach is needed, including alleviation of financial burdens for underserved prostate cancer patients, empowerment of patients with skills to navigate the healthcare system, access to culturally competent providers, and consistent monitoring of access to quality care.