Barriers to Podiatric Healthcare Seeking and Diabetes in the San Quintín Valley, Baja, Mexico

Background: Commonly, diabetes is associated with preventable lower-extremity comorbidities. We examined barriers to podiatric healthcare seeking and lifetime diagnosis with diabetes among residents of an agricultural region in rural Baja California, Mexico.

Methods: In April 2011, 100 community members from rural, migrant communities in northern Baja California, Mexico underwent an interviewer-administered survey. We measured diabetes (e.g., “Has any health professional ever told you that you have diabetes?”) and barriers to podiatric healthcare seeking. Logistic regression identified correlates of a lifetime diagnosis of diabetes.

Results: Of 100 participants, 22% were male and 34% primarily spoke an indigenous language. The median age was 46 years; 28% reported diabetes; 45% perceived that visiting a doctor/clinic for a diabetes-related issue is very important; and 69% reported ever encountering any barrier to podiatric healthcare seeking. Factors independently associated with a diagnosis of diabetes included being older (AOR=1.07 per 1-year increase; 95% CI=1.01-1.12), living farther from a doctor/clinic (AOR=1.05 per 1-km increase; 95% CI=1.02-108), perceiving that visiting a doctor/clinic for a diabetes-related issue is very important (AOR=5.72; 95% CI=1.36-24.12) and reporting any barrier to podiatric healthcare seeking (AOR=6.10; 95% CI=1.01-37.85).

Conclusions: Nearly 30% of participants had been diagnosed with diabetes, among whom encountering barriers to podiatric healthcare seeking was common, suggesting a possible relationship between barriers to podiatric healthcare and diabetes in this rural area. In a region where podiatric services are limited and residents face many challenges in accessing healthcare, interventions to increase podiatric awareness and treatment of podiatric-related diabetic manifestations are urgently needed.