Access to Healthcare among Hispanics

Minority groups lack insurance coverage at higher rates than whites [1]; 7.6 million (20.5 percent) of African-Americans, and 15.3 million (34.1 percent) of Hispanics in the U.S are uninsured compared to 10.8% of Whites [1]. In our managed care health system, the uninsured are thus denied medical care*. As a result, these groups lack a regular source of care in the form of preventive care. Bearing in mind that preventive care has been linked to better health status, these individuals are inclined to seek care in local Emergency Departments where the nature of their illness may be in advanced form [Rodriguez Et al., Annals of Emergency Medicine, Volume 26, Issue 5, Pages 615-620. ]. This lack of a regular source of care is a major point that needs to be addressed if large positive impact is to be made in these patients. A classic example where preventive care, as a regular source of care, can effectively counteract health disparities is in the aspect of vaccinations. A pneumonia vaccination provided at a preventive care clinic can avert a highly detrimental illness, avoid excessive healthcare cost, and improve health status. The reality is that better measures need to be implemented to address the lack of regular source of care due to lack of insurance.

An issue specific to the U.S Latino population and disparities in access to health care is legal status. In 2006, out of the 11.5 to 12 million illegal immigrants living in the U.S, approximately 57% came from Mexico, and 24% from Central or South America [2, 3]. Despite the fact that most Hospitals do not require patients to show proof of legal residence, illegal immigrants may still feel hesitant to seek healthcare because of fear of deportation. Furthermore, a majority of these individuals are employed in low paying jobs (i.e. agriculture) and meet low income standards to qualify for MedicAid, however current policy prohibits the allocation of state funded health insurance to illegal immigrants. As a result, legal status can adversely affect specific subsets of the population.

In order to access healthcare resources, some patient must overcome existing structural barriers. These structural barriers include inadequate transportation, an inability to arrange appointments quickly or during convenient hours, or excessive time spent in waiting rooms, all of which affect a person's ability and readiness to obtain needed care. These structural barriers in the access to healthcare are most evident in rural underserved areas throughout our country, which happen to consist largely of minority groups [4]. In analyzing the changing demographic profile of rural American, Kirschner et al found that “rural places are generally declining in their proportions of non-Hispanic whites and increasingly are Latino, Asian, American Indian or African American [4].” A direct consequence of these barriers is the marginalization of these patients when it comes to access to medical technologies located usually in large non-rural cities. Many patients have to travel or be transported long distances to get the care they need, specially trauma and critically ill patients [Davis, R 2008, Feb 26. Shortages of Surgeons Pinches U.S hospitals. USA Today, pp.A1-A2]. To address this crucial issue, various medical schools and academic medical centers have implemented programs aimed at training future medical professionals to serve in rural areas and to counteract the structural barriers that discourage patients from seeking and obtaining healthcare. The University of California Irvine has upheld this mission by funding training programs for medical students to become medical leaders in the Hispanic community [5].

-Michael Garcia

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* Exceptions include those insured by MedicAid programs aimed at insuring select individuals below the poverty line, defined as < $10,210/year per individual.