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Food Insecurity and Low Self-efficacy are Associated with Health Care Access Barriers Among Puerto-Ricans with Type 2 Diabetes

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Abstract

Racial/ethnic minorities are disproportionately affected by barriers to health care access and utilization. The primary objective was to test for an independent association between household food insecurity and health care access/utilization. In this cross-sectional survey, 211 Latinos (predominantly, Puerto-Ricans) with type 2 diabetes (T2D) were interviewed at their homes. Factor analyses identified four barriers for health care access/utilization: enabling factor, doctor access, medication access and forgetfulness. Multivariate logistic regression models examined the association between each of the barrier factors and food insecurity controlling for sociodemographic, cultural, psychosocial, and diabetes self-care variables. Higher food insecurity score was a risk factor for experiencing enabling factor (OR = 1.46; 95% CI = 1.17–1.82), medication access (OR = 1.26; 95 CI% = 1.06–1.50), and forgetfulness (OR = 1.22; 95 CI% = 1.04–1.43) barriers. Higher diabetes management self-efficacy was protective against all four barriers. Other variables associated with one or more barriers were health insurance, perceived health, depression, blood glucose, age and education. Findings suggest that addressing barriers such as food insecurity, low self-efficacy, lack of health insurance, and depression could potentially result in better health care access and utilization among low income Puerto-Ricans with T2D.

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Acknowledgment

This study was funded and supported by the Connecticut NIH Export Center for Eliminating Health Disparities among Latinos (NIH- NCMHD grant # P20MD001765). We would like to thank all study participants and community health care workers at the Hispanic Health Council. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Nutritional Sciences, University of Connecticut, Unit 4017, 3624 Horse Barn Hill Rd Ext., Storrs, CT, 06269, USA

    Grace Kollannoor-Samuel

  2. Connecticut Center for Eliminating Health Disparities Among Latinos (CEHDL), Storrs, CT, 06269, USA

    Grace Kollannoor-Samuel, Sonia Vega-López, Jyoti Chhabra, Sofia Segura-Pérez, Grace Damio & Rafael Pérez-Escamilla

  3. Arizona State University, Mesa, AZ, 85212, USA

    Sonia Vega-López

  4. Hartford Hospital, Hartford, CT, 06102, USA

    Jyoti Chhabra

  5. Hispanic Health Council, Hartford, CT, 06106, USA

    Sofia Segura-Pérez & Grace Damio

  6. Yale School of Public Health, New Haven, CT, 06510, USA

    Rafael Pérez-Escamilla

Authors
  1. Grace Kollannoor-Samuel
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  2. Sonia Vega-López
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  3. Jyoti Chhabra
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  4. Sofia Segura-Pérez
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  5. Grace Damio
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  6. Rafael Pérez-Escamilla
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Correspondence to Grace Kollannoor-Samuel.

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Kollannoor-Samuel, G., Vega-López, S., Chhabra, J. et al. Food Insecurity and Low Self-efficacy are Associated with Health Care Access Barriers Among Puerto-Ricans with Type 2 Diabetes. J Immigrant Minority Health 14, 552–562 (2012). https://doi.org/10.1007/s10903-011-9551-9

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  • DOI: https://doi.org/10.1007/s10903-011-9551-9

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