Socio-ecological Influences on Health-Care Access and Navigation Among Persons of Mexican Descent Living on the U.S./Mexico Border
- 1.1k Downloads
The study reported here examines factors influencing decision-making concerning health care access and navigation among persons of Mexican origin living along the U.S./Mexico border. Specifically, the study examined how persons with limited financial resources accessed these two systems. Seven focus groups were held with 52 low income Mexican American people aged 18–65 years. Transcripts were analyzed to identify themes in Atlasti 5.0 software and the theory used included a socio-ecological framework and complemented by constructed from the Social Cognitive Theory. We found that in addition to a lack of insurance and financial resources to pay for health care; fear, embarrassment and denial associated with a diagnosis of illness; poor medical personnel interactions, and desire for quality but streamlined health care also influenced decision making. This theory-based study raises important issues if health care is to improve the health and welfare of disadvantaged populations and points to the need for greater focus on medical homes and prevention and early intervention approaches.
KeywordsMexican Americans Immigrants Decision making Health care Access Navigation
We thank our research team particularly Mayra Vanessa Saldana, Rosa Sauceda and Kendra Stine. We also thank the community of Brownsville and the participants who so willingly participated in this study. We would like to express our thanks to the anonymous reviewers for their helpful comments. This work was supported by MD000170 P20 funded from the National Center on Minority Health and Health disparities (NCMHD), and the Center for Clinical and Translational Sciences, which is funded by National Institutes of Health Clinical and Translational Award UL1 RR024148 from the National Center For Research Resources.
- 2.Balluz L, Okoro C, Strine T. Access to health-care and preventive services among hispanics and non-hispanics United States. Morb Mortal Wkl Rep. 2004;53(40):937–41.Google Scholar
- 11.Derose KP. Networks of care: how latina immigrants find their way to and through a County Hospital. J Immigr Migr Health. 2000;2(2):78–87.Google Scholar
- 14.DaNavas-Walt C, Proctor BC, Mills RJ, US Census Bureau. Income, poverty and health insurance coverage in the United States: 2003. Washington, D.C.: US Government Printing Office; 2004.Google Scholar
- 15.Zuckerman S. Gains in public health insurance offset reductions in employer coverage among adults. In: Snapshots of Americas’ Families III, No. 8. Urban Institute; 2003.Google Scholar
- 16.US General Accounting Office. Health insurance: characteristics and trends in the uninsured population. Washington, DC: US General Accounting Office; 2001.Google Scholar
- 23.Sultz HA, Young KM. Health care USA: understanding its organization and delivery. 6 ed. ed. Buffalo: Jones and Barlett; 2009.Google Scholar
- 25.Supreme Court. National federation of independent business v. sebelius, secretary of health and human services. http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf. Accessed July 2, 2012.
- 28.Kaiser. Commission on medicaid and the uninsured. Key facts: the uninsured and their access to health care. Commission on Medicaid and the Uninsured 2006.Google Scholar
- 32.Bastida E, Brown S, Pagan JA. Persistent disparities in the use of health care along the US-Mexico border: an ecological perspective. Am J Public Health. 2008; 1987–1995.Google Scholar
- 48.Bureau of Transportation Statistics. Research and innovative technology administration (RITA); Border Crossing/Entry Data. 2011.Google Scholar
- 49.Embassy of the United States Mexico. Embassy of the United States Mexico 2006.Google Scholar
- 50.CDC. Prevalence and trends data, Texas health care Access/Coverage. 2009.Google Scholar
- 51.US Census Bureau. State and county quickfacts: Texas. 2008.Google Scholar
- 52.Fisher-Hoch SP, Vatcheva KP, Dang M et al. Missed opportunities for prevention in severe health disparity: the Cameron County Hispanic Cohort. Preventing Chronic Disease 2011.Google Scholar
- 53.Texas State Historical Association. Brownsville, Texas. TSHA Press 2012; Available at: URL: http://www.tshaonline.org/handbook/online/articles/hdb04. Accessed March 16, 2012.
- 56.Bandura A. Social foundations of thought and action: a social cognitive theory. Upper Saddle River: Prentice Hall; 1986.Google Scholar
- 58.Salinas J, McCormick JB, Rentfro A, Hanis C, Hossain MM, Fisher-Hoch SP. The missing men: high risk of disease in men of Mexican origin. Am J Men’s Health. 2011;5(4):332.Google Scholar
- 64.Health Reform for Latinos: The Affordable Care Act Gives Latinos Greater Control Over Their Own Health Care. The White House; 2010.Google Scholar