Journal of Immigrant and Minority Health

, Volume 16, Issue 2, pp 218–228 | Cite as

Socio-ecological Influences on Health-Care Access and Navigation Among Persons of Mexican Descent Living on the U.S./Mexico Border

  • Belinda M. ReiningerEmail author
  • Cristina S. Barroso
  • Lisa Mitchell-Bennett
  • Marge Chavez
  • Maria E. Fernandez
  • Ethel Cantu
  • Kirk L. Smith
  • Susan P. Fisher-Hoch
Original Paper


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.


Mexican 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.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Belinda M. Reininger
    • 1
    Email author
  • Cristina S. Barroso
    • 1
  • Lisa Mitchell-Bennett
    • 1
  • Marge Chavez
    • 2
  • Maria E. Fernandez
    • 3
  • Ethel Cantu
    • 4
  • Kirk L. Smith
    • 5
  • Susan P. Fisher-Hoch
    • 6
  1. 1.Health Promotion and Behavioral Science, University of Texas Health Science CenterSchool of Public HealthBrownsvilleUSA
  2. 2.NursingUniversity of Texas at BrownsvilleBrownsvilleUSA
  3. 3.Health Promotion and Behavioral Science, University of Texas Health Science CenterSchool of Public HealthHoustonUSA
  4. 4.Behavioral SciencesUniversity of Texas at BrownsvilleBrownsvilleUSA
  5. 5.Internal Med-EndocrinologyUniversity of Texas Medical Branch at GalvestonGalvestonUSA
  6. 6.Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science CenterSchool of Public HealthBrownsvilleUSA

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