Improving access to primary care for a growing Latino population: the role of safety net providers in the rural Midwest.
BACKGROUND
Many rural Midwestern communities are experiencing rapid growth in Latino populations with low rates of health insurance coverage, limited financial resources, language and cultural differences, and special health care needs.


OBJECTIVE
We report on 2-day site visits conducted in 2001 and 2002 in 3 communities (Marshalltown, Iowa; Great Bend, Kansas; and Norfolk, Nebraska) to document successful strategies to meet Latino health care needs.


METHODS
We interviewed key informants to identify successful community strategies for dealing with health care access challenges facing the growing Latino population in the Midwest.


RESULTS
Interventions have been developed to meet new demands including (1) use of free clinics, (2) school health programs, (3) outreach by public health, social services and religious organizations, and (4) health care providers' efforts to communicate with patients in Spanish. Strain on safety net services for Latinos is due in part to a complicated and unstable mix of public and private funds, a large but overtaxed volunteer provider base, the dependence on a limited number of community leaders, and limited time for coordination and documentation of activities.


CONCLUSIONS
We suggest the development of a Rural Safety Net Support System to provide targeted funding to rural areas with growing immigrant populations. Federal community health center support could be redirected to new and existing safety net providers to support the development of a safety net monitoring system.
Blewett
Lynn A
LA
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA. blewe001@umn.edu
Casey
Michelle
M
Call
Kathleen Thiede
KT
D000328:Adult; D002648:Child; D003153:Community Health Services / Q000458:organization & administration*; D003159:Community-Institutional Relations; D004641:Emigration and Immigration; D005249:Fees and Charges; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006630:Hispanic or Latino; D006801:Humans; D007484:Iowa; D007615:Kansas; D008297:Male; D019303:Multilingualism; D009329:Nebraska; D011247:Pregnancy; D011314:Preventive Health Services / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration*; D012572:School Health Services / Q000458:organization & administration