Context matters: where would you be the least worse off in the US if you were uninsured?
OBJECTIVE
We examined the health care access, quality, and cost experienced by uninsured Latino mothers in two communities in Minnesota and Texas. These communities differ substantially by the size of the local population without health insurance coverage.


METHODS
Four focus groups were conducted with uninsured Latino mothers who were caring for at least one child in their household. Seventeen mothers participated in each community. All focus groups were conducted by the same trained staff from a non-profit, community-based research organization.


RESULTS
Uninsured Latino mothers in Minnesota rated the quality of health care services in their community to be much higher than their Texas counterparts, but were more likely to emphasize the high costs of care and health insurance coverage. Participants in Texas also described having to go to Mexico to obtain health care services.


CONCLUSIONS
Policies making provision for health care services to the uninsured are likely to be more effective when they take into account the context or composition of each specific local health care system as well as the financial and non-financial spillovers that these uninsurance-related contexts generate.
Garcia
Carolyn
C
School of Nursing, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA. Garcia@umn.edu
Pagán
José A
JA
Hardeman
Rachel
R
D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D004608:Eligibility Determination / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D017048:Health Care Costs / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research; D006630:Hispanic or Latino / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000208:ethnology* / Q000706:statistics & numerical data; D008910:Minnesota; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D013781:Texas; D017664:Uncompensated Care / Q000706:statistics & numerical data; D014481:United States