title: Policy barriers to health care access fuel discriminatory treatment: the role of Promotoras in overcoming malos tratos.
abstract: This article demonstrates that policy barriers resulting in access to health care inequities were significantly decreased by 2 Promotora interventions for 416 legal and undocumented Latino immigrants in the California Central Valley. Promotoras conducted baseline/follow-up assessments and referrals/phone-calls/visits during a 3-month period. In-depth interviews with Promotoras and a policy analysis on policy-driven access programs were carried out. Access to care was significantly increased between legal and undocumented immigrant from baseline to follow-up. Systemic barriers to access (malos tratos) reflected on personal barriers such as affordability of care. Promotoras help participants overcome barriers but do not change the policies determining access and procedures.
authors.affiliation: Central Valley Health Policy Institute at California State University, Fresno, California 93710, USA. tpacheco@csufresno.edu
authors.forename: Tania L
authors.initials: TL
authors.lastname: Pacheco
authors.forename: Mariana A
authors.initials: MA
authors.lastname: Ramirez
authors.forename: John A
authors.initials: JA
authors.lastname: Capitman
mesh_terms: D002140:California; D003150:Community Health Workers; D054242:Emigrants and Immigrants; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D007407:Interviews as Topic; D017058:Mexican Americans; D024382:Professional Role; D011640:Public Policy