title: Place Matters in Non-Traditional Migration Areas: Exploring Barriers to Healthcare for Latino Immigrants by Region, Neighborhood, and Community Health Center.
abstract: This paper identifies differences in adult Latino immigrant barriers to healthcare in the Cincinnati area in Hamilton County, OH, on three levels: by region, by neighborhood, and by community health center. Secondary data analysis was performed on 439 surveys. Respondents were aggregated by the geographic regions and neighborhoods where they live and by two community health centers where they receive care. Outcome measures included pragmatic and skill barrier indices adapted from the Barriers to Care Questionnaire (BCQ); the pragmatics index consists logistical barriers, including transportation and cost; the skills index is made up of items related to navigating the healthcare system, including communicating with physicians and completing paperwork. The results indicate that immigrant Latinos living in western Cincinnati and northern Hamilton County face significantly higher pragmatic barriers to care, while Latino immigrants going to a community health center in western Cincinnati have significantly fewer pragmatic and skill barriers than immigrants utilizing a nearby community health center. Because healthcare options for undocumented immigrants do not improve with the Affordable Care Act, community health centers will continue to serve as their primary source of care. This is particularly true in non-traditional migration areas, where immigrants tend to be isolated and lack resources. Efforts to improve access to healthcare for immigrant Latinos require place-based approaches that allow for targeted resources to improve care in these locations. This study helps to fill that need by identifying variation in barriers to care on multiple levels and offering strategies to alleviate these barriers.
authors.affiliation: HealthLandscape Division, American Academy of Family Physicians, Leawood, KS, USA. mtopmiller@aafp.org.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0002-3864-6507
authors.initials: M
authors.lastname: Topmiller
authors.affiliation: Department of Psychology, University of Cincinnati, Cincinnati, OH, 45220, USA.
authors.forename: Jenny
authors.initials: J
authors.lastname: Zhen-Duan
authors.affiliation: Department of Psychology, University of Cincinnati, Cincinnati, OH, 45220, USA.
authors.forename: Farrah J
authors.initials: FJ
authors.lastname: Jacquez
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vaughn
mesh_terms: D000328:Adult; D003151:Community Health Centers; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009820:Ohio; D012111:Residence Characteristics
keywords: Health disparities; Immigrant; Latinos; Place-based approaches