From 2000 to 2003, a research team at Columbia University's Mailman School of Public Health studied disparities in access to primary and preventive care for Latinos in the United States.

The project entailed database and literature searches, key informant interviews and background papers commissioned from members of the research team. The Washington based research firm Lake Snell Perry & Associates supported research with Latino focus groups, which the Columbia research team used to enrich its analysis.

Key Findings

Findings from the database and literature searches, key informant interviews and background papers included:

• Three kinds of barriers to health care access contribute to poor health outcomes and disparities among Latinos:
  • Financial barriers (e.g., one-quarter of the nation's 44 million uninsured are Latino).
  • Systemic or structural barriers — e.g., difficulties obtaining transportation, lack of interpreter services, and disparities between the percentage of Latinos in the population and the percentage of Latino physicians.
  • Sociocultural barriers that occur in the context of the medical encounter between patient and provider.
• A number of public and private sector efforts have been made to address ethnic and racial minority access to primary and preventive health services but in general these have not been specifically focused on Latinos.
• Most efforts to address Latinos' access to primary and preventive health services are void of strategic context and do not address the need to empower the Latino community to advocate collectively on behalf of their own health issues.

Key observations garnered from the focus groups with Latinos include:

• The basic reason Latinos do not get preventive health care services is the lack of health insurance coverage and the expense of health care.
• Latinos said they were frustrated with many aspects of the health care system in the United States.
• Employers are often an impediment to health care, either because they do not provide affordable health insurance or because workers feel unable to take time off from their jobs to seek care.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through three grants — two to Columbia University's Mailman School of Public Health and one to Lake Snell Perry & Associates — totaling $292,334.