Measures of Access to Health Care Need for Hispanics to Reflect Cultural Differences

During 1999 and 2000, Claudia L. Schur, PhD, and researchers at Project HOPE (Health Opportunities for People Everywhere) examined the role and implications of cultural bias in a commonly used measure of access to health care, particularly as it is applied to different subgroups of the Hispanic population.

They also replicated a previous Community Tracking Study using different access measures to demonstrate the inadequacy of the commonly used "difficulty-in-obtaining-needed-care measure." The Community Tracking Study is funded by the Robert Wood Johnson Foundation (RWJF) in its Health Tracking program.

The project was part of the Robert Wood Johnson Foundation (RWJF) Changes in Health Care Financing and Organization (HCFO) national program.

Key Results/Findings

  • Researchers developed an alternative to the "difficulty-in-obtaining-needed-care measure," called the "utilization-health status access measure," which evaluates actual medical care received relative to health status based on an insured population of all races.

  • While about half of uninsured non-Hispanic white respondents of the Community Tracking Survey reported barriers to medical care, only 27 percent of Hispanics interviewed in English and 17 percent interviewed in Spanish (most likely to be recent immigrants) reported barriers.

  • Application of two alternative access measures (physician visits and having a usual source of care) to a previous ranking of 12 communities resulted in quite different rankings.