Volume 34, Issue 1 p. 47-67

HEALTH CARE ACCESS AMONG HISPANIC IMMIGRANTS: ¿ALGUIEN ESTÁ ESCUCHANDO?[IS ANYBODY LISTENING?]

Rafael Pérez-Escamilla

Rafael Pérez-Escamilla

Yale School of Public Health and Connecticut Center of Excellence for Eliminating Health Disparities among Latinos

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Jonathan Garcia

Jonathan Garcia

Yale School of Public Health

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David Song

David Song

University of Connecticut School of Medicine and Connecticut Center of Excellence for Eliminating Health Disparities among Latinos

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First published: 24 November 2010
Citations: 79

Abstract

This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the United States. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with nonimmigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care because of program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HI living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand (1) the net influence of acculturation on migrant health; (2) the role of informal (e.g., family) versus formal (e.g., promotoras) social support at facilitating health care access; (3) issues related to ‘single’ male migrant farm workers; (4) the “Hispanic mortality paradox”; (5) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HI have to gain access to health care.