Description
The purpose of this study was to examine the use of health care services and the barriers to access among low-income Latinas living in San Diego, California. Data were collected from nine focus groups with 46 participants. The Behavioral Model for Vulnerable Populations (BMVP) provided the theoretical framework for the study. Participants had a mean age of 32.56 (SD 6.5), 86% reported Latino descent, 76.1% had no health insurance and 48.8% reported monthly incomes of less than $2000. Participants shared their experiences accessing and using health care services. As suggested by the BMVP, themes were organized into four categories: (1) Predisposing factors, (2) Enabling factors, (3) Need factors, and (4) Outcomes. A fifth category was added based on the literature and data to capture those methods used to maintain health despite limited resources, (5) Strategies to maintain health. The five themes were each subcategorized into positive and negative. The "positive" components included the predisposing, enabling, need factors and outcomes that encourage Latinas to seek health care services and the "negative" components were those factors that prevent or discourage Latinas from seeking health care services. The two categories from the BMVP with the most important constructs and themes for this study were the predisposing and enabling factors. In addition, the category of strategies to maintain health was important in understanding the practices used to access care and maintain health in the absence of resources. Participants identified immigration status, health beliefs, family, language and literacy, and gender as predisposing factors that influenced utilization of health care services. The most commonly mentioned enabling factors functioned negatively and prevented access to care. These included health insurance, cost of health care, perceived barriers to care, discrimination, and case managers. The strategies used to maintain health for both participants and their families included public programs, mobile clinics and health fairs, and home remedies. The findings support many of the constructs within the BMVP and suggest new ones that apply to low-income Latinas in San Diego. This study reveals that there are structural barriers to care, such as institutional racism, residential segregation, administrative barriers, and lack of access for those with few resources. Furthermore, this study provides suggestions for health care providers and those seeking to improve the health of low-income Latino populations.
