Access Barriers to Health Care for Latino Children!

Latinos will soon be the largest minority group in the United States, but little is known about major access barriers to health care for this group and whether these barriers result in adverse consequences. Flores surveyed parents coming to the pediatric Latino clinic at an inner-city hospital, focusing on barriers to health care.

Parental ethnicity included Dominican (30%), Puerto Rican (34%), Central American (13%), and South American (11%). Only 42% of parents were American citizens, whereas 36% had green cards, and 13% had no documentation. Eight percent of parents and 65% of the children were born in the United States. Parents rated their ability to speak English as: very well/well, 27%; not very well, 46%; and not at all, 26%. The median annual household income was $11,000; 40% of parents never graduated from high school, and 49% headed single-parent households. Forty-three percent of the children were uninsured. A sick child was routinely brought to hospital clinics by 56% of parents, to the emergency department by 21%, and to neighborhood health centers by 21%.

When asked to name the single greatest barrier to health care for their children, parents cited language problems (26%), long waiting time at the physician's office (15%), no medical insurance (13%), and difficulty paying bills (7%). When parents were asked if a particular barrier had ever caused them not to bring their children in, transportation was cited by 21%; not being able to afford health care, 18%; excessive waiting time in the clinic, 17%; no health insurance, 16%, and lack of cultural understanding by staff, 11%. Some parents who spoke little or no English reported that medical staff not speaking Spanish had led to adverse health consequences for their children, including poor medical care (8%), misdiagnosis (6%), and prescription of inappropriate medications (5%).

(Flores G. Access barriers to health care for Latino children. Arch Pediatr Adolesc Med 1998; 152:1119-1125)

COMMENT: I am afraid the current shortage of Spanish speaking health professionals, including school nurses, doesn't bode well for an early solution to the language barrier.