Four-County Community Health Needs Assessment 2004

first generation hispanic immigrant men focus group

Summary

Northwest Arkansas has experienced one of the fastest growing Hispanic communities in the United States , during the past 5 years.   Diverse experiences, legal standing, bilingual abilities, health insurance status, length of residence within the United States, gender roles, familial and community values, and knowledge and beliefs in regard to the United States health care system, are all factors which affect the Hispanic community's ability to successfully access needed health care services in Northwest Arkansas.

In recognition of the unique challenges that confront the Hispanic community in meeting their health care needs within Northwest Arkansas, staff members from the University of Arkansas Social Work Research Center conducted a focus group with first generation Hispanic immigrant men.   The purpose of this focus group was to obtain in depth information from selected members of the Hispanic community, in regard to their perceived health care needs.

Seven men, aged 21-34 years (average age 27), participated in the focus group.   The focus group was conducted with the Multicultural Center at the Jones Center for Families and Children, in Springdale , Arkansas .   The focus group was conducted in Spanish in order to assist participants of the focus group to feel comfortable and speak freely about health care issues.   Focus group participants were selected by staff members of the Multicultural Center , and the focus group was facilitated by a resident of the Northwest Arkansas Hispanic community.

Topics discussed during the focus group included; knowledge of health care issues which affect the Hispanic community in Northwest Arkansas, personal and familial health care experiences, pediatric care, dental care, emergency services, cultural and language barriers in accessing health care services, and alternative (non-traditional), health care strategies.

Cost of Health Care

"There are few medical costs that would be too high for a Latino family member to pay,
if the family member was to be cured and live".  

A significant concern, as cited by members of the focus group, involved the expenses associated with health care and medication usage.   Cost for health care services was cited as a pervasive problem regardless of the "status" of the Hispanic community member (e.g. , insured, uninsured, legal status, young, old, etc).   Significant problems associated with health care costs, as described by the focus group included the following: having to pay for medical services prior to the receipt of health care services, lack of medical payment plans, emergency health care costs, changes in employee health care benefits, and "undisclosed" charges associated with tests, diagnostics, and specialized services.   The range of medical costs, as described by members of the focus group ranged from $2,000 to $25,000.   Secondary to the high costs associated with receiving health care services, some members of the Northwest Arkansas Hispanic community go without needed health care services or underutilize medical services, travel to other states or to Mexico to in order to receive health care services at a lower cost, or seek out local members of the Hispanic community in order to receive medications or alternative medical services at a reduced rate.   As many of the men in the focus group had family members who had health care insurance or were uninsured, they had direct knowledge of the different levels of medical care family members received based upon their ability to pay for medical services.

One group member explained, "there are few medical costs that would be too high for a Latino family member to pay, if the family member was to be cured and live".   However, the focus group members did recommend that all costs associated with medical treatment needed to be discussed at the time that services were delivered and that realistic payment plans needed to be developed.

 

Accessibility to the Right Level of Care

One member summarized the group discussion saying, "if you haven't been there before, you wait two weeks.. if you have an appointment, they tend to you, if not, they don't, so you have to die. "   A variety of concerns regarding access to health care services as discussed by the group members were based upon personal and family experiences.   The general consensus of the focus group was that there is not enough health care available for urgent health issues which results in long waits, delayed appointments (2-3 weeks), not being seen until an illness becomes acute, and people going either without health care services and/or receiving emergency room services.   The group also stated that clinics are only open during the day, and are not available when people become ill.   Other issues cited included: insured people getting expensive services that did not seem necessary, uninsured individuals not being seen or simply given over the counter medications, feelings of being placated or misdiagnosed due to language barriers, and patients (insured or not) not being told by insurers or health care providers of follow-up services or preventative services for which they might be eligible.   One member recounted a personal experience during which he paid out of pocket to see a doctor (not in his insurance plan) because the "Hispanic community knows" by reputation that the referred doctor's office "treats patients with respect and gives prescriptions that work".

Another participant who cited the shortage of pediatric services recounted the experience of he and his wife rushing a feverish daughter to a clinic.   The doctor reportedly did not physically examine the girl (the couple believed), because they had no healthcare insurance.   The girl was given Tylenol and sent home.   The family later found a blood engorged tick in the girl's hair, and brought down her fever with home remedies.   They were later billed for the office visit.

 

Communication Barriers

Current health care service providers do not have adequate and available bilingual staff members.   The group stated that their personal or family experience with health care was inadequate because the medical care staff could not understand Spanish, they have been under diagnosed, not informed about services they may be eligible for, or were made to feel unimportant.   One young man stated that he was embarrassed to translate his mother's personal health symptoms to the doctor. However, he felt that he had no choice but to translate for his mother in order for her to be understood and diagnosed appropriately.   Additionally, important medical consent and intake forms (with complicated small print) are offered quickly and with limited explanations.   Even the bilingual group members were intimidated by displaying the limits of their language abilities and were likely to just agree without fully understanding the medical, insurance, and consent for treatment forms.


Lack of Dental Care

The limited dental care that exists is expensive, requires long waits, and provides no payment plans, per the focus group.   People travel to Fayetteville or Missouri for less expensive dental services, or go without care until their dental pain escalates to the point that requires emergency room care.

 

Current Health Care System

The major concerns voiced by the focus group involved large medical debts that can accumulate, threats from bill collectors, and fear which causes people not to go for medical treatment because of the extreme costs.   Some members of the Hispanic community travel to Mexico for medical care or to access less expensive medications.   Some other local Hispanic residents reportedly go to local people "who obtain medications from outside of the country and receive oral and injectible medications".

Recommendations for improvement by members of the Hispanic focus group:

 
webdesign by chris bray