Academic journal article Journal of Rural Social Sciences

Assessing Barriers to Health Care Services for Hispanic Residents in Rural Georgia*

Academic journal article Journal of Rural Social Sciences

Assessing Barriers to Health Care Services for Hispanic Residents in Rural Georgia*

Article excerpt


Since the 1990s, many Hispanics have been relocating to the rural South and their permanency (although beneficial to the economy) poses new challenges at the institutional level. One area of major concern is the adequate provision of health care. Our article evaluates the socioeconomic, cultural, and geographic/transportation barriers that Hispanic residents face when seeking primary health care services in Toombs County, Georgia. Data were acquired through personal interviews with Hispanic residents, local health professionals, and key community informants by using a combination of opportunity sampling and a snowball approach. Results indicate that the local health system and the county as a whole have not yet fully adapted to the health needs of Hispanic migrants. There was a consensus among all respondents that language and communication issues were the primary barriers to accessing health care.

Hispanics are the largest minority group in the United States, in 2010 numbering more than 50 million people and accounting for 16.3 percent of the total population (U.S. Census Bureau 2010). Before the 1980s the major Hispanic settlement areas were Τexas, California, and New York. During the 1980s, Hispanic settlement patterns moved from Texas to the Midwest and in the 1990s migration and settlement patterns shifted away from the traditional areas to the Southeast (Saenz et al. 2003). Indeed, many Hispanics are relocating in the rural South, especially in Alabama, North Carolina, South Carolina, and Georgia, where a combination of rural industrialization and employment opportunities on farms and in forests have provided ample work and economic opportunities (McDaniel and Casanova 2003; Torres 2000). Hispanic immigration is no longer a temporary borderlands issue, with many Hispanic immigrants coming to the United States to stay and seek permanent rather than seasonal employment. Once established, the Hispanic population significantly influences local socioeconomic well-being by contributing workers to, and expanding the consumer base for, local businesses. On the other hand, a rapidly increased Hispanic population poses new challenges and financial costs at the institutional level, notably in schools and in health care (Erwin 2003; Torres 2000).

In this paper, we focus attention on health care. The primary purpose of this study was to examine barriers to access to primary health care services faced by Hispanic residents (including migrant workers) in the rural South. We report on a qualitative case study based on interviews with Hispanic residents and medical professionals in Toombs County, Georgia. We examine issues of access to primary health care using the five dimensions of access identified by Penchansky and Thomas (1981), which are:

1. Availability - the relationship between the volume and type of existing services compared with client needs

2. Accessibility - the relationship between the location of supply and the location of clients, taking account of client transportation resources and travel time, distance, and cost

3. Affordability - the relationship between the cost of health services and the clients' income, ability to pay, and existing health insurance

4. Accommodation - the relationship between the manner in which health services are provided and both clients' ability to accommodate those factors and the clients' perception of their cultural appropriateness

5. Acceptability - the relationship between clients' attitudes about personal and practice characteristics of providers and the actual characteristics of existing providers, as well as provider attitudes about acceptable personal characteristics of clients.

Hartley (2004) argued that the traditional approach to understanding rural health disparities, which focuses on questions of access, needs to be expanded to include cultural dimensions of health. In this paper we examine questions of both access and cultural factors that affect the broad definition of access adopted here. …

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