Overcoming Barriers to Health Care Access in Rural Latino Communities: An Innovative Model in the Eastern Coachella Valley.

INTRODUCTION

Latino farmworkers lack access to basic needs, including health care services. These farmworkers face barriers common to rural areas (eg, limited health services and public transportation), as well as language barriers, an unfamiliar medical system, no health insurance, and income-based financial challenges exacerbated by a lack of workers' rights.

METHODS

This study involved focus group discussions to elicit community health priorities and barriers to health care service use among Latinos in rural farm working communities, as well as participants' ideal model for health care services delivery. Free mobile clinics were subsequently implemented at locations and times the community identified as ideal, and pre- and postinterviews of patients' experiences utilizing clinic services, and perceptions of access barriers, were conducted.

RESULTS

Results from focus group discussions (n = 82) and one-on-one interviews (n = 15) to evaluate mobile clinic health care services use confirmed documented barriers to health care for this population, shed light on structural and cultural barriers to service access, and suggested innovative models for service delivery to Spanish-speaking Latino farmworkers in rural communities. These models should (1) provide care within farm working communities, (2) offer services at times outside of business hours, and (3) encourage provider immersion in patient communities to better understand their health care needs.

DISCUSSION

Traditional models of care that expect patients to access health care services at brick and mortar structures are impractical for Latino farmworkers in rural communities. Innovative models bringing health care services to community spaces can reduce access barriers and emergency department utilization and improve health outcomes for this structurally vulnerable population.