Access to health promotion, protection, and disease prevention among impoverished individuals.

Health care access was surveyed in a sample of 182 northern Texas individuals (57% Hispanic) who provided information on 658 family members in northern Texas. Barriers were evaluated using the Institute of Medicine (Millman, 1993) and the L.A. Aday and R.M. Anderson (1981) conceptual framework and a survey research design. Eighty-eight percent of the 182 respondents were 54 years old or younger, yet the majority reported fair health status with currently unmet needs and untreated health problems. Forty-nine percent used an emergency room within the last year. Forty-two percent of the respondents always worry about their future health and 40% perceived little or no influence over their family's future health status. Forty-one percent of the variance in chronic health problems was accounted for by barriers, mental health needs, educational needs, and use of social services. Seventeen percent of the variance in health status was explained by mutable barriers to access. Unmet needs negatively affected physical and mental health. This study demonstrated that this relatively young sample (77% < 44 years old) was experiencing health care access needs. These data aid evaluation of the Healthy People 2000 goal of reducing disparities that exist among Americans in health promotion, protection and prevention.