IMPROVING ACCESS TO HEALTH-CARE IN LATINO COMMUNITIES

Public debate about health care reform often focuses on the need for h ealth insurance coverage, but in Latino communities many other barrier s also inhibit access to medical care. In addition, basic public healt h services often go underfunded or ignored. Thus, health care reform e fforts, nationally and in each State, must embrace a broader view of t he issues if the needs of Latino communities are to be served. This re port reviews and summarizes information about the mounting problems La tino communities face in gaining access to medical care. Access to app ropriate medical care is reduced by numerous financial, structural, an d institutional barriers. Financial barriers include the lack of healt h insurance coverage and low family incomes common in Latino communiti es. More than 7 million Latinos (39 percent) go without health insuran ce coverage. Latinos without health insurance receive about half as mu ch medical care as those who are insured. Structurally, the delivery s ystem organization rarely reflects the cultural or social concerns of the communities where they are located. Therefore, providers and patie nts fail to communicate their concerns adequately. These communication problems are exacerbated by the extreme shortage of Latino health car e professionals and other resources available. Institutional barriers often reflect the failure to consider what it means to provide good se rvice as well as high-quality medical care. Reducing these barriers to medical care requires modifying governmental and institutional polici es, expanding the supply of competent providers, restructuring deliver y system incentives to ensure primary care and public health services, and enhancing service and satisfaction with care.