Context: Many rural Midwestern communities are experiencing rapid growth in Latino populations with low rates of health insurance coverage, limited financial resources, language and cultural differences, and special health care needs. Purpose: We report on 2-day site visits conducted in 2001 and 2002 in 3 communities (Marshalltown, Iowa; Great Bend, Kansas; and Norfolk, Nebraska) to document successful strategies to meet Latino health care needs. Methods: We interviewed key informants to identify successful community strategies for dealing with health care access challenges facing the growing Latino population in the Midwest. Findings: Interventions have been developed to meet new demands including (1) use of free clinics, (2) school health programs, (3) outreach by public health, social services and religious organizations, and (4) health care providers' efforts to communicate with patients in Spanish. Strain on safety net services for Latinos is due in part to a complicated and unstable mix of public and private funds, a large but overtaxed volunteer provider base, the dependence on a limited number of community leaders, and limited time for coordination and documentation of activities. Conclusions: We suggest the development of a Rural Safety Net Support System to provide targeted funding to rural areas with growing immigrant populations. Federal community health center support could be redirected to new and existing safety net providers to support the development of a safety net monitoring system.

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rural area immigrant Rural Health Services primary medical care Health Care Surveys public health service Community Health Services community care health care personnel Preventive Health Services Nebraska human rural population Kansas population growth financial management Hispanic Americans qualitative research Health Services Needs and Demand interview United States School Health Services Humans Hispanic male female safety pregnancy outpatient department Article Fees and Charges adult health care access government health care need Emigration and Immigration Health Services Accessibility health center Community-Institutional Relations Iowa rural health care Multilingualism primary health care Child