Journal of Community Health
Volume 43, Issue 2, 2018, Pages 356-365

Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California (Article)

Maxwell A.E.* , Young S. , Moe E. , Bastani R. , Wentzell E.
  • a Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900, United States
  • b Mixteco/Indigena Community Organizing Project, PO Box 20543, Oxnard, CA 93034, United States
  • c Department of Anthropology, University of Iowa, Iowa City, IA, United States
  • d Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900, United States
  • e Department of Anthropology, University of Iowa, Iowa City, IA, United States

Abstract

This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care. © 2017, Springer Science+Business Media, LLC.

Author Keywords

access to health care Navigators Indigenous farm workers from Mexico Promotore Community assets In-depth interviews

Index Keywords

immigrant agricultural worker health insurance human statistics and numerical data Agriculture Aged language ethnology Mexico interview Young Adult tongue Humans migrant California Interviews as Topic Emigrants and Immigrants Zapotec (people) female clinical article women's health health care utilization adult health care access patient attitude Patient Acceptance of Health Care medical care

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85030315599&doi=10.1007%2fs10900-017-0430-8&partnerID=40&md5=dd05327652ceea08fd176a28438e4f11

DOI: 10.1007/s10900-017-0430-8
ISSN: 00945145
Cited by: 2
Original Language: English