Hispanic immigrants are increasingly residing in rural communities, including in the midwestern United States. Limitations in the ability of rural Hispanics to access and utilize health care contribute to patterns of poor health and health disparity. A conceptual model of "vulnerability" guides this community-based participatory assessment project designed to explore rural Hispanics' perceived barriers to accessing and utilizing health care. Findings from a series of 19 focus groups with 181 participants from three communities in the upper Midwest identified perceived barriers at the individual and health care system levels. The most commonly perceived barriers were the lack of and limitations in health insurance coverage, high costs of health care services, communication issues involving patients and providers, legal status/discrimination, and transportation concerns. Findings imply that these barriers could be addressed using multiple educational and health service delivery policy-related strategies that consider the vulnerable nature of this growing population.

focus groups Latino/Hispanic immigrants health care Access to Needs assessment rural

information processing doctor patient relation vulnerable population Needs Assessment rural area immigrant health care policy Communication community care Consumer Participation health insurance interpersonal communication human patient transport Insurance Coverage rural population health service priority journal Insurance, Health Hispanic Americans United States health care cost Humans racism Hispanic conceptual framework Emigrants and Immigrants qualitative analysis Article health care utilization major clinical study Transportation health education legal aspect health care access health care need Health Services Accessibility health care system Healthcare Disparities rural health care Focus Groups Medical Assistance Midwestern United States health care delivery