Reaching a Hidden Population of Latino Immigrants to Understand Healthcare Utilization and Barriers to Care

Introduction: The tremendous Latino growth combined with the challenges of living in a nontraditional migration area make Latino immigrants, particularly those who are undocumented, a “difficult-to-reach” and understudied population in research. In this paper, we describe the results of a co-researcher study that investigated healthcare utilization and barriers to care among Latino immigrants living in a Midwestern non-traditional migration city.

Methods: Latinos Unidos por la Salud (LU-Salud) is a community research team composed of Latino immigrant community members and academic researchers working in a health research partnership. The community team members are considered “co-researchers” since LU-Salud was designed within a community-based participatory research framework where we partnered and engaged in shared decision making at each phase of the research process from design, data collection, and interpretation of findings to dissemination. A co-researcher model has many benefits, including higher participant engagement, enhanced understanding of community needs, development of more relevant research questions, enriched research interpretation, wider dissemination and translation of results, and increased sustainability. Co-researchers administered 518 surveys and conducted Data Interpretation Sessions with 34 Latino immigrants.

Results: Participants more often relied on community clinics for care and utilized healthcare less often than the U.S. population. Results revealed significant healthcare barriers, which Latino immigrants attribute to language, interpreters, documentation status, and discrimination. The healthcare inequities experienced by many Latino immigrants in the city are not addressed with the Affordable Care Act; local structural changes to address documentation and language challenges are required to improve healthcare access and quality.

Conclusions: Partnering with co-researchers in LU-Salud allowed the team to access reliable, quality data from difficult-to-reach Latino immigrants living in a nontraditional migration city. The co-researcher approach promoted shared decision-making and community empowerment throughout the research process with the co-researchers providing expertise about the “what” (Latino immigrant health-related beliefs and behaviors, questionnaire content, interpretation of data) and the “why” (to obtain perspectives from Latino immigrants who typically don’t engage with academics) and academic researchers bringing expertise about the “how” (research design and methods, grant funding).