Migrant Health Care in North Carolina: Where We Are and Where We Should Be

It is estimated that forty five million Americans lack health insurance (DeNavas-Walt, Bernadette Mills, 2003). There are more than 40 million Latinos living in the United States (US Census, 2004). As part of this problem, most of the Latinos living in the United States lack health insurance as well (Institute of Medicine, 200 I). Despite major technological advances in the medical field, access to healthcare is one of the greatest challenges of the modem era in the US. Healthcare costs have been on the rise, while at the same time, people with adequate health insurance have been decreasing (Employee Benefit Research Institute, 2004). Moreover, Latinos represent the largest minority group in the United States (US Census, 2004). North Carolina has experienced a rapid increase in the Latino population in the last ten years, from 1.04 percent to 4.7 percent (NC Latino Health, 2003). Specifically, this is due to migration patterns of workers and a high birthrate among Hispanics. Despite technological advancements in the agriculture and farming industry, manual labor is still needed. This strenuous physical work that pays low wages but requires high risk makes it undesirable for many. People that want to migrate to the United States see migrant work as a golden opportunity. They want to be able to live and work in better conditions than the ones that exist in their county of origin. Many are also trying to escape from economic depression and possible political or religious discrimination. Medical care provided to migrant workers has been largely limited to treating acute medical conditions, mainly due to occupational illnesses. Thus, their birth rate is high due to lack of access to family planning services. Conversely, the medical needs of migrant workers have increased over time as more chronic medical conditions have developed. 3 Multiple factors are associated with the health disparities seen in the Latino migrant worker population in the United States. These factors of health disparities include social factors such as low income, inadequate housing, limited education, violence in the communities, and restricted access to recreational activities (Vines Godley, 2004). In addition, culturally specific barriers to healthcare are also present, such as cultural beliefs, language barriers, and a lack of healthcare facilities with cultural competency for the Hispanic community (Vines Godley, 2004). Multiple venues provide some form of primary health care to Hispanic migrant workers and their families, but these efforts are limited in the number the venue can absorb scope of practice, and language and cultural competencies (Vines Godley, 2004). The best setting to provide adequate primary medical care to the Hispanic community is within competent, specialized clinics that understand the unique needs, culture, and language barriers of the Latino population, with the cultural competencies that will in tum assure adequate delivery of preventive and medical care. Those specialized clinics should be made accessible to Hispanic migrant workers and their families in order to facilitate the timely delivery of basic medical treatment, including medications, education on health prevention, and access to secondary and tertiary medical care.Master of Public Healt