The Haitian community of Miami-Dade County: A cross-sectional study of needs, access and utilization of health services

This study\u27s objectives were to identify the health care needs of the Haitian community of Miami-Dade County, Florida, to determine whether those needs are met by the existing health care structure, and to assess the consequences of barriers to care on the health outcomes of this community. A questionnaire was used to obtain information on demographic characteristics, need for health services, and health care access and utilization from a probability sample of 650 Haitians and Haitian Americans living in or near the \u27Little Haiti\u27 area of the county who were recruited using census and county property appraisal data. The outcome variables were health care coverage, the availability of a usual place of care, and utilization of health services. Logistic regression and chi-square were used for data analysis. Only fifty-two and 77 percent of the population had health care coverage and a usual place of care, respectively. Participants without a high school diploma, with a family income of less than $31,000, who were non US citizen, have been living in this country for 10 years or less, or speak poor English were the least likely to have health coverage or a place of care. Compared to those without coverage, individuals with health care coverage were eight times as likely to have had a place of care, 2.5 times as likely to have had a physical, and three times to have had a medical check-up for a serious health condition during the past 12 months. Participants with a place of care were three times as likely to have had a physical, compared to those without a place of care. Hypertension, arthritis, and diabetes were serious health concerns for this community. In adjusted analysis, citizenship status was the single most important determinant of health care utilization (odd ratio = 2.5 and 45 for physical and medical check-up, respectively); gender, low family income, and short US residence were significantly associated with insurance coverage; and insurance coverage, gender, and English proficiency were associated with a usual place of care