Barriers to Health Care Among Laotian Americans in Middle Tennessee

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority. Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to health care services among Laotian Americans in Middle Tennessee. Method. A cross-sectional study with in-person data collection via a self-administered questionnaire was used. Data were collected from September 2014 to October 2014 at Xai Family Medical Clinic and Wat Lao Buddharam. 312 Laotian Americans in Middle Tennessee participated. Results: 275 participants were used for data analysis. 77.8% visited primary care providers (PCP) routinely (P \u3c 0.05). Based on the multivariate Chi-Square analyses, access to health services was associated with regular visits after controlling for all other demographics and personal beliefs variables in the model. Factors influencing access to health care for the Laotian populations include age, birthplace, time in the US, marital status, health insurance coverage, having a primary care provider, and whether they prefer that their provider speaks Lao. Additionally, access to health care was significantly and negatively associated with whether the participant knows where to get a health check, whether the participant feels well and able to do everything, and whether the participant is able to pay for health screenings and blood tests. The study did not indicate significant differences between those participants who had low socioeconomic status, low education level, or limited English proficiency. However, the findings also highlight the need for health care providers who can speak a patient’s native language. Discussion: Health care providers could use the study results to develop strategies to positively impact the health promotion and disease prevention activities of the Laotian-American minority. These results may also help health care providers to better understand the context of disparities in accessing to health care services among this minority group of Laotian Americans. Conclusion: Intervention strategies personalized to cultural beliefs influence barriers to health care. Language and socioeconomic status may be associated with accessing healthcare services when patients are not able to communicate with PCP. Health care facilities could target at-risk subgroups, particularly those who are elderly and those with limited English language ability. Culturally appropriate strategies could also be developed to promote lifelong healthcare access for this population