Health care needs and social integration among Pittsburgh's uninsured Latinos

BACKGROUND: The Latino population of greater Pittsburgh is considered invisible because it is not concentrated within one geographic area. This is of great public health significance, because such dispersion is a major barrier for Latinos seeking quality health care and social services. In the last ten years, this population has grown over 44%, and many of the estimated 20,000 Latinos in the Pittsburgh area do not have medical insurance. Across the nation, research has shown that Latinos often suffer from higher incidence of diseases and accidental deaths. Latinos also frequently experience limited access to health care and social services, and the level of social integration experienced by population members is directly related to this diverse community's quality of life.METHODS: This study is based on qualitative interviews with a small, purposive sample of young adult Hispanic immigrants, a group likely to experience barriers to accessing services. A free clinic, staffed by bilingual volunteers, was the initial access point to reach uninsured population members. Interviews with participants were recorded, transcribed, and studied to discover which health care and social service needs the community feels they lack, and how their level of social integration was related to their access to services.RESULTS: The most frequently mentioned service needs were dental services, health insurance, bilingual health service providers and/or translation services, and English language classes. Social isolation, lack of legal documentation, fear, racial discrimination, and lack of cultural competence on behalf of institutional employees were frequently cited as major barriers to accessing services. The length of respondents' stay in Pittsburgh did not appear to have a significant effect on improving respondents' access to needed services. Access to services was related more to the size and extent of one's social network, which usually consisted of family members who had lived in Pittsburgh before the respondent arrived, or which grew slowly over the time the respondent lived in Pittsburgh.CONCLUSIONS: Pittsburgh's Latino population would benefit from increased outreach efforts and increased community mobilization strategies. As a new growth community, Pittsburgh service providers are not fully prepared to reach the needs of the population. Additional research, qualitative in nature, will help to increase awareness and understanding of the challenges faced by this community as it seeks to access much needed services and health care