Increasing Access to Medical Care for Hispanic Women Without Insurance: A Mobile Clinic Approach.
Suzanne PhelanMarilyn TsengAnita KelleherErin KimCristina MacedoVicki CharbonneauIrebid GilbertDavid ParroLuke RawlingsPublished in: Journal of immigrant and minority health (2024)
The purpose of this study was to describe the health status and barriers of people who sought care on a free mobile health clinic for women without insurance in California. Participants were 221 women who attended the Salud para Mujeres (Women's Health) mobile medical clinic between 2019 and 2021. Medical chart abstractions provided data on sociodemographic factors, medical history, barriers to care, depressive symptoms, and dietary factors. Anthropometric measure, blood pressure, and biomarkers of cardiometabolic disease risk were also abstracted. Participants were young adult (29.1 [SD 9.3] years), Hispanic (97.6%), farm-working (62.2%) women from Mexico (87.0%). Prevalent barriers to accessing (non-mobile) medical care included high cost (74.5%), language (47.6%), hours of operation (36.2%), and transportation (31.4%). The majority (89.5%) of patients had overweight (34.0%) or obesity (55.5%), and 27% had hypertension. Among those (n = 127) receiving a lipid panel, 60.3% had higher than recommended levels of low-density lipoprotein and 89% had lower than recommended levels of high-density lipoprotein. Point-of-care HbA1c tests (n = 133) indicated that 9.0% had diabetes and 24.8% had prediabetes. Over half (53.1%) of patients reported prevalent occupational exposure to pesticides and 19% had moderate to severe depressive symptoms. Weekly or more frequent consumption of sugar sweetened beverages (70.9%) and fast food (43.5%) were also prevalent. Mobile health units have potential for reaching women who face several barriers to care and experience major risk factors for cardometabolic disease. Findings suggest a compelling need to assure that Hispanic and Indigenous women and farmworkers have access to healthcare.
Keyphrases
- healthcare
- polycystic ovary syndrome
- blood pressure
- depressive symptoms
- pregnancy outcomes
- end stage renal disease
- cervical cancer screening
- type diabetes
- breast cancer risk
- primary care
- young adults
- insulin resistance
- ejection fraction
- metabolic syndrome
- newly diagnosed
- chronic kidney disease
- cardiovascular disease
- affordable care act
- public health
- high density
- quality improvement
- weight loss
- machine learning
- pain management
- peritoneal dialysis
- social support
- autism spectrum disorder
- body composition
- body mass index
- weight gain
- mental health
- sleep quality
- deep learning
- early onset
- patient reported outcomes
- mass spectrometry
- health information
- high resolution
- blood glucose