Barriers to health care utilization among older adult Mexican Americans in Milwaukee County

This study examined the barriers that older adult Mexican Americans perceive to prevent their access and use of health care services in Milwaukee County. This study was guided by Andersen's behavioral model of health care utilization and employed a questionnaire using sections of the HHANES and ARSMA-II, and questions developed by the researcher. The questionnaire was administered face-to-face and through a mailing, resulting in 110 participants. A test-retest method was employed to establish content reliability resulting in correlations of r = .737, p < .001, r = .510, p < .05, and r = .652, p < .01 for ethnic identity, barriers, and use of folk medicine respectively. Internal consistency for the primary study produced alpha scores of .798, .808, and .527 for these same items respectively. Bivariate and multivariate tables were constructed to determine associations between the dependent and independent variables. Health care utilization was the dependent variable, and the independent variables included acculturation level, 13 barriers, perception of health status, sociodemographic level, health insurance coverage, and use of folk medicine. The key findings indicated that cost and availability of services were the primary barriers for the majority of participants, with the majority also having a regular source of care and some type of health insurance. Having health insurance had no significant impact on utilization, but participants covered by Medicare used health care services more recently. Using Andersen's model, the findings revealed that predisposing characteristics, including language, ethnicity, and marital status, had the greatest impact on health care utilization. Participants who were more acculturated were more likely to use health care services. Use of folk medicine and its impact on health care utilization revealed that 26% of participants used folk medicine but not as a substitute for conventional medicine. There was no statistical significance for the relationship between the use of folk medicine and health care utilization. The findings suggest that Milwaukee County will need to add facilities to serve the health care needs of this population, and expand services to include child care, transportation, and patient education.