Community-Based Health Care Navigation's Impact on Access to Primary Care for Low-Income Latinos

Sonali Saluja; Michael Hochman; Rachel Dokko; Janina Lord Morrison; Celia Valdez; Steven Baldwin; Megha D Tandel; Michael Cousineau

doi:10.3122/jabfm.2022.01.210253

Community-Based Health Care Navigation's Impact on Access to Primary Care for Low-Income Latinos

J Am Board Fam Med. 2022 Jan-Feb;35(1):44-54. doi: 10.3122/jabfm.2022.01.210253.

Authors

Sonali Saluja¹, Michael Hochman², Rachel Dokko², Janina Lord Morrison², Celia Valdez², Steven Baldwin², Megha D Tandel², Michael Cousineau²

Affiliations

¹ From The Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine of USC, Los Angeles, CA (SS, MH, MC); Keck School of Medicine, University of Southern California, Los Angeles, CA (RD, MDT); Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA (JLM); Maternal and Child Health Access, Los Angeles County, Los Angeles, CA (CV); Division of Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA (SB); Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA (MC). sonali.saluja@med.usc.edu.
² From The Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine of USC, Los Angeles, CA (SS, MH, MC); Keck School of Medicine, University of Southern California, Los Angeles, CA (RD, MDT); Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA (JLM); Maternal and Child Health Access, Los Angeles County, Los Angeles, CA (CV); Division of Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA (SB); Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA (MC).

PMID: 35039411
DOI: 10.3122/jabfm.2022.01.210253

Abstract

Introduction: Despite the Affordable Care Act's insurance expansion, low-income Latinos are less likely to have a primary care provider compared with other racial/ethnic and income groups. We examined if community-based health care navigation could improve access to primary care in this population.

Methods: We surveyed adult clients of a community-based navigation program serving predominantly low-income Latinos throughout Los Angeles County in 2019. We used multivariable logistic regression models, adjusting for sociodemographic characteristics, to calculate odds ratios for differences in access to primary care and barriers to care between clients who had experienced approximately 1 year of navigation services (intervention group) and clients who were just introduced to navigation (comparison group).

Results: Clients in the intervention group were more likely to report having a primary care clinic than the comparison group (Adjusted Odds Ratio [aOR] 3.0, 95%CI: 1.7, 5.4). The intervention group was also significantly less likely to experience several barriers to care, such as not having insurance, not being able to pay for a visit, and not having transportation.

Conclusions: Community-based navigation has the potential to reduce barriers and improve access to primary care for low-income Latinos. In addition to expanding insurance coverage, policymakers should invest in health care navigation to reduce disparities in primary care.

Keywords: Access to Health Care; Affordable Care Act; Health Policy; Hispanic Americans; Los Angeles; Minority Health; Poverty; Primary Health Care.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Health Services Accessibility*
Healthcare Disparities
Hispanic or Latino
Humans
Insurance Coverage
Insurance, Health
Patient Protection and Affordable Care Act*
Poverty
Primary Health Care
United States