Because of discrimination and inequality, survivors in Latin@ communities in the United States face major challenges that affect the need for culturally specific health care and advocacy services: Employment and Economic Insecurity: Significantly, fewer Latin@s go on to college or earn above the median income for all Americans working full-time. The total national poverty rate for Latin@s is close to 26 percent, compared to about 11% for non-Hispanic whites (PewResearch Hispanic Trends Project, 2013). Employment and economic insecurity is also tied to discrimination in the work environment. Latin@ immigrants, particularly those who are undocumented, are vulnerable to wage theft and denial of rights and benefits, including protection against harassment and violence (Salcido & Adelman, 2004). Educational Barriers: Twenty percent of U.S.-born Latin@s and 50% of immigrant Latin@s do not have a high school credential. Contributing factors identified by the American Council on Education (2011) include language barriers, pressing economic needs, legal status, and educational background in country of origin. These educational levels affect job eligibility and therefore family income. In addition, lower educational levels are associated with lower levels of health literacy, which is the ability to obtain and process information about health and health services. More than 75 percent of adults with less than a high school education are at the basic or below-basic level of health literacy, which means it is difficult for them to do tasks such as reading a prescription label, knowing when to take medications, or calculating insurance costs (U.S. Department of Education, 2003). Barriers to Receiving Health Care: In Washington State, Latin@ adults are less likely than all other racial or ethnic groups to have a personal health care provider (Governor’s Interagency Council on Health Disparities, 2010). Nationally, “the most commonly perceived barriers [to health care access for Latin@s] were the lack of and limitations in health insurance coverage, high costs of health care services, communication issues involving patients and providers, legal status/discrimination, and transportation concerns” (Cristancho, Garces, Peters, & Mueller, 2008, p.633; see also Holmes, 2013; Kauffold, Zuroweste, Garcia, & Drewers, 2004; McGuire & Georges, 2003). Documentation Status: Undocumented individuals have reduced access to and utilization of health care services (Vargas Bustamante et al., 2010; Berger, 2009; Salcido & Adelman, 2004). Even when services are not contingent on documentation status, fear of discovery and lack of trust in authority figures play a role in how undocumented people interact with the health care system. “Most women identified undocumentedness as a major and overriding concern that influenced their thoughts about seeking health care, or that complicated their lives with fear” (McGuire & Georges, 2003, p. 190).
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The Enlace Project: Practice Guidelines for Working with Latin@ Pregnant and Parenting Survivors