Tennessee and Kentucky Latino Health Access Coalitions

In October 2001 the U.S. Department of Agriculture and its Fund for Rural America awarded a four-year, $539,000 grant to the University of Kentucky’s Department of Preventive Medicine in support of a pilot project aimed at improving access to health care among Hispanics in rural communities. The goals of this project, which included Montgomery and Shelby Counties in Kentucky and Bedford and Coffee Counties in Tennessee, were to (1) establish and main local coalitions to help identify and address health access issues among Latinos; (2) increase access to health care by removing language barriers for Spanish speakers; (3) improve the cultural competency of health care professionals and other service providers through opportunities for learning and cultural immersion; (4) empower coalition members to work collectively in seeking locally supported strategies and solutions; and (5) create an Extension/Public Health partnership model that advances the land grant-missions of the University of Kentucky, the University of Tennessee, and Kentucky State University.

The Montgomery County Migrant Coalition was formed in 2001, and member organizations used several data collection methods to identify the unmet health care needs of Latinos and other low-income, uninsured, and underinsured persons in the region. Analysis of focus group findings and secondary data revealed that the rapidly growing target population lacks a general knowledge of health and wellness issues and does not place a great deal of importance on preventive health care. The coalition learned that work and family concerns frequently supersede the personal health care needs of many Latino immigrants. Limited transportation, inability to communicate in English, inability to navigate the local health care system, and inability to pay were identified as substantial barriers to care. Case studies and focus groups also identified specific health conditions among the target population, including dental problems (such as gingivitis, missing and/or broken teeth, or decayed teeth) and chronic diseases such as diabetes and hypertension.

Among numerous grant activities, the Southeast Center trained coalition members in asset mapping; i.e., identifying and categorizing potential resources including individuals, institutions, and informal organizations in the target counties. The Center also hosted annual meetings and workshops of the member coalitions: a two-day multistate meeting in 2002, a three-day meeting (October 1-3) in 2003, a joint meeting of the Kentucky coalitions on July 13, 2004, and a three-day meeting of the Tennessee and Kentucky coalitions from July 12-14, 2006.

Member organizations in the Sterling Health Care Access Network began informing community leaders about a new HRSA grant opportunity in 2003. By sharing this information and providing opportunities for feedback, coalition members gained valuable insight into local needs, as well as buy-in from the larger community. In 2004, the Southeast Center for Agricultural Health and Injury Prevention assisted the Montgomery County Health Department in revising and resubmitting its application for a Rural Health Care Services outreach grant from HRSA. The Department received notice of a $375,000 award in May 2006. The Southeast Center also assisted the Montgomery and Shelby County coalitions in submitting $5,000 grants to the Foundation for Healthy Kentuckians, to increase outreach to migrant farm workers and other Hispanic populations. Both of these mini grants were awarded by the Foundation.

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