Migrant Barriers and Facilitators To Access Medical Services and Engage in Healthcare-seeking Behaviors in the Southeast United States: A Mixed-Methods, Exploratory Study.

Prior research indicates that Hispanic immigrants in the United States face numerous barriers to healthcare. But few studies have considered areas without a history of migrant inclusion, particularly the US South, even though their numbers are growing in this part of the country. This paper investigates the challenges that hinder healthcare-seeking behaviors of Hispanic immigrants in Georgia using a mixed-method approach. In-person surveys, conducted in urban Savannah (n = 30) and rural Vidalia/Lyons (n = 30), identified barriers including difficulty accessing care (68%), not having a primary care doctor (81.4%), and lacking insurance (46.7%). The inability to pay for care services is higher in urban areas (50% vs. 23.3%, p = 0.032), and the inability to pay for medicines is more common in rural areas (rural = 60.0% vs. urban = 33.3, p = 0.038). Qualitative analysis of an urban-based focus group (n = 12), and interviews with immigrants, providers, religious leaders, and community advocates (n = 20) highlight the following barriers: linguistic challenges, discrimination, fears over legal status, transportation issues, and limited times to access care outside of work hours. Non-government organizations, along with a scarce number of free and discounted clinics and health departments, play an important role in facilitating access. Key opportunities for interventions include education on the health system function, costs, insurance options, services, and legal health rights/protections. Facilitating access to healthcare, and ensuring the availability of compassionate, culturally, and language competent healthcare staff has the potential to increase healthcare-seeking behaviors in these populations.