BACKGROUND 

Access to quality health care is a fundamental determinant of health outcomes. However, disparities in access to health care persist among minority populations, including Latino communities in the United States.

Latinos represent the third largest population in Minnesota. According to the American Community Survey in 2024, approximately 388,435 of the state’s inhabitants were Hispanic or Latino (U.S. Census Bureau, n.d.a) and almost 3,000 of them lived in Watonwan County (U.S. Census Bureau, n.d.b).

However, in the state, almost 18% of Hispanic/Latino people lack health insurance, which represents one of the highest rates in the country, contributing to delays in care and worse health outcomes (U.S. Census Bureau, 2022). Barriers such as language differences, cultural factors, and socioeconomic constraints limit the ability of Latino communities to access preventive and primary care services. These barriers often lead to an increase in emergency room visits and untreated chronic conditions.

In this project Hispanic Advocacy and Community Empowerment Through Research (HACER), in collaboration with Blue Cross Blue Shield of Minnesota (BCBSM), sought to learn about access to health care, including telemedicine services, among Latino communities in Watonwan County, MN. The collection of the data was carried out through a series of community engagement activities with Latino residents of this county. Moreover, this study utilized a Community Advisory Board (CAB) that worked closely with HACER’s research team to ensure that the recruitment efforts and project activities were culturally responsive and aligned with the needs and culture of Latino Community in Watonwan County.

Objectives:

➢ Raise awareness: Highlighting the major issues, challenges, and disparities that Watonwan County’s Latino community has faced when trying to access health services where they live.

➢ Build potential community partnerships: Collaborate with local clinics, community-based organizations, and Health Promoters (promotores de salud) to strengthen information outreach efforts.

➢ Provide necessary recommendations to improve accessibility to the health system: Uplift community recommendations based on the experiences and perceptions that the Latino community itself has expressed.

METHODS

1. Research Design

In this study we used qualitative and quantitative methods to explore lived experiences of participants when they had accessed or attempted to access Watonwan County health services. Methods include in-depth individual interviews and a community survey. Participants of the study were given a gift card as appreciation for their time and thoughtful contribution to the project.

2. Participants

A total of 120 members of the Latino community in Watonwan County participated in the surveys, and an additional 13 were interviewed. Participants were recruited with the help of the Community Advisory Board which was comprised of 4 residents of the cities of Saint James and Madelia. This study’s participants were contacted by phone, door to door outreach, and at various places and events held in the cities of Saint James and Madelia. Inclusion criteria required participants be 18 years of age or older, self-identify as Latino, and be residents of Watonwan County.

3. Data Collection and Analysis

Data was collected through semi-structured, in-depth interviews. Each interview lasted approximately 45 minutes and was conducted via Zoom. An interview protocol was developed to ensure consistency, covering relevant topics such as health services experiences, cultural appropriateness, and information access (Appendix 3). All interviews were audio-recorded with participants’ verbal consent and transcribed using fathom transcription. With these transcriptions, the initial codes were generated and then grouped into broader categories (Appendix 2). Finally, these categories were adapted to be presented according to the five domains of the Social Determinants of Health (SDOH).

For the surveys, we used a quantitative, cross-sectional design to assess prevalence and identify potential relationships between key variables (Appendix 4). Survey data were entered and cleaned in Microsoft Excel, and prevalence estimates were calculated using formulas and pivot tables to support accurate analysis.

Both the interview and survey formats were validated with the CAB and subsequently sent to BCBS representatives for approval.