Improvised care: public health with Latinos in new immigrant destinations

human services;public health;immigrants;Latinos;new destinations

Lanesskog, Deirdre McGlone

关键词: human services;    public health;    immigrants;    Latinos;    new destinations;   

Others  :  https://www.ideals.illinois.edu/bitstream/handle/2142/92771/LANESSKOG-DISSERTATION-2016.pdf?sequence=1&isAllowed=y

美国|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

As Latino immigrants continue to settle in new destinations across the U.S., human service institutions in these communities struggle to meet the intense needs of their increasingly diverse clients (Jiménez, 2007). Health care providers in particular are often ill-equipped to serve Latino newcomers who speak limited English, come from different cultures, and who are more likely than their peers in traditional destinations to be poor (Kandel et al., 2011), uninsured (Portes, et al., 2012), and undocumented (Passel & Cohn, 2009).The mismatch between Latino clients' needs and providers' capabilities raises doubts about the long-term prospects for these communities and their new residents.Moreover, providers' abilities to overcome such challenges are critical to ensuring the well being of the 17 million children of immigrants who are mostly American-born and yet are less likely than the children of American parents to receive human service supports (Perreira et al., 2012).This study examines how human service institutions in 18 new destinations respond to the needs of their growing Latinos populations.This qualitative study used 28 in-depth interviews with 30 public health administrators and front-line staff to identify how agencies serve Latino clients in new destinations.I used a two-step process of purposeful and snowball sampling to recruit participants (Patton, 1990).First, I invited the administrators from 28 Illinois counties with fast-growing Latino populations to join the study. Second, I asked administrators to nominate Latino-serving employees to participate. I analyzed the data using open coding to identify themes in the data, axial coding to determine the ways themes related to one another, and theoretical coding to tell the story of how institutions respond to this demographic shift (Strauss & Corbin, 1990). Findings from this study suggest that inadequate structures and resources for serving diverse clients prompted new destination public health agencies to improvise service delivery for Latino residents.The lack of government oversight of human services work with immigrants led agency administrators and staff to use considerable discretion in their work.Further, the dearth of bilingual professionals in these communities led administrators to rely heavily on non-professional bilingual clerical and intake staff to address Latino clients’ complex needs.Consequently, agencies adopted a plethora of unsystematic and untested practices to address the heightened linguistic, cultural, and contextual barriers their Latino clients experienced.Latino immigrants are likely to encounter different types of services, levels of access, and quality of care across these communities.This study highlights the need for increased attention to human service delivery in new destinations where Latino clients' needs and providers' capabilities are often incongruent.It underscores the need for additional research to identify evidence-based interventions that simultaneously attend to clients' needs and agencies' limitations. This research also highlights the need for strategies to overcome a scarce bilingual workforce, including appropriate guidelines for the use and supervision of bilingual non-professionals.Finally, this study emphasizes the need for enhanced government planning, oversight, and resources for human services with immigrants in the many new destinations across the country.