Rural Hispanic Women in Missouri: A Needs Assessment
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An interdisciplinary team of public health researchers in women's health from the University of Missouri Sinclair School of Nursing, School of Social Work and the University of Missouri-Kansas City School of Nursing received funding from the Missouri Foundation for Health to perform an assessment of health and health services among rural-residing women 50 years and older in specific counties of rural Missouri. Focus groups occurred with groups of Spanish-speaking Latinas in two rural counties. A total of 25 women between the ages of 50-65 (12 in one group and 13 in the other) were queried about the health status of women in their community. They were also asked about facilitators and barriers to health care services for women in their age group. Common health disorders that were reported were 24 obesity, diabetes mellitus, depression, poor nutrition, high blood pressure, chronic pain, stress, and difficulty sleeping. Several women noted that they did "not like" going to see a physician and others that they were afraid to go because of what the doctor might find and what the findings might mean related to financial concerns ("because of so many bills", who would care for their children, and missing work). One participant noted that she is afraid to go to the nurse at her place of work when she has symptoms because the nurse will send her home and she will miss a day of pay. Many participants expressed the idea that women?s health services should be available free of charge and geographically accessible, noting that "in Mexico they do it for free." Although free mammograms had been available with the "truck" in the past, they were no longer available. Further, transportation to places in which services are available is problematic, and many physicians and health services require multiple visits. Acquiring dental services is acutely problematic since money is typically expected prior to treatment and treatments, including cleaning, may require more than one visit. In general, lack of confidence in health care providers and prescribed treatments were frequently expressed opinions. Older Hispanic women in rural communities of our state share many of the challenges to health faced by urban women. However, distance, a greater need for transportation and even more limited resources suggest that targeted programs are in order if we are to improve their health status. These findings should inform policy decisions and the development of appropriate interventions for this population.