Crossing the border for health care.

A survey was administered to adults attending a health fair in south Los Angeles County, approximately 140 miles from the U.S.-Mexico border. The survey revealed that 14 percent of respondents had crossed the border to seek medical care during the past year. Nearly 80 percent of respondents crossing the border for medical care were uninsured, while 70 percent reported the low cost of medical care obtained across the border as being the most common reason for seeking care there. Twenty-eight percent of respondents reported purchasing medication in Mexico, with antibiotics and pain medication being reported in highest frequency. Ninety percent of these respondents were uninsured. This study shows that the high cost of health care and lack of insurance compels the poor and uninsured to seek low-cost health care and medication in Mexico to meet their most urgent health care needs, despite the burden of cost and travel.

Utilization of health care services among adults attending a health fair in South Los Angeles County.

A bilingual survey was developed to collect information regarding socio-demographics, access to medical and dental care, health insurance coverage, perceived health status, and use of folk medicine providers from 70 adults presenting to a health fair in South Los Angeles County. Ninety-seven percent of respondents were foreign-born. Seventy-nine percent reported having no health insurance during the year prior to survey. Of the uninsured, 61 percent lacked a doctor visit and 76 percent lacked a dental visit during the previous year. The high cost of care was the most frequently cited barrier to seeking medical (58 percent) and dental (67 percent) care even when respondents felt it was necessary. Respondents who felt they needed medical attention but did not seek it had a lower perceived health status (7.0 +/- 2.2) than those who did (8.0 +/-2.0). Among respondents perceiving themselves in poor health, only 17 percent were insured. Relatively few respondents (7.2 percent) reported seeing a folk healer during the past year. Our results support the argument that the medically indigent in some localities face serious financial, as well as less salient, barriers to access. These local conditions reflect inadequate enforcement by local governments in correcting the difficult problems indigent populations face in accessing medical and dental care.

Refractive errors and visual acuity impairment among self-selected Hispanic, white, and black adults examined by the UCLA Mobile Eye Clinic.

BACKGROUND: Occurrence of refractive errors and uncorrected visual acuity impairment among self-selected, indigent, medically underserved Hispanic, white, and black adults examined by the staff of the UCLA Mobile Eye Clinic (MEC) are described in this study and compared to population-based studies. METHODS: The study sample consisted of all 2,970 Hispanic, 1,228 white, and 1,028 black participants, for a total of 5,226 self-selected adults, ages 25 to 74 years, who received vision screenings and eye examinations by the staff of the UCLA MEC from 1987 to 1997. Tests consisted of visual acuity, refractive error, intraocular pressure, retinoscopy, slit-lamp biomicroscopy, direct ophthalmoscopic examination, and indirect ophthalmoloscopy with pupillary dilation. Levels of visual acuity impairment were defined as mild (20/50-20/80), moderate (20/100), or severe (20/200 or worse) in either eye. RESULTS: Self-selected whites in this study had higher rates of astigmatism, anisometropia, and hyperopia, while myopia was higher among self-selected blacks. Myopia and hyperopia occurred more frequently among younger age groups for all ethnic groups. Whites had a higher occurrence of mild, moderate, and severe visual acuity impairment, as compared with Hispanics and blacks. CONCLUSIONS: Both refractive errors and impaired visual acuity of this self-selected sample are similar to those of adults from the National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey, and the Baltimore Eye Survey. The data presented in this study provide a crude estimate of the occurrence of refractive errors and impaired visual acuity among self-selected, medically underserved, indigent Hispanic, white, and black adults in the Los Angeles area.