Background: A key public health problem is the lack of health insurance coverage among Latinos, the United States’ largest minority group. The increase in Latino populations in the U.S. has coincided with a rise in Latino health disparities that, in both prevention and access to quality care, are rooted in a lack of health insurance coverage. Studies frequently cite cultural and linguistic issues among the largest barriers for access to coverage and care. In 2000, 75% of all U.S. Latinos reported speaking Spanish at home with 40% speaking English poorly. Additionally, Spanish-preferred Latinos are nearly twice as likely as English-preferred to be uninsured. Therefore, health insurance information in Spanish is important. The health disparities between Latinos and non-Hispanic whites are called the “Cultural Divide.” Additionally, the internet era created a “Digital Divide” for Latinos that compounded the Cultural Divide: Access to high-speed internet and Spanish online resources lags behind English content. However, Latinos are the fastest growing group of mobile internet device users, as well as the top users of non-telephonic applications and seekers of health information via these devices. While these trends are significant, research also shows that over half of Latinos prefer health information in printed formats. Undeniably, Latinos are mixed media consumers. From both a social justice and economic standpoint, it benefits society to bridge these divides.
Program background: Latino Consultants started an initiative to bridge these divides in 2011 with the first QR Codes (Quick Reader scan/bar codes readable via mobile devices) in a bilingual health education and outreach magazine: The Guide to Health Programs/Guía de Cobertura de Salud. The Guide, funded by the California HealthCare Foundation, provides bilingual summaries of public health programs with URL resources. The QR Codes provide single-click access to additional online information (68 million URLs are mistyped daily). In 2012, Latino Consultants is completing the bridge from the mobile device direction, with the “iCoverageGuide” App that combines the bilingual information in the Guide with geolocation for local resources, links to enrollment and assistance, a Federal Poverty Level (FPL) calculator, and scalability for more programs, languages and resources. It will be available on all mobile platforms.
Evaluation Methods and Results: The iCoverageGuide App provides secure, anonymous behavioral data. User testing results, utilizing these data, will be discussed as part of this presentation.
Conclusions: Most mobile health Apps are English and consumer based, bypassing language issues and lack of insurance coverage that are causes of disparities. A linked mix of media, that are culturally and linguistically competent, can provide the critical pathway for health coverage information and enrollment to linguistically isolated populations. Increasing coverage is a prevention model in that it empowers access to a “health home” where screenings and advice resonate. Regardless of reform, the aperture to insurance will be via coverage programs where enrollment follows assessing benefits and eligibility.
Implications for research and/or practice: The state-based initiative with the Guide to Health Programs and promoting the iCoverageGuide App has national implications for reducing minority health disparities.