Migration, Health Care Behaviors, and Primary Care for Rural Latinos with Diabetes
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BRIEF COMMUNICATION
Migration, Health Care Behaviors, and Primary Care for Rural Latinos with Diabetes Gerardo Moreno1 • Leo S. Morales2 • Felicia Batts3 • Christine Noguera4 Marilu Isiordia5 • Carol M. Mangione6,7
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Ó Springer Science+Business Media New York 2015
Abstract Many US Latinos migrate or travel between the US and Mexico on a regular basis, defined as circular migration. Latinos with diabetes (n = 250) were surveyed about circular migration and their ability to use medications and perform recommended diabetes self-care activities. A review of medical charts was performed. Twentyeight percent (n = 70) of patients traveled to Mexico during the last 12 months. Older Latinos were more likely to report traveling to Mexico and back into the US. Among those that traveled, 29 % reported use of less medication than they wanted to or were prescribed because of travel and 20 % ran out of medications. The rate of reported problem areas while traveling were 39 % (27/70) for following a diabetic diet, 31 % (21/70) for taking medication, and 37 % (26/70) for glucose self-monitoring. The results suggest that the structure of primary care and care coordination are important for this population to fully engage in diabetes self-care. & Gerardo Moreno [email protected] 1
Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA 90024, USA
2
School of Medicine, University of Washington, Seattle, WA, USA
3
Livingston Health Centers, Inc., Livingston, CA, USA
4
Community Health Centers, Inc., Stockton, CA, USA
5
University of California Davis, Davis, CA, USA
6
Division of Health Services Research and General Internal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
7
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
Keywords healthcare
Latinos Diabetes Migration Bi-national
Introduction Although Latinos are rapidly growing in communities across the US, their patterns of migration in and out of the US and implications on health are not well understood [1– 3]. For Latinos settled in the US, migration patterns vary and include those that move both ways across the US– Mexico border throughout the year, including those that stay in Mexico for a few weeks or months. This pattern of migration and travel is also known as circular migration [4]. Circular migration or travel is likely more common among Latinos who are first generation immigrants, citizens, or naturalized residents with strong roots or family ties in Mexico. The impact of US–Mexico circular migration on Latinos with chronic health conditions such as diabetes has not been well characterized [5, 6]. Latinos in the US have a high prevalence of type 2 diabetes and are at risk of poor diabetes-related outcomes [6, 7]. Latinos with type 2 diabetes have high rates of poorly controlled glycemia [8–11] and diabetes-related complications, including amputations [12, 13]. Primary care physicians who care for this
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