Download Low German Mennonite Farmworkers: Increasing Access to

Low German Mennonite Farmworkers:
Increasing Access to Preventive and
Primary Health Care Services
Kansas Public Health Association, Inc.
2006 Fall Conference
Introduction
• Kansas Statewide Farmworker Health
Program (KSFHP) works to increase
access to health care and help
farmworkers stay healthy.
• KSFHP utilizes a voucher/case manager
model to serve farmworkers through out
the state, relying on a network of public
and private health providers to deliver
services.
Background/Need
• Farmworkers in Kansas are typically low income
(under 200% of income), and uninsured.
Traditionally farmwork in Kansas has been done
by Latino migrant or recent immigrants from
Mexico.
• Beginning in the late 1990s a new group of
people began to come to Kansas to work in
farmwork. They are Low German speaking
Mennonites (LGMs) from colonies in Mexico. In
2005 they made up 39% of farmworkers served
in KSFHP.
Background/Need
In 2003, KSFHP partnered with the
Mennonite Church U.S.A, Western District
Conference to survey the LGMs to learn
more about their culture, language and
health needs.
Survey Exposed Significant
Health Needs
• Only 3% of the LGMs had health
insurance
• 26% of LGMs had never been to a doctor
or clinic
• 41% were not planning their families
• 19% had not been to the dentist in the
past five years (4% had never been)
• 48% had had six or more teeth removed
Healthy Kansas 2010-Social
Determinants
KSFHP staff recognized that low income,
insurance status, language and culture
were all issues impacting on access to
care and we determined that while we
could do little to address disparities
through income, we could impact them
through education and social support for
the LGM farmworkers.
Goals/Objectives
KSFHP determined that our focus with the
LGMs would be on two of the three HP2010
Leading Health Indicator objectives :
• Increase the proportion of persons who
have a specific source of ongoing care
• Increase the proportion of pregnant
women who begin prenatal care in the first
trimester of pregnancy
A New Model to Achieve Our Goals
Through the addition of bilingual LG/English health
promoters, KSFHP would be able to
• Provide outreach to the LGM community
• Educate LGMs regarding U.S. Healthcare system
• Educate regarding the importance of preventive
care such as family planning and prenatal care
• Present KSFHP as a means to help them find a
medical home that was affordable
• Provide support in access and follow up and to
assure barriers (such as language) are identified
and addressed.
Harvest of Health
To provide health information in a language
that LGMs could utilize, Harvest of Health,
audio recordings on health topics in English,
Spanish and Low German were developed
and distributed to farmworkers and
providers. To hear these audio recordings go
to www.kdheks.gov/olrh/FWAudioEd.htm
Who Is Involved?
KSFHP has relied on its partnerships with
the farmworker community, the church, the
network of public and private health
providers throughout the state as well as
early funding from foundations to implement
the survey, pilot the health promoters project
and develop the Harvest of Health project.
Progress
As a result of the health promoter program and the
a resulting Medical Expansion Grant, KSFHP
has:
• Dramatically increased the number of LGM
farmworkers accessing care through KSFHP. In
2002 359 LGMs were served, while in 2005
KSFHP provided health services to 1466 LGMs.
• Experienced an increase in LGM women
accessing family planning, and
• Seen an increase in LGM women accessing
early prenatal care.
Future Impact of HK 2010
Continued improvements in comprehensive access to
care and application of social determinants
understanding to removing barriers.
Move beyond healthcare access to encourage healthy
choices through health/wellness marketing.
Immunizations-Educate and support LGM families to
immunize children who are not up to date.
Develop small groups to utilize aspects of the Chronic
Disease Model to address Depression and Anxiety.
Application
Increase use of preventive services and
access to care through identifying and
addressing barriers. In the case of non
dominant cultural or language groups, a
health promoter model may reduce barriers,
and increase trust, knowledge, and provide
encouragement for clients to utilize
preventive health services and make
healthier choices.