FRONTIERS: Foreign-Born Latinos Cancer Screening

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Project Summary Latino immigrants experience numerous disparities in the receipt of routine health care. They may be at risk for significant poor outcomes from cancer; however, the extent to which Latino immigrants experience appropriate cancer screening and prevention services, compared with US born-Latinos and non-Hispanic whites, is not well understood. This may be, in part, because studying the health care of Latino immigrants has numerous challenges. Foreign-born status is not widely and routinely collected, and foreign-born patients may not have the access to healthcare related datasets that would objectively record their healthcare utilization. Additionally, while there is some scientific evidence that different sub groups of immigrants (Mexican individuals, for instance, Spanish speaking individuals, rural- residing immigrants) may utilize services differently in general than contrasting groups, the knowledge on these differences is incomplete because studies to date have failed to include all necessary data to understand these relationships. In order to better understand cancer prevention disparities between foreign-born Latinos, US-born Latinos, and non-Hispanic Whites, we will leverage a unique data resource from a large, national network of community health centers with shared electronic health record data that is linked to community-level social determinants of health data. This large, longitudinal dataset contains country of birth for >100,000 Latinos and also contains unprecedented data linkages which will let us assess disparities and better understand which specific groups are most at risk for the under-utilization of cancer prevention. Understanding these factors that most heavily impact cancer preventive service use is crucial to the prioritization of population-based interventions to improve cancer outcomes. This research will enable action/intervention in three ways: 1. It will help clinical providers understand their patients' barriers to care utilization, and further point-of-care efforts to address these barriers that influence their Latino immigrant patients' utilization of recommended cancer prevention services. 2. It will facilitate strategic partnerships between healthcare providers and community agencies poised to intervene in social factors in the lives of Latino immigrants. 3. It will enable more informed policy decisions to improve public health and wellness in foreign born Latinos.