Immigrants’ access to health care in a nontraditional immigration destination during the COVID-19 pandemic: a mixed-methods study

Purpose Non-traditional immigration destinations (NTIDs) are areas without a long history of immigration to their communities, resulting in less accessible health infrastructure for immigrants. This study aims to examine how immigrants’ access to health care was impacted by the COVID-19 pandemic in Cincinnati, an NTID city in the Midwestern United States of America. Design/methodology/approach Local immigrant experiences in seeking and accessing health care were gathered using group-level assessments (GLA) and phone interviews through a partnership with a local legal nonprofit. Findings GLA participants described that confusion and practical barriers affected care-seeking. Many phone interview participants had primary care access with moderate-high levels of approachability, acceptability, appropriateness and availability/accommodation. Affordability of care was a primary barrier described in GLA sessions, and nearly half of phone survey participants indicated that they sometimes, often, or always delay or avoid seeking care because of cost. Those who did not access care during the COVID-19 pandemic did not know where they could receive care or reported that available places were too far away. Most people used their social networks to find out where to get health care. A few participants reported needing mental health services during the pandemic, and primary care was the setting where mental health services were accessed. GLA participants suggested improving dissemination of specific information about available care to community immigrants through schools and churches. Originality/value This study used a participatory research method called GLA to study the barriers of health care for immigrants using a robust framework on variables that affect access to care. In addition, the setting in an NTID offers perspectives about access to care in a particularly vulnerable immigrant population.