According to the U.S. Census Bureau, the number of immigrants to the United States has increased in recent years; as of 2011, 79% of the US immigrant population was Hispanic. As a result of the rapid influx of Hispanic immigration, little information is known about immigrant healthcare practices. The purpose of the undergraduate research in the fields of Biochemistry and Spanish is to bridge the gap to better understand how Hispanic immigrants utilize medical care in the East Tennessee area. Healthcare utilization data was collected by interviewing individuals through a survey adapted from a validated Health Survey instrument used for assessment of national healthcare trends by the Pew Hispanic Center. Fifty-six Hispanic volunteers were interviewed using questions that encompassed such topics as health care provider, knowledge of common diseases, vaccinations, medications, medical insurance, and language barrier among others. Once the data had been compiled, statistical analysis, such as the chi square and t-tests, were used to compare the East Tennessee population to the National Hispanic survey and to investigate differences in healthcare utilization between subgroups in the East Tennessee population. East Tennessee data approximated national results fairly well in most areas of investigation and showed that the largest Hispanic subgroup in both studies were Mexicans at 71% for East Tennessee and 61 % nationwide. Hispanics in both studies had comparable rates of common diseases such as diabetes, heart disease and respiratory disease as shown by p-values of 0.830, 0.599 and 0.293 respectively. Therefore, there were few significant differences between the East-Tennessee survey population and the national population with regard to demographics, healthcare, health utilization, or diabetes knowledge. Immigrants also reported utilization and knowledge of a wide range of healthcare resources and a health status of good to excellent which was comparable to the national population. The results from the East Tennessee research showed that of Hispanics that needed a translator, 94% had no health insurance, were 24% more likely to rate their health as only fair instead of excellent compared to those that did not require a translator, and were 48% more likely to utilize a free clinic instead of a private doctor's office compared to those that did not need a translator. The data suggests that if language barriers could be overcome, several areas of healthcare services would be improved.
Hometown: Argentina/Knoxville, Tenn.
Major: Biochemistry and Spanish
Senior Study Title: “Analysis of Medical Care Among East Tennessee Hispanic Immigrants”
Advisor: Dr. Angelia Gibson, Associate Professor of Chemistry; and Dr. Geoffrey Mitchell, Associate Professor of Spanish
Fiorina Adorati wanted to find out how Hispanics living in Blount County and the surrounding community accessed medical care and to see if the results followed a national trend for the growing minority group.
Adorati, who graduated in May with majors in biochemistry and Spanish, said the diverse double major made it a challenge to come up with a thesis topic. After brainstorming with her advisors, Dr. Angelia Gibson, associate professor of chemistry, and Dr. Geoffrey Mitchell, associate professor of Spanish, the topic of immigrant healthcare rose to the forefront.
Gibson said Adorati’s future career goal of becoming a physician’s assistant sparked her decision to pursue this area of study.
“I had to find a way to combine both of these majors,” Adorati said. “I enjoyed my thesis very much. I think the key is finding something you want to do and then proceeding from there.”
Ultimately, her thesis with its original research component has shown her that she wants to focus her career working the Hispanic population. Adorati, who is originally from Argentina, moved to the Knoxville area about 13 years ago because of a family member’s medical issues.
As a thesis student, she interviewed local residents about their healthcare practices and knowledge of common diseases, using a survey that she created based on a national tool developed by the Pew Hispanic Center.
“It’s an exemplary thesis,” Mitchell said, pleased with the outcome of linking the majors. “She combined two very different majors in an innovative way.”
He thought the project might lean more toward the sciences; however, her interviews and much of her work was in Spanish.
“It’s a bit of a challenge for all Spanish majors who write their theses in English and then have to present it in Spanish,” he said, complimenting her efforts in doing this.
Mitchell recommended Adorati’s thesis for inclusion in the College’s Lamar Memorial Library’s select collection of Senior Studies, and Gibson agreed.
“Fiorina has been a great student, very interested in her studies,” Mitchell said. “The fact that this was an exemplary thesis didn’t surprise me in the least. She’ll go far.”
Gibson said Adorati demonstrated a strong work ethic and excellence in the way she approached her project. This type of study has not been done on a local level, and it provided new information about immigrant healthcare, she added.
“It exemplified the work ethic of a student taking ownership in his or her project,” Gibson said. “It also included a message for this community that could help immigrants get better health care if the language barrier was addressed.”
For her research, she interviewed 56 parishioners of Our Lady of Fatima Catholic Church in Alcoa, which provided the interviewees with a comfortable and familiar environment.
“It was easier for them to open up about their health status,” Adorati said. “I enjoyed doing it there because they felt safe.”
The questions addressed topics including knowledge of medical conditions such as diabetes and heart disease, vaccinations, medications, medical insurance and language barriers. Adorati said she was surprised by a couple of outcomes. Ninety-five percent of the participants wanted to be interviewed in Spanish. After looking at her data, she discovered that 94 percent of them didn’t have health insurance, and they did need a translator for a doctor’s visit. Her research showed that participants who didn’t need an interpreter during a medical appointment were more likely to have health insurance while the reverse was true for those who did need one. Additionally, those requiring a translator were more likely to access their medical care through health departments or free clinics.
“As a result, it can be assumed that language can often be a barrier to obtaining the highest quality care and the ability to obtain medical insurance,” she reported in her thesis.
The study points to a local need for trained translators at medical facilities and gives insight into how Hispanics access healthcare in East Tennessee, Adorati said in her concluding remarks. She also said more research in this area is needed.
This story was written by Bonny Millard, a freelance writer for the Office of Communications.