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Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants in northern Colorado. The program was implemented by a migrant/community health center in rural northern Colorado based on findings from an in-depth health needs survey of the target population. The program consists of community outreach services vertically integrated into the main medical clinics, which comprise Salud Family Health Centers. A mobile unit went to nontraditional areas identified by community workers as gathering places for Mexican immigrants. Services provided included preventive health care (screening for diabetes, hypertension, mental health problems, dental problems, and HIV); education; and primary care for acute problems. Patients were referred to a health care home for ongoing care. In the first 6 months, 1,553 Mexican immigrants were seen on the mobile unit. Hypertension and psychosocial problems were the most common problems in this population. Thirty-five percent of patients who received consultation in the mobile unit have visited any of the clinics for follow-up within the following year. A community-based mobile outreach program targeted toward Mexican immigrants can be effective in uncovering medical and mental illness and in directing patients to a health care home. This is an important first step in eliminating health disparities among this population.

Participants in this study were 300 Mexican women of rural origin who were born and raised in villages of that country and who belong to one of three groups: married and living with their husbands in Los Angeles, California (n = 100), married to migrant workers but living in Mexico (n = 100), and living in Mexico with their spouses (n = 100). Trained female professionals conducted face-to-face interviews in Spanish, in Mexico and in the United States. The purpose of this study was to identify specific sexual practices, coping strategies in sex-related situations, and fears and concerns regarding sexual intercourse. This article analyzes how these elements place Mexican rural-origin women at risk for HIV/AIDS. It discusses the need to design intervention strategies to prevent HIV/AIDS that take into consideration the limited power of women in traditional societies and the cultural precepts that promote gender roles characterized by male dominance and female submissiveness in the sexual arena.

Objectives: To describe how all-payer claims databases (APCDs) can be used for multistate analysis, evaluating the feasibility of overcoming the common barrier of a lack of standardization across data sets to produce comparable cost and quality results for 4 states. This study is part of a larger project to better understand the cost and quality of healthcare services across delivery organizations., Study Design: Descriptive account of the process followed to produce healthcare quality and cost measures across and within 4 regional APCDs., Methods: Partners from Colorado, Massachusetts, Oregon, and Utah standardized the calculations for a set of cost and quality measures using 2014 commercial claims data collected in each state. This work required a detailed understanding of the data sets, collaborative relationships with each other and local partners, and broad standardization. Partners standardized rules for including payers, data set elements, measure specifications, SAS code, and adjustments for population differences in age and gender., Results: This study resulted in the development of a Uniform Data Structure file format that can be scaled across populations, measures, and research dimensions to provide a consistent method to produce comparable findings., Conclusions: This study demonstrates the feasibility of using state-based claims data sets and standardized processes to develop comparable healthcare performance measures that inform state, regional, and organizational healthcare policy.