Karina Barillas and Eva Melissa Astudillo, La Casita Center – Guest Contributors

In December 2021, La Casita Center in Louisville, Kentucky, conducted a survey to members of their community including those who are Latinx, immigrant, or Spanish-speaking to better understand the community’s utilization of health insurance, telehealth services, and barriers to accessing coverage and care. Project designed by the consulting team of La Casita Center in collaboration with Kentucky Youth Advocates. Data was collected via in-person questionnaire, phone, and social media polls.

Below La Casita Center provides information about the importance of this research and recommendations that come from the recent findings.

This project focused on hearing the voices of those that are often overlooked by the system and mainstream, with the hope of elevating their voices to evoke systemic change and encourage policies that are inclusive to all communities. Even though the survey represents a limited sample, we have learned from the community through our 17 years of work, advocating for families to thrive. This survey presents, with data, the realities and stories that we have heard from our families for many years. The survey shows the many challenges that our communities face when accessing resources and the many invisible barriers that the systems place intentionally or inadvertently, preventing families from accessing quality health care. This increases the gaps and inequalities that put families at risk and in more vulnerable situations for their health and wellbeing.

Equitable access to health care by immigrant communities is more than a question of language access, it requires intentionality, inclusivity and to have the community sitting at the table when things are being developed to truly and meaningfully reach to families that have been long marginalized.


  • Culturally relevant campaigns and meaningful access to those resources. We learned through this survey that the community doesn’t have easy/meaningful access to information and resources. Many times, information is available only on websites and only in English. Even with translation, some participants describe the process of searching for health insurance as complex, difficult to follow, and intimidating. Translations are not always culturally relevant, meaning that the concepts will not resonate with communities. They are also not very inclusive for different literacy levels, and in many cases, since translation is “automatic” will only translate the “text” of the website leaving in English the PDFs, infographics/flyers, and videos, which are usually a more inclusive distribution format.
  • Publish in platforms that people use and trust. We have also learned through years of experience and work that the Latinx community tends to utilize communication platforms more than websites. This includes the local Spanish Language Media and social media platforms like Facebook, WhatsApp, and Youtube. The community will follow Facebook pages or join groups of organizations that they highly trust, like La Casita Center, as the platforms to get information from.
  • Quality language access. An often named barrier by the Latinx immigrant community was the difficulty of finding information in their first language. This is something that can be a discouraging factor when calling, researching, and trying to access resources or information in the first place. We learned from the indigenous groups that finding things in Spanish was challenging, and virtually impossible to find interpreters for indigenous languages. It is often assumed that Spanish is the only first language for the Latinx community. A recommendation would be to focus on the recruitment of a diverse and multilingual workforce that can better relate, and support individuals in the target language.
  • Outreach campaigns in collaboration with trusted organizations. The community outreach approach is highly important for campaigns to be successful. Organizations such as La Casita Center have long histories of working with the community, developing and honoring their trust. Working in collaboration with trusted organizations, and listening to their wisdom, is instrumental when building meaningful, inclusive, and effective campaigns.
  • Inclusive policies. The main barriers identified and named by the community were systematic barriers. This includes policies that prevent entire communities from accessing resources. Most people who responded to the survey shared that they would not apply or try to access health insurance because they would not qualify. In many cases they even opted to not apply, advised by lawyers and fearing that it would negatively impact them in their residency path in the future. There is a high distrust of policies and government since they fluctuate based on the political climate, putting people in harmful situations for their immigration process.

The Kentucky Oral Health Coalition and Kentucky Youth Advocates appreciate the partnership from the entire staff of La Casita Center who supported this project and insight shared by the community. Kentucky can be strongest when we work together to ensure all members of the community are safe, healthy, and thriving.

You can view the full report here