Comparing government-sponsored and community-based safety-nets for health and wellbeing among Latiné adults in California.

Abstract

Objectives: Latiné populations in the United States face a persistent health and mental health burden, in part driven by stressors associated with social determinants of health. In response, it is critical to develop a nuanced understanding of Latiné communities' perceptions of government- and community-based social safety-net services, both as distinct and interacting systems, designed to support health and social needs of Latiné adults.

Design: We conducted semi-structured interviews with Latiné adults (N = 13) in English and Spanish to explore perceptions of and experiences with government-sponsored and community-based safety-net services, as well as the implications for health and wellbeing. A thematic analysis approach was used to identify emergent themes.

Results: Themes highlight shared and unique factors that enable and inhibit access to safety-net services from government- and community-based systems. Awareness of safety-net services and their benefits facilitated access to both systems, but knowledge of rights surrounding eligibility enabled access to government-based services in particular. In contrast, limited awareness of service availability and concerns about quality of services created barriers to access across both community- and government-based services. Unique to government-based services, complex and burdensome application processes, mistrust, and stigma associated with using public assistance were highlighted as barriers.

Conclusion: Findings provide critical insights to improve Latiné communities' access to safety-net systems to support health and wellbeing. Our results highlight the need to: strengthen communication strategies to inform resource awareness and counteract misinformation; rebuild trust between government institutions and communities; reduce stigma and shame surrounding safety-net service utilization; simplify bureaucratic processes for using government safety-nets; and foster connections between community and government systems to enhance access to services that address upstream social determinants of health. These strategies represent steps towards building more accessible safety-net systems to support the health and wellbeing of Latiné communities.