Social determinants of health among uninsured Spanish-speaking patients in Florida

Social determinants of health (SDOH) such as occupational exposures, income status, education level, and language barriers contribute to poor health outcomes among uninsured populations. Migrant and seasonal farmworkers (MSFW) are particularly affected. Identifying structural and environmental factors impacting MSFW can provide valuable insights for addressing patient needs. Further research is needed to uncover additional factors that impact the health of this vulnerable population. The aim of this study is to identify the SDOH that impact MSFW and other Spanish-speaking uninsured patients, with the goal of improving care. Patients at two student-run free clinics in Florida were surveyed to assess SDOH using the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE), a nationally standardized survey. Upon completion, participants were provided with a list of local community resources. A total of 77 patients completed the survey. Spanish was the primary language of 97.4% of respondents, 24.7% reported farmwork as their primary source of income, and 87.0% were uninsured. Participants reported significant barriers related to accessing basic needs, including insecurity in transportation (35.1%), food (41.6%), clothing (38.9%), and medical care (44.2%). Additionally, 45.5% of respondents had less than a high school education, potentially impacting health literacy. Significant social and structural barriers affect MSFW and Spanish-speaking uninsured patients including access to basic needs. Low educational attainment and limited English proficiency further compound these challenges. Addressing these SDOH through targeted interventions and resource integration in free clinics may promote health equity in this vulnerable population.