A recent national survey conducted by Florida Atlantic University’s Business Survey and Economy Initiative has found that about one in five Hispanic women, and one in 10 Hispanic men, in the United States are still without health insurance.

According to Fox News Latino, a little more than 21% of Latino women in the U.S. do not have medical insurance, which is more than twice the rate of all Hispanics in the United States. The study, which was released Thursday, found that rates for Latino women with health care has not seen significant improvement over the last year. The sample surveyed includes 529 Hispanics across the country and has a margin of error at a little over 4%.

Last year, 22.6% of Hispanic women were without health insurance, which is only about a 1% drop in the last 12 months. The rates of health insurance coverage are better for Hispanic men; only 9.8% of them are without medical insurance.

Director of Florida Atlantic University’s Business Survey and Economy Initiative, Monica Escalaras, says that “possible explanations for the gender difference in healthcare coverage and affordability can be that women on average have lower incomes than men so they have a harder time paying for health care costs.”

What is troubling about this is that more than 31 million injuries that require a doctor’s care occur each year in the United States, but those who are uninsured are less likely to seek treatment.

According to The Huffington Post, there are a few factors that may be causing such high rates of uninsured people among the Hispanic population in general. One of them is that many Latinos in American are immigrants who are more likely to work jobs that do not offer health insurance. Even if employers do offer health insurance, it is often prohibitively expensive.

Additionally, language proves to be another barrier which may be keeping Latinos for signing up for health insurance. The translations for health insurance exchange at the state and the federal level were littered with mistakes like the word “prima” for premium, which actually translates to “female cousin.” Rather than having a Spanish speaker translate, some states opted to use translators like Google Translate, which are prone to errors.

Though the rates of uninsured Hispanics are improving, there are a number of different factors that complicate the issue, like immigration status, communication, and application processes. Some states do offer safety-net type programs that do not discriminate based on income or immigration status, to serve those who are uninsured or underinsured.