September 15 through October 15 is National Hispanic Heritage Month, a time to reflect on and celebrate the history, culture, and achievements of our country’s diverse Hispanic and Latino communities.
It’s also a time, in the medical world, to confront a hard truth: Healthcare for the people of these communities isn’t what it could be. For example, when a recent Pew Research Center survey asked Hispanic Americans why their community faced health disparities compared to other Americans, 27% said a major reason was that providers gave their well-being lower priority, while another 33% said this was at least a minor reason.1 And while 51% of Hispanic adults think health outcomes for Hispanic people have improved over the past two decades, another half of Hispanic adults reported negative experiences like feeling rushed or not taken seriously in a healthcare context.2
One obvious challenge to equitable care for these communities is the language barrier. The Spanish/English divide is an important issue when considering health disparities: Studies show that language concordance leads to stronger trust and higher patient satisfaction.3 An estimated 42 million Hispanic Americans in the U.S. consider Spanish to be their first language and use it at home.4 And about a third of Hispanic Americans say they prefer to see a healthcare provider who speaks Spanish.2 If we hope to meet the needs of the 21st century, there is no question that we’ll need increased language flexibility and fluency among providers.
But there are other factors to consider as well.
Not a Monolith
While there certainly are salient, general facts about healthcare and Hispanic Americans at large — for example, that they’re less likely than people of other backgrounds to have health insurance1 — it's important to remember that this broader community is not a monolith, but rather a mosaic of people with nuanced identities. It includes individuals with ancestral and cultural ties to at least 20 different countries of origin.6 And it doesn't stop there. In a study and analysis of the most recent U.S. census, which separates out race and ethnicity questions for Hispanic Americans, 58% said their race was white, with 27% checking off the "some other race" box, 8% selecting "two or more races," and 2% selecting "Black or African American."7
Factors such as racial diversity within the Hispanic/Latino population point to additional, more nuanced disparities: Black Hispanic adults, for example, are 15% more likely to say they’ve received lower-quality medical care than their white Hispanic counterparts.2
What this all boils down to is that there isn’t a one-size-fits-all answer when it comes to healthcare for Hispanic and Latino Americans.
Meeting People Where They Are
Complex problems require complex solutions. In order to meet the needs of these growing communities, we have to be nimble and adaptable. And we must acknowledge the diversity and dynamism of the people we serve. Yes, translating patient education into Spanish is vital, but it's not the only way to make content more accessible and useful to these audiences.
For example, WebMD Ignite recently produced a series of brochures about healthy food choices for those with diabetes, offering not only general guidance about food groups and macronutrients, but also tips for diabetes-friendly cooking and eating within specific cuisines, such as Mexican, Puerto Rican, and others from around the world. These pamphlets identify culturally familiar dishes that are already diabetes-friendly, as well as recipe ideas and ingredient substitutions to make other favorites more beneficial to the reader's blood sugar levels.
The Power of Data
But patient education and communication aren’t the only areas with room for improvement. We know, for instance, that detailed ancestry information can help us save lives. This is because people of different backgrounds display different rates of genetic predisposition to disease. For example, groups from the Caribbean develop glioma tumors at higher rates than those from Central America.8 Or take bronchial asthma — it’s a bigger problem for people of Puerto Rican descent than it is for those from Mexico.8 The list goes on, and yet, despite the potential importance of such information, many hospitals have room to grow in the way they compile data on their patients. If we expand our datasets to include information like place of birth and migration history, we can fine-tune and personalize care — not to mention assess risk — for those who need it.9
Going Local
Understanding how to reach people practically and effectively is also key. Even when we can’t fill in all of the knowledge gaps, we can lean on and empower those who can: Promotores de salud, a Spanish-language term for community health workers, are often highly in-touch with the communities they serve. Sometimes directly funded by the CDC’s Racial and Ethnic Approaches to Community Health (REACH) program, promotores can help underserved communities by teaming up with local health departments, clinics, churches, and schools to provide education and informational get-togethers on best health practices and tips on navigating the healthcare system.10 By building trust with a variety of local groups on the ground, the promotores help improve health outcomes.
The More We Know
The Hispanic population is projected to constitute 28% of the total U.S. population by the year 2060.11 If we hope to improve outcomes for this community, we must take steps toward bettering our knowledge of its unique needs. This National Hispanic Heritage Month, let’s celebrate what we accomplish when we come together — and face the future with a stronger understanding of how far we still need to go.
Sources:
- https://www.pewresearch.org/science/2022/06/14/hispanic-americans-experiences-with-health-care/
- https://www.pewresearch.org/short-reads/2023/10/30/5-facts-about-hispanic-americans-and-health-care/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9959935/
- https://cvc.cervantes.es/lengua/espanol_lengua_viva/pdf/espanol_lengua_viva_2016.pdf
- https://latino.ucla.edu/research/latino-population-2000-2020/
- https://dceg.cancer.gov/about/diversity-inclusion/inclusivity-minute/2022/disentangling-identities-hispanic-latino-americans
- https://www.pewresearch.org/race-and-ethnicity/2021/11/04/measuring-the-racial-identity-of-latinos/
- https://www.aamc.org/news/how-recognizing-diversity-among-hispanics-could-improve-health-outcomes
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667592/
- https://www.brookings.edu/articles/latinos-often-lack-access-to-healthcare-and-have-poor-health-outcomes-heres-how-we-can-change-that/
- https://www.census.gov/library/visualizations/2018/comm/hispanic-projected-pop.html
