Caring for Latinos requires more than knowing Spanish
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Few nursing home residents have received second COVID-19 vaccine dose
      Fresenius building renal genomic registry to inform precision care for kidney disease
      clinic_2.jpg
      Cleveland Clinic project expected to create 1,000 R&D jobs, lands state tax credits
      The missing piece in our fight against COVID-19: primary care
    • Few nursing home residents have received second COVID-19 vaccine dose
      The missing piece in our fight against COVID-19: primary care
      Google to convert office space for COVID-19 vax clinics
      The Check Up: Dr. Joseph Kerschner
      The Check Up: Dr. Joseph Kerschner of the Medical College of Wisconsin
    • Ascension’s St. Mary’s Hospital Surgery Center at Towne Centre and Allegheny Health Network’s Bethel Park surgery center
      Hospitals see opportunity, risk in ambulatory surgery centers
      Health suffers as rural hospitals close
      Medicare ACO participants fell in 2021
      Louisiana gets reports vaccine providers are discriminating
    • MAIN-Health Bill_iStock_i.jpg
      Insurance-tech firm MultiPlan makes $155M buy after blank-check deal
      Last-minute COVID costs cut into UnitedHealthcare's $396 million operating income
      CMS approves rule forcing insurers to ease prior authorization
      COVID-19 still a big uncertainty for insurers in 2021
    • It's a secret: California keeps key virus data from public
      lacewell_linda_supertinendent_dept_of_financial_services_8.47.jpg
      New York state investigates drug price spikes during pandemic
      Health experts blame rapid expansion for vaccine shortages
      HHS freezes rule targeting community health centers' drug discounts
    • KPMG says deal activity will stay high in '21: 10 takeaways
      By the Numbers: 20 largest healthcare investment banks in 2020
      Providers await new HHS coronavirus grant reporting deadline
      Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
    • Google to convert office space for COVID-19 vax clinics
      Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next 4 years - Transcript
      A man in a room with servers.
      Momentum grows to outsource hospital tech functions in 2021
    • China pushes conspiracy theories on COVID origin, vaccines
      Avocado
      Avocado a day keeps the doctor away
      50% of Americans make resolutions. Fewer than 27% keep them over time.
      Data Points: Sticking with your resolutions
      An older man wearing a mask receiving a vaccine.
      Want more diversity in clinical trials? Start with the researchers
    • WEb_i.jpg
      Q&A: Dr. Cliff Megerian, University Hospitals' soon-to-be CEO
      ZentyWeb_i.jpg
      Tom Zenty is leaving a legacy of transformational growth at University Hospitals
      Cerner names Erceg as new CFO
      Elizabeth Richter will serve as acting CMS administrator
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Dr. James Hildreth
      How medical education can help fight racism
      Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Quotes from rebadged employees
      Outsourcing IT, revenue cycle takes toll on internal culture
    • A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
    • Regional insurers bet big on virtual-first plans
      MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • The missing piece in our fight against COVID-19: primary care
      Ambulatory surgery centers offer extraordinary value in a high-cost healthcare system
       Alan B. Miller
      Looking ahead with optimism as we continue to transform healthcare
      Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • bright.md logo lockup webinar
      Sponsored Content Provided By Bright.md
      Webinar: Enabling a hybrid care model — Streamlining the patient path to both telehealth and in-person care
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Next Up Podcast: Saving Rural Health
    • Beyond the Byline: Regulators aim to boost value push with fraud and abuse law updates
      An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Dr. Joseph Kerschner
      The Check Up: Dr. Joseph Kerschner of the Medical College of Wisconsin
      The Check Up: Chip Kahn
      The Check Up: Chip Kahn of the Federation of American Hospitals
      The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
September 08, 2018 01:00 AM

Caring for Latinos requires more than knowing Spanish

(Se necesita saber mas que Español para servir a los Latinos)

Maria Castellucci
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    Bill Healy

    Griselda Cruz and her children, shown with CEO Esther Corpuz, left, visit Alivio Medical Center for pediatric and women's healthcare.

    For Griselda Cruz, the long drive from her home in Indiana to Alivio Medical Center in Chicago is well worth it.

    Cruz, 25, likes that she can speak with the Alivio providers in Spanish, her first language. She also feels they take good care of her and her three young children.

    Cruz visits Alivio for pediatric and women's healthcare appointments. “If my children are sick, they can see them on the same day,” she said in the waiting room of one of Alivio's clinics in the city's Little Village neighborhood, which has a predominantly Latino population.

    Alivio, a federally qualified health center that opened in 1989, has a mission to provide culturally competent care to Chicago's Latino community. It only employs providers who can speak both English and Spanish and offers services taking into consideration the population's unique needs.

    Alivio's tailored approach to serving the Latino population is becoming increasingly necessary across the country as the healthcare system tries to catch up with those growing demographics. In Chicago, Latinos represent an estimated 29% of the population as of 2017, according to the U.S. Census Bureau.

    But providers like Alivio are an anomaly.

    Even with the quickly changing landscape in the U.S., experts think healthcare systems aren't prepared to adequately treat the Latino population, which has unique healthcare challenges and needs. (For the purposes of this story, we're using Latino instead of Hispanic, which is the term used in census data that includes all Spanish-speaking people.)

    Latinos are 50% more likely to die from diabetes or liver disease than whites. They are also 23% more likely to be obese.

    Only a few healthcare systems—even those in areas with a large Latino population already—have invested in services targeted for Latinos beyond language services, which hospitals are legally required to provide under the Civil Rights Act.

    “In order to provide high-quality care to this sizable and growing population, it's vital to consider language and culture,” Alivio CEO Esther Corpuz said. “When I was trying to sell to hospitals how important it is to have bilingual, bicultural providers, I would tell them it affects quality scores. You can imagine if things get lost in translation, mistakes can happen—medical errors.”

    Melissa House exams patient during monthly pregnancy check-up.

    Melissa House, a bilingual nurse practitioner at Alivio, exams Brenda Salmeron during her monthly pregnancy checkup. Salmeron said she found out about Alivio through a friend and likes that she can speak to her provider in both English and Spanish. (Bill Healy)

    A new Health Affairs study that showed California, which in 2015 became the first state in the nation to see the number of residents who identified as people of color eclipse whites, now has better outcomes than the rest of the nation because of the state's diversity. The study found all populations except for blacks had lower rates of mortality and infant mortality and higher life expectancy than the national averages. The major drivers were better outcomes among both Latino and Asian populations, which combined make up 52% of the state's population and had lower mortality and higher life expectancy than whites. One factor was that communities of color cater to their residents' needs.

    The pressure is on for healthcare systems to offer services like the ones at Alivio. Latinos made up 18% of the U.S. population in 2017, accounting for half of the population's growth since 2000. A statistic that should concern providers is that 17% of Latinos are uninsured, the highest rate among all ethnicities, meaning the growing population may also lean heavily on providers' uncompensated-care budgets.

    Additionally, census data projections show 24.6% of the population will be Latino by 2045, and the U.S. will be minority white.

    The healthcare workforce doesn't reflect these demographic characteristics. There are only 105 Latino physicians per 100,000 Latino patients, compared with 315 white physicians per 100,000 white patients, and research shows the disparities are only getting worse.

    “I wish it were as simple as language but I think it's more complex. There is culture, socio-economics, social determinants of health—many things that I think are very real for patients across the country that need to play into how the healthcare system adapts to the healthcare population they are trying to serve,” said Dr. Gloria Sanchez, associate clinical professor of the David Geffen School of Medicine at UCLA, who conducted a study of Latino physicians. “I hate to say it but they (providers in states with large Latino communities) are not ready.”

    The states with the largest populations of Latinos by percentage are New Mexico, California and Texas. Healthcare systems in those states offer a variety of approaches.

    The methods vary(Los metodos varian)

    Presbyterian Healthcare Services, based in Albuquerque, offers some services in Spanish, but doesn't have programs or initiatives specifically for the Latino population, according to a spokeswoman.

    Houston-based Memorial Hermann also doesn't provide programs targeted at Latinos. Instead, the health system implements programs focused on patients' insurance status or disease, said Carol Paret, senior vice president and chief community health officer. “Houston is certainly a multi-ethnic community, so we find that there are more important kinds of breaks in populations rather than just ethnicity,” she said. “Houston has a huge uninsured population, so we deal with that population.”

    Texas, which didn't expand Medicaid, had a 16.6% uninsured rate in 2016, the highest in the U.S. According to 2010 census data, 39.4% of the population was Latino.

    Memorial Hermann tries to enroll the uninsured and Medicaid populations who are high users of the emergency room in medical homes. The system also hires patient navigators who are bilingual. The goal is to set patients up in a model that will work best for them. “We do this at the individual patient level,” Paret said. “What do you need and what will work for you?”

    Albuquerque-based Lovelace Health System and Oakland, Calif.-based Kaiser Permanente have both made more targeted approaches to care for the Latino population. About 38% of Lovelace's patient population is Latino, according to Dr. John Cruickshank, CEO of the system's medical group. Because of that percentage, “We really need to pay a lot of attention to meeting the needs of that group culturally.”

    Lovelace, which operates five hospitals in New Mexico, opened a clinic early last year in a predominantly Latino neighborhood in Albuquerque because there were limited healthcare options there. Lovelace also hired a bilingual Latino physician to work there.

    Designing an app(Diseńando una 'app')

    Lovelace is also currently working with the National Institutes of Health and the National Cancer Institute on a mobile app targeted at Latino women to manage their diabetes. The app is still in development, but Lovelace plans to roll it out to its patient population during the pilot phase.

    “It's important to focus our work on women; the Latino family structure is a matriarchy, so they are making a lot of decisions about diet and how the family receives healthcare,” Cruickshank said.

    Kaiser Permanente has focused on training its workforce to understand and consider the unique culture of Latinos. One of its programs offers education to physicians about Latino culture and how it might affect care. For instance, classes touch on how to address religious beliefs and any alternative care Latino patients might be seeking outside of traditional Western medicine, such as herbal treatments.

    Seniors gathering at Casa Maravilla.

    Seniors gather for meals and coffee every day at Alivio's Casa Maravilla, a housing and activity center for adults ages 55 and over. The center opened in 2011 and provides meditation, fitness classes and wellness courses. (Bill Healy)

    “We want to make sure our staff are all trained so they know how best to care for our patients, and it's not only about language but cultural nuances,” said Dr. Gina Gregory-Burns, physician director of diversity and inclusion at Kaiser Permanente.

    Kaiser also provides English and Spanish education classes for patients on different diseases like diabetes and hypertension. Weight loss and emotional wellness sessions are offered, too. A bilingual health educator typically runs the classes.

    Lack of insurance also can prevent Latinos from seeking care, allowing conditions to worsen, Alivio's Corpuz said. To address this, the center deploys a mobile wellness unit to different parts of the community to let residents know healthcare is an option for them even if they lack insurance. As a federally qualified health center, Alivio offers free services to those who qualify and charges others on a sliding scale determined by their income. A typical visit costs $30.

    Problems that haven't been solved(Problemas que no se han resuelto)

    Although hospitals are required to offer interpreter services to patients, it's much more beneficial if the provider can speak in the patient's preferred language, Corpuz said.

    Corpuz said it's become increasingly more competitive to recruit providers who speak Spanish because the pool of options is not only small, but more hospitals are realizing such providers are an asset.

    Efforts and initiatives to improve those numbers are underway. A program at UCLA, called the International Medical Graduate Program, recruits immigrants from Latin America with medical degrees to complete their residency training in primary care. The program helps students pass the U.S. medical board examinations, which can be difficult without the additional help because of differences in testing practices.

    The doctors are then required to work in an underserved community with a high Latino population for at least two years. A large majority of the doctors—75%—choose to stay in the community after the two years are up, said Dr. Michelle Bholat, executive director of the program.

    A total of 128 students have participated in the program since it started in 2007. “No other program in the country exists that does this, and we hope that we can take this concept and make it work in the Southeast and North,” Bholat said. “It is about serving your community and where your community is missing doctors.”

    Finding the right providers has been essential to Alivio's approach, which emphasizes the fact that all parties benefit if culturally sensitive care is provided properly. “It's not just about patient experience,” Corpuz said. “It has an effect on compliance and really the whole continuum of care.”

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Hospitals see opportunity, risk in ambulatory surgery centers
    Hospitals see opportunity, risk in ambulatory surgery centers
    Health suffers as rural hospitals close
    Health suffers as rural hospitals close
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing