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, 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.