Many In Latino Community Lack Health Insurance

Mon, December 12, 2011

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KMUW / Fletcher Powell

The number of Hispanic and Latino children in Wichita schools has doubled over the last decade, and is expected to grow larger than the number of white students within five years.  This is reflected in national trends, as the number of Latinos has doubled and tripled in areas throughout the United States in recent years. But as Latinos are becoming the largest minority group in the country, they are also, by far, the least likely racial group to have health insurance.

The story begins with the numbers. According to the Centers for Disease Control and Prevention, a full third of Latinos under the age of 65 in the United States don’t have health insurance. That number is almost 50 percent higher than African-Americans, and twice as high as the uninsured rate among whites. The numbers in Kansas aren’t any better, with a 37 percent uninsured rate among Latinos in the state, compared to only 11 percent for whites, according to the Kaiser Family Foundation.

And taking undocumented immigrants out of the equation? The numbers hardly change at all.

One of the most apparent factors behind this huge gap is socioeconomic. Kaiser says that a similar number—34 percent—of Latinos also live below the poverty line.

Emira Palacios is the immigrant initiatives coordinator for Sunflower Community Action, a Wichita non-profit that advocates for low-income individuals and immigrants in the city. Palacios, herself an immigrant from Mexico, says that what she sees is that a lot of Latinos simply don’t have the same kinds of opportunities to find health insurance:

Palacios:  …and so that’s part of the problem that this… Latino community, a lot of them work in places where they don’t even offer health insurance. And even if they do, you know, Latinos have to, you know, decide whether they put their money into getting health insurance or food on their table, in many cases.

And the statistics bear this out. While two-thirds of whites report they have some kind of employer-sponsored health coverage, only a third of Latinos say the same thing.

Palacios says, from her perspective, it seems like sometimes people just don’t want to make waves by asking too many questions about things like health insurance:

Palacios: And so a lot of times, you know, we don’t want to, as Latinos, we don’t want to upset the supervisor… so we try to keep ourselves straight, do our job, not get into any trouble… Because we care about our job, it’s our livelihood, that sort of thing.

But this can’t be all of it. The poverty rate among African-Americans is similar to that of Latinos, but we don’t see nearly the same level of uninsured.

Gracia: Well, sometimes some of the challenges may just be knowing how to actually access services, and so that may be from a standpoint of accessing culturally and linguistically appropriate services and difficulty knowing what programs that they may be eligible for but also how to apply for and seek insurance if they don’t have that through their employer-based coverage.

This is Dr. J. Nadine Gracia, the acting director of the Office of Minority Health at the US Department of Health and Human Services. And what she says about offering services that are appropriate for the Latino community can make a huge difference. It’s not hard to imagine that if all of your health care information is in a language that you don’t understand very well, not only are you less likely to ask questions, but you might be less likely even to know what to ask. And it’s important to remember that cultural differences can make people look at their health care differently, too.

Gracia: ...there’s a great need to have that cultural competency to understand there are different health beliefs, different cultural practices, so, yes, there may be differences as far as when Latino populations will seek care and what type of care they’ll seek and who they’ll actually seek it from.

Both Gracia and Palacios point to increasing education and awareness among Latinos as an approach to closing the insurance gap, helping people simply to have the information necessary to be able to ask questions and make decisions. Gracia talks about a grassroots movement toward what are called “promotores de salud,” or promoters of health—knowledgeable members of each community who can provide reliable information in ways that make sense to the people around them:

Gracia: So they’re viewed as trusted individuals who understand the community and can provide and be a great resource to Latinos in the community to provide health education, to help connect them to health care services, and to help them navigate through the health care system, but also to be a resource to let them know about other services that they may need.

But Dr. Gracia says that, while education and outreach are important, it’s vital that Latinos also have access to high-quality primary care. And she says this is something that she expects the Affordable Care Act—last year’s health care overhaul—to go a long way toward addressing:

Gracia: And one of the investments that we’re making is into community health centers, for example, which have a long history of providing quality primary care in communities that really are largely underserved communities. And so making an investment of $11 billion over five years to expand the construction and services offered in those community health centers is a vital way, so that once Latinos enter the health system, that they’re also receiving the quality health care.

Of course, as Gracia and Palacios both point out, Latinos and Hispanics are not a homogeneous group. Gracia says that, for example, Puerto Ricans are more likely than other Latinos to have asthma, Mexicans are more likely to have problems with diabetes. And she says because of this, they’re taking steps to recognize these differences by expanding the categories in their data collection:

Gracia: So, as opposed to only classifying as Hispanic-Latino, we will now have those subpopulations of Mexican, Mexican-American, Chicano, Chicana, Puerto Rican, Cuban, and other Hispanics to be able really to see if there are further disparities in those sub-populations and try to address them.

The U.S. Census Bureau projects 30 percent of the nation to be Hispanic by the year 2050. And as the face of the country changes, the hope of people like Dr. Gracia and Emira Palacios is that these investments will help close the health care gap well before that time.

From the Office of Minority Health at the US Department of Health and Human Services:

The first website in Spanish to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool.

http://www.cuidadodesalud.gov/enes/

Funding for KMUW’s Sound Mind & Body series is made possible, in part, by Via Christi Health.