How to tackle major health care challenges.

Closing the Hispanic Health Care Gap

When it comes to accessing health care, Hispanic Americans face a unique set of challenges.

By Dr. Sonali Saluja

Health care access is an issue for many people in the U.S. But a unique set of challenges puts the country’s Hispanic population at greater risk for facing access barriers — and that needs to change. Hispanic Americans see higher rates of chronic conditions such as diabetes and obesity than other groups; this issue often is intertwined with challenges in accessing preventive care and/or hesitation (stemming from a variety of concerns) about obtaining preventive care.

We know from tracking COVID-19 data that eliminating those barriers can help reduce disparities in outcomes. Even though Hispanic populations were more likely to test positive for the virus and die from the virus than white populations, Hispanic people who were hospitalized for COVID-19 treatment were less likely than white patients to have severe symptoms or to die from it, according to a study by NYU’s Langone Health published in December 2020. In short, closing the access gap has a huge impact on outcomes.

The first major barrier is insurance coverage: The Hispanic population has the lowest rate of insurance of any racial or ethnic group in the country. Just 82% of Hispanic individuals are insured, compared with 95% of non-Hispanic whites and 90% of African Americans. But while the Affordable Care Act’s expansion of Medicaid has paved the way for the possibility of insurance for many, it’s a mistake to think that access to insurance automatically translates into access to health care. For example, for recent immigrants, navigating an extremely complicated health care system in a language they may not be comfortable speaking can make difficult tasks — like finding a primary care provider who accepts your insurance — even more daunting.

Young Hispanic American mother and father holding a baby.

Cactus Creative Studio/Stocksy

Social determinants of health (SDOH) can also have a huge impact on the health outcomes of Hispanic Americans. A 2019 study conducted by Salud America identified three key SDOH that affect the health of those in the Hispanic community: a lack of affordable housing, unreliable public transportation and lack of access to green spaces. Combined, these factors can impact the ability of Hispanic communities to thrive and achieve health equity.

I’ve been encouraged by patient navigation initiatives, which aim to tackle these problems by making dedicated health care professionals available to connect patients to the resources they need. In my home county of Los Angeles, for example, the Department of Public Health’s Children’s Health Outreach Initiatives is working to connect patients to available services using a model called OEUR (outreach, enrollment, utilization, retention). Staffers conduct follow-up calls with clients and help them troubleshoot problems, among other things. We are currently studying this model, and the preliminary results look promising. This is a program that could easily be adopted elsewhere.

LA County’s My Health LA program provides free primary care and some tertiary care for immigrants who are ineligible for Medicaid. Similar programs are growing across the state of California and in other areas, including New York City. I’ve also seen an increase in health care information available in multiple languages. But while these resources are growing, they are still far from available across the board.

With concerted effort, we as providers have the power to reestablish trust with Hispanic communities and address inequities head-on, giving them the power to access the care they need.