For the first time in the nation's history, minority babies, including Hispanics, made up the majority of the U.S. birthrate last year, according to the Census Bureau. And the Affordable Care Act is expected to pump millions of uninsured patients into the health care system in the near future, many of them whom speak primarily Spanish. Is your hospital prepared to provide doctors and nurses who can navigate the language and cultural barriers that this trend will create?
That was one of the questions raised during a Web seminar hosted last week by Excelencia in Education, a Washington, D.C.-based nonprofit working to bolster Latino success in higher education. Health literacy in the Spanish-speaking community is disproportionately low, Russell Bennett, vice president of Latino Health Solutions with United Healthcare, said during the seminar. Hispanics make up more than 16 percent of the country's population, but the proportion of total doctors is less than 4 percent, and even lower for nurses and dentists.
"Latinos are the most uninsured population in our country today," Bennett says. "However, with the modernization of health care, it's projected that some 9 million Hispanics will enter the insured health care system over the coming years. Many of those newly insured Hispanics will be seeking services from Hispanic health professionals, and our country continues to suffer from a disparity between patient need and health professional availability in terms of language and culture."
Excelencia analyzed the top 25 schools in graduating Latinos in health professions, and released its findings on May 16. Among them, the nonprofit says Hispanics are more likely to land lower-paying jobs in the health care workforce, they're largely earning lower-level certificates or associate degrees, and the top undergraduate institutions are concentrated in just six states — Texas, Florida, California, Arizona, Illinois and New Mexico.
Bennett says barriers keeping Latinos from becoming doctors include a lack of awareness of the earning possibilities, and the long course of studies. Populating the health care workforce with Latino primary care physicians is critical to serving that population, says Mayra Alvarez, director of public health policy in the Office of Health Reform at the Department of Health and Human Services.
"It's hard to take control of your health care if we don't have a primary care provider to answer your questions," she says. "And for Latinos, when one in three doesn't have health insurance and one in two doesn't have access to a consistent doctor, we have tremendous barriers in front of us."
So what can leaders in the C-suite do so their hospitals are helping to break down those barriers? In addition to hiring more Latino doctors, CEOs can make sure that their staff is prepared for the changing population they'll be serving, and aware of cultural preferences toward grooming, grieving and end-of-life practices, Fred Hobby, president and CEO of the American Hospital Association's Institute for Diversity in Health Management, said when I spoke with him last week. CEOs can help foster "culturally competent care," he says, by adding Latinos to both their board of directors and their senior leadership teams.
Hospitals must also make sure that Spanish translators have the needed medical expertise to bridge the gap between patient and doctor.
"Just because I have two hands doesn't mean I can play the piano, and just because I speak two languages doesn't mean I can be an interpreter," Hobby says. "It's really important that the people we use as interpreters in a health care setting are trained and tested for their mastery of both English and Spanish, and medical terminology."
Hobby says the institute also encourages hospitals to perform "cultural audits" to determine whether there are populations in their community going underserved, as well as to assess employees' attitudes toward serving those populations.