By Anabell Castro Thompson, MSN, APRN, ANP-C, FAAN, FAANP
The COVID-19 pandemic focused some long-overdue national attention on the health inequities faced by America’s Latino community.
A host of statistics have made these disparities undeniable. Latinos make up 18.5% of the U.S. population, but they account for 25.1% of the nation’s COVID-19 cases. Compared with white, non-Hispanic people, Latinos face 1.5 times the risk of infection, 2.3 times the risk of hospitalization, and 1.8 times the risk of death from COVID-19, according to the Centers for Disease Control and Prevention (CDC).
Unfortunately, the health disparities can be illustrated by myriad other numbers as well. For example, Latinos generally experience obesity at much higher rates than non-Hispanic whites. Among Latino American women, 78.8% are overweight or obese, compared to 64% of non-Hispanic white women, according to the U.S. Department of Health and Human Services’ Office of Minority Health.
Latinos are more likely to have Type 2 diabetes (17%) than non-Hispanic whites (8%), according to the CDC. Over their lifetimes, U.S. adults have a 40% chance of developing Type 2 diabetes, but Latino American adults have a greater than 50% chance, and Latinos are more likely to develop it at a younger age.
Additionally, Latinos are less likely to receive treatment for depression, anxiety, and other behavioral issues than whites. These are just a few examples; other health conditions and risk factors that significantly affect Latinos include asthma, chronic obstructive pulmonary disease, HIV/AIDS, suicide, and liver disease.
What’s driving the disparities
Many factors drive the health disparities affecting the Latino community, and these disparities are further exacerbated by the inaccessibility and unaffordability of U.S. healthcare. While the Affordable Care Act has narrowed some health disparities, Latino adults continue to report significantly higher uninsured rates than other groups. A 2020 Commonwealth Fund study revealed uninsured rates of 24.9% for Latinos, 14.4% for Blacks, and 8.6% for whites.
A lack of health insurance often equates to difficulty in obtaining continuity of care and problems with prescription adherence, for example. People without insurance also often do not seek out preventive services and obtain care in expensive emergency room settings.
Recently, the healthcare industry has begun to understand that social and economic factors, such as housing, healthy food, transportation, and income—which are collectively known as social determinants of health (SDoH)—drive up to 80% of health outcomes, making them critical components in any “whole-person” approach to healthcare. In general, SDoH factors go a long way in determining both the access and quality of care available to people.
Providers’ role in reducing health inequities
Because the factors driving ethnic health disparities have been centuries in the making, taking steps to reverse the situation can seem daunting for physicians and other healthcare providers. Smaller practices, in particular, may lack the time and resources to take on the challenge and seek the help of a partner. Nonetheless, following are three steps healthcare systems and providers can take toward reducing health inequities among the Latino population:
- Survey patients for SDoH factors: Clinicians can’t begin to address patients’ needs until they know which problems are most prevalent in their patient populations. Provider organizations should perform annual surveys to collect patients’ demographic and personal information, as well as information about SDoH challenges. To avoid disrupting the flow of visits with physicians and other healthcare providers, this information would ideally be collected pre-visit, either in the waiting room or via a survey patients can complete at home. Collecting SDoH data allows providers to determine factors that may make it difficult for patients to follow through on their care plans. It’s important to provide bilingual options for Latino patients, as 28.4% of Latinos are not fluent in English, according to the Office of Minority Health.
- Evaluate the data for SDoH trends: Once healthcare systems or providers have identified individual patients’ SDoH challenges from surveys, they should combine all patient data to generate a full picture of the challenges faced by their Latino patients. Whether the most prevalent issues are food insecurity, housing insecurity or transportation challenges, for example, clinicians can use this information to begin exploring ideas and having conversations about how the community can work together to solve them.
- Create a network of trusted community-based partners: Clinicians are empowered to catalyze change in patients’ lives, but they aren’t all-powerful, and they can’t go it alone. That’s why it is important to build networks of community-based organizations to which physicians can refer patients who are experiencing SDoH challenges. These partners may include food banks, utility and rental assistance coordinators, job-training centers, and similar organizations. Strong connections between physicians and community-based organizations are essential because patients spend most of their time in their communities, as opposed to engaging directly with the health system.
The factors that have resulted in the massive health inequities faced by Latinos stem from deep, systemic issues within American society and won’t be reversed overnight. However, health systems, physicians, and other healthcare providers can play a valuable role in creating opportunities for changing the health of their patients. By surveying patients for SDoH issues, analyzing the data, and building networks of community partners, they can help their patients address the challenges that lead to inequitable health outcomes.
Anabell Castro Thompson is a nurse practitioner and senior vice president of health equity for Equality Health, where she leads projects that reduce barriers to care for vulnerable populations. She is a fellow of the American Academy of Nursing and the American Association of Nurse Practitioners, and Immediate past president of the National Association of Hispanic Nurses.