As we move into a post-pandemic existence, what can we do to advance equity in healthcare access for Latinos? What would such a future look like? What are the best practices and the most natural mistakes? Finally: as a community, what stops Latinos from accessing the health care they need?
At Maryland Latinos Unidos, we want to find solutions to these challenges, and while it is important to advocate on behalf of a community, it is not enough to protest or point out the barriers it faces. Therefore, at MLU we have established three initiatives based on the results of the program we administer, the Mid-Atlantic Latino Coalition for Equitable Access to Vaccines (MALVEC):
We believe that it is necessary:
- Address communication barriers and improve cultural competency within the health system in Maryland,
- inform health systems about the limitations that prevent Latinos, especially immigrants, from accessing health care and,
- work to develop a permanent system of community health organization teams that engage vulnerable members of the community and help them navigate through the complexities of health care across the state.
Transforming systems is a process that requires all parties to work together. We hope that these three initiatives will identify areas where we can collaboratively create systemic change based on what has worked in the past. We must avoid anything that keeps our community in a perpetual cycle of being unable to develop healthy habits and facing barriers to health care.
Communication is one of those major obstacles. In health equity reports from counties across the state, the language barrier consistently appears as a challenge in engaging members of the Latino community.
Healthcare institutions have an increasing responsibility to increase diversity, equity, and inclusion (DEI) efforts, not only to deal with their employees but also to better serve patients and their families. Beyond bilingualism and cultural sensitivity, there is also a lack of understanding of how local Spanish media outlets work and how Latinos receive information.
The health care industry has a particularly unique opportunity to make a greater impact, due to the direct effects it has on the health and quality of life of patients. The pandemic has laid bare how immigrants in particular face cultural and logistical challenges when suffering from serious illness. Health professionals and health care systems must be prepared to address these unique needs, including differences in language, gaps in health knowledge, insurance barriers, and limited financial and social resources.
We know that historically, in Maryland and across the country, Latinos are hesitant to access health care due to many factors including language, lack of understanding, and fear for all kinds of reasons, including misinformation and misinformation.
Deterrents can be complex and often include deep-seated and even intergenerational trauma. Addressing them requires an understanding of the stigmas surrounding issues like mental health and disabilities within the Latino community. It requires an understanding of machismo and the important roles that gender plays in Latino families and society, as well as the roles of religion, charity, and classism. It is also important to know what care is available to these individuals when their immigration status is in question or if they are afraid of missing out on a green card because they believe they have “crossed the line” by accepting assistance.
We believe that an effective way to address deterrents is with strong, bilingual community health organizing teams made up of community health workers and community health organizers.
Community health organization teams, made up of bilingual and culturally sensitive members of the same community, help overcome doubts and access medical care.
At MALVEC, our teams are made up of community health workers and community health organizers who coordinate resources and act as liaisons with local health systems. Organizers stay up to date on the latest health care trends and offerings in the counties they work in, ensuring workers know what’s available. The latter constitute the last mile between community services and the communities they serve.
When there is no crisis, such as the COVID-19 pandemic, these community health organizing teams are among the first to be eliminated. The cycle of temporary support when there is a crisis, and the slow return to old habits once the crisis is over and funders move on, means barriers to care remain intact.
In the end, creating true systems change requires policymakers to commit to the process and be willing to put resources behind the necessary adjustments. It requires prioritizing the changes and not just the end result.
Perhaps the time has come for a completely different healthcare system – perhaps a single payer system? Until such changes occur, we must be aware and support each other. Our communities cannot afford to wait for another crisis. It is time to address the challenges we face today to build a system of care for all, one in which health care prevails as a human right.