September 15, 2000

A Dose of Better Health Care For Hispanics Would be a Tonic for Everyone

National Hispanic Medical Association Prescribes Improved Services to Remedy Growing Problem

By Dr. Elena Rios

Washington, D.C. —One surprising find of the 2000 Census is that Hispanics already are the largest minority group in the United States. Their numbers should sound no alarm, but their health is another matter.

Hispanics have one of the worst health statuses in this country, and the situation is far from improving, especially as this population grows.

This fall, a coalition of Hispanic organizations called the National Hispanic Leadership Agenda will release a policy report that will include some critical findings on the state of Hispanics' health. These findings, compiled by the National Hispanic Medical Association, will show that two out of five Hispanics have no health insurance; one out of three Hispanics have no family doctor or health clinic; and one out of three Hispanics live below the federal poverty level.

Because of these problems, the health of Hispanic Americans is suffering.

Diabetes Type 2, is three times higher among Hispanics than non-Hispanics. Hispanic women have the highest rate of cervical cancer, and Hispanic men are not faring much better with prostate cancer. HIV is the third leading cause of death among Hispanics.

To improve the health of our nation's 40 million Hispanics, we, at the National Hispanic Medical Association, have recommended in this report that the United States expand health insurance coverage and make health care more affordable, accessible and user friendly for all.

We also must build a system where there are minimum standards for hospitals, clinics, HMOs and other health care facilities. Those minimum standards, which will be announced this fall by the Office of Minority Health in the Department of Health and Human Services, would require health care facilities to have staffs that are bilingual and bicultural so patients feel comfortable walking in the door.

For many Hispanics, they can't even get in the door of a clinic or doctor's office because they don't feel comfortable when they are not understood.

Once we help patients feel comfortable at doctor's office, then we need to focus on making health care more affordable. For example, prescription drugs —a form of preventive care— should be made available under Medicare. For many patients, prescription drugs can mean the difference between life and death. The ability to buy prescription drugs through Medicare can mean having a better quality of life and not having to choose between buying food or buying medication.

Making the system more accessible also means creating and posting health care symbols that are internationally recognized so people of all cultures can understand where to find a hospital in an emergency. Universal health symbols would help patients match diseases with their medications.

We, the doctors at the National Hispanic Medical Association, wholeheartedly believe that such symbols are just one more vital step in increasing access to health care and breaking down language and cultural barriers that exist for all patients — not just those whose first language is Spanish.

The sad fact is that today we're faced with a health care system that has little or no capacity to deal with populations of different cultural backgrounds. Worse, in some cases, health care facilities are plagued by classism, racism and discrimination instead of being a place of caring and comfort.

Government-funded programs can help turn this distasteful picture around by providing cultural competence training for health care workers. To be even more effective, these training programs should begin in medical schools, where all students can learn how to work with people of various cultures.

We should also applaud programs such as the American Medical Association's "Partnership in Health" literacy campaign, which highlights the problem of illiterate patients. The AMA turned a spotlight on the issue with a 1997 study showing that 21 percent of Americans are functionally illiterate and that an additional 27 percent are marginally literate.

Patients who have inadequate reading skills have misinterpreted their prescriptions far more than other patients. Not knowing whether you're taking too much of one drug and not enough of another can be a deadly mistake.

If Americans want to have a quality health care system — and ultimately a healthy society — there needs to be a commitment from the federal government to increase the financial support it gives to cultural competence training for doctors and other health care professionals.

We can no longer ignore the health of our growing Hispanic population; the health of the nation is too closely tied to it. By helping Hispanics and others to live healthier lives, everyone wins.

Dr. Elena Rios is president of the National Hispanic Medical Association (NHMA), a non-profit organization that represents Hispanic physicians and others dedicated to improving health care for Hispanics. Readers may contact Dr. Rios at the National Hispanic Medical Association, 1411 K St. N.W., Suite 200, Washington, D.C. 20005 or visit the NHMA Web site at

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