In Pursuit of Hispanic Health Equity, Representation Matters

By Dr. Maja Castillo, AVP Pediatric Medical Director, Healthfirst

A Spanish-speaking Healthfirst member was recently readmitted to the hospital a few weeks after he underwent major heart surgery. He went to the emergency room and told doctors there he was dizzy and weak — and that he hadn’t taken his prescribed medication after the surgery because he didn’t understand the instructions.

While this is just one case I recently reviewed, it illustrates a common occurrence among the population we serve.

Medication nonadherence is common among people with chronic illnesses, and Latinos have been found to fare worse than other groups. Latinos report taking their antihypertensives less (67%) than their Black and white counterparts (77% and 77%), and demonstrate worse glycemic control and worse adherence to psychiatric medications than other ethnic groups. While speaking only Spanish is one of the biggest risk factors for medication nonadherence, language is far from the only barrier to care for Latinos. Cultural differences and beliefs can limit the receipt of health information, socioeconomic factors can lead to difficulties in following treatment plans such as paying for medications or attending follow-up visits, and discrimination can also present a barrier to care. Several studies have even shown that perceived discrimination leads to mistrust of the healthcare system, delays in filling prescriptions and poor health outcomes.

Representation matters

The Hispanic population is the fastest growing minority population in the United States and deserve equal access to quality care. A more representative healthcare workforce is imperative in achieving that goal. Studies have found that minority patients who see physicians of their same race or ethnicity are more likely to use needed health services, are less likely to postpone or delay seeking care, and report a higher volume of use of health services. Patients in race concordant patient-provider relationships also report greater satisfaction and better patient-provider communication. It carries over to the pharmacy setting as well: In a small study in which bilingual pharmacists counseled non-adherent Hispanic hypertensives, medication adherence increased significantly.

It is vital for those of us who identify as Hispanic to encourage more of us to enter the healthcare industry to provide the kind of care that will improve our community’s health outcomes as well as teach others to do the same. At Healthfirst, 30% of our employees are Hispanic, from the call center to pharmacists and care managers. And through DEI affinity group events, communication workshops and rounds, we are actively teaching others so they can better provide the type of culturally competent, bilingual care our members deserve.