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The Commonwealth Fund recently released the results
of a new study, "Hispanic Patients' Double Burden:
Lack of Health Insurance and Limited English,"
which focuses on what effects having or not having insurance
and speaking English have on access and quality of care.
The Hispanic population of the United States is estimated
at 35 million (about 12.5 percent of the total population).
Although Louisiana has only a small number of Hispanics
(2.41 percent of the state population in the 2000 census),
Texas now has about 7 million-about 32 percent of the
total population-and some areas of Texas have more than
double that percentage.
In Texas, where we have the highest overall percentage
of uninsured people in the country, more than 35 percent
of the Hispanic population is uninsured, although the
majority are employed. The major findings of the Commonwealth
Fund report are worthy of attention:
"Hispanics have less access to the health care
system and experience less continuity in their care
compared with whites or African Americans. Spanish-speaking
Hispanics are particularly vulnerable." The report
notes that two-thirds of Hispanics who are uninsured
do not have a regular doctor, a much higher percentage
than found with Caucasians or African Americans.
"Once Hispanics gain access to the health care
system, they have more difficulty than non-Hispanic
whites or African Americans understanding what doctors
tell them and comprehending written health information."
The understanding and comprehension difficulties were
higher than other groups even after the differences
in insurance status, educational levels and income were
taken into consideration.
"There is a great unmet need for trained, Spanish-speaking
interpreters." It is the norm, rather than the
exception, for Hispanic patients not to understand what
they are told by their doctors.
Clearly, being uninsured and unable to speak English
fluently are creating problems with Hispanic patients
regardless of their diagnoses. Add to that the cultural
differences that are not understood by many health care
professionals and you have a recipe for not only poor
health, but poor health care as well.
We need to be aware that even within an ethnic group,
there are variations in language and culture. Not all
Hispanic people come from Mexico.
It is especially important in Texas-and most especially
in the southern and southwestern parts of Texas where
the Hispanic population is large-to provide for ways
to effectively communicate orally, in writing and culturally
with these patients. One solution would be to have more
bilingual health care professionals; another would be
to recruit more Hispanics into nursing (only 2 percent
of all RNs are Hispanic). More Hispanic nurses would
go a long way toward improving the care we give to these
patients.
Discuss this and other topics with your colleagues
at www.nurseweek.com/rnvillage
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