NurseWeek News

Access for All
More hispanic nurses needed to improve care of underserved population

By Beth Ulrich, Ed.D., RN, South Central Editor
March 13, 2003

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