Posts Tagged: healthcare
Disparities in HIV Care Among Hispanic/Latino Men and Women
There is a significant prevalence of diagnosed HIV infection among Hispanics/Latinos in the United States compared with non-Hispanic whites. Researchers recently aimed to describe characteristics of Hispanics/Latinos in medical care by sex in order to identify disparities, emphasizing the need to decrease ethnic disparities in order to reach national prevention goals across populations.
The report, published by the CDC, used the 2013 and 2014 cycles of the Medical Monitoring Project (MMP) to collect demographic, behavioral, and clinical characteristic data among Hispanics/Latinos by sex.
The data revealed that Hispanic/Latina women were significantly more likely than men to live in poverty, report not speaking English well, and receive interpreter, transportation, and meal services. However, there were no significant differences between Hispanic/Latino women and men in prescription of antiretroviral therapy or sustained viral suppression, according to the report.
The lack of significant differences in clinical outcomes among Hispanic/Latino women and men may demonstrate a higher use of ancillary services by women, according to the authors.
“Levels of viral suppression for Hispanics/Latinos are lower than those found among non-Hispanic whites and lower than the national prevention goal of at least 80% of persons with diagnosed HIV infection,” the authors noted. “Providers should be cognizant of the challenges faced by Hispanics/Latinos with HIV infection in care and provide referrals to needed ancillary services.”
The data collected from the MMP included 1774 men and 577 woman who self-identified as Hispanic or Latino. The report noted that 78% of Hispanic/Latina women receiving HIV care lived at or below the federal household poverty level, compared with 54% of men. This is significant because the management of HIV care is known to be affected by poverty at all stages of the HIV care continuum. However, the higher reportage of meal and transportation services among women may helped certain negative consequences to their clinical outcomes.
“Overall, 38% of women and 21% of men reported not speaking English well, which can affect ability to understand a provider's instructions and ability to navigate the healthcare system,” the report stated. “In addition, the language barrier might prevent care providers from understanding the patient and could lead to missed opportunities to provide needed support or direction. Bilingual providers or interpreter services might have mitigated linguistic barriers.”
The report concluded it is necessary for providers to be aware of the challenges faced by this population and to improve access to ancillary services. Ethnic disparities need to be reduced in order to attain national prevention goals among this population, despite the lack of disparity found in viral suppression in HIV care in this report.
Source: Published originally on www.ajmc.com, Disparities in HIV Care Among Hispanic/Latino Men and Women, by Alison Rodriguez, December 1st, 2018.
Language may impact diabetes care for Latinos with limited English
When researchers studied 31,000 patients with diabetes who received insurance and healthcare through Kaiser Permanente in Northern California, they found that about 60 percent of Spanish-speaking Latino patients skipped filling prescriptions at least 20 percent of the time in the two years after they were told they needed the drugs to help control the disease.
That rate was only about 52 percent among English-speaking Latino patients and 38 percent among white patients.
"Latino patients with diabetes, even when insured and facing relatively low barriers to healthcare, are much more likely to have poor medication adherence than their white counterparts," said lead study author Dr. Alicia Fernandez, a researcher at San Francisco General Hospital and the University of California, San Francisco.
The study didn't find any difference in medication adherence for diabetics with limited English based on whether they saw Spanish-speaking doctors.
This suggests factors beyond just language and communication may come into play, researchers conclude in JAMA Internal Medicine.
"Physicians who care for Latino patients with diabetes should focus on medication adherence and explore individual barriers to adherence," Fernandez added by email. "These may include lack of 'buy-in' to medication treatment, concern regarding side effects, concerns regarding costs, and competing life demands on medication use and self-care."
But while this study didn't find that having Spanish-speaking doctors improved medication adherence, a separate study of Latino diabetics published in the same journal did see some benefit.
The researchers on the second study also looked at data from Kaiser Permanente, in this case to see whether patients with limited English proficiency might have better blood sugar control when they switched from English-speaking to Spanish-speaking primary care physicians.
This study included about 1,600 Latino patients who preferred speaking Spanish to English.
At the start of the study, 54 percent of these patients saw a primary care provider who didn't speak Spanish. During the study, 48 percent of this group of patients switched to a Spanish-speaking doctor.
After this switch to Spanish-speaking doctors, 74 percent of these patients had blood sugar in a healthy range, up from 63 percent when they saw English-speaking doctors. This increase was 10 percent more than the patients who just switched from one English-speaking doctor to another.
"Having a primary care provider that speaks your language appears to be important for several reasons; it improves lines of communication, may reduce the risk of misunderstandings, increases patient satisfaction and now there is evidence that it may also improve management of diabetes," said lead study author Melissa Parker, a researcher at Kaiser Permanente in Oakland, California.
Both studies have some limitations, including the lack of data on some factors that can influence how much patients take their medicine or follow advice from doctors, such as health literacy or the degree of spoken or written abilities in English and Spanish for physicians and patients.
Still, the results from these studies suggest that it would make sense to prioritize access to Spanish-speaking doctors for Latinos with limited English who are newly diagnosed with diabetes, Dr. Eliseo Perez-Stable, director of the National Institute on Minority Health and Health Disparities, writes in an accompanying editorial.
That's because seeing a doctor who speaks Spanish may be more important for establishing a treatment regimen than maintaining one, Perez-Stable writes.
"Communication between clinicians and patients is essential in most aspects of medicine but it is especially true in management of a chronic disease such as diabetes," Perez-Stable said by email.
Ideally, there would be more Spanish-speaking and bilingual doctors, Perez-Stable added by email. Absent that, patients should make sure there's a professional interpreter available and also bring someone to clinic visits who is bilingual and can help support the treatment plan after patients go home.
Source: Published originally on foxnews.com, Language may impact diabetes care for Latinos with limited English,, January 24, 2017.
New findings show Hispanics’ sources for healthcare information
The results were consistent with research conducted by Pew in 2008. Hispanics have the same motivators and attitudes in how they receive healthcare information, and they can still be reached the same way, too—whether it's through clinics, doctors or TV. Here are some of the findings.
Trust Multiple Sources
Doctors are the most trusted source of healthcare information for both Hispanics and non-Hispanics. However, Hispanics seem to trust significantly more. In fact, Hispanics are much more likely to say doctors (66% vs. 58% for non-Hispanics), clinics (54% vs. 31% for non-Hispanics) and hospitals (56% vs. 37% for non-Hispanics) are extremely trustworthy.
Pharmacists, however, have a lower trust score – only 38% say they find pharmacists extremely trustworthy vs. 50 percent of non-Hispanics. This may be because the role of the pharmacist is very different in the U.S. than in many Hispanic countries of origin. In Latin America, pharmacists develop relationships with their customers and spend time listening to their needs. They are considered true partners in the Latino healthcare universe. U.S. pharmacies stand to gain a lot with Hispanic patients if they work on building those relationships, too.
More Likely to Take Action
TV, radio and digital play a strong role in how Hispanics receive health information. And, across the board, Hispanics are more likely to take action from the information they receive vs. non-Hispanics. For example, Hispanics are at least 23 percent more likely than non-Hispanics to say that online, TV or radio healthcare messages “led me to see a doctor or medical professional about a specific drug.” When you dig deeper, Hispanic women are even more likely to take action than their male counterparts. This suggests that healthcare marketers may see better results if they target their campaigns toward these Chief Medical Officers of the household.
Hispanics are listening to, trusting and reacting to healthcare messages from many sources. They also tend to worry more about the health and wellness of their families (78 percent say they worry a “great deal” vs. 59 percent of non-Hispanics).
Source: Published originally on Univision Hispanic Insights Weekly Digest as New Findings Show Hispanics' Sources for Healthcare Information byEric Talbot, August 6, 2014.
Unemployment and economic growth: greatest concern to nearly four in 10 Hispanic voters
Among all Americans and U.S. registered voters, healthcare, economic growth, and the federal deficit roughly tie as the most important issues, while immigration ranks last among both groups of Americans.
The new USA Today/Gallup poll makes it clear that economic issues -- particularly unemployment and economic growth -- are more important to Hispanic voters nationwide than immigration.
Hispanic immigrants and first-generation Hispanic Americans are more likely to mention immigration than those whose family has been in the U.S. longer than that. Specifically, 16% of Hispanic voters who are themselves immigrants to the U.S. name immigration as a priority, similar to the 14% of those who were born here but with at least one parent born abroad. By contrast, 7% of Hispanic voters who, along with their parents, were U.S.-born do the same.
The findings are based on Gallup Daily tracking interviews with 1,753 Hispanic adults in all 50 U.S. states and the District of Columbia conducted April 16-May 31. The sample includes 1,005 Hispanic registered voters who, on a weighted basis, represent 47% of the total sample of U.S. Hispanics.
Source: Gallup, Hispanic Voters Put Other Issues Before Immigration, www.gallup.com, June 25, 2012.
/span>Undocumented immigrants use fewer health services than rest of population
“It’s a common misperception that undocumented immigrants overuse medical services and rely primarily on hospital emergency rooms for care,” said UCI anthropologist Leo Chavez, author of the study. “Despite what we hear in the public debate, there is not a great deal of social science data on healthcare for undocumented immigrants.”
The study found that 89.3 percent of non-Latino white survey respondents had accessed medical services in 2005, compared to 68.8 percent of all Latinos and 54.8 percent of undocumented Latino immigrants. The type of care sought varied, with undocumented immigrants more apt to utilize hospital outpatient clinics, health centers and public health clinics, while legal immigrants and citizens – both Latino and white – frequented private doctors’ offices at a higher rate.
This contrast, said Chavez, is tied to health coverage. “Latinos with medical insurance were 2.27 times as likely as those without it to seek medical care,” he said. “As a whole, legal immigrants and citizens were 72 percent more likely than undocumented Latinos to seek medical care.”
The findings are significant, Chavez noted, as underutilization of medical services is associated with poorer health and higher mortality rates. “Healthcare for undocumented immigrants has become so politicized that current healthcare reforms explicitly exclude them,” he said. “The reality is that they face great obstacles to obtaining healthcare, and it’s not clear at this point what will happen to them as a result of reforms.”
Source: UC Irvine News, “Undocumented immigrants in O.C. use fewer health services than rest of population,” October 13, 2011.