Imagine that you or a family member has an urgent medical emergency. In most circumstances, this would undoubtedly prompt a trip to the emergency room; however, for millions of residents in the United States today, this is not a privilege they possess. With every medical emergency comes a difficult choice: either call the ambulance and risk deportation or silently suffer from serious health complications.
Figure 1 from census.gov displays projected growth estimates for the Hispanic population in the United States
Although Hispanics are the nation’s largest and fastest-growing minority group, they are the least likely to seek medical care. Among the numerous obstacles these patients face, a lack of legal documentation poses the most substantial challenge. In addition, a multitude of linguistic and cultural barriers discourage many from seeking assistance due to a lack of understanding regarding the healthcare system. This miscommunication significantly detracts from the quality of care that Hispanic patients receive.
Approximately 5 million undocumented immigrants of Hispanic origin reside in the United States today (Manuel et al., 2019). It is a population that endures daily isolation from their communities, fear of detention and deportation, and the trauma of separation from family and loved ones (Cutts et al., 2016). The combination of these factors negatively impacts the likelihood that Hispanic patients will seek appropriate medical treatment. Although hospitals are required to provide emergency medical care to undocumented patients irrespective of their immigration status, this obligation ceases once the patient stabilizes. At this point, in accordance with federal law, hospitals are required to create a discharge plan and transfer patients to more appropriate facilities. Given that these patients entered the country illegally and do not have access to health insurance, they will often be sent back to their country of origin through a fairly unregulated and obscure process called medical repatriation (Kuczewskim, 2012). By seeking medical assistance, Hispanic patients risk both their ability to remain in the United States and the quality of subsequent outpatient care.
In addition to legal concerns, the language barrier between Hispanic patients and healthcare providers has a detrimental effect on the quality of care that these patients receive. The lack of communication prevents many patients from receiving proper treatment or even seeking medical attention in the first place. (Escarce et al., 2006). Given the complicated nature of medical terminology and the fast-paced environment of United States healthcare settings, this lack of communication can be especially problematic (Durazo et al., 2014). Compared to both white Americans and African-Americans, Latinos generally report poor communication between themselves and their doctors, and are twice as likely to leave a doctor’s appointment with unanswered questions. Given this disparity, there is an increased probability that Hispanic patients will endure untreated or misdiagnosed health issues (Wagner et al., 2000).
Figure 2 from kff.org shows various healthcare disparities among the Hispanic population in the United States
Many Hispanic patients value the concept of bienestar, a state of holistic wellness derived from the interconnection between family, community, and good health; however, United States healthcare settings, with their emphasis on efficiency, seem every bit the antithesis. (Cersosimo et al., 2017). Given that many Hispanic patients are accustomed to a more personalized approach to healthcare, they are often unsettled by the impersonal nature of medical care in the United States (Vega et al., 2009). This lack of cultural awareness and empathy generates a strong sense of distrust between many Hispanic patients and their American healthcare providers. These patients are much less likely to feel comfortable disclosing personal information or following medical advice (Velasco-Mondragon et al., 2016).
Among numerous barriers, fear of deportation, language barriers, and cultural miscommunication have the most significant impact on Hispanic patients in the U.S. Improving access to healthcare for this population is a nuanced issue and cannot be resolved through a single approach. Instead, it is crucial that the United States healthcare system comprehensively addresses the main aspects of the problem. By challenging controversial practices such as medical repatriation, encouraging bilingualism among medical professionals, training more medical translators, and promoting an empathetic healthcare environment, change remains possible. Given the shifting demographic of our nation, the United States healthcare system must adapt to accommodate this change and ensure equal opportunity to healthcare access for all.
Edited by Alexa Rome
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