The U.S. Health Care System

I believe that the United States is currently in a state of denial when it comes to health care. We proclaim that America’s medical care is the best in the world, and many wouldn’t trust the care in any other country. However, the U.S. ranks dead last and second to last in life expectancy for men and women, respectively, among the 17 wealthiest nations in the world (CDC). The most prominent reason that this reality exists is that the U.S. ranks so poorly for certain racial, ethnic and socioeconomic groups for health outcomes.

In this paper, I will consider one particularly vulnerable population in the U.S. in regard to health outcomes. A large portion of Hispanics face disparities when it comes to access to health care, preventative services, quality of care, and preventative mortalities. More specifically, Spanish-language preference marks a subpopulation of US Hispanics CDC have even less access to good health outcomes. It is important to analyze the disparities that Spanish-speaking Hispanics vs English-speaking Hispanics in contrast to the entire US population, as many socioeconomic and systematic issues affect Hispanics in the US. This paper attempts to uncover the disparities that Spanish-speaking Hispanics face specifically due to difference in language. However, it is also necessary to analyzing the overarching systematic, cultural, socioeconomic issues to understand the topic.

I first became interested in this topic because of my work as a Patient Care Assistant at Neurology and Rehab Associates in Manhattan, KS. Many of our patients are Hispanic, and many do not speak English proficiently. The clinic does not offer translation services, and I see the often damaging effects of not having the appropriate resources to provide Spanish-speakers with the quality of care they deserve. As a future nurse, I want to better understand these inequalities and how they are maintained, so that I can attempt to redistribute the justices to marginalized populations through my work.

In this paper, I will discuss the health care disparities that exist for Hispanics, including illness, death rates, and access to care. I will explain the racialization of Hispanics in regard to Spanish-speaking, the requirements of health care providers in regard to providing language assistance services, the results of linguistic barriers in health care, the causal factors involved with health care disparities for Hispanics, and possible solutions to the issue. I will specifically focus on the subpopulation of Hispanics in the U.S. which is particularly marginalized, Spanish- speaking Hispanics.

Disparities in Health Care for Hispanics

Illness and Death Rates

Death and disease rates among Hispanics was the most surprising part of my research. Hispanic death rates are 24% lower than whites in regard to the 10 leading causes of death in the United States. They have 35% less heart disease and 49% less cancer. Hispanics are 50% more likely to die of diabetes and liver disease than whites. The Hispanics born outside the US are even less at risk for heart disease (50% less likely), cancer (48% less likely), high blood pressure (29% less likely), (CDC). In general, the lower the poverty rates of a population, the lower the overall health of that population. The seemingly positive mortality profile for Hispanics in the US, and specifically for Spanish-speaking Hispanics in regard to the main causes of death in the US could possibly be attributed to the fact that many Hispanics in the US were born outside the US. Many researchers argue that immigrants have a generally resilient, as circumstances force them to be. To immigrate to the US, they have to be generally healthy. However, Hispanics are more likely to have diabetes, obesity, and liver disease. This could be explained partly by the fact that obesity and diabetes are illnesses that are more prominent in developing nations and are more often a result of lifestyle choices of those with more resources. This could also be one possible explanation for why Spanish-speaking Hispanics are less likely to have certain ailments than English-speaking Hispanics.

In addition to being more likely to have diabetes or liver disease, Hispanics are 50% more likely to die of these diseases than non-Hispanic whites who have the same ailments (DuBard and Gizlice). It is important to point out that higher rates of liver disease are not largely attributed to alcohol abuse, and research has shown that alcohol related disorders are not higher for Hispanics than for non-Hispanic whites, despite a common racist misconception. One hypothesis is that Latinos have higher rates of hepatitis C viral infection, which is a risk factor for liver disease (Vega). However, when Hispanics die at higher rates of the same diseases as whites, we can conclude that they face barriers to health care at higher rates than whites, which will be discussed in the following sections. In addition, Hispanics are almost three times as likely to die of homicide than non-Hispanic whites (Vega). This could be due to a number of causal factors and is most likely attributed largely to the socio-economic disparities that exist in the US for Hispanics, especially immigrants, which increase rates of homicide. It is also important to note that there is a disproportionately more amount of research done for the top causes of death for whites than there is for Hispanics in the US, which differ.

Access

Hispanics in the US experience inequality when it comes to access to health care. More than 25% of Hispanics in the US lack a usual health care provider (Livgston). In addition to not receiving regular care, many report not receiving any medical advice in the past year. The disparities for Hispanics who prefer Spanish are higher, indicating the language barrier as a barrier to quality care in addition to other socioeconomic factors.

One study done by C. Annette DuBard and Ziya Gizlice examined the self-reported health status, behaviors, access to care, and preventative services among the US Hispanic population. Their results showed that over 55% of Spanish-speaking Hispanics in contrast to 23% of English-speaking Hispanics did not have health insurance. Fifty-eight percent did not have a personal doctor to go to compared with 29% of English-speaking Hispanics. Forty-five percent were less likely to have had a check up in the last year, with 45% of Spanish-speaking Hispanics indicating this vs 36% of English-speaking Hispanics (DuBard and Gizlice). These disparities are attributed to socio-economic disparities, as well as language, as seen by the different in disparities among English-speaking Hispanics and Spanish-speaking Hispanics.

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