Introduction
Health care delivery in the USA has faced challenges and developments in equal measures over the past decade. The minorities, particularly, have been heavily affected by the disparities in the health sector. In my community, the population of the poor Latino community is projected to increase. Made up of a bigger share of the Mexicans, they increasingly face a daunting task in accessing quality care services. A large number of them could pose a threat to the quality of health care services if culturally competent health care is not provided to them in an efficient manner. Literature indicates that culture, among other factors, plays a huge role in hindering the poor Latinos’ access to health care. Several strategies and policies have been formulated in the past to reduce the disparities in health care with little success. The disparities in health care among the poor Latinos can only be reduced through accommodating their diversity and providing them with culturally competent health care. The lack of a consistent strategy that promotes culturally competent health care is to blame for the health disparities associated with the poor Latinos. In this paper, the demographics of the poor Latino community will be reviewed together with the cultural values that affect their health care decisions. The health services available for them in West Virginia will be reviewed as well.
The Demographics of West Virginia
The Latino community makes up about 1.5% of West Virginia’s population (Sizer, 2012). The Latino share of the State’s population grew from 0.7% in 2000 to 1.5% (or 26,580 people) in 2014 based on the U.S. Census Bureau (Saenz, 2014). In addition, 90% of the children in Latino families are U.S. citizens (Sizer, 2012). I live in Berkeley County that has the Latino community with the growing number of poor people. There are over 2000 occupied homes by the Latino families who reside in Berkeley (Saenz, 2014). The number of children and old people rises at a fast rate, which leads to the popular notion of a “miniboom” of the Latino community in West Virginia. West Virginia’s population is one of the oldest in the USA, and its median age rises, increasing from 38.8 in 200 to 42.2 in 2013 (Saenz, 2014). The majority of the population in West Virginia remains rural with an average of 77 persons per square mile. These residents face the unique challenge to their health such as lack of access to health care facilities (Saenz, 2014).
West Virginia’s population has large disparities in the level of education with a majority of the population having a high school diploma as the highest education level. By 2012, the percentage of the population that was recorded to be living below the poverty line was 17.2% (Notaro, 2012). Notaro (2012) indicates that in the same year, about 18.8% of the population reported having some disability compared to the lower 12% rate of the U.S population. Specifically, 17.2% of the population of the age between 18 and 64 reported having a disability, while 43.4% of people above 65 also reported to having a certain disability (Notaro, 2012). The percentages of the population citing disabilities bring additional problems for health care because they also tend to suffer from other secondary conditions. In Berkeley County, the rate of obesity rises at an alarming rate, especially among the Latino community. Additionally, the number of people suffering from diabetes in the Latino community also rises in a trend that seems to vary by race and ethnicity. Disparities are also common in other chronic disease levels as well. In my County, the number of people with cardiovascular diseases increases steadily as compared to other sections around West Virginia. In fact, the four greatest causes of potential life lost among the Latino community in Berkeley are heart disease, injuries, suicide, and cancer-related conditions. The changing demographics of the West Virginia community and the growing disparities in the health status of the people from diverse backgrounds are huge factors that could challenge the health care providers.
Health Care Services
West Virginia offers a variety of health care services for its people. All services are aimed at improving the quality of life for the population. One of the popular health service offered by practitioners is the Medicare program. The Medicare program offers a health insurance coverage to the U.S. citizens and residents aged 65 and older. It has been revised to include the permanent residents less than 65 years with certain medical illnesses. In 2014, over 400,000 total beneficiaries enrolled for the program in West Virginia (Ruíz & Sánchez, 2006). The Medical program provides the required health care services for low-income persons and families with children, foster care, children and low-income people with certain diseases such as breast cancer, tuberculosis, and HIV/AIDS. There are approximately ten primary care physicians in my community. Overall, by 2012, West Virginia was recorded to have an average of 108 primary care physicians for every 100,000 of the population (Stavans, 2012). These physicians include the practitioners, obstetricians, internists, and those engaged in family practices. However, a big proportion of the Latino community does not have access to the primary care providers. Although there is emergency, medical services are a critical link in the chain of care in my community, complex problems related to access and costs have emerged to limit the services that the Latino community can access. In addition, my community has emergency departments that are offered to the people in the community.
Description of the Latino Community
In my community, Latinos are among the uninsured ethnic groups. That is notwithstanding the fact that they are disproportionately affected by serious health problems. Some poor Latinos in my community prefer to find their health care services in non-clinical places. A large number of them rely on folk medicine as well as traditional healers. From the trending experience, it is clear that while primary physicians would follow the procedure of diagnosing and later treating an illness, the traditional healers treat the patients as if they already suffer from an illness. Some of the traditional healers that cater to the Latino community include herbalists, spiritual healers, Mexican healers, and traditional bonesetters. These practitioners charge no fees and only use prayers, teas, and other ritual practices to correct the health issues (Chong, 2012). Among the poor Latino subculture, some illnesses can only be treated traditionally. Although not all the Latinos follow these subcultures, a larger proportion consisting of the less fortunate ones still relies on folk medicine. In fact, some have been quoted as having experienced greater improvement after seeing the folk practitioners than their previous appointments with “Western doctors”.
The Latino community shares a strong heritage that involves religion and family. Every subgroup has unique cultural customs. The poor Latinos rely more on advice from family members and friends for their perspectives on related medical issues. Initially, they will prefer to self-diagnose and treat themselves using home remedies and will only think of professional advice if their symptoms persist. In the case that a Latino member seeks some professional advice, following the instructions and other routine check-ups become a huge challenge. Even then, the family recommendations are considered to be of utmost importance when there are health-related decisions to be made. Sometimes, strong family values can act as a hindrance to effective health care because they can delay important medical decisions due to the extended level of family consultation. Failure of a practitioner to appreciate the role of family values can lead to conflicts with the patient. I have experienced a Latino in my community who preferred to seek information about health from his church before considering the advice of a health care professional. Across Berkeley, many churches serve as an important source of spiritual support for the Latino community.
In general, the Latinos are reluctant to admit an overall feeling of illness since it is associated with the signs of weakness and failure. Cases of depression are hidden from the public as much as possible. It is easier for a member of the Latino community to admit being anxious than depressed due to the negative stigma involved. Language has also acted as a barrier to the poor Latinos’ health care because many members of the Latino subculture would prefer to visit a hospital with a diverse bilingual practitioner. They feel that they have a better chance of being understood better by another Latino. In addition, trust acts as a strong cultural value. A patient from the Latino community may take an extended duration of time to build up trust required for one to accept their health advice. The Latino community perceives the US health care as an insensitive system to their feelings and discomfort mostly due to the high numbers of the opposite gender available and other processes that are thought to invade their personal privacy. The traditional gender roles associated with the Latino family influence the way a Latino seeks health care. These ideas have a debilitating effect on the level of health care that the Latino community can access in Berkley, West Virginia.
Health Service Programs Designed for the Poor Latinos
Poor Latinos face the challenge of accessing and receiving care in a way that is culturally and linguistically appropriate for the rising number of patients with low levels of general health literacy. However, my community has devised innovative ways through which the Latino community can easily access the health services. One of these is the Latino Health Insurance program that has been designed to respond to the high rate of the uninsured and poor Latinos in Berkley. The program has been a positive influence on the community because reports indicate the number of the Latinos seeking insurance services rises by the day. The program’s aim in the community is to address the cultural and financial obstacles that impede the Latino community from seeking medical help. In addition, the program addresses the flow of information that the community should access regarding health insurance. In my community, several seminars have been held for the population to learn more about the different health conditions that can be covered by health insurance.
There are other various health service programs available in the community designed to meet the needs of the poor Latinos. A Hispanic Federation program has been designed by different health providers in my community with an aim to work on improving the health of the Latino community. The program has been expanded to cover the larger Berkley County as the population of the Latinos rises. So far, the program has been campaigning for the provision of direct assistance to at-risk and under-served poor Latinos in the community. It has also been educating the poor Latinos throughout the community about the critical health issues. The health program is designed to address the existing health disparities among the poor Latinos by advocating for more local resources to be channeled towards the community. Since its inception, the health program has been helping the low-income Latinos in the community to enroll in low-cost health plans such as Medicaid and Child Health Plus. More Latino children and families have been able to access the health care services with the help of the program. In addition, the health program in my community has started a health prevention campaign that seeks to educate the under-served Latino families on cancer, obesity, cardiovascular disease, and hypertension. The program has had a huge impact in offering counseling sessions as well as health screens for the poor Latinos in the community.
The needs of the poor Latinos are observed by the Latino Health Promoters program that serves the County with a special emphasis on the poor Latinos. The aim of the health program is to educate the community on various health issues and offer them the support they need to keep their fellow community members healthy through supplying them with health-related information. The selected promoters have gained trust with the Latino community to an extent that the residents can seek health-related advice from them. According to Cisneros and Rosales (2009), communication is always critical in the process of health care delivery. It has profound effects on the patient-provider relationship and the ultimate quality of the health care service. A language barrier between a provider and a patient can result in the decreased use of primary care, misunderstanding of medication use, and inadequate follow-up. However, the program has managed to create an understanding between the health care providers and the community by facilitating their communication. They have been of great assistance to the poor Latino community, especially as they can link the community with services and other resources that improve their health status. The health program has been directly involved into the breaking of the cultural barriers that have impeded access to health services for a long period. Recent arrivals to the Berkley County are more likely to be accommodated to mainstream U.S. society, a situation that encourages appropriate and timely care for the poor Latinos. The quality of life in West Virginia is set to improve through the intervention of more programs. These programs should be designed to contribute to the implementation of a culturally and linguistically competent health care system that values and supports the Latino families.
The Ideal System for Culturally Competent Healthcare
The ideal system that would be appropriate for the community has to be aimed at reducing the health disparities associated with the health care system. The system should be set around a health saving account (HAS) that should help the community to afford the insurance coverage they require for their children and other family members. The impact of the affordable care act (ACA) on improving the health status of the community depends on the extent of the uptake of the health insurance. There should be an uneven implementation of the ACA across the USA, particularly in the states that have high numbers of Latinos. Access to affordable health insurance has been a huge problem that disproportionately affects the Latino community. The Latino community has been established as an ethnic community with lower income levels than the rest of the population. The community also has a higher proportion of the uninsured people, therefore, lacking health coverage. The population of the poor Latinos is predicted to increase. That means that if a system is not set in place, the disparities will still be highlighted in accessing health insurance and health care among the minorities. My immediate community requires more services that should accommodate the minorities.
There is a need for adding ambulatory and preventative services such as doctor’s offices and acute care services, such as hospitals, to sustain the growing population. The hospitals will provide quality services to the population. The poor Latino community is increasingly being faced by a myriad of medical problems that require extensive care from the health care practitioners. The poor Latino community has disproportionately higher rates of diabetes and obesity. The new hospitals would be fitted with appropriate screening equipment to detect and diagnose the chronic conditions at an early stage. Extensive research should be conducted over the folk medicine used by the Latino community to reveal if the community can be supplemented with conventional treatment. The personnel working at the hospitals should also be elevated to accommodate some qualified members of the Latino community to create a welcoming health care environment for fellow Latino patients. The move would ensure that the barrier that stems from cultural mistrust is cleared in a manner ensuring that conventional treatment is not delayed. Expanding the diversity of the personnel should be made a priority for the nation-wide hospitals to ensure that the health care system is streamlined to target culturally appropriate care. Currently, many hospitals lack trained interpreters and they have to rely on ineffective interpretation by the bilingual staff. Therefore, the new hospitals should be able to offer professional interpreter services to remove the language barrier. Apart from the need for new hospitals in the community, more nursing homes that should not be segregated are required. The nursing homes should have nursing aides on a 24-hour basis to provide medical care and occupational therapy to the aging population across the USA. The racial distribution of residents in nursing homes should be eliminated to ensure there is no discrimination.
Conclusion
The Latinos are a diverse demographic in my community. The number of port people in the Latino community is projected to increase with time. However, intermingled with the increase of the population growth are the issues of access to health care services among the Latinos. It has been documented that the poor Latinos have lower rates of health insurance coverage. The access to health care has been hindered by various factors including lower income levels and cultural values. The health care system in my community has to adopt practices that accommodate the Latinos. Many poor Latinos prefer to seek their health care services from folk medicine and traditional healers. An appropriate system has to be designed to eliminate the barriers that impede health care delivery to the population. It is recommended that a system should be set that allows the introduction of the traditional health saving account (HAS). That strategy should help the community to afford the insurance coverage they require for their children and other family members. There is also the need for adding ambulatory and preventative services to curb the rise of chronic diseases among the Latino community and general population. Finally, the community health care system should expand the diversity of the personnel of the hospitals to ensure that the health care system is streamlined to provide culturally appropriate care. Health care providers have to appreciate the fact that addressing the cultural diversity in the community goes beyond understanding values and practices of the Latinos. Cultural diversity cuts across a wide spectrum that complicates the health care service delivery.