Factors that Influence Access to Health Care
The Affordable Care Act passed in 2010 and the exchange plan implemented in 2012 has broken down some of the barriers that were affecting the Hispanic community. Prior to the Affordable Care Act, the Office of Minority Health identified the Hispanic community as one of the most vulnerable population in the U.S. In addition, the OMH mandated the usage of cultural and linguistic competent care in all health care facilities.
The implementation of providing a culturally and linguistically competent care and the Affordable Care Act was superseded by the report from the Institute of Medicine “To Err is Human” in which the IOM identified ...view middle of the document...
When providing care for the Hispanic community, nurses first have to search their conscience and see if they hold any generalization or belief that may distort the care they give to the patient. The Hispanic community is a closely tied community where illness and disease is managed by family members. Some of the issues that the Hispanic patient relayed as unmet are 1) Feeling misunderstood about health complaint and illness. 2) Feeling unheard by health care professional and 3) Feeling of unmet needs such as family involvement in decision making.
Similarly, reports show that cancer patients of Hispanic origin suffer more pain and are not given the chance to die at home as desired by the patient. This is not because of neglect by the practitioner but rather it is because of cultural misunderstanding. In actuality, current trend to caring for the Hispanic patient is moving toward providing a culturally congruent care (Carrion, 2010). In fact, the study by Carrion (2010) about physician’s perception of caring for the terminally ill Hispanic patient revealed that the physician’s felt there need to be more Spanish speaking health care providers to accommodate the patient; they understood that family (including extended family) was very important to the Hispanic patient and that decisions were made after consulting with the entire family.
As a whole, the health care system is moving toward the right direction by recognizing the need to provide culturally and linguistically competent care to the Hispanic patient. However, Pena-Purcell, Boggess, and Jimenez (2011) cite a quasi-experimental study finding that health care providers assume that Hispanic patients do not follow treatment plan. Contrary to the belief however, the study found that Hispanic patients were non-compliant because they did not understand the direction provided in English.
On the other hand, a study by Wallace, DeVoe, Rogers, Protheroe, Rowlands and Fryer (2009) found that overall the Hispanic population felt providers don’t always listen and allow patients to participate in their care. This specific study also found delineation within the Hispanic population based on country of origin. For example, Cubans tended to have at least a high school diploma and are from a higher socio-economic status whereas Mexicans tend to not have a high school diploma and are from a lower socio-economic level. Additionally, communication between provider and the patient was influenced by whether or not the patient spoke English predominantly or Spanish. When a patient is fluent in English, communication was rated as adequate with provider than when the patient is predominantly a Spanish speaking individual (Wallace et al. 2009).
Regardless of the language spoken, the study showed that Hispanics felt unheard and unaccounted for in relation to communication with health care providers. Thus, the need for recruiting more Spanish speaking health care providers in to the field is...