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Minorities face hurdles in getting health care

Published: Wednesday, June 27 2012 11:50 p.m. MDT

"If you don't have insurance it is pretty much game over for you," she said. "A lot of the minority jobs don't offer health insurance and when you don't have insurance it's really hard to get the care that you need."

Even if minorities can overcome the insurance hurdle, though, studies show they may not get quality care.

Language is often an issue.

"Not having the ability to communicate with your health care provider in your primary language has been shown to cause more medical errors and worse health care outcomes," Hernandez-Cancio said.

Researchers, controlling for access-related factors such as insurance status and income, have also found evidence that racial stereotyping and biases may contribute to unequal treatment in health care settings. For example, in a 2011 study of 220 medical interns, Harvard researchers found most physicians tended to harbor biases against black patients. When randomly assigned a black patient with chest pain or a white patient with chest pain, interns tended to give minorities less care. Similarly, Columbia University recently found minorities with obstructive pulmonary disease were less likely to receive transplants and more likely to die than whites.

Judi Hilman, executive director of Utah Health Policy Project, got up close and personal with racial and cultural bias in 2004 when Primary Children's Medical Center physicians refused to place an eligible Hispanic toddler on the heart transplant waiting list. When she and now-Senator Luz Robles, D-Salt Lake, tried to intervene on the 2-year-old's behalf, she said they were told in no uncertain terms that the girl was turned away because her parents, who were immigrants, were illiterate.

"They were convinced the family would not be able to handle the home care instructions to the letter," Hilman said. "We thought they would bring together support for the family — case managers, interpreters, whatever they needed to make it happen — but they just didn't."

When the girl died, Hilman said the family was taken by surprise. Because of the language barrier, they never quite understood the gravity of the situation.

"Things are definitely getting better," she said. "Still, we worry that when there are decisions of life and death and the level of care that is required is very complicated, decisions are being made inappropriately."

Improving health

As Mosqueda waits for her daughter to return from the pharmacy, she explains her health care plan.

"The best thing to do is to not get sick," she says.

If the family is healthy, she won't have to worry about paying medical bills.

It's a goal easier stated than accomplished, but with the help of Communities United, a Salt Lake City nonprofit dedicated to improving health outcomes among minorities, Mosqueda says she is learning the steps to take to ward off illness. On her fridge, Mosqueda has posted a diagram of a plate sectioned off to represent how many vegetables, grains and meats she should feed her family each day. Before taking a free nutrition class from the nonprofit, Mosqueda says she cooked "food that had a lot of grease." Now she's deep frying less and making salads more. Communities United also taught her about the importance of getting regular mammograms and helped her find a doctor who would perform the exam pro bono. She is grateful, she says, because her tests came back irregular.

Mosqueda learned of Communities United from a neighbor who works as a health promoter. Community leaders who promote preventative health among neighbors and friends play an important role in helping to close the health care gap, Hernandez-Cancio said. Like "the mom that everyone goes to for advice," these health promoters already have the trust of the community. They have proven effective in helping friends and neighbors cross cultures, overcome financial barriers and navigate the health care system.

"Community health centers are incredibly important because they address some of the issues of providing," Hernandez-Cancio said. "They are taking the lead in providing programs and do prevention work and they go the extra mile, for example, providing a van to drive a patient to services."

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