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Pandemic planning is incomplete without health equity at its core

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As our country continues to reflect on the devastating impact of Covid-19 and the World Health Organization has noted that the ‘end is in sight’ for the pandemic, we must acknowledge the disproportionate hardship faced by Black and Latino communities. acknowledge and address. last two plus years. Latino communities, which have experienced some of the highest rates of infection, hospitalization and death compared to other racial and ethnic groups in the US, have been mostly forgotten and excluded when testing and vaccine efforts were planned and carried out. In addition to the continued spread of the virus in our communities, there has been a shortage of programs to support families and individuals whose economic, educational, housing and nutritional needs are at risk due to the pandemic.

As new bivalent boosters become available, and demand for monkeypox vaccines increases, while federal funding for testing and vaccinations simultaneously declines, it is more urgent than ever to take the necessary steps to ensure that the needs of Latino communities are included become in future public health planning to avoid repeated mistakes that have led to unnecessary suffering.

Improving visibility of Latino communities during public health crises

During the Covid-19 pandemic, cases in Latino communities were undercounted and underreported, leading to skewed reporting and reduced efforts to urgently address the impact of the virus. The invisibility of Latinos was common throughout the pandemic, as death rates for Latinos were 2.3 times higher than for white Americans, including younger Latinos, who were more likely to be essential workers and thus at greater risk of infection, with 45% of adults who have jobs that require them to work outside the home. Despite the availability of vaccines in our country, a staggering 35% of unvaccinated Latinos feared immigration consequences when considering the vaccine, and 15% reported being asked for a social security number—which is not required by law is not required for a vaccination.

Despite these staggering statistics, media coverage grouped Latinos with other communities of color, and while reporters highlighted communities across groups, they failed to focus on risk factors that specifically affected the Latino community. These include access to health care services and information available in Spanish, masking and social distancing policies that were not realistic in many multigenerational Latino homes, and immigration status fears and mistrust. These disparities impacted the way the Latino community experienced the pandemic, but little was done to offer culturally appropriate solutions until it was too late.

Addressing the unique needs of the Latino community

The pandemic has only shone a spotlight on what we in the public health community have been sounding the alarm about for years about the systemic inequities that run rampant in our health care system. In the US, our system and payers have failed to adapt their processes and services to meet the cultural needs of the growing number of Latinos, who are expected to make up 30% of the population by 2050.

We can no longer rely on a one-size-fits-all health care system that continues to ignore us and refuses to build trust with our Latino community. In addition to neglecting the cultural and health literacy needs of Latino patients, our community experiences medical gaslighting by providers with implicit biases about the lifestyle choices and belief systems of Latinos that impact the way we think about our health. For example, a Latino patient may look to family and friends for medical advice before seeking health care from a physician for fear of being labeled “noncompliant” or receiving unrealistic care recommendations.

To combat this, hospitals, practices, and providers must invest in developing and implementing training to understand the diverse cultures that make up the U.S. Latino population. This includes the many protective factors such as social support systems and informal networks that provided the community with much-needed resources and services when the existing system excluded them. In addition, it is imperative that providers reflect the diversity of their patients – the more we can bring in providers who come from our community and empathize with our traditions and values, not to mention speak our languages, the better chance we have to achieve true culturally relevant and competent care.

A better way forward

My hope is that health equity does not become another trendy buzzword. We must ensure that everything we have learned over the past few years will be integrated into business goals and eventually become the fabric of our healthcare system. To do this properly, there are a handful of key elements to delivering culturally competent public health services that will set us up for success.

First, we must integrate culture into care. As our community continues to grow, we should embrace the traditions and unique qualities that make up our identities, instead of forcing our people to hide their language, vulnerabilities or basic needs. This goes far beyond providing translation services, which often lack cultural awareness. Offering the Latino community care teams, with providers who have a deep and personal experience with our culture, traditions and health outlook, is the only way we will rebuild trust.

Additionally, addressing gaps in health care coverage is essential to improving access in our community. A large portion of our community and country do not qualify for state or federal subsidies or cannot afford commercial or employer health insurance plans. This gap significantly affects the Latino community in states that do not extend Medicaid benefits to people who immigrated to the US or states with concentrated Latino neighborhoods where domestic work is common and health benefits are often not provided or used. If these issues are not addressed, they will continue to play a role in the health disparities experienced by the Latino community.

New care models such as primary and specialty care membership with direct payment help access, but there is a need to cater for wider communities beyond the Whites and affluent. Well-known players in the space have focused on developing seamless experiences for customers, but where these companies fall short is in their ability to tailor services to the communities that need these solutions most. If these primary care models are to succeed, improving access must be part of the overall growth plan.

In addition to improving cost and accessibility, communities should be able to engage with care teams that look and sound like them while providing culturally appropriate care in their homes, neighborhood clinics, and via virtual services. These new solutions typically rely on technology to open the door to care. We know that technology alone will not solve the systemic issues in the healthcare system, and to be successful, technology must enhance established care relationships so that these touchpoints help patients and providers build stronger connections to promote better health outcomes. Innovative solutions can and must preserve the culture and traditions that make the Latino community strong.

We are at an inflection point as a society where we need to change our perspective on what it will take to ensure that ALL patients are seen, heard and cared for – both in everyday and dire healthcare scenarios. Our sisters and brothers are dying from preventable chronic conditions, and no one is doing anything about it. We have to do something else. We need to stop pretending that we need health care, and our access is fair. It just isn’t.

Photo: Nuthawut Somsuk, Getty Images

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