The Hispanic community in the United States faces barriers to care that have serious medical consequences. A number of clinical trials have shown that discrimination can indeed harm a person’s health.
In medical settings, discrimination happens when a health care provider:
- Doesn’t take you seriously
- Dismisses any symptoms or health concerns you might have
- Doesn’t provide you with medical care information in your preferred language
A Vicious Circle
Structural and institutional racism in medical settings and society as a whole exists for a number of complex reasons.
For example, at the start of the 20th century, researchers performed medical experiments on people from marginalized groups without their knowledge or consent. So it’s clear that:
- There are health care providers who are still prejudiced against patients who are not White.
- A number of Hispanic and Black patients are still distrustful of doctors and the field of medicine as a whole.
What’s more, there is a long history of discriminatory housing and lending policies in the United States that continues to this day. For example, although racial segregation is legally prohibited in the United States, it is still a reality for many Hispanic people and people from other marginalized groups.
This social condition brings with it barriers to:
- Adequate housing
- Jobs with good salaries
- Healthy food
- Educational resources
- Good medical care
To break down these barriers, the World Health Organization put together a commission to identify the social determinants of health.
What Are the Social Determinants of Health?
The social determinants of health are the social, economic, and physical conditions of where a person is born, grows up, works, lives, and gets older. At first glance, it doesn’t seem like they have anything to do with health. But several clinical trials have shown the significant effect these social determinants have on quality of life and health status. Research has also shown that Hispanic people and people from other marginalized groups have a high risk of getting chronic diseases such as type 2 diabetes when their social determinants of health are defined by racism.
The idea is simple: It’s very unlikely for people who work long hours for little money and don't have health insurance to buy fresh, healthy food, let alone have the time to prepare it. This type of lifestyle that leaves little time for self-care can increase a person’s risk of type 2 diabetes and other chronic diseases.
The World Health Organization and several medical professionals recognize that to reduce the risk of chronic diseases in people who come from vulnerable groups, it’s necessary to go beyond preventive education and improve people’s socioeconomic conditions. Prevention education alone is never going to be enough for people with prediabetes who don't have access to the resources they need to reduce their risk.
The Overall Effect of Type 2 Diabetes on the Hispanic Community
It’s natural to feel stress, fear, anxiety, and even depression after being diagnosed with type 2 diabetes. These feelings usually go away as you adjust to living with the disease. But when these feelings continue, it’s important to talk to your doctor so you can get the help you need. It might seem like a pretty simple thing to talk to a doctor about your mental health. For some Hispanic people, it can be a little difficult.
Talking publicly about mental health is considered taboo among many Hispanic people. The stigma about mental health is still common in the Hispanic community. There are still people who refuse to seek help because they don’t want to be considered “crazy.”
It can also be difficult for Hispanic people to find a mental health professional for a number of reasons. Even if they are willing to speak to a mental health professional, Hispanic people might not be able to find someone who:
- Speaks Spanish or who can provide a bilingual medical interpreter
- Accepts their health insurance plan
- Is culturally competent
These are the consequences Hispanic people face because of their social determinants of health. These determinants make it difficult or even impossible for many Hispanic people to access good mental health care. Despite having the same vulnerability to mental illness as the general population, Hispanic people are half as likely to receive medical care for mental health.
What Steps Can the Medical Community Take?
Health care providers understand the urgent need to gain the trust of people who come from vulnerable groups. But health care providers must also recognize that discrimination exists and do everything they can to dismantle it.
Doctors can wipe away certain biases just by taking the time to find out which of their patients are having a difficult time because of:
- Low incomes
- Long working hours (inflexible schedules)
- Inadequate health insurance plans (or not having health insurance at all)
- Their ability to keep medical appointments, either because of a lack of money or time
Doctors can also do the following:
- Identify and report any instances of discrimination.
- Discuss the racism that exists in medical settings with medical students so they can consider their own behavior and how it may affect their patients.
- Promote racial and ethnic diversity in hospitals, clinics, and private medical practices.
- Provide bilingual medical interpreters for people who need them.
- Provide medical forms that patients fill out in multiple languages.
Don’t Shy Away From Advocating for Yourself
Ultimately, it’s up to you to manage your diabetes by monitoring your blood sugar, eating healthy foods, exercising, and keeping your care team up to speed on how you’re doing. But you also need support from others. Consider the following tips:
- Find a doctor who is culturally competent and can communicate clearly with you, either in Spanish or with the help of a bilingual medical interpreter. Your doctor should always make you feel comfortable and respected.
- If your doctor recommends something that won’t work for you, be honest. Let your doctor know if a prescription medicine is too expensive or not covered by your health plan or if a diet plan doesn’t take your cultural preferences into account.
- Ask your doctor to recommend a diabetes care and education specialist for you and your family. Your loved ones should understand your diagnosis as much as possible so they can support you as best they can and never make you feel self-conscious or judged.
If someone makes you feel bad, be it a loved one or your doctor, be your own advocate and let them know how they are making you feel.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
CDC: “Diabetes Stigma: Learn About It, Recognize It, Reduce It.”
Clinical Diabetes: “Diabetes and Depression in the Hispanic/Latino Community.”
The Commonwealth Fund: “How Discrimination in Health Care Affects Older Americans, and What Health Systems and Providers Can Do.”
Jama Network Open: “Patient-Reported Experiences of Discrimination in the US Health Care System.”
The Journal of Clinical Endocrinology & Metabolism: “Casting a Health Equity Lens on Endocrinology and Diabetes.”
National Alliance on Mental Illness (NAMI): “Hispanic/Latinx.”
Office of Disease Prevention and Health Promotion: Health.gov: “Social Determinants of Health.”
Organización Panamericana de la Salud: “Determinantes sociales de la salud [Social Determinants of Health].”
