Multiple sclerosis (MS) is a long-term (chronic) inflammatory disease that damages the protective coating around nerve fibers (myelin) in the central nervous system. This disease can be difficult to diagnose because it’s unpredictable and doesn’t affect everyone in the same way.
In the United States, MS is more common among Black and White people than it is among Hispanic people. However, symptoms are often more severe in Hispanic people who get the disease.
If you have been diagnosed with MS, you have the right to high-quality medical care. But according to a few clinical trials, Hispanic people in the United States face barriers to care that can have a negative effect on their health.
What Are the Social Determinants of Health?
According to the medical community, the social determinants of health are defined as the conditions in which people are born, grow, live, work, and age. These social determinants have a major influence on health. For example, someone with a low income and no health insurance doesn’t have the same access to health care as someone who earns a good salary and has good health coverage. If both of these people get sick, it’s likely for the uninsured person to have a delayed diagnosis. When a diagnosis is delayed, it can raise the risk of MS getting worse or its symptoms getting more severe.
Barriers to Care
The disparities faced by Hispanic people in the United States may contribute to how common MS is in that population, as well as how severe its symptoms are.
Some of the barriers they face can include:
- Lack of health insurance or lack of health insurance that provides enough coverage
- Cost of living
- Low income
- Limited access to transportation
- Language barriers
- Systemic discrimination and bias of care providers
- Lack of adequate representation in clinical trials
Overcoming Financial Barriers
Even if you have health insurance, it can be costly to get medical care for MS. Those costs may include:
- The copay for each medical appointment
- The copay for medicines or other MS therapies
- The cost of transportation to medical appointments
- Rehabilitation (which might not be covered at all)
- Modifications that need to be made to your home
Even if you have health insurance, talk to your doctor if you need financial help. Many hospitals offer financial assistance to people who meet certain criteria and who cannot afford their medical treatments. Ask your doctor if they can recommend a hospital that offers this type of care.
There are also several organizations and programs that offer help with the financial aspect of this disease. For example, the National Multiple Sclerosis Society has:
- A list of organizations that offer different types of benefits
- Free drug programs for people who don’t have health insurance
- Drug programs for people who do have health insurance
- Information about getting health care without insurance
- Information on how to apply for Social Security disability benefits
Overcoming Language Barriers
In an ideal world, you’d find a neurologist who has a good understanding of MS and speaks Spanish. But doing so can be difficult.
But your doctor doesn’t have to speak Spanish to be the best doctor for you. Make sure your doctor:
Communicates in a clear, kind, respectful, and empathetic way. If your doctor makes you feel uncomfortable or you feel like they don’t listen to you or respect you, find a new one.
Is culturally competent. A doctor with cultural empathy understands that:
- All their patients are culturally different, and they all deserve respect.
- It makes sense to try to learn how to speak Spanish to better communicate with all their Spanish-speaking patients.
- Some patients need a medical interpreter, so it’s best to provide one.
- Medical care must be tailored to fit the needs of each patient, and that means taking into account each person’s culture.
Remember that in the United States, anyone who doesn’t speak English or has limited proficiency in that language has the right under federal law to receive the services of a medical interpreter. A medical interpreter can be a good idea even if you speak English and even if your doctor speaks Spanish. MS is a fairly complex disease, and it can be difficult to understand everything your doctor tells you. An interpreter can help you and your doctor understand each other.
If your doctor doesn’t offer you an interpreter, ask for one. What’s more, if you receive information about MS or instructions about the treatment you need to follow, be sure to ask for translated versions. Your understanding of the information about this disease and the effect it has on your health is very important.
Consider Taking Part in a Clinical Trial
Several clinical researchers are aware of how underrepresented Hispanic people are in clinical trials. Ask your doctor to recommend a clinical trial that’s right for you. If you take part in one, you may have access to new medicines that aren’t available to the general public yet. You’d also be helping researchers better understand the development and advancement of MS in Hispanic people and identify better therapies for them.
Show Sources
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SOURCES:
American Medical Association Journal of Ethics: “Clinicians’ Obligations to Use Qualified Medical Interpreters When Caring for Patients with Limited English Proficiency.”
Clínica Universidad de Navarra: “Esclerosis múltiple [Multiple Sclerosis].”
The Eleanor Mann School of Nursing: “Access to Healthcare for the Hispanic/Latino Population.”
National Academy of Sciences: “What are the Social Determinants of Health?”
National Multiple Sclerosis Society: “Financial Resources,” “Guide to Prescription Financial Assistance,” “Disability Insurance,” “Speaking the language of MS.”
Salud América! “MS in Latinos: What Do We Know?”
World Health Organization: “Closing Inequalities in a Generation: Achieving Health Equity by Acting on the Social Determinants of Health: Analytical Summary of the Final Report.”
