As a rising sophomore in college and a chronically indecisive person, I’ve changed my majors quite a few times: 3, to be exact. When I finally committed to nursing, however, people were hardly surprised. I grew up idolizing my grandmother, a retired nurse, so of course I would want to follow in her footsteps. In many ways, their assumptions are right: I aspire toward the level of compassion and knowledge she has cultivated as a nurse. However, hearing her stories nearly scared me from the profession entirely; she clearly touched and saved many lives, but her career was also filled with immense frustration at what seemed like a broken healthcare system.
In my community, migrant farmworkers are the foundation of the economy and the majority of the population, yet the minority of patients at clinics and hospitals. When they do come, it is for emergencies– usually chronic problems that they neglected for lack of time, money, or education. Efforts to funnel resources and culturally competent care were few and far between, if not thwarted entirely. As a second generation immigrant myself, the lack of attention to predominantly Hispanic communities feels like a personal attack. I did not want to work for an institution that seemed indifferent to people like me.
This lack of representation at the patient level is a reflection of their care providers. According to the US Census Bureau, white people are over-represented in 23 of the 30 major health occupations. Only 5.4% of the 3 million nurses in the United States identify as Latino or Hispanic. As long as Latino patients don’t have sympathetic medical advocates who understand the systemic barriers to care in all their complexity, they will continue to impede Latinos’ right to health.
This would explain why Latinos are the least likely out of every ethnic group to seek medical treatment; cultural incongruities even follow those few who do. In a 2008 survey conducted on 28 Latinas, 26 said that the amount of information they disclosed to their physicians depended on the level of trust and mutual respect. Ultimately, this causes patient secrecy as American professionalism, efficiency, and linguistic differences translate to cold and rushed appointments. Thus, underrepresentation harms quality of healthcare for Latinos in addition to the rate at which they seek it.
The pandemic exposed this fact as it ravaged predominantly nonwhite communities. Latinos were over twice as likely to be hospitalized due to complications with COVID with nearly double the mortality rates compared with white people. Still, despite such desperate need for medical intervention, the healthcare industry proved to be an ineffective mediator. Instead of licensed professionals, community health workers (CHWs) came to many Latinos’ aid for protective gear, information about the disease and vaccine, and emotional support. In short, they served as peer intermediaries for health care providers and their patients.
The importance of CHWs’ work, especially during the pandemic, cannot be overstated. However, the extent to which the US healthcare system relied on these (often unpaid) workers is not only exploitative, but also a mere band-aid over a more pervasive issue: lack of diversity in the healthcare workforce. The healthcare system should spend less time outsourcing trusted community members and more time educating, training, and hiring them to provide medical relief. Studies show that healthcare professionals of color are more likely to serve in medically underserved areas than are white people. Thus, one generation of healthcare providers can potentially uproot decades of skepticism toward Western medicine within the black and brown patients who disproportionately get sick and die without it.
Our most vulnerable population deserves and requires a healthcare staff equipped with the experience to understand and treat them more effectively. However, until Latinos are valued by the healthcare system, recruiting them to staff hospitals will be a challenge. Neglecting minority health is cyclical; it will fuel a culture of distrust of the healthcare institution, not only de-incentivizing them to seek care when needed, but also to fill positions in frontline staff.
Latino health can no longer be brushed aside: by 2060, Latinos are estimated to comprise 28% of the population. Lack of diverse healthcare staff will become as much of a public health crisis as COVID is if it is not addressed now. However, while COVID was inevitable, staffing a diverse workforce will require legislation, dialogue, and an overall shift in society’s attitude toward Latinos. This change must start with how healthcare workers reach out to patients. Latinos must be brought from the margins and to the forefront of health; our wellbeing as a nation depends on it.
By Zoe Rosales, Associate Project Manager – Intern, for HOP’s series of monthly staff blogs.