“Most American healthcare deals with a kind of factory approach where you’re in and out and that’s that,” says Salcines. “But for Latinos, we value having a relationship with our doctors.”
A 2008 study that interviewed 28 Latinas about their experiences with American healthcare supported this claim. One interviewee, explaining her recent visit with a doctor, said, “I didn’t feel comfortable with him, the meeting was too short and fast … he didn’t pay attention to what I was saying, he didn’t ask me my name, and he didn’t introduce himself. He went directly to check me. It was the most uncomfortable situation.”
Twenty-six of the women said the amount of information they disclosed to their doctor depended on “developing a trusting relationship with their physician based on mutual respect.” The researchers wrote that, “for these women, their willingness to disclose information decreased if they did not sense that their physician was compassionate.”
I relate to these women’s concerns. I’ve never felt quite comfortable with most doctors’ styles, and I often leave visits frustrated that the doctor asked little about me, prescribed medication quickly, and didn’t bother getting to know more about my situation as a whole. I always mentally compare these experiences to the comfort and familiarity of my grandmother’s remedies. As a generally-healthy young adult, this is one of the reasons I feel unmotivated to apply for healthcare.
Discomfort with doctors also intensifies when the health topic is culturally taboo, like sexual health or mental illness. Latino males are almost 2.5 times more likely than whites to have HIV and Latina females are five times more likely than whites to experience teen pregnancy. Yet stigma around the subject prevents patients from talking about it. In the 2008 study of Latina women, interviewees said their culture “regarded sex as a personal, intimate issue to be discussed only with one’s partner and sometimes not even then.” During my visits with gynecologists, I am always surprised by how openly doctors expect me to discuss issues I’ve been raised to believe are private.
For mental health, reactions are similar. A 2001 Surgeon General's report found that only 10 percent of Latinos with a psychological disorder contact a mental health specialist. Often this is because Latinos aren’t familiar with mental health issues, nor comfortable talking about them. Some members of my family don’t know what “anxiety disorder” or “depression” truly mean. Instead, they often simply say that a family member is “not right” or “not well,” and consider it a phase that will pass with individual effort.
When healthcare professionals don’t share our same background, we are even less comfortable asking for help. Latinos represent more than 16 percent of the population, yet only 5 percent of physicians. In 2011, only 15 percent of students entering medical school were black or Latino. In heavily Hispanic states like California, Texas, and New Mexico, this gap becomes even more significant.
Our cultural emphasis on trust makes having a doctor we can relate to even more crucial. Salcines recalled how her Cuban mother would wait five hours in a waiting room to see a Latino doctor, rather than visit a non-Hispanic physician: “There’s a level of confianza or trust that you feel with someone Hispanic. It just gives you an instant feeling of, ‘Okay, I can tell this person what I really feel.’”
With all these cultural influences involved, when medical care is not reasonably priced, even middle-class Latinos will feel disinclined to pursue it. My own middle-class family often weighed the necessity of visiting doctors against the money we’d save by staying at home.
The frustrating result from all this is that many Latinos may not receive the care they actually need. A third of Latinos have diabetes, and as many as half are not aware of how to treat it. According to the FDA, Latinos have worse diabetes control than other groups and are more likely to experience complications from the disease.
Even among the generally healthy, not addressing Latinos’ attitudes toward healthcare puts our demographic at a disadvantage. Without visiting doctors, we are not accessing information that could change our daily health decisions or getting the preventative care we need.
Healthcare workers can address these issues by offering their services on a sliding scale and translating health information into Spanish. But healthcare professionals also need to be aware of the cultural values that Latino patients find significant. They need to focus on building relationships with patients and understanding their background, as well as emphasizing health education programs in Latino communities.
Having more Latino doctors would also help alleviate these concerns. Reports suggest that once Latino and black students become doctors, they are more willing than other groups to practice in underserved areas. But in pre-med programs, many Latino students often lack the prerequisite courses to succeed, like Advanced Placement Chemistry and Biology. They also often lack mentors to help navigate the medical-school application process. And the staggering price of medical school can make this career choice seem daunting. Providing more support for Latino students facing these challenges would ultimately allow them to contribute their essential background knowledge to the medical field.
The diversity within the Latino community means that addressing their healthcare issues is going to take more than a few, simple solutions. If healthcare providers want to attract the more than 50 million Latinos who live in the United States, they need to commit to learning about our diverse community and its multifaceted culture. They can start by recruiting Latino professionals who can provide personal insight about how to help them best.