Latina Women: As Health Care Recipients

Hispanic American/Latina Women: Getting Health Care

Despite being the richest country in the world, 50 million people living in the United States are uninsured. The increasing privatization of medical insurance has transformed health care from a human right into a privilege of the wealthy.1 According to the 2002 Census, 63% of employed Latinos lack access to health care of any form.2 26.1% of the Latino population has no health insurance in comparison to the 9.3% of the non-Hispanic white population.3 A shocking 60% of employed Cubans, 53% of employed Mexicans and 46% of employed Puerto Ricans are uninsured.4 The drastic disparity in access to health care for the Latino community and Latinas specifically can be attributed to four barriers: linguistic, cultural, legal and financial.

Linguistic Barriers

Spanish as a native language is a parameter used to define the term Latino. Although not declared the official language of the United States, English is the most commonly utilized language in the medical field. Despite the fact that California ranked first in the U.S. in percent of the population lacking fluency in English, only 28% of primary care physicians and 17% of specialists consider themselves fluent in Spanish.5

Latinas are less likely than their male counterparts to learn English. In Latino culture, the female gender role is targeted towards motherhood and other domestic tasks. Therefore, Latina women often have lower education levels and are more likely to be confined to households in neighborhoods where access to ESL classes is limited. In the rare case that a medical professional can communicate in Spanish, the wide variety of dialects poses a large problem. Spanish spoken by Puerto Ricans is completely different from that spoken by the Mexican population.6

Cultural Barriers

The United States has an explicit health care structural organization with defined roles of the provider versus the patient. These roles often conflict with the structure Latina women are accustom to following. Medical decision making in Latin American countries often resides in the hands of the patient’s family. Failure to consent to the provider’s recommendations is much more common than in the United States. Additionally, in many Latin American countries, public health services are provided free without income verification. Reporting income is required in the United States and often causes anxiety and fear in Latinas deterring them from utilizing these services.7

Latino culture places more emphasis on holistic medicine as opposed to traditional western medicine. For example, many Latinas believe that health is a state of balance within the body and that disease is the manifestation of an imbalance. As a result, the hot-cold theory, in which hot medication is used to heal cold illnesses and vice versa, is commonly utilized. Foreign born Hispanics are used to the availability of over the counter “hot” and “cold” drugs that are only accessible via prescription in the United States.8 Sadly, education regarding cultural differences is not a norm in the field of health care. Issues of poverty and the health care of immigrant women is included in fewer than 40% of residency programs and other health profession training.9

Legal Barriers

Due to the variety of immigration legislation passed and overturned, a constant fear has been instilled in the Latino population. Many Latinas believe that utilizing free medical services or Medicaid will entangle them in legal complications. The misconception that “public charges” accumulate from use of free health care services scares many Latinas who fear jeopardizing their chances of becoming citizens or sponsoring relatives for future immigration. Even more are unaware that the reporting of legal status by health care services is illegal and fear deportation. A San Francisco study revealed that 75% of Salvadoran and 54% of Mexican undocumented women reported fear of deportation as the primary reason for failing to utilize free medical services.10

This widespread distrust is a direct result of legislation such as California’s Proposition 187 (1994) which prohibited public education and health services to illegal immigrants. Consequentially, many Latinas use the Emergency Departments (ED) of hospitals as a main source of medical care.11 In 2001, 7.8 percent of visits among Latinos occurred in emergency rooms compared with 6.6 percent of whites’ visits. Additionally, the probability of non-urgent ED visits is the lowest for Latinos.12

Financial Barriers

As mentioned in the introduction, quality health care has come to depend upon wealth accumulation. According to the 2002 Census, 22% of the 38 million Latinos live below the poverty line.13 The theory of “feminization of poverty” which predicts that poverty and low income is proportionate to female headed families can be applied to Latina women. The fact that 23% of Latino families are headed by women in contrast to the 16% for the white population, visibly demonstrates this theory.14

The marginalization of Latina women as a result of their gender and immigrant status manifests itself in job availability. The jobs Latina women are eligible rarely offer health care benefits. Additionally, these jobs do not excuse medically related absences. Caught in this web, Latina women are discouraged from receiving medical care in two respects; a visit to a health care professional costs money out of their pocket while causing them to forfeit a work day’s pay and possibly risking their employment status.15


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