Study Looks at Hispanic Health Care
By Brad Branan
SPRINGDALE -- Mario Vega worries that his reluctance to get
medical checkups will haunt him someday. He hasn’t visited a doctor
in years even though he’s insured through his wifes health insurance
said his medical resistance is rooted in his native country. He
relied on teas and herbs from his grandmother when he was sick in
Mexico. “I was raised
like that,” said Vega, co-owner of the Lasting Impressions car shop
in Springdale. “We didn't get sick very often, and we didn't worry
avoidance of medical care isn’t unusual for Hispanics in Northwest
Arkansas, a recent survey shows. State health officials have long
suspected Hispanics avoid health-care providers in
study, by Tulane University School of Public Health student Mary
Ramey, found 64 percent of Hispanics didn’t visit a doctor in the
past year. Of the 1,200 people Ramey surveyed, 70 percent had never
received a physical checkup.
Ramey’s survey, which was done as a master's degree
requirement, is the first systematic study of how many Hispanics in
Northwest Arkansas miss out on medical care, officials with the
state Department of Health said.
Ramey’s report tries to explains why Hispanics dismiss
American health care. Most Hispanics --78 percent -- said it’s
because they don’t have health insurance. Hispanics often skip out
on insurance and doctor visits because they come from countries with
attitudes about health care that are different from beliefs in the
U.S., Ramey said.
think doctors and hospitals are for rich people,” she said. “They
come from a culture that doesn't recognize the importance of
insurance. They also come from places where illness is viewed as a
result of sin, or an act of God.”
Doctors’ offices intimidate Hispanics, Ramey and health-care
providers said. Physicians and nurses rarely speak Spanish, and they
sometimes fail to understand important cultural differences, they
avoiding doctors, Hispanics put themselves at risk for complications
from diseases such as diabetes and other serious illnesses, they
said. Medical screenings could prevent or alleviate the
health-care providers advised Ramey what questions to ask in her
survey. Ramey interviewed about 400 Hispanics in focus groups and
had another 800 complete surveys at places such as Wal-Mart stores
and poultry processing plants. The survey was supervised by Tulane
professors and University of Arkansas professors.
recently presented her findings to the Northwest Arkansas Hometown
Health Improvement Project, a group of health-care providers
organized by the state Health Department. She plans to hold a
seminar in October in an effort to get more medical care for
Hispanics and to help physicians understand the needs of
Hispanics continue to rely on the health-care methods learned
in their homelands, Ramey said. They turn to folk healers, who
conduct ceremonies to rid them of illness. Folk healers believe
illnesses can come from fright or loss of soul, and use eggs, lemons
and herb branches as ceremonial tools, Ramey said.
Hispanics often turn to herbs, teas and vitamins. Some of
them consider penicillin to be a vitamin, and many of them get the
drug from relatives in Mexico where a prescription isn’t required.
The survey showed 72 percent of respondents took the medication
every day. That finding troubled many Arkansas health-care providers
who heard Ramey’s report. Continual use of penicillin can render it
ineffective when someone really needs it, they said.
90 percent of the survey respondents said they trusted the use of
herbs and other folk medicine. Among the people who avoided doctors
or clinics, every respondent listed a lack of sympathy or
understanding from doctors as one of the reasons.
Rodriguez is among Northwest Arkansas Hispanics who are insured. She
receives health insurance through Springdale's Rockline Industries,
Rodriguez said she recognized the need for insurance because
she understands English, the language Rockline officials used to
explain the health insurance program.
“Sometimes people don't get it because nobody explains it to
them in Spanish,” Rodriguez said. “If they don't ask for it, they
don't get it.”
Employers often fail to explain health insurance in Spanish
or explain the importance of insurance, Ramey said.
not the case at Tyson Foods Inc., where there are 1,750 Hispanic
employees at plants in Benton and Washington counties, spokesman Ed
Nicholson said. The company automatically enrolls new employees in
health insurance programs, which are also available to family
members. The benefits are explained in Spanish-language newsletters
given to employees.
some Hispanics don’t use the insurance they have. Rodriguez hasn’t
visited a doctor since she joined the Rockline health program two
years ago. Instead, she calls her grandmother in Texas when she gets
buys me medicine in Mexico,” Rodriguez said. “I don't know why, but
it works better.”
Hispanics are particularly at
risk for diabetes and hypertension caused by pregnancy,
administrators at the University of Arkansas for Medical Sciences,
Fayetteville branch, said.
Complications from diseases such
as diabetes are more likely to be avoided if they are caught early,
UAMS officials said.
Hispanics consider pregnancy a
sign of good health and a blessing. To Hispanics, the idea of
prenatal care doesn't make sense, Ramey and UAMS officials
idea of preventative care is alien to them,” said Carla Mills, an
interpreter at The Family Health Center, the UAMS facility in
Fayetteville. The center has about 1,000 active Hispanic
center has taken steps to better serve Hispanics. It received a
grant from the Community Care Foundation to provide prenatal care
and hired two full-time translators to educate doctors on the
Spanish language and culture.
Physicians and nurses need to
understand Ramey’s findings to serve Northwest Arkansas’ growing
Hispanic population, county health officials said
“There’s a recognition that cultural sensitivity is
something that's lacking,” said Loy Bailey, head of the Benton
County Health Department.
Rick Johnson of the Washington County Health Department
agreed. “It’s pretty
evident that Hispanics have different ideas about medicine,” he
Johnson’s ideas echo those of Fay Boozman, director of the
state Health Department. Poverty and distrust keep Hispanics out of
doctors’ offices, Boozman said at a conference last year in
“For many, the modern medical system and its
administration are intimating,” Boozman said at the conference on
Northwest Arkansas doctors only a decade ago had less of a
need to understand Hispanics or the Spanish language. The Census
Bureau counted 1,769 Hispanics in Washington and Benton counties in
1990. The counties’ Hispanic population was counted at 26,401 in the
“It’s critical that we understand these issues,” said
Lynn Sallings, an administrator at the family practice residency
program at UAMS. “I don't see how we can provide effective care
without understanding them.”
said she has doubts that private practice doctors will make the
economics,” Sallings said. “They have to see a certain amount of
patients to get by. It takes twice as long to serve a patient who
needs a translator.”
article was published on Sunday, February 24,
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