Nebraska Latinos Lack Access to Health Care

Women attending a breast cancer workshop at the Women's Health Summit at Mahoney State Park in Nebraska. (Photo by Ariana Brocious, NET News)
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June 5, 2013 - 6:30am

Nebraska’s Latino population jumped by 70 percent from 2000 to 2010. But many in that growing group lack access to basic health care, and knowledge of resources that exist to help them.

A conference room at the Eugene T. Mahoney State Park buzzed excitedly, as more than 80 Latina women filed past informational booths, collecting handouts and eventually finding their seats. Maria Luna is a stay-at-home mom in Lincoln, attending the Encuentro de la Mujer Sana—Women's Health Summit—a day full of speakers, workshops and information about health resources for Latinos.

“I’m here today to learn more about women’s health,” Luna said. She said the event is a good opportunity because there aren’t many places that provide such information for the Hispanic community.

More than a third of working-age Latino Nebraskans don’t have a personal physician. Nearly the same number of Nebraska Latinos is uninsured. Rates of obesity and STDs are higher among Latinos than whites in Nebraska. These findings come from a new report from the University of Nebraska Medical Center, the University of Nebraska at Omaha and the state health department.

One of the report’s lead authors is Dr. Shireen Rajaram, of the UNMC College of Public Health. She said the fact some Latinos are in the country illegally can be the first barrier.

Dr. Shireen Rajaram is an associate professor in the Department of Health Promotion and Social and Behavioral Health in the College of Public Health at the University of Nebraska Medical Center.

"Sometimes, even if you’re documented but someone in your family isn’t, you still fear for the family and don’t want your family to be split apart. So the policies that we have that might be hostile toward immigrants, especially undocumented, really don’t help us in public health at all, in terms of reaching out to people," Rajaram said.

(Photo courtesy of UNMC)

“If you don’t have legal status, it becomes very difficult for you to do basic things people take for granted.  It creates a high level of stress and fear in you. And so that essentially disenfranchise you and shuts you out from accessing any kind of institutional resources that might exist,” Rajaram said.

Another major barrier is language—particularly because Latinos aren’t a homogenous group. They come from many different countries, cultures, and sometimes don’t speak Spanish, much less English. This can lead to social isolation and a lack of knowledge about health care services, Rajaram said.

“People might live in groups within the community and all too often the information that we put out through mainstream media may not necessarily reach people,” Rajaram said.

Education level and social class also play a role. Latinos in Nebraska have higher rates of poverty and unemployment than whites, and lower household incomes. Many Latinos in Nebraska end up working in low-skill, low-wage jobs, which are unlikely to provide health insurance or paid sick leave. Employment and income affect your health, Rajaram said. “Where you live, what kind of food you get to eat, what schools you get to send your children to. What kind of access to health care you’re going to have.”

As employment goes, men also tend to work in dangerous, high-injury industries, like meat packing, construction, and agriculture. Unintentional injury is the third leading cause of death for Latinos in Nebraska (fifth for whites), following cancer and heart disease. And as Latinos adjust to the American lifestyle, their health actually worsens, as they tend to adopt the use of drugs, alcohol, and tobacco, and a sedentary lifestyle. UNMC report author Athena Ramos said lifestyles are often different in Latino immigrants’ country of origin, where they might be more physically active.

“A lot of times you’re going to the market every day, buying fresh fruit. So they’re used to that type of lifestyle. But then they realize when they get here, holy moly this is expensive to live that way, we can’t walk anywhere because our communities aren’t built for walking. Then obviously, you see health declines,” Ramos said.

A nutrition-oriented booth at the Women's Health Summit provided examples of the caloric value of traditional Hispanic foods. (Photo by Ariana Brocious, NET News)

Women’s Health Summit organizer Antonia Correa of UNMC has been educating the Hispanic community on options for access to health care for the last decade. She said lack of access often translates into lesser quality health care and expensive emergency medical services for Latinos. The summit is important because many of the women attending do not have access, Correa said.

“All the workshops, information, all the resources, we’re providing things that they do not necessarily have,” Correa said.

Part of Correa’s work is educating Latinos—especially women—about the value and importance of preventative care, which isn’t always part of the culture. The summit included workshops on breast cancer, domestic violence, nutrition, and having LGBT family members. In addition to health education, Correa said the day was about strengthening Latinas’ sense of empowerment.

“That’s one of our major goals. We want them to discover that, ‘I exist, I’m valued, I have to take care of myself, and then I can think about others,’” Correa said.

This resonated with Estela Valencia of Lincoln, another conference attendee who said women are often called the pillar of the family.

Athena Ramos is program coordinator for the Center for Reducing Health Disparities at the University of Nebraska Medical Center.

"Without appropriate educational services or economic development and planning services, we’re going to continue to lose segments of our population in terms of health and well-being overall," Ramos said.

(Photo courtesy of UNMC)

“If women are informed, we’re going to know how to act or where to find help. If we are well, our children will also be well. And the community and society will benefit,” Valencia said.

That’s exactly what Josie Rodriguez wants to hear. Rodriguez is administrator of the Office of Health Disparities and Health Equity at the state health department. She said people acting as “health ambassadors” are helpful in immigrant and minority communities, where education and outreach can be more difficult.

“We’re really hoping that they will take back that information and apply it to their own lives but also talk to people in their communities about how they can improve their health,” Rodriguez said.

Latinos are not the only minority group in Nebraska where health disparities exist, but being the largest and fastest growing makes them a key target population for these efforts.

Ultimately, Ramos of UNMC said we need to take a more comprehensive approach to health care as a society.

“Health is not just about health, it’s a whole bunch of social factors. So it’s education, health is the neighborhood in which you grow up, access to parks—pretty much every social policy you can think of. More than just transforming the medical sector, we have to transform an entire community,” Ramos said.

See the full report, including policy recommendations, here.



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