The Role of Trust and Communication in Hispanic and Latinx Healthcare Engagement

Medical mistrust in the Hispanic and Latinx community has contributed to the growing national concern about the Latino community’s healthcare engagement¹. What is medical mistrust? It is the lack of trust in healthcare providers and/or the medical system overall². This medical mistrust exacerbates the already disproportionate health disparities and inequalities present in this community. To combat the distrust, we must address the underlying factors at play.

Discrimination and Racism

A 2017 survey found that approximately 1 in 5 Latinos have reported experiencing discrimination, specifically in healthcare settings. This rate is around four times greater than that of their non-Hispanic counterparts². As a result, a significant portion of the Latinx population avoids seeking healthcare services altogether due to the worry that they will experience discrimination as soon as they enter the hospital doors³.

Discrimination severely impacts the quality of healthcare that Latinos receive. A separate study found that Hispanic individuals reported significantly lower patient satisfaction rates compared to White patients, with one of the main factors being the perception that clinicians not disclose important information regarding their health status⁴.

Language Barriers and Limited Latinx Healthcare Workers

What may seem like a simple problem with an easy fix is one of the most widespread issues that the Latinx community faces. Over half of the Latino population has experienced communication issues with their physicians⁵, including understanding what the physician is saying to them and accurately describing their  symptoms or concerns.

Because many Hispanic patients cannot fully communicate with their healthcare providers, they often resort to family and friends who speak English attend doctor’s appointments with them.

There are several issues with this. Firstly, this places an unnecessary burden on the individual who will interpret for the patient. If the interpreter is busy, the patient is left to fend for themselves. Additionally, if the family member or friend has little to no experience in the healthcare field, there is no guarantee that they will successfully convey the message to the patient, especially in complicated cases.

Finally, if the patient has a concern regarding a sensitive topic (such as sexual health), they may feel hesitant to share that information in front of their loved ones.

Shockingly, nearly one-third of hospitals nationwide do not offer accessible linguistic services, and there is an interpreter shortage in hospitals that do offer such services⁶. These issues are further exacerbated by the lack of Hispanic / Latino physicians, which currently make up only 5.8% of the physician workforce⁷.

References

1. Velasco-Mondragon E, Jimenez A, Palladino-Davis AG, Davis D, Escamilla-Cejudo JA. Hispanic health in the USA: a scoping review of the literature. Public Health Rev. 2016;37:31. Published 2016 Dec 7. doi:10.1186/s40985-016-0043-2
2. Findling MG, Bleich SN, Casey LS, et al. Discrimination in the United States: Experiences of Latinos.Health Serv Res. 2019;54 Suppl 2(Suppl 2):1409-1418. doi:10.1111/1475-6773.13216
3. Jaiswal J, Halkitis PN. Towards a More Inclusive and Dynamic Understanding of Medical Mistrust Informed by Science. Behav Med. 2019;45(2):79-85. doi:10.1080/08964289.2019.1619511
4. Taber JM, Leyva B, Persoskie A. Why do people avoid medical care? A qualitative study using national data. J Gen Intern Med. 2015;30(3):290-297. doi:10.1007/s11606-014-3089-1
5. Escarce JJ, Kapur K. Access to and Quality of Health Care. In: National Research Council (US) Panel on Hispanics in the United States; Tienda M, Mitchell F, editors. Hispanics and the Future of America. Washington (DC): National Academies Press (US); 2006. 10. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19910/
6. Schenker Y, Pérez-Stable EJ, Nickleach D, Karliner LS. Patterns of interpreter use for hospitalized patients with limited English proficiency. J Gen Intern Med. 2011;26(7):712-717. doi:10.1007/s11606-010-1619-z
7. 1Figure 18. percentage of all active physicians by Race/ethnicity, 2018. Diversity in medicine: facts and figures : 2019. AAMC. Accessed May 11, 2023. https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101778455-pdf.