Latin@s Facing Ongoing Health Disparities; It's Time to Do Something About It

(Note: Latin@ is a gender-neutral way to refer to people with Latin American roots.)

We know that we are a nation of great inequality. The question is whether we have the will to do something about that.

One of our most egregious injustices is unequal access to health. Our health care system still privileges the wealthy and disadvantages low-income people, who remain disproportionately people of color. As more data emerge, we are continually reminded that we are failing African Americans and Latin@s, and others long mired in poverty.

The U.S. Department of Health Human Services Office of Minority Health, marking National Hispanic Heritage Month, urged individuals to become more aware of Hispanic/Latin@ American history, and join with others in helping to "raise awareness about the health disparities that impact Hispanics, and connect members of your community to resources" that will advance health and well-being.

As executive director of the National Health Law Program (NHeLP), I'm involved every day with a remarkable group of litigators and policy advocates who are devoted to protecting and advancing the health rights of low-income individuals and underserved communities. We cannot ignore the fact that Latin@s are disproportionately living in underserved communities and on limited incomes or our collective complicity in the structures that have fueled the disparities. Latin@s are also disproportionately lacking in access to health. This is a vicious circle -- many low-income people lack access to the health care they need, physical and behavioral, but their lack of health care makes it difficult to break the poverty cycle. When we finally achieve the goal of health equity - giving everyone in this country an equal opportunity to be healthy, many more Americans will be able to enjoy the opportunities offered in our country and our workforce and economy will be stronger for it.

Medicaid, the Civil Rights Act of 1964, the Americans with Disabilities Act, and the Affordable Care Act are all tools that NHeLP relies on to secure and advance health rights for low-income individuals. All of these tools are needed to help Latin@s overcome health disparities, and to have the opportunity to enjoy better lives.

Federal and state government agencies, health advocates, scholars, foundations, nonprofits and others are increasing and bolstering the study of health disparities. We know for example that while the ACA has brought down uninsured rates for many people, Hispanic communities remain with highest rates of uninsured. As NHeLP's Fabiola Carrión, notes in this piece for the Network for Public Health Law's blog, a Commonwealth Fund study revealed that "23 percent of 19-64 adults or 31 million people were underinsured, with Latin@s representing the largest underinsured ethnic group." Carrión's work goes on to highlight in great detail the extra barriers Latin@s face in accessing comprehensive reproductive health care. (Yet, another obstacle facing Hispanic families who are struggling to get by on limited incomes.) A mid-October study from the Centers for Disease Control and Prevention showed that Latino men disproportionately are not receiving quality HIV medical care. According to the study for the Morbidity and Mortality Weekly Report, the "most prevalent unmet" medical needs are "ancillary services, such as oral health care and vision." Adding to the difficulty of getting proper HIV care for Latin@s, 18-29 years and 30-39 years had "a higher prevalence of unmet needs for both shelter and housing services and HIV peer group support," than their white counterparts.

Inequality in access to mental and behavioral health services is equally striking. A recent study published by the International Journal of Health Services, states that, "one in five Americans is estimated to have a mental health condition at any given time," and to be without the ability to access treatment. That study went on to note that this dire situation is far worse for Black or Hispanic children. Shefali Luthra, reporting on the study for Kaiser Heath News, wrote, "Black and Hispanic children saw someone for treatment far less often than did their white counterparts - about 130 fewer visits per thousand subjects. Black young adults visited a mental health specialist about 280 fewer visits per thousand; Hispanics 244 fewer visits." According to the study, one indicator fueling the disparity centered on where the families resided, noting that Latin@s "often live in the most underserved areas." And there are myriad other hurdles to access, such as language and transportation barriers. Heaped on top of these obstacles to healthier lives, research shows that Black and Latino boys disproportionately receive punishment and detention in school instead of mental and/or behavioral health care. Their white counterparts are not facing such dangers or impediments.

In California, NHeLP, MALDEF, Civil Rights Education and Enforcement Center (CREEC), and Feinberg, Jackson, Worthman & Watsow are working to assist scores of Latin@s denied health services they are entitled. The groups have lodged a complaint with HHS alleging that the state's Medicaid agency, Medi-Cal, is violating the civil rights of Latin@s by making it more difficult for them to access Medicaid services in the state. Medi-Cal, the complaint states, is locking them out the services they are entitled to by not providing adequate networks - too many health care providers won't participate in the state's Medicaid program because of dreadfully low reimbursement rates.

A strong, thriving republic is not one where privileged groups of people enjoy the benefits of liberty and others remain left behind. We need to overcome health disparities. We must make drastic shifts toward racial justice, which includes ending inequities in access to health.