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A recent study in the Annals of Family Medicine explored factors that influence what Latinas tell and don’t tell their doctors. It was reported that  a warm and compassionate patient-doctor relationship will help create trust is key to fostering good communication between Latinas and their doctors.

 

While this study didn’t interview white women or women from other ethnic groups, the authors mention another study that found that “found that almost double the number of patients (including Latinos) reported satisfaction with care when they were treated with dignity.” Makes sense, but the question is, what are the barriers for Latinas in trusting their doctors with important personal health information?

 

As a qualitative, exploratory study, this may not be able to point to concrete policy approaches to improving the doctor patient encounter, but it does support a diverse and growing body of literature that supports the need to address several important aspects of healthcare for Latinas.

 

1) The need for quality, professional interpreters. It is not only that family members or friends should not have to interpret, but also that interpreters need to make clear their commitment to professional, confidential, non-judgmental and compassionate services. This is especially important for patients seeking sexual and reproductive health care, which can be a sensitive and private topic. Unfortunately, few healthcare facilities made full-time professional interpreters services a funding priority.

 

2) Patients felt that their doctors were not always interested in hearing about their concerns. Appointments are short and often rushed, making women feel dismissed and not giving them a chance to feel comfortable enough to talk about health concerns. The dominant health insurance system in the United States does not reimburse physicians to have discussions with women- just to diagnose disease and perform procedures- so information and advice that helps women address their health concerns might take a back seat. 

 

3) Latinas in the study considered sexual and reproductive health topics sensitive and very personal. Therefore, trust and respect are essential in order for Latinas to feel they can discuss and address issues of sexuality, sexual health, and family planning. The authors noted that a lack of continuity of care could be a barrier to building this trust, and it true. Women of color and low-income women are more likely to get their sexual and reproductive health care needs covered by different funding streams and programs and services, making it difficult to get to know a provider. What if women could get family planning, abortion care, prenatal care, and well-child check-ups, as well as their other primary care needs under the same plan and in the same place? Currently, the superficial separation of sexual and reproductive health care from other services places an undue burden on women, especially Latinas.

 

4) One reason that Latina’s don’t disclose certain health information to their doctors is because the doctors don’t ask! Physicians and other providers need better training in proactively addressing women’s health needs by recognizing how our jobs, families, and other social contexts contribute to our sexual and reproductive health.

 

Contributed by Liza Fuentes, Senior Research Associate

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The National Center of Health Statistics found that the U.S. infant mortality rate declined 2% in 2006, after 5 years of remaining unchanged. This is great new for women and their families. The infant mortality rate is one the key indicators of the overall health of a country and lowering it is one the of Healthy People 2010 goals. But we still have a long way to go to reach that goal: At 6.71 death per 1,000 births, the rate would have to fall 50% to reach the 2010 goal of 4.5.

 

Underlying this good news is the stark reality that major reproductive health inequities still exist between white women and women of color. In 2005, Puerto Rican women had an infant mortality rate almost 1.5 times higher than white women. For black women the rate was 2.4 times higher than white women and for Native American and Alaskan Native women, it was 1.4 times higher.

 

The NCHS doesn’t report infant mortality differences by income or neighborhood, but other data indicate that the poorest neighborhoods, where Latinas are more likely to live, also have higher rates. In 2005 my south Bronx neighborhood, which is 73% Latino, had an infant mortality rate more than 3 times that of the Upper East Side of Manhattan, which is only 6% Latino and 83% white.

 

These data show that there is much work to do to eliminate the reproductive health inequities that Latinas and their families face. We can start by ensuring that all Latinas are able to get early and high quality prenatal and post natal care. This will require a better integration of all reproductive health services into regular primary care, a national health care plans that covers the entire range of reproductive health care services, and Latinas’ equitable access to the services, resources, and facilities that promote the healthiest pregnancies.

Contributed by Liza Fuentes, Senior Research Associate

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