Latinos comprise approximately 17 percent of the United States population yet in 2012 accounted for one third of uninsured individuals. An estimated 10 million Latinos have become eligible for health coverage either through the federal or state marketplaces since implementation of the Affordable Care Act. News reports published in the past two months, however, report low enrollment rates. This is most commonly attributed to the delayed availability of a Spanish-language Healthcare.gov website, “CuidadoDeSalud.gov”, confusion regarding eligibility and legal status, and low computer literacy. One issue not frequently discussed which was recently publicized is the availability of culturally competent health care providers.
Last week Kaiser Health News published a report of an interview conducted with Dr. Elena V. Rios, president of the National Hispanic Medical Association, in which they discussed the importance of diversity in the health care workforce and how dynamics will be influenced by the Affordable Care Act (ACA). Dr. Rios emphasized the need for medical professionals to be well-versed in the traditions and culture of their patients in order to best provide supportive care. Ensuring that health professionals are proportionate to the populations they serve and receive training in cultural competence has the potential to significantly increase adherence to care thereby reducing health disparities
Missing from both the Kaiser Health News report and general media coverage, however, has been discussion of the Promotores de Salud, or community health worker, model as an effective means for overcoming the barriers Latino communities face during the enrollment process and in accessing care thereafter.
Promotores de salud (promotores) are trained community members who work to strengthen and expand community networks focused on improving health outcomes, in particular among “hardly reached” populations such as Latinos living in rural communities. As members of the communities they serve, promotores are considered trustworthy and reliable sources of health information and who oftentimes help individuals “navigate” the complex health care system. They best understand how to tailor outreach efforts to meet the linguistic and cultural needs of the local population(s) seeking health care while simultaneously fostering partnerships with the entities capable of providing such services. Promotores are an indispensable connection linking community members to local navigators or certified application counselors assisting with ACA enrollment, and medical professionals.
Farmworker Justice recognizes and supports the critical role promotores occupy in increasing people’s knowledge of important health issues and facilitating access to services and increase enrollment in federal programs including the ACA. For example our Conexiones: Connecting Rural Latino Families to Medicaid and CHIP is a national collaboration, supported by the Centers for Medicaid and Medicare Services (CMS), to increase the capacity of promotores de salud to empower Latino communities and advance enrollment in Medicaid and the Children’s Health Insurance Program (CHIP).