The Time is Now

Our health is largely the product of social determinants such as income, race, education, environment and geography. Housing, transportation, education, energy, agricultural policies and our health care system all impact the quality of our health. Unfortunately, inequities in this social system can be deadly for Latinos. Unjust? Yes. Unavoidable? No. Together we can change the face of health disparities.

I have seen firsthand the inequities in health that Latinos face. In the Congressional District I represent in East Los Angeles and the San Gabriel Valley, more than 60 percent of the people I represent in Congress are Latino. One out of three in these communities lack health insurance. Nationwide, Latinos make up 14 percent of the population, more than 42 million people, yet 34.1 percent, more than 15 million, are uninsured compared with 20.5 percent of African Americans, 15.5 percent of Asian/Pacific Islanders, and 10.8 percent of non-Hispanic Whites. Twenty-seven percent of Latinos, including those with health insurance, lack a consistent place for care. This is three times the percentage among non-Latino whites.

These numbers alone underscore the point that the health care system is failing Latinos. A usual place for care, which can include a doctor or clinic, leads to preventive care and better health. Yet, diseases such as diabetes, obesity, asthma and cancer are registering in the Latino community at two to three times that of non-Latino communities. In 2004, HIV was the 6th leading cause of death for Latinos and was the 5th leading cause of death for Latinas. Latinas are 4.5 times as likely to die from HIV/AIDS as non-Latina white women. Latinos typically live in counties that violate federal air pollution standards, compared to whites, leading to higher rates of asthma and mortality.

Factors such as language and cultural barriers, lack of access to preventive care, and lack of health insurance contribute to the growth in health disparities for the Latino community. Culture can define how we receive, interpret, and act on health care information. Communication barriers, such as the lack of language services, between patients and providers contribute to reduced quality of care, adverse health outcomes, and increased racial and ethnic disparities. One-third of Latinos report problems communicating with or understanding their doctor, compared to only 16 percent of whites. This statistic is even worse for Spanish-speaking Latinos. More than 40 percent of Spanish-speaking Latinos have difficulty communicating with or understanding their doctor.

Immigration status also impacts our health. In 2006, more than 46 percent of non-citizen immigrants were uninsured, compared with 19.9 percent of immigrants who gained citizenship and 15 percent of U.S.-born residents. To address the epidemic of HIV/AIDS among Latinos, we must address language and cultural barriers, stigma, migration issues, and distrust of the health system for immigrants. Congress recently repealed the law barring HIV-positive visitors and immigrants from entering the United States, but we must do more to address this epidemic. Given the existing health inequities of our health care system, I introduced H.R. 3014, the Health Equity and Accountability Act with the support of my colleagues from the Congressional Hispanic, Black, and Asian Caucuses. This legislation will help break down the language and cultural barriers which contribute to the lack of health care access, increase diversity in health professions, encourage cultural competency, and increase data collection. Without a doubt, it will help eliminate the persistent health disparities that leave millions of Americans in poorer health and more likely to die prematurely during their most productive life years.

I am proud that we have the support of more than 100 Members of Congress and more than 300 organizations for this effort to end health disparities. Recently, this legislation and the issue of health disparities was the subject of the first hearing in more than eight years. Although people of color remain underrepresented in Congress, our voices and the voices of our communities are finally being heard. I am proud that we in Congress have taken the first, but significant, step to achieve health equity for communities of color, and I hope we can continue to build our momentum.

Health will likely be a major issue for our next President and Congress. The time is now to deal with the current health care crisis, before another generation faces a lifetime of preventable health problems. As we move forward toward national health reform, we must work together to make sure that Latinos are not left behind.

By Congresswoman Hilda L. Solis