While programs such as the Affordable Care Act have significantly increased, for now, the number of Latinos in Connecticut and elsewhere who have health insurance, getting this population, particularly new arrivals in this country, to use this system remains a major challenge,
According to healthcare researchers, Latino physicians, especially those fluent in Spanish, are seen as the critical component in alleviating the communication and cultural issues which can complicate medical diagnoses and exacerbate a reluctance of many Latinos to seek treatment from non-Hispanics.
However, there is a persistent gap between the availability of Latino physicians and the need to provide care to an under-served and burgeoning minority population that is beset with a disproportionate greater share of poverty-related diseases such as diabetes.
While Latinos comprise 17 percent of the nation’s population they account for just over five percent of practicing physicians, and there is evidence that this under-representation actually grew in the last 30 years and that the number of new Latino physicians being produced by medical schools continues to fall short of the need in some communities.
Last year, several Latino students at the University of Connecticut School of Medicine translated their interest in providing some unity to addressing this under-representation in medical personnel and to also play a role in helping improve healthcare for Latinos in Connecticut. With the support of the school’s Health Careers Opportunity Program, they formed a chapter of the Latino Medical Student Association, a national nonprofit organization that has 129 active chapters of various sizes and more than 3,500 individuals registered for membership on its website.
Nationally, the mission of LSMA is to unite and empower medical students through service, mentorship, and education, as well as to advocate for the health of the Latino community,” said Verónica Schmidt Terón, who along with Alexandria Meyers and Andria Matthews, started the UConn SOM chapter.
At UConn, the LMSA chapter has been active in the recruitment and mentoring of Latinos and has contributed to the school’s Medical Spanish program. The students also have begun to reach out to the state’s large Latino population. This initiative includes setting up a bilingual health education program at a Hartford library.
In April, the UConn group’s board members, attended the 12th annual national conference held at Hofstra University on Long Island where more than 50 schools were represented. This gathering also encompassed the 44th annual conference for the northeast group which was founded in 1972 as the Boricua Health Organization. The regional group has about three dozen chapters, according to the national website, including UConn and Yale School of Medicine from Connecticut.
Many LSMSA members feel “a social responsibility” to take the training and skills that they acquire in medical school and residency back to their communities to help people in need, said Schmidt, who recently wrapped up her second year in medical school and is interested in working in public health.
This view is underscored by Christina Valentin Rivera, the UConn chapter’s president, who stated, “It definitely is my intention to practice where I am most needed and most useful.”
Various studies have found that Latino physicians are far likelier than non-Hispanic whites to practice in communities with a large concentrations of Latinos or with a large underserved population. Other research has shown that Latino patients who have limited English-language skills visit doctors less frequently than those with stronger English proficiency.
Even with an awareness of this problem by healthcare leaders, it may take many years to make a serious dent in the under-representation of Latino doctors. According to the Association of American Medical Colleges, only 6.4 percent of the students out of U.S. medical schools in 2010 were Latinos and some have gone into higher-paying specialties rather than practices that would put them directly in minority communities.
Meanwhile, the growth in the number of Latino physicians has not even kept pace with population trends. According to one national study, the number of Hispanic doctors per 1,000 Hispanic residents had shrunk to 105 in 2010, as compared to 135 in 1980. Meanwhile, the number of non-Hispanic white doctors per 1,000 whites grew from 215 to 315 during the same period.
In Connecticut, only 2 percent of the physicians a decade were Latinos, according to a study by the Hispanic Health Council. How much this number has changed is unclear, but looking at the number of Latinos attending UConn, the state’s only public medical school, dramatic improvement is unlikely.
As recently as 2008, only four Hispanic-Americans were among the 331 students enrolled at UConn. Over the last eight years, Hispanic enrollment has been stronger, averaging about 18 students a year.
For the fall 2016 semester, total enrollment at UConn had grown to 408 with under-represented minorities accounting for 21 percent of the students. The Hispanic total had also grown to 25 or 6 percent, or near the national average.
Meanwhile, UConn is among those medical schools who are making a concerted effort to alleviate some of the language and cultural issues, even among its non-Hispanic students, that inhibit many Latinos from seeking appropriate health care.
For the last two years, the Farmington school has offered medical and dental students and residents the opportunity to practice Medical Spanish through workshops. This past year, LMSA members worked with course leaders to enhance the value of this elective offering.
Among the objectives of the Medical Spanish programs is to teach future doctors how to interview a patient who is not fluent in English and, in general, to be more comfortable speaking with Spanish-speaking patients.
At the same time, Medical Spanish students who are not fluent in Spanish learn to understand their limits in regard to communicating with some Latino patients, explained Salem Harry, LMSA member from Brownsville, Texas.
Harry, who is of Mexican descent on his mother’s side, just completed his first year at UConn SOM and is interested in the public health program. He plans to take a year off from medical school to earn a master’s degree in public health and then resume his work toward a MD degree.
Harry is policy chairman and by acting as a “voice for the community’s health needs” reflects the organization’s advocacy mission. “I am interested in different (government) policies, how they impact the community and how they effect families and patients,” said the medical student.
At UConn, the LMSA members meet with potential minority students during the interview process and help in the recruiting process.
Once the Latinos arrive, LMSA members also endeavor to lower some of the barriers typically identified, along with financial issues, as major reasons these students may not finish medical school. These concerns include a lack of mentors, feeling of isolation and poor career guidance.
As part of its mentorship role, Valentin said, LMSA provides information to Latino students about medical boot camps and other programs related to their studies. Some of the students, Valentin said, are unaware of where these opportunities exist.
For example, the group’s Facebook page, Latino Medical Student Association – UConn Chapter, recently posted information about a Minority Student Emergency Medicine Program in New York.
Moving forward, Schmidt said, the chapter is discussing how it can make a greater impact in the Hartford community and how to work more with high school students, counseling them about medical careers and what preparation is needed to succeed in medical school.
Also, Schmidt said, “We plan on collaborating with other LMSA chapters both regionally and nationally to create policy to improve Latino/Hispanic health…. and are looking forward to enhancing our recruitment efforts by encouraging and supporting more Hispanics/Latinos to realize their dreams in a career in medicine, medical research, academic medicine, and attend UConn SOM.”
She added, “Everyone in our organization is passionate about helping their community.”
Various factors have influenced the LMSA members to pursue medical careers that would help their community.
Schmidt said she has drawn upon the example of an uncle who is a pediatrician in Puerto Rico and how physicians at Hartford Hospital helped the medically underserved. Moreover, her mother, Yanil Terón, executive directive of the Center for Latino Progress in Hartford, instilled in her “an interest in helping out in the community.”
The health care barriers Latinos face in Connecticut was somewhat a surprise for Valentin who grew up and attended college in Puerto Rico where Spanish is the predominant language and virtually all the doctors were Puerto Rican.
“It is not fair,” she said, of what it is like to be a Puerto Rican here. She added this perspective has added to her self-motivation to “be the best student and best doctor I can be so I can help and make a statement.”
Harry expresses a strong desire to serve his community, but has not chosen where yet. “There are Latinos everywhere and the need is everywhere,” he said. “There is a lot of good work to be done.”
LMSA’s national agenda
The following are the Latino Medical Student Association’s initiatives for this year, as provided by Eric Rodolfo Molina, national president and a student at the Baylor College of Medicine.
1. Standardizing mentorship programs for undergraduate and high school students so that members can effectively interface with students interested in careers in the health professions.
2. Continue the development of the LMSA Chapter Physician Advisor Training so that Chapter Faculty Advisors know the history of LMSA and can become effective mentors to chapters in terms of career development and chapter programming.
3. Planning a successful National Conference (13th) in the organization’s Southeast Region, April 2018.
4. Returning to the Association of American Medical Colleges headquarters in Washington, D.C. for the 4th annual Policy Summit to train members how to advocate and communicate effectively in the political and policy arenas. The meeting will take place October 20-22, 2017.
5. Working with partner institutions to help provide opportunities and benefits to our members across all regions.