ANOTHER VOICE: Mistrust, discrimination influence Latino health care satisfaction

Mistrust of the medical community and perceived discrimination by health care providers can affect how satisfied young adult Latinos in rural Oregon are with their health care, new research from Oregon State University shows.

Health care satisfaction, or the lack of, could influence health outcomes for patients, affect participation in health care programs under the new Affordable Care Act, and contribute to disparities in health care access for Latinos, said lead researcher Daniel López-Cevallos, associate director of research for the Center for Latino/a Studies and Engagement at OSU.

“Health care reform is about people getting insurance so they have access to services, but mistrust may lead people to delay care,” López-Cevallos said.

Findings of the research were published recently in “The Journal of Rural Health.” The article was co-authored by S. Marie Harvey, associate dean and professor of public health, and Jocelyn T. Warren, assistant research professor in the College of Public Health and Human Sciences. Harvey received funding from the Centers for Disease Control and Prevention for the research.

Researchers surveyed 387 young adult Latinos, ages 18-25, living in rural Oregon. Patient satisfaction information was collected as part of a larger study about health issues among young, rural Latinos.

Participants were not asked about their immigration status; more than half, about 58 percent, were born outside the U.S. and the average length of U.S. residency was 13.8 years.

The majority of participants, about 73 percent, reported being moderately or very satisfied with their health care. Among those who were not satisfied, medical mistrust and perceived discrimination were identified as factors. Other factors including age and health insurance did not affect satisfaction, the study showed.

The research suggests a need to improve “cultural competency” among health care providers, from the doctors to the receptionists to the lab technicians, so Latinos are treated with respect and dignity, the researchers said. A bilingual/bicultural workforce may be more effective in addressing health issues affecting a patient.

“Trust is huge; it allows patients to disclose concerns and be honest,” Harvey said. “In a previous study we conducted, young adult Latino men reported that ‘confianza,’ a term that encompasses trust, respect, level of communication and confidentiality, affected their access to and use of health care services.

Efforts to enroll Latinos in health care programs under the Affordable Care Act won’t be successful if patients don’t feel comfortable at their doctor’s office, López-Cevallos said.

“These are young, healthy adults,” he said. “We want them in our health insurance pools to help average the risk and keep costs down. This is an opportunity, but we have a lot of work to do.”

About the OSU College of Public Health and Human Sciences

The College creates connections in teaching, research and community outreach while advancing knowledge, policies and practices that improve population health in communities across Oregon and beyond.

About the OSU Center for Latino/a Studies and Engagement

The center integrates the study of Latino communities in the United States and is supported by the College of Liberal Arts, the office of the Provost, the Research Office, and the Division of Outreach and Engagement at OSU.

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Parkdale third graders sing "12 Disaster Days of Christmas"

Welcome to your sing-able Christmas gift list. What follows is an emergency rendition of “12 Days of Christmas” – for outfitting your home or car in case of snow storm, earthquake, flood or other emergency. Read it as a simple list, or sing it to the tune of “12 Days” – you know, as in “ … and a partridge in a pear tree…” Not to make light of it, but the song is a familiar framework for a set of gift ideas that you could consider gathering together, even if the recipient already owns items such as a bunch of coats, tire chains and flashlights. Stores throughout the Gorge are stocked up on all these items. Buying all 12 days might be prohibitive, but here are three ideas for checking any of the dozen off your list (notations follow, 1-12.) The gift items needed to stay warm, dry and safe are also coded to suggest items in your abode (A) in your car (C) or both (B). 12 Gallons of Water (A) 11 Family meals (B) 10 Cans of propane (A) 9 Hygiene bags (B) 8 Packs of batteries (A) 7 Spare coats (B) 6 Bright red flares (C) 5 Cozy blankets (B) 4 Tire chains (C) 3 Flashlights (B) 2 cell phone chargers (B) 1 And a crush-proof first aid kit (B) Price ranges? Here’s a few quotes for days Three, Two, Four and Nine: n A family gift of flashlights (three will run $15-30, Hood River Supply, Tum-A-Lum) n Cell phone chargers (two will run $30-60) n Tire chains (basic set, $30, Les Schwab, returnable if unused for the winter) n Family meals ($100 or so should cover the basics for three or four reasonably well-fed days) n The home kit should be kept in a handy place near an exit, and remember that water needs to be replenished every few months. If you have a solid first aid kit already, switch out the gift idea with “and-a-sto-o-u-t- tub-for it-all …” Otherwise, it’s a case of assembling your home or car kits and making sure all members of the family know what the resources are and how to use them (ie flares and propane). Emergency situations are at worst life-threatening, at best deeply uncomfortable if you and your family are left without power for an extended period, or traveling and find yourself in a situation where you need to wait out a storm, lengthy traffic delay, or other crisis. Notes on the 12 gift ideas: 12 – Gallons of water: that’s one per person in a four-member family to last for three days, the recommended minimum to be prepared for utility outages. 11 – Easy-open packaged goods, energy bars, dried food and nuts are good things to include for nutrition. Think of what your family of four needs for three days to stay fortified and hydrated (see number 12). Can-opener also recommended 10 – If you have a propane camping stove, keep extra fuel handy. 9 – Hygiene bags: put packaged moistened towelettes, toilet paper, and plastic ties in large garbage bags (for personal sanitation) Resource list courtesy of Hood River County Emergency Management, Barbara Ayers, manager/ 541-386-1213. The county also reminds residents to Get a Kit, Make A Plan to connect your family if separated, and Stay Informed. See www.co.hood-river.or.us to opt-in for citizen alerts. Enlarge



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