Navigating Healthcare and Language: Unraveling the Complex Experiences of Hispanic Americans in Sickness and in Health Restricted; Files Only

Martin, Lillian (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/79407z717?locale=es
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Abstract

For Hispanic Americans, culturally distinct conceptions of wellness and illness, access to culturally appropriate care, and Low English Proficiency (LEP) are some of the largest barriers to consistent, high-quality healthcare. Using data collected through a Pew Research Center survey, this paper investigates the historical, cultural, and social contexts that inform Hispanics’ health access and experiences in the United States, while deconstructing the homogenization of the label “Hispanic.” STATA software was used to conduct linear and logistic regression on the pool of nearly 15,000 participants and tease out the most salient points of experience among Hispanics. Additionally, Spanish-dominant, bilingual, and English-dominant categories were isolated to provide further insight into the varied experiences of those within the Hispanic diaspora. Compared to their White peers, Hispanics reported significantly lower quality of care, but they did not report a statistically significant difference in ease of accessing care nor receiving less respect from providers. Spanish-dominant and bilingual groups preferred and recently used ethnically concordant care. They also preferred Spanish concordance with providers, which they ranked as providing superior care. The findings of this study support implementing culturally informed healthcare for Hispanic populations through interpretation services, ethnic and linguistic concordant dyads, and increased health literacy in patient populations.

Table of Contents

I. Introduction

II. Theories of Ethnicity, Race, and Health

a. Who are Hispanics within the U.S. Context?

b. Historic Patterns of Homogenization of Spanish-speakers on the Racial, Ethnic, and Linguistic Historical Landscape of Latin America

c. Colorism and Linguistic Discrimination in the United States

d. Medical Care as a Social and Cultural System

e. The Social Determinants of Health

f. The Culture of American Healthcare & Limited English Proficiency Patients

III. Hispanics’ Access to and Experiences in Healthcare Spaces

a. The Practical Applications of the Social Determinants of Health

b. Acculturation of Hispanic Groups in the American Context

c. Gaps in Health Literacy

d.  Language as a Barrier to Care

e.  The Healthy Migrant Wrinkle and Other Statistical Complications

f.  Argument Against Concordance

IV. Methods

a. Independent Variables

b. Dependent Variables

c.  Hypotheses

d.  Demographic Characteristics

      i.    Table X: Demographic Characteristics by Ethnicity

      ii.    Table Y: Demographic Characteristics by Language Dominance Among Hispanics

V. Results

a.  Table 1.1: General Experiences with Healthcare System Across Ethnic Groups

b.  Table 1.2: General Experiences with Healthcare System Among Hispanics

c.  Table 2: Preference for and Experience with Ethnically and Linguistically Concordant Care 

d.  Table 3: Comparison between Concordant vs. Non-concordant Care

e.  Table 4: Perceptions and Causes of Ethnic Group Health Outcomes

f.  Table 5: Citizenship Concerns with Friends & Family

VI. Discussion

a.  Study Findings

b.  Implications for Improved Care 

c.  Limitations

VII. Conclusion & Future Research

VIII. Works Cited

IX. Appendix

a. Question Bank

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