By Erik Cardenas, Co-Founder & CEO, Zócalo Health
The COVID-19 pandemic exposed many gaps in the U.S. healthcare system, but the most devastating gap has been the disproportionate impact of the pandemic on communities of color. Black, Hispanic, and Asian communities have seen drastically higher infection rates, hospitalizations, and mortality rates compared to white Americans. The pandemic highlighted how great the divide is between those who receive care and those who need care the most.
For communities of color, many recent innovations are not easily accessible. This limitation further magnifies existing barriers to care. Addressing these disparities requires fundamental changing the way healthcare is delivered. Health tech investment dollars soared by 157% from 2020 to 2021, totaling $29.1B in 2021 alone. This investment has provided a glimpse into a future where changes to the underlying health system build something better. However, many of these innovations have failed to meet the needs of underserved communities.
These underserved communities are not insignificant. Latinos – now numbering 60.6 million, or 18% of the population – are expected to make up 30% of the population by 2050. Yet healthcare systems today fail to connect, build trust, and meet their needs. As more digital health startups recognize the opportunity to build digital health tools for this large, underserved market, critics will continue to speak up. Here are three common myths about the use of digital health tools among Latinos and why we need to rethink our approach.
“Technology doesn’t solve inequities; it compounds them.”
Critics of digital health tools for underserved communities argue that virtual options like telemedicine could eventually worsen health disparities. According to this theory, the rich would get healthier, and the poor (with limited digital literacy and technology access) would get sicker.
But technology is now extremely common in many populations, including Latino Americans. 85% of Latinos in the U.S. own smartphones, and their Internet use is widespread, with younger generations online the most. 76% of adults earning less than $30K own smartphones, with that number increasing to 83% when their income is $30-$50K annually.
Technology alone does not worsen health disparities. A broken health system made digital will. A pattern found across major cities with the largest Latino population showed that zip codes with a Latino majority had limited access to primary care. In white (non-Latino) zip codes, there was one primary care physician for every 1,200 residents. In Latino-majority zip codes, there was one primary care physician for every 5,000 residents. Using technology to try and squeeze more capacity out of already strained primary care resources isn’t going to do much. Leveraging technology to bring primary care services from other areas to those in need can help reduce the average wait time for an appointment from 35 days to 1-3 days.
We see here a population with wider access to the Internet and technology than to basic, “traditional” healthcare. Of course, not every Latino owns a smartphone. No single healthcare tool can reach everyone. But transforming aspects of healthcare into a digital experience can widen the door and shorten the journey, making it a worthwhile investment.
“Language barriers are the main problem.”
Language is a barrier, of course. Thirty-nine million Latinos speak Spanish at home, and limited English proficiency correlates with less usage of health services. More healthcare providers are translating English content into Spanish, but current services stop short of really connecting with Latino patients and helping them feel heard and involved in their own health.
A lack of cultural awareness around traditional beliefs and unconscious biases can leave patients feeling unheard, misunderstood, and alone. A Latino patient may feel judged as foolish for attempting to cure a headache with a relative’s homemade herbal tea. A surprise medical bill may make them feel scammed. A provider may make assumptions and tell the patient what they should do while dismissing their pain or concerns altogether. This lack of trust and relationship-building can cause Latino patients to avoid care altogether, using informal networks for advice and treatment instead.
It’s important that health equity innovators understand that culturally competent care goes beyond translations – digital health tools need to address so much more.
“Digital health tools are a silver bullet.”
Despite digital health skepticism, new entrants have entered the space eager to develop technological solutions that address health inequities. To these pioneers, the simplicity of booking and attending a virtual appointment seems paramount.
While it can be easy to lose the human connection behind screens, technology shouldn’t replace relationships. Instead, it should enhance them. When used the right way, technology can help patients and providers build more fulfilling relationships that can be maintained outside of the doctor’s office.
Culturally, Latinos see healthcare as a series of relationships. Family members, friends, and the wider Latino community help each other decipher insurance plans, accompany each other to healthcare appointments, and take care of one another. As a result, it’s crucial that providers working with the Latinos build care teams that come from and resemble the communities they serve, so they can tailor relationships and recommend relevant services based on trust.
Relationship-based partnerships, over time, have proven power to influence health outcomes. As valuable as an app might be in starting the conversation, the relationship built through it has the power to transform community health for the long-term.
Digital tools for true wellness
As health leaders pursue health equity as part of their business objectives, it’s essential that they understand both the value and limitations of digital tools. True wellness goes beyond the absence of illness – it fosters community-wide physical, mental, and social strength. Tools that blend innovation with the traditions of culture have the potential to enhance digital access and provide holistic experience, making them the best shot at creating true impact.
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