By Joe Goldeen
The (Stockton, CA) Record
Learn English and you'll live a healthier life.
"I never have insurance," said Miguel Hurtado, 25, an unskilled construction laborer from Mexico who speaks very little English after seven years working in California.
Through a friend, Jaime, 25, who declined to give his last name, Hurtado said that if his English was better, he knows he could get a better job that includes health-insurance.
The two young immigrants say they spend most of their time working for an electrical contractor throughout Northern California and don't have the time or enough energy to take English classes.
Poor education, lack of citizenship and the inability to speak English -- all more common among Spanish-speaking Latinos -- result in lower wages and fewer jobs that offer health insurance, according to a recent study by the Washington-based Center for Studying Health System Change.
The exhaustive study -- funded by the Robert Wood Johnson Foundation -- examined why the proportion of Latinos with employer-sponsored health coverage is so much lower than whites' and why the rapid growth in the Latino population hasn't broadened the gap.
The ability to speak English is a major indicator of whether Latinos have employer-sponsored coverage, according to the study. English-speaking Latinos are more similar to whites in the workplace and access to employer health coverage than they are to Spanish-speaking Latinos.
Spanish-speaking Latinos also appear more sensitive to out-of-pocket premium costs and less likely to accept an offer of insurance when it's made available, according to the study.
"It's something we've always known, that in order to be successful you have to have the ability to speak English," said Jose Rodriguez, executive director of the Stockton-based Council for the Spanish Speaking, or El Concilio, a nonprofit service organization.
Rodriguez said the inability to speak English has always been an obstacle to adequate health care, and it continues to be a pervasive problem.
"Since the No. 1 way to get insurance is through the employer, the problem is that Hispanics generally have jobs that are part-time and low-skilled. It's the type of positions that we hold," he said.
And that is despite the fact that more Latino males -- 97 percent -- than any other ethnic group are working, according to Department of Labor statistics, Rodriguez said.
It will be difficult, if not impossible, for the recent effort to reform the health-care system to work without "a good amount of education on how health care works in this country. For any health-care system to work, you are going to need an educated consumer," Rodriguez said.
In San Joaquin County alone, with a 2006 estimated population of 673,000 according to the U.S. Census Bureau, almost 227,000 residents speak a language other than English at home. That's 33.7 percent. Statewide, the percentage is higher -- 39.5 percent whose primary language isn't English. That's about 14.4 million people out of 36.5 million residents.
"After 24 years of public-health education and community service, where thousands of people were screened, immunized, counseled and referred -- free of charge -- we learned that the most dangerous of all diseases is ignorance," said Guillermo Vicuna, a retired Stockton dentist and co-founder of the Su Salud Health Education Fair and Tour of Life who has made health education his life's work.
"It's the lack of information and knowledge of our health and well-being which contributes to overutilization of emergency rooms, unnecessary suffering and premature death," said Vicuna, who hosts a Spanish-language health-education radio program.
"I believe that if we do not put emphasis on this issue -- on patient education, providing direct counseling from doctors who are not being trained to prevent diseases, only to treat diseases -- we will never fix the health-care crisis that we are facing. This is absolutely a disaster," he said.
In addition to Vicuna's radio program and Tour of Life health-education series, there are numerous opportunities for non-English speakers to learn English around the county. For example, Stockton Unified School District's Adult School at 1525 Pacific Ave. offers free classes in English as a second language in the morning, afternoon and evening to accommodate just about any schedule. Its open-enrollment policy means students can begin classes at any time. Information: (209) 933-7455.
Stockton-based Community Medical Centers Inc. operates 13 health clinics in the region for low-income and uninsured patients. Chief executive Michael Kirkpatrick said a demographic review of his clientele in 2006 supports the nationwide study.
Community Medical Center clinics treated 52,000 individuals during 150,000 clinical visits in 2006. Of those patients, 63 percent identified themselves as Latino -- about 33,000; 46 percent had no insurance while almost half had publicly funded insurance -- either Medi-Cal, Medicare or Healthy Kids.
Just 6 percent were covered by private insurance, Kirkpatrick said.
"Sixty percent of the Hispanic patients of record are monolingual Spanish speakers. This along with low income levels and a lack of insurance pose a barrier to accessing specialty care, understanding the majority of written material available on preventive health education and self-management techniques to control chronic diseases," Kirkpatrick said.
Spanish-speaking patients are accommodated at Community Medical Center clinics because "the bilingual, bicultural staff goes out of its way to help these patients achieve access to primary medical services and to navigate the complexities of ancillary, specialty care, and pharmacy services in the community, which they may need," he said.
Spanish-speaking patient Marta Flores, 48, who came in for an exam last week for pain in her arm, agreed.
"It's not been difficult to get care because the people who help me have all spoken Spanish," Flores said through an interpreter.
However, Maria Vasquez, 25, also speaking through an interpreter, said not speaking English is a serious problem for her young family.
"The lack of money, the lack of employment, the lack of English is very hard," said Vasquez, who stays home with her children while her husband is employed as a farm worker.
Joanna Galindo, who enrolls eligible children from Spanish-speaking homes in the Healthy Families subsidized insurance program for $45 a year as program director at Catholic Charities, sees the gap in insurance coverage growing -- especially for children -- if Congress and the Bush administration don't provide continued funding for the State Children's Health Insurance Program (Healthy Families in California).
"I'm on the front lines and I see the kids who don't have insurance. We are unclear on the reasons, but there are literally thousands of Hispanics who live in our region whose children are not insured, and they feel comfortable coming into Catholic Charities to register for one of our programs," Galindo said.
"We do not ask why they do not have insurance, but our guess would be that the study is correct, that many are in very low-paying jobs that do not have insurance as a benefit," she said.
Source: The (Stockton, CA) Record (
www.recordnet.com).
From: Insurance News Net (
www.insurancenewsnet.com)
