Influencing health disparities in Spanish communities
If Hispanics in the United States were a country, they would be the second-largest Spanish-speaking country in the world, and with $1.5 trillion in buying power, the 15th largest consumer economy in the world. According to the latest U.S. Census data, last year marked the first year that more than half of the nation’s population under the age of 16 identified as a racial or ethnic minority. Among this group, Latino or Hispanic and Black residents together comprise nearly 40% of the population.
The nation is diversifying faster than ever, and Latino and Hispanic communities are at the forefront. Yet we know that language barriers to accessing essential health and social services exist for all non-English speaking populations. Recently, a study of nearly 20,000 in-patient admissions revealed that in-patients that requested an interpreter were granted access to one only 4% of the time – and that is just for inpatient hospital care. Now imagine the situation for outpatient care and social services? As a nation and health care system, we must do better.
These language barriers have a negative impact on the health and well-being of the Hispanic community. Hispanic women contract cervical cancer at twice the rate of white women. Hispanics are more likely to be diagnosed with diabetes and are twice as likely to die of the disease compared to non-Hispanic whites. The stats go on. The outcomes continue. Physicians are less likely to detect depression in Hispanics, and Hispanics are 50 percent less likely to receive mental health treatment or counseling.
How can the healthcare system work to fix these issues? For starters, with the use of technology, healthcare providers can improve language equity. That will enable the Hispanic patient populations to become part of the majority receiving quality health and social services.
As a mission-driven organization, Activate Care, a nationally recognized provider of community coordination and referral management technology designed to improve community health outcomes, has officially made their platform available in Spanish. Systems like Activate Care support care coordination and patient engagement, breaking down barriers to accessing essential services a patient may need. By offering a bi-lingual platform, both caretakers and patients with Spanish as their primary language can receive proper care.
As a member of the Hispanic community and a current member of a company working to identify SDOH (Social Determinants of Health) in at-risk patients and provide proper care, I understand how complicated navigating healthcare systems can be for native Spanish speakers.
I chose to go into public health because of my experience working and living in St. Louis, Missouri. I worked for a nonprofit called Athletic Scholars Academy that ran school-based programs in under-resourced communities to promote healthy eating, physical activity, and academic achievement. For those four years of my life I listened to the everyday experiences of students, parents, teachers, administrators, and other school community members and learned more than I ever could in a classroom.
I was regularly reminded that so many communities around the U.S. do not have access to resources nor opportunities for people to be mentally, physically, socially and economically healthy. I learned that these differences in health were actually avoidable and are rooted in injustices that disproportionately affect Black and Latino communities. Working to address these avoidable differences in health became my “why” in public health.
My father is Colombian but grew up in Spain, and my mother is Indian but grew up in Kenya. I am half Indian and half Colombian. My parents were first generation immigrants when they came to the United States as college students and have been here ever since. I am a first generation American but hearing from my parents and grandparents about the inequities in Kenya, Colombia and India, I could draw parallels to the inequities – avoidable distribution of resources and opportunities – that disproportionately affect Blacks and Latinos in America.
This further reinforces why I wanted to get involved in Public Health. I continue to use the privilege I have been given from my grandparents and parents to do more to address health inequities in the U.S. One of the first things I am lucky to have is my ability to understand and speak Spanish, fluently. With that ability, I can help remove one of the biggest barriers Latinos face. Personally, I think speaking to Spanish speakers in their native language is the first step in showing Latinos that we, as in the healthcare industry, understand and care about them.
As a millennial, I see the power that technology can provide in the public health space. We know that in the industry, issues are often embedded in the disconnections between healthcare and social services. Technology can offer a chance to connect these services across the continuum of care, and can provide a more efficient and secure way of sharing and communicating information across teams that are often disconnected from each other.
Last week Alejandro Gutierrez and Katie Young hosted “Focus on #TechQuity: Influencing health literacy, equity and disparities with Spanish-speaking Communities”, a webinar exploring technology’s impact on the disparities that have been exacerbated by COVID-19 and civil unrest in the USA. Click here to watch
To register for the next webinar “Care Coordination in the Time of COVID-19: Doing the Job that Referrals Can’t” on September 30, 2020 at 2 PM EST click here
Long haul Covid, the brain and digital therapies
It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain.
Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain.
What is long Covid exactly?
Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.
How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!
When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover.
If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus.
The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.
What symptoms does this cause?
These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.
In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.
This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.
How does long-haul Covid affect mental health?
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.
How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.”
We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain.
We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and running half marathons again.
At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response.
The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival.
What digital therapies or apps are proving effective at treating long-haul Covid?
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy.
What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.