Latino State of Enrollment: Persistent Health Disparities, Barriers and Gains Under the ACA
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This document discusses a grant from the National Association of Hispanic Nurses (NAHN) to increase health insurance coverage in Latino communities. It notes that Latinos suffer disproportionately from chronic diseases and have the highest uninsured rates. The grant trained over 100 NAHN nurses and students to educate over 6,375 individuals about Affordable Care Act protections and options. Key strategies included partnerships, addressing intergenerational families, cultural events, and culturally responsive messaging. Barriers like limited awareness, hard to reach populations, and challenges for farmworkers still persist.
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Latino State of Enrollment: Persistent Health Disparities, Barriers and Gains Under the ACA
- 1. © 2016 Enroll America | StateOfEnrollment.org Latino State of Enrollment: Persistent Health Disparities, Barriers and Gains Under the ACA
- 2. © 2016 Enroll America | StateOfEnrollment.org National Association of Hispanic Nurses · 6301 Ranch Drive · Little Rock, AR 72223 · T 501-367-8616 · F 501-227-5444 · E info@thehispanicnurses.org · W www.nahnnet.org The National Association of Hispanic Nurses: Partnerships to Increase Coverage in Communities (PICC) Initiative Grant #5 CPIMP141072-02-00 G. Adriana Perez, PhD, ANP-BC, FAAN Grant Principal Investigator Assistant Professor of Nursing, University of Pennsylvania
- 3. © 2016 Enroll America | StateOfEnrollment.org 2015 Virtual Conference Overarching Goal To promote health and wellness using the ACA as a platform to teach multicultural communities about the protections, benefits, health insurance options, and health insurance literacy. 3
- 4. © 2016 Enroll America | StateOfEnrollment.org The Health Status of Latinos Suffer disproportionately from certain chronic diseases – Twice as likely, as non-Hispanic whites to be diagnosed with diabetes, higher rates of end-stage renal disease, higher risk factors for heart disease/stroke, more likely to die from certain cancers Highest uninsured rates compared to any other racial or ethnic minority group 20% of low-income Latino youth have gone a year without a health care visit Almost 50% of Latinos report not always getting care when needed – Compared with 43% black and 41% of white Americans 4Source: http://www.hhs.gov/healthcare/facts/factsheets/2012/04/aca-and- latinos04102012a.html
- 5. © 2016 Enroll America | StateOfEnrollment.org Historical Opportunity for NAHN 1. Teaching patients, families, peers and community – cited as #1 motivator for nurses participating in this program. 2. Need to clarify myths, learn about local and national resources to refer families. -- Learn about federal subsidies and application process -- Become more knowledgeable of “how insurance works” 3. Opportunity to gain leadership skills in educating bilingual, multicultural communities on health care reform. -- Building confidence -- Practicing communication skills (public speaking) 5
- 6. © 2016 Enroll America | StateOfEnrollment.org IRB Approval University of Pennsylvania Nurse Outcomes – >100 NAHN Nurses/Students Since Year 1 – “Readiness” Survey Individual & Family Outcomes – >6,375 attended group education sessions – 861 community health screenings Community Outcomes – 88 partnerships nationwide (Additional Funding from Accolade & AARP) – >2,400 via social media, messaging, traditional print/news – Robert Wood Johnson Foundation Charting Nursing’s Future – NBC News: Latino Leaders Press Call with HHS Secretary Burwell – Conference call with First Lady Michelle Obama Recipient of iCohere’s “Serving Those Who Serve Others” 2015 Grant – >320 completed training Publications Progress to Date
- 7. © 2016 Enroll America | StateOfEnrollment.org 2015 Virtual Conference Strategies for Success 1. Be inclusive, so that no one is left behind Consider those already with health insurance coverage, those who feel do not qualify for tax credits, etc. – they may be your best marketing strategy 2. Latinos are intergenerational (la familia primero) Include grandparents for education and outreach 3. Strategic Partnerships Nurses can offer health screenings as an entry to discuss health insurance coverage/literacy 4. Annual and ongoing cultural events 5. Test culturally responsive messaging Promote the value of health insurance coverage consistent with the values and priorities of consumers 7
- 8. © 2016 Enroll America | StateOfEnrollment.org – Limited awareness remains a critical barrier – Hard to reach populations especially in need of in- person, bilingual assistance (technology can augment but not take place of) • Rural, border communities experience shortage of resources, including health care providers – Season & Migrant Farmworker Challenges – Culturally responsive messaging impacts perception • Do not make assumptions • Promote the value of health insurance coverage consistent with the values and priorities of consumers; focus on health Barriers Persist 8
- 9. © 2016 Enroll America | StateOfEnrollment.org adrianag@nursing.upenn.edu
- 10. © 2016 Enroll America | StateOfEnrollment.org Thank You! Liliana Ranon, Associate Director of Latino and AAPI Affairs, U.S. Department of Health and Human Services Liliana.Ranon@hhs.gov Adriana Perez, PhD, ANP-BC, FAAN, Assistant Professor, University of Pennsylvania School of Nursing Samantha Vargas Poppe, Associate Director, National Council of La Raza
Editor's Notes
- National Association of Hispanic Nurses Mission: Committed to advancing the health in Hispanic communities and to lead, promote and advocate the educational, professional, and leadership opportunities for Hispanic nurses. The purpose of the Promoting Increased Coverage in Communities (PICC) Initiative (HHS, OMH) is to identify and assist minority populations, to educate them about the Health Insurance Marketplace.
- Latinos suffer from certain illnesses at higher rates than non-Hispanic white Americans. Studies link poor health to poverty, language barriers, cultural factors (access), and lack of health care coverage all of which are difficult issues in many Hispanic communities 2014 Survey -- 78% did not know that the health care law offered financial assistance or subsidies to help pay for their health plans, underscoring the need for continued education in this community. According to national examination surveys, Hispanics are almost twice as likely as non-Hispanic whites to be diagnosed with diabetes by a physician. They have higher rates of end-stage renal disease, caused by diabetes, and they are 40% more likely to die from diabetes as non-Hispanic whites. Higher rates of CVD risk factors Hispanic American men and women generally have lower cancer rates than the non-Hispanic white population. However, disparities still exist in certain types of cancer. Highest uninsured rates compared to any other racial or ethnic minority group 20% of low-income Latino youth have gone a year without a health care visit Almost 50% of Latinos report not always getting care when needed Compared with 43% black and 41% of white Americans
- Data from our NAHN ACA Educator evaluation form.
- We are excited to report that our organization was competitively selected as a recipient of the iCohere’s “Serving Those Who Serve Others” grants for 2015, a special program that awards high-tech resources, expertise, and platform for hosting a nationwide virtual conference on our PICCI grant. We were selected due to the unique contribution of Hispanic Nurses (NAHN) on this topic, noting that we were informed that we “clearly conveyed both the organization’s high level of commitment to those whom we serve, as well as our eagerness to expand the effectiveness of our community outreach through the benefits of hosting a major online event.
- Lessons learned since 2014 Be inclusive, so that no one is left behind Consider those already with health insurance coverage, those who feel do not qualify for tax credits, etc. – they may be your best marketing strategy Latinos are intergenerational (la familia primero) Include grandparents for education and outreach Strategic Partnerships Nurses can offer health screenings as an entry to discuss health insurance coverage/literacy Annual and ongoing cultural events Focus on various target groups (including health care providers) Testing culturally responsive messaging Do not make assumptions Promote the value of health insurance coverage consistent with the values and priorities of consumers
- Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions; Application assistance from navigators and others was the strongest predictor of enrollment, while Latino applicants were less likely than others to successfully enroll; Hard to reach populations especially in need of in-person, bilingual assistance Rural, border communities experience shortage of resources, including health care providers Season & Migrant Farmworker Challenges Seasonal employees, those in positions for six months or less per year, are not considered fulltime employees and do not have to be offered health insurance. Advertising was strongly associated with perceptions of the law; State policy choices appeared to have had major impacts on enrollment experiences among low-income adults and their perceptions of the ACA. Culturally responsive messaging impacts perception Do not make assumptions Promote the value of health insurance coverage consistent with the values and priorities of consumers