Focus On...Overcoming Latinx Health Disparities One Person at a Time with Vanessa Fernandez, MD

The Latinx community has always faced a disparity in the US healthcare system. But why is that, and what can we do about it?

As a Latina healthcare provider, I have a good understanding of why the Latinx community lags in healthcare use. The major factor is culture. So many of our ancestors, and even immediate family members, come from a mindset that tells them not to go to the doctor unless they are sick.

That means no regular checkups and no help with disease prevention. The culture says to try to manage everything for yourself. Many patients take that approach, and we often don’t see them until an illness has advanced. Unfortunately, that attitude is ingrained generation after generation, and it is hard to break.

Finances and education are big factors here. Financially, many Hispanics work in jobs that lack support and benefits. Our families are frequently large, and in the US, people often send money home to their families in other countries. It’s not unusual for them to be working seven days a week to support the family.

To address financial barriers, Ryan Health sees patients regardless of their ability to pay. We also connect patients to Medicaid managed care plans if they qualify. For individuals and families who are uninsured, we have a sliding fee scale based on income and family size.

And here’s where education comes in: teaching patients, and potential patients, about the benefits of preventive care. Because Ryan Health is always in the community, we can reach out where people are.

That’s what drives my approach to healthcare. I am based at Ryan Health | Wadsworth, which is in Washington Heights. There is a large Latinx population in the neighborhood, many from Caribbean countries. Our center is bilingual, and I often have Spanish-speaking patients.

Recently, Ryan Health | Wadsworth held a health fair, and a neighbor walked through. He was around 40 years old, and we convinced him to check his blood pressure and blood sugar. He was shocked that his initial blood pressure was 200/106 and then 180/102 on a repeat check. He was at risk for organ damage including blindness, heart attack or stroke, and we recommended he immediately go to the hospital. He chose to come to the center the following week and we are now getting his blood pressure under control, saving his life. With our health fair, Ryan Health brought the medical team to him.

Those one-on-one interactions are effective with the Latinx community. I always tell stories and use my examples with my patients, so they know that this isn’t just my profession, it’s what I believe and how I live. If we’re talking about vaccines, I’ll let them know that my husband, who wasn’t boosted, got COVID last December, and was sick for a week. I am boosted and didn’t get sick. Giving real-life examples, instead of only talking about statistics, really connects with my patients.

Food plays such a large part in Latinx culture. It’s our love language. We eat with friends and family and share what we cook. It’s not uncommon for Latins to believe that the more you feed someone shows how much you love them. But that can have negative health consequences. I’ll often show a picture of my dinner or what I’ve packed for lunch, so they learn that you can eat Latin food with sensible portions and be healthy.

I recognize that changes like these don’t occur in just one visit. Education takes time. But I want my patients to know that all these things can become part of their routine. My patients need to know where I’m coming from, not as a physician but as a person. Reaching the Latinx community to improve their health outcomes can be done, and a personal, hands-on approach works best for me.