KC Checkup: Four Questions For Paula Cupertino
The Latino population has been booming in Kansas in places where growth is otherwise stagnant.
Today, one in 10 Kansans is Latino. But there’s a big disconnect between that growing community and the health care system, according to Paula Cupertino.
She’s the Brazil-born director of Juntos, a group based at the University of Kansas Medical Center that examines Latino health in Kansas. She answered four questions as part of our monthly series, KC Checkup.
There have been a lot of recent efforts to make health providers more culturally sensitive and able to work with people who might not speak English. Does not being able to speak English still make a big difference in someone’s ability to get health care?
Yes. And it’s not only that we have a lack of providers who are fluent in Spanish, but we’re also still working on the development of adequate, appropriate interpreting services available at clinics, at prevention programs, at hospitals, and so on. And not having the language or the cultural connection between patient and the healthcare system limits access, limits trust and consequently has an impact on adherence to treatment, on following up with the recommendation from the physician. And we know Latinos in the United States and in the state of Kansas are suffering epidemics of diabetes and other cardiovascular diseases. They’re chronic diseases that demand continuity of care. So a Latino who has got diagnosed with diabetes is not able to develop the trust, the connection with their clinic, with their health care — it’s more likely they’re going to do a poor job in terms of managing their diabetes.
When someone comes to Kansas and gets settled, how does that change their nutrition and approach to health?
First of all, we see a change in the context and the food supply. Most of the Latinos, primarily from Mexico, coming here come from rural areas where access to fast food or to high-caloric food may not be available at the cheaper prices that are available here in the United States. So with that, you have a significant change, and we also need to think about foods in terms of prestige. Imagine you grew up in a rural community, primarily eating what you produce within your community and suddenly you move to Wyandotte County, in which you can order a $5 pizza to be delivered to your door within minutes. So what does this change — I think it has a lot to do with prestige. I’m no longer eating what I produce in my backyard, but suddenly I have someone who delivers a $5 pizza to my door. It’s kind of, I’m moving up the ladder and the social mobility.
How significant an impact has the Affordable Care Act had on Latinos?
Results from last year have shown us that the ethnic group that has been affected most from the Affordable Care Act has been Latinos. We know that there are many Latinos that have been contributing to the state and to the country for many, many years that did not have insurance because they’re more likely to be in the poverty level. And they’re more likely to opt out in the wellness and healthcare programs within their business, within their work. So the Affordable Care Act had a significant impact in reducing the number of Latino uninsured at the state level and nationally.
How does the experience of rural Latinos compare with those living in urban areas when it comes to health?
It’s interesting that at some levels it looks like rural are less likely to have access to specialty services, to hospitals and to procedures. But at some levels, they are most likely to have access to primary care. In community organizations, I think the fact that they are so far away and the resources are so limited, they are much more likely to collaborate and get organized at the community level to provide access to the primary levels of service. And here in Wyandotte County, on the contrary, you’re in an urban area where you’re expected to have easier access to primary care, but it doesn’t happen. We know in Wyandotte County, where most of the Latinos live in the urban core, Wyandotte County has the worst health outcomes in the whole state.