To meet the needs of the rapidly increasing population of Latinos without medical insurance, the Medical Center has received a one-year, $835,911 grant from the U.S. Department of Health and Human Services to coordinate a comprehensive health care improvement program for uninsured Latinos in Durham County.
Through improved physical and mental health services, as well as health education aimed at greater awareness of proper health care system use, Latino Access to Coordinated Healthcare intends to improve the overall health of a Latino population that increased 729 percent in Durham County between 1990 and 2000.
Currently, Latinos account for approximately 40 percent of the uninsured in Durham.
To plan and now implement LATCH, the Medical Center has partnered with Durham County and several local health care institutions.
Susan Epstein, chief of the division of community health and a coordinator of the program, explained that one of the greatest obstacles for Latinos--many of whom have recently immigrated to the United States--is a lack of knowledge about how to utilize the health care system.
For example, many Latinos will only go to the emergency room because it is often the only option they know is available, Epstein said. "At Duke, there's an enormous amount of care being given to Latinos, but at the most expensive end," she said. "We thought, 'Let's start at the beginning.... Let's teach them about the health care system. Let's teach them how to take care of themselves.'"
With that in mind, the program will coordinate neighborhood outreach programs and initiate health education classes at El Centro Hispano, a health care facility partnered through LATCH that currently treats many Latinos. Social workers will also ensure that patients eligible for state Medicare benefits are receiving them.
To avoid common time conflicts with work, the program will fund a nighttime clinic for infectious disease testing at Lincoln Community Health Center, another LATCH partner.
The program, which plans to begin enrolling patients in January 2003, also recognizes the need to overcome Latinos' language barrier.
"The big majority of Latinos in Durham County are first-generation. Spanish is their first language. They're making an effort to learn the [English] language, but it doesn't happen overnight," said Ivan Parra, executive director of El Centro Hispano. "The services that Spanish-speaking peoples were receiving was clearly not up to that of others."
To meet this need, all staff hired through LATCH will be bilingual, including a mental health social worker and a nurse practitioner for medical care, who will work at Lincoln. "What is significant is that these systems didn't exist before these projects," Parra said. "A lot of [the programs' benefits] are services people usually take for granted, and that Latinos didn't have access to. This program will make it possible for Latinos to get the same quality of health care as everyone else."
Parra felt the program was a huge step forward for an underserved population. "This is clearly the largest and most comprehensive effort this county has had for Hispanics... in terms of medical care," he said.
By emphasizing non-emergency room options, the program will also attempt to ease some of the stress placed upon Lincoln, which faces the brunt of the uninsured Latino population. Of the 33,000 different patients the center treated in 2001, 26 percent were Latinos, and the ratio has increased every year, said Evelyn Schmidt, executive director of Lincoln.
"Since the early '90s, we've seen an increase in the number of Latinos getting care at Lincoln," Schmidt said. "I think the outreach can really help the patients.... It's important they learn how to use services in the community."
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