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Achieving Latinx Health Equity in California: Real Impact through Innovative Philanthropy

July 2019

Ana Marie Argilagos, President and CEO, Hispanics in Philanthropy

Imagine this: your doctor tells you your pregnancy is high-risk and you will need weekly shots of progesterone. Your anxiety spikes. You have no health insurance and you risk losing your job if you leave work for these weekly appointments. What if you also cannot find a clinic where a doctor and staff speak your language? Add to this a final straw: you do not have legal citizenship and a trip to the doctor’s office could mean deportation and your family being split apart.

This is just one example illustrating the difficult circumstances Latinxs face when it comes to accessing safe, affordable, and culturally competent health care. Despite decades of government and community efforts to improve health equity in Latinx communities, vast disparities remain. For example, Latinxs are the group least likely to be insured or to report having a doctor in California. And, although there has been significant progress, Latinas remain the group with the highest teenage pregnancy rate in the state, reflecting both challenges in seeking care and the impact of persistent poverty and more limited educational opportunities, particularly in rural areas.

The mission of the organization I lead, Hispanics in Philanthropy, is to strengthen Latinx leadership, influence, and equity by leveraging philanthropic resources. Health equity is a crucial part of that picture. That’s why, last year, we decided to take a critical look at Latinx health equity with our report, “Taking a Pulse: Latinx Health Equity in California: Facing Disparities and Building for the Future.”

What did we find?

First, let’s start with the fundamentals. The goal of health equity is to reduce—and, ultimately, eliminate—the disparities in health among socially and economically disadvantaged groups, including Latinxs. An essential foundation for this work is an understanding of the social determinants of health: an approach that looks at key elements in a strong community that are essential in order for health equity to exist, such as a sound economy, employment, housing, and an unpolluted environment. In effect, this is a more inclusive approach that looks beyond health care access and treatment.

With this holistic framework as context, we found that there are steps funders and community-based agencies can take to advance health equity in California’s Latinx communities. Read on for a snapshot of some of the challenges facing the community and a few of our recommendations for how funders can make headway (and check out our full report for a comprehensive review of these issues).

 

Challenges to Achieving Health Equity

The challenges to health equity are manifold. Issues around immigration can have a significant effect. The psychological impact of immigration, particularly the issue of deportation, keeps people from seeking out needed health care. Even documented residents have avoided seeking services that are legally available to them for fear of how it might affect their status.

Language barriers, particularly for indigenous Latinx immigrants who speak languages other than English or Spanish, also affect health equity, as does the dearth of clinicians who have a culturally-informed understanding of how immigrant clients might perceive health care and treatment. This, along with unconscious biases, impacts their ability to provide quality, culturally competent care. Add to this another challenge: lack of health insurance and an inability to pay for care.

Many other challenges affect health equity. Mental health issues for Latinxs are often exacerbated by poverty, racism, criminalization, deportation fears, a polluted environment, and the stress of acculturation and assimilation. Yet, evidence exists that they are less likely than non-Hispanic Whites to receive mental health care.

In terms of sexual and reproductive health, substantial disparities still remain by income, race/ethnicity, and immigration status. For example, the birth rate among adolescent Latinxs remains higher than in any other race/ethnicity. In addition, environmental health issues, such as air pollution and exposure to pesticides, disproportionately impact poor and underserved communities in California, many of which are Latinx.

 

How Philanthropy Can Make a Difference

Health equity advocates in California have identified several ways that funders can work with and in communities to address these challenges. These are just a few (see our report for a full rundown):

  1. Truly listen to communities to better understand their needs and how they themselves want to address them. Funders should resist making assumptions and engage communities in shaping new initiatives in order to build strong, trusting relationships based on integrity.
  2. Monitor who controls and distributes funding and sets priorities to ensure that organizations being funded bring in community members, local voices, and stakeholders as active collaborators.
  3. Foster collaboration by promoting efforts that bring different stakeholders together and by taking steps to ensure that small grassroots organizations have a voice and opportunities to receive funding. Shift funding from a competitive to a collaborative model.
  4. Support organizations that are putting forth an inclusive narrative for health equity that understands how the social determinants of health operate within families and communities and that are focusing on the root causes of health inequities, such as structural racism and economic injustice.
  5. Support organizations that are committed to and have the capacity to address healing and trauma in their communities. This includes funding capacity-building grants that provide training for health care providers on unconscious bias and cultural humility.
  6. Provide funding for existing services through general operating grants in order to facilitate sustainability. Commit to long-term investments, because health equity efforts span long periods of time and require immense commitment and consistency to achieve lasting results.

There are many obstacles to achieving Latinx health equity, but there are also promising practices for change — with the ultimate goal of increasing philanthropic support for Latino-serving organizations advancing health equity. For example, more than 100 nonprofits, foundations, government agencies, and public and private clinics are working to improve health equity in California in key areas such as health care access, reproductive justice, racial justice, environmental justice, and housing. If we work together to create solutions through a holistic lens, it is possible to dramatically advance health equity.