To the Editor:

Latino communities are among the fastest-growing demographics, a trend seen across the country. From 2000 to 2014, Latinos accounted for more than half of the growth in the total U.S. population.

Simultaneously, Hispanic and Latino communities are experiencing the fastest increase in diabetes rates. More than 12 percent of all Latinos in America have diabetes – a rate nearly two times higher than people who are white (approximately 7 percent).

This disease can be debilitating. If left uncontrolled, diabetes can take years (even decades) off a person’s life. On top of a shortened lifespan, poorly managed diabetes can be an extreme financial burden for both the patient and health care system.

There is a need for communities to better engage and help address this problem. To effectively support our high-risk Hispanic and Latino communities, we must first understand the challenges many face in properly managing this disease. At Tufts Health Plan, we are focused on addressing health care disparities, particularly for those living with diabetes in the Latino and Hispanic communities. Our efforts to improve their health and wellness have taught us several lessons.

Screening is crucial. Using data, we are able to identify members at risk for developing diabetes. Working with providers and other support services, guiding members through their health information, or what puts them at risk, and supporting their desire to make healthy choices is critical to reducing the risk for developing this chronic disease.

Information must be bilingual. Without this, things as ‘simple’ as medication directions could be misleading and have devastating consequences. A prescription indicating “ounces,” for example, could easily be interpreted as “once” (Spanish for “11”). We have been working to ensure all resources and forms are available in Spanish, and are working to convert medication labels to avoid misinterpretation.

Effective diabetes intervention. This requires a deep understanding of the populations served. By training everyone that patients encounter, from customer service representatives to physicians, we can help care teams better understand cultural nuances that can impact the health of their patients. Our Tufts Health Plan teams are working with clinicians to help them understand how traditional foods may put some communities at higher-risk for chronic conditions, and provide support for advising on simple and culturally-appropriate diet adjustments.

Understand what it is like to live with diabetes. We want clinical staff to truly understand the daily challenges patients living with diabetes face. We have encouraged empathy-building exercises, for example, where clinicians draw their own blood, measure their own glucose levels, wear insulin monitors for an entire day, and learn how to administer insulin injections with a dry syringe. This experience puts providers in the shoes of their patients and further helps them understand difficult factors that influence their health, both physically and emotionally.

Collaborations are key. Many of us understand that nutrition plays an important role in managing your health and preventing disease. With diabetes, diet is crucial. Tufts Health Plan works with Good Measures, a digital nutrition program that can be personalized for Latin cuisines. People with diabetes learn about factors that affect their blood sugar, like food, activity, medication, and stress, and how to improve and manage them. Coaching by registered dietitians is available by phone and online, whenever it is most convenient – days, evenings, and weekends. Interpreter services are available for non-English-speaking members.

Community collaborations work when they not only address challenges communities face, but address them through strategies and solutions tailored to the populations they serve. Right here in Rhode Island, our Tufts Health Plan Foundation is funding the Own Your Health Collaborative through the Rhode Island Parent Information Network, which aims to expand wellness and prevention training to older adults in both Spanish and English.

Health plans and providers play important roles in keeping people healthy by breaking down walls and providing accessible, simple-to-use resources. Recognizing language barriers, dietary differences, and cultural norms when caring for members of diverse backgrounds can provide breakthroughs for patients that allow them to live healthier lives.

Tilak Verma, MD, 

MBA Senior Medical Director of Tufts Health Plan

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