June 4th, 2010
06:12 PM ET

Why do Latinas avoid the doctor? Study investigates

By: Sabriya Rice
CNN Medical Producer

Social and cultural factors may play just as big a role as economics in the poor health care outcomes of Latinas, a new study finds.

The small study, published in the journal Ethnicity and Disease, looked at Latinas in upstate New York found that 70 percent of the women reported delaying doctor appointments, even though nearly all  had insurance and over half had diagnoses of chronic medical conditions including diabetes, heart disease and cancer.

"Diagnosis should typically motivate you to seek further attention," says Janie Jurkowski, an assistant professor at the University at Albany's School of Public Health and co-author of the study. "It's really quite scary and striking to see that even with a chronic disease people are delaying care.”

Among the reasons the women listed for avoiding their doctor appointments included opting for alternative therapies, previous experience with discrimination in a clinical setting and a preference for doctors of their own race who "speak their language." Jurkowski says the cultural competence of the provider is very relevant in today's society and efforts to diversify the work force, provide interpretation services and encourage cultural sensitivity benefits everyone in the long run.

"The longer the these patients delay, the worse the outcome and the more rigorous and costly the treatment,” Jurkowski notes. “Getting people in sooner would be better for the healthcare system as whole, especially in the era of rising costs. "

Most of the participants in this study were of Dominican and Puerto Rican heritage, however the trend has been viewed in other Hispanic groups in the U.S., and the number of Hispanic Americans continues to rise. According to census reports, the Hispanic population is increasing at more than three times the growth rate of the total U.S. population, and by the year 2020 Hispanics will represent nearly 18 percent of the U.S. population.

"There are lot of places in this country that are seeing fast growing Latino populations, and the health care system is not ready culture-wise to respond to the growth," Jurkowski says.

soundoff (137 Responses)
  1. Claudia

    Latinas don't go to the doctor even though they have insurance because even the tiniest treatment costs several hundred dollars ON TOP of what the insurance pays.

    To give an example, I have Blue Cross Blue Shield, and they pay 40% of dental treatments, but only 40% of what THEY consider appropriate payment, not what the doctor actually bills, So they really only pay about 20% of our medical bills. It's all a big fraud and I don't go to the doctor any more either.

    June 6, 2010 at 20:04 | Report abuse | Reply

    WOW...I am just amazed by the racist, ignorant comments after this story! I wish people would become informed and stop being so ignorant. Just a few issues here:

    1st and foremost, many doctors who come from Latin America are not provided witht he opportunity to practice medicine here in America, either because of the lack of English or the lack of time for further training and fees to pay to get a medical license from the United States.

    2nd, Latino students in America are NOT provided with the same opportunities as white students. Only a small percentage goes to college and even a small percentage graduates from college. Continuing with percentages, only and even smaller percentage goes on to medical school and most are lost after organic chemistry because of the lack of proper training prior to medical school!

    3rd, Latinas avoid the doctor because we are brought up in a culture where our family and home and now days career, are placed before our needs..we do not have time!!

    4th, are we really going to begin the bilingual argument?! Is a shame that America is the only nation that prides itself on monolingualism!! And contrary to common belief, Latinos DO want to learn to speak ENLGISH and many many do, by the second generation many families lose Spanish because of our subtractive educational system.

    Finally, not all LATINOS come from Mexico or Puerto Rico, there are over 17 other LATIN AMERICAN NATIONS!

    June 6, 2010 at 20:19 | Report abuse | Reply
  3. Mark

    Okay lets get this straight....You dont have to know english. So all you spout offs who demand that everyone speak english your wasting yoru time. As big as the United states is we are the only country who try and prmotoe being monolistic speaking. If you are so worried pick up another language yourself and step up a notch. Im 50 yrs old and can speak 3 languages and was born and taught english and from OHIO. YOur constant demanding or speaking english is a waste of time because eventually people will learn different languages because of a closer world. You will be left out. There are many doctors who speak spanish they just don't happen to live up around New York and them parts. No one need to speak a word of english although it maybe handy. There is no where in teh Bill of Rights or Constitution that demands of it. So get off yoru high horse and learn a thing or 2 about people and possibly your ancestors. Your wasting time.

    June 6, 2010 at 20:25 | Report abuse | Reply
  4. Mark B

    June 4th, 2010 19:54 ET
    Thank you Jennie
    If people want to receive medical services in this country, then learn to SPEAK ENGLISH! They are NOT in Puerto Rico or Mexico anymore. If they want to continue living here, they need to integrate into our society, which means they speak English and don't have a problem seeing doctors of another race. I have had to work with medical professionals from a different country who are definitely not of my race. But that does not prevent me from using their expertise and services. Latinos should not get special privileges just because of their race.

    June 6, 2010 at 21:22 | Report abuse | Reply
  5. Isabel

    First, I actually think that this article is very bias. Truly, why look upon the Latin American cultures and health?...I won't say that there might not be any sort of relation between the way in which many Latinos react to illness, and the way in which their cultures actually influence upon their decision-making when going to see a doctor, but I consider it quite bias. I was not interviewed on this, neither was any woman in my household. Most Latinas I meet do in fact go see a doctor when necessary. Most of the times, and in this I agree with Lea, the body will try to recover itself. If it's not deadly, most of the time, the doctor will not be able to do anything for you. Instead, you only waste time.
    Secondly, I do not understand where this idea that we do not value education comes from...Let us not generalize peoples. Not two individuals are the same, and as a result, it is highly unfair to say that we do not value education. I am an educated Latina. I teach children and so, I am teaching the next generation, hopefully to be more curious and to have a desire to learn and have an open mind as many of my generation do not. Quite shameful to say the least.
    Thirdly, let us not insult other people's cultures. To say that reference to the Virgin Mary, to many is sacrilege, and shameful as well, whether this comes from a person of religious background or atheist. Respect does not see religious beliefs. Respect should be given, regardless of the person's beliefs.
    Lastly, let us not forget the long waiting lists the US health system has. It takes sometimes, months to be able to see a doctor, and not a doctor of specific ethnic background. Other people from, mostly European nations complain of their long waiting lists and how long it can take to see their doctor, and that makes us think we are better. But let us not forget, we also have those endless waiting lists unless of course, you're among the privileged few.
    This article describes too many generalization that help further a wrongful stereotype on my community, when many people still do not quite understand it and do not make an effort. And perhaps to you it might seem the effort is not given for assimilation to happen, but the latter will happen inevitably. We are however, not much different from other immigrant groups who have come prior. Learning a new language is actually difficult when all you do is work, one. Still many of us succeed, and assimilation and integration into the American culture happens in more than one way. Perhaps only an immigrant would know this, because only an immigrant would perceive how much he/she has changed and how different he/she is from the time when s/he arrived.
    As for speaking English, alright, but I suggest you also learn to speak English properly and write it correctly as well, Murray.

    June 6, 2010 at 21:29 | Report abuse | Reply
  6. Jerry

    I wish I could find a doctor who spoke my native language and spoke it well enough to be understood.

    By the way, my native language is American English.

    June 6, 2010 at 21:40 | Report abuse | Reply
  7. ahm

    Richard J. Cortez said, "We need more of are own Mexican Doctors! Period!"

    In the United States, "our own" doctors, regardless of ethnicity, are American. If you are going to insist on Mexican doctors, go to Mexico. While you're there, tell the other Mexicans to stop demanding that U.S. taxpayers pay for their health care and other expenses.

    If you are here as a guest or a legal immigrant, then stop complaining. I've had great and mediocre black doctors, great and mediocre Indian doctors, and great and mediocre white doctors. That's just how it is.

    June 6, 2010 at 22:56 | Report abuse | Reply
  8. Pluto

    Some hispanics must be pretty darn racist if they refuse to see the doctor simply based on cultural or racial differences. The only ones to blame are them. Get off your high horse and go see the doctor. If you can`t speak English then learn to speak English.

    June 7, 2010 at 00:07 | Report abuse | Reply
  9. Zachary Carter

    They avoid the doctor (thankfully) because they are here illegally and should NOT be taking adavntage of our medical services for free while decent americans can't get service!

    June 7, 2010 at 00:38 | Report abuse | Reply
  10. jimmy

    Its called ignorance. You have people coming over here who are uneducated and ignorant, then they have kids who are raised with this example. One generation to the next, it continues...

    June 7, 2010 at 01:10 | Report abuse | Reply
  11. bookworm4

    This article is just ridiculous,

    "a preference for doctors of their own race who "speak their language.""?

    All the Latina women I know don't want a doctor of their own race because its impossible to find one, they merely want someone who can speak their own language. And I would know quite a lot, seeing as I am a Latina college student myself. Another reason, is the way most Latina women (like other women regardless of race) take care of their husbands and children before themselves, its just the way most women who have families think. They worry about their family first and then about themselves second.

    And this article also fails to mention several factors, among them the fact that many Hispanic women don't consider it appropriate when another man other is inspecting them, however this could be said of any women regardless or race. Many women feel much more comfortable when talking to another women, due to the fact that there would be more trust and possibly more understanding among two women. Also, many Latinas don't run to the doctor unless its really serious.

    And for those saying that they should learn English and that English should be the official language, all of you are idiots. Many people DO want to learn English, but as we all know, learning new stuff just takes longer as one gets older. SO its NOT THAT THEY DON"T want to, but that they are probably in the process of learning, or are too busy working,like most people. And even then, depending on where you live, there could be low numbers of places where you could learn English, thus many people might not even get a chance to learn English, even if they wanted to. And what ever happened to the notion of America being a melting pot, one that had people whose culture AND languages who come from many parts of the world come together to make one nation???

    And even I who have insurance don't wan to go to the doctor. Why? Because most doctors, like many of you who have posted here, are quick to write a prescription for over the counter pain killers without looking at what is causing the pain. My youngest cousin nearly died of pneumonia, due to the fact that all the doctors my uncle took him to, said it was mearly a cold, and not to worry, because it would go away on its own. Imagine what would have happened if my uncle actually listened to those so called doctors??? And even if you have insurance, expect to pay a lot of money just for one visit.

    June 7, 2010 at 01:23 | Report abuse | Reply
  12. Mike

    My wife an MD came from India; learned English went through USMLE residency, boards and now practices; her friend from Russia same learned her language for 2 years before becoming a doctor; pulmonary and critical care. IF YOU WANT GOOD CARE LEARN TO SPEAK THE LANGUAGE DON'T CROSS THE BORDER AND WALK INTO A FAST FOOD RESTAURANT TO WORK INVEST IN EDUCATION; AND DON'T EXPECT DOCTORS TO SPEAK SPANISH OR A DIFFERENT LANGUAGE FOR EVERY PATIENT NOT WORTH THE INVESTMENT

    June 7, 2010 at 03:00 | Report abuse | Reply
  13. Bernie

    Everytime I read an article on CNN I am becoming less surprise at the stupidity from the other posters. Even in the 21st century the bigotry still continues. It saddens me that people do not have compassion for another human being, regardless of where they come from. Has it occurred to any of you that some latin women do not have money or insurance to go see a doctor? And just like many Americans who don't go to the doctor is because they don't trust them. Just as any of you would not trust a doctor if you are in another country. And that is just personal preference, I don't think this have anything to do with race, culture, or ethnicity.

    Since so many of you apparently flunked out of Geography class, you would know that PR is a USA territory where a good majority of the people already speak ENGLISH!!! You mono-lingual Americans always expect everyone to speak English when they don't have to just to satisfy your own insecurities. Even when you travel to other countries you expect people to speak English there too. How about any of you try learning the language so then you can understand the struggle it is to speak English!! People from other countries make better attempt to learn the language but many of you do not realize English is not the easiest language to master. So much so that not even Americans can master the language well either. In other words, STOP PASSING JUDGMENT!!! You are no better than anyone else. This country did not start off as an English speaking, that came later. And I'm sure you didn't know that America derived from "Amerigo Vespucci" who by the way is Italian. Before you people get onto you high horse and learn your history instead bashing others!!

    June 7, 2010 at 03:13 | Report abuse | Reply
  14. Bernie

    Boo Radley, Terry, and Barbs...the three of you are absolute idiots!! Go and crawl back under the rock you came out of. You are the lowest forms of human beings, if I can call you human, I have ever seen!!

    June 7, 2010 at 03:24 | Report abuse | Reply
  15. PhillyRick

    Imostly agree with LatinaDoctors comments except #2. I disagree that hispanic students are not afforded the same opportunities as white students. In Philadelphia, they mostly go to the same schools, have the same teachers, have the same text books. Where is the lack of opportunity? What is lacking is the "taking advantage" of the opportunity. Granted there may be some language barriers, but these can be overcome with patience and determination. I do not want to sound racist, but i dont see why an immigrant from any country would not want to learn the language of there adopted country. I spent several years in Japan and learned the language. I think it unrealistic to think that an entire country should adapt to the few. We have street signs in spanish, chinese, and other languages in this city. At the same time i have a neighbor from colombia who has been here over 20 years and he simply refuses to learn the language. This isolates him to his own little community. Of course it's all the white man's fault that this guy cant get a decent paying job. I cannot think of one other country except Cananda which is polylinguistic and has survived. I work with many new americans from eastern Europe and the one thing i have found in common in all of them was the desire to learn english, because as one woman said to me "this is my country now, this is my language now".

    June 7, 2010 at 05:04 | Report abuse | Reply
  16. FromGermany

    My bolivian wife and I live in Germany, and I must say that unfortunately it has sometimes been rather difficult (and still is) to motivate her to either go to the Doctor, even for known and recurring illnesses, or to follow through with a treatment. I'm writing this not as a criticism of my wife (whom I love very much), but indeed there seems to be a pattern here.

    June 7, 2010 at 05:19 | Report abuse | Reply
  17. Brenda

    THANK YOU TAMARA!!!! Are you not aware that English is one of India's official languages (it was, after all, under British rule for many years!), thus people from India learn to speak English in school and come to North America with those language skills! Same for most industrialized Asian countries (English is taught in their schools, to varying degrees). English is taught in schools in Latin America, but obviously those with the least education have little English skills to speak of.

    From someone who is a member of a highly educated (most of us attained graduate degrees) family of Mexican descent (yes, my college professor parents emigrated to the US legally), I am alarmed and horrified at the hatred and ignorance so prevalent amongst so many within our country today.

    June 7, 2010 at 05:44 | Report abuse | Reply
  18. Tony

    Not everyone wants to come to the US to live. Paradises do not exist on Earth. Spanish Americans who desire to come to the US are usually not the rich ones. It applied to all the people that have moved to the US in general. Why do you think the US gave another meaning to the English word billion? Because those who came were not the most literate. It was like that then, it will be like that for still a while. Some of the newcomers in their willingness to forget their previous miserable lives changed their names, imposed English language on their children. As a result, we see most of the "assimilated population" crying for "England", they believe that England is the same as UK. The language is the carrier of the culture. If some newcomers are more enlightened, and do not want to relinquish the culture from which they came, why should that bother some? Some say that darkness hates the light. Many (most) of those that come here to work now from Mexico are manual workers, they do not really intend to stay here, they send most of their money back to their country. Doesn't it tell much already? They are visitors that came to work. As such, they should be respected and appreciated. Manual workers do not care about integrating because they intend to go back, the same way that you intend to come back when you go to Iraq or Afghanistan. What may happen is that you may stay longer than you may have planned, because of many reasons. Mexican workers come here to work. We go to those countries to do another kind of work.

    June 7, 2010 at 06:56 | Report abuse | Reply
  19. Carlos Espinosa

    I am first generation immigrant, first of my families to go to colleges and i find very hard to find a decent jobs. i posted my resume as a test one time, which a make believe name of Jonathan smith, i have over 60+ hit email and calls. Now i posted the same resume with my name, got only 10 hits, 2 junk email no calls. What kind of opportunity are out there, dicrimination is alive and well here in the U.S
    Another thing i have been approach by Latin American doctor which CANT get a lincese here in the U.S although they practice medicine in the native countries, to apply for a PA program, again cost are too great for someone of my background.

    June 7, 2010 at 07:41 | Report abuse | Reply
  20. C Vazquez

    Memphis Slim- I agree with you.

    I went to a 'very good white doctor'. He wanted me to schedule a C-section 3 weeks before my due date for no reason. I said hell no. My experience with some doctors is that they think you are an idiot just becuse you are latina. Hence the reason we are apprehensive... by the way I had two healthy 8+ pound babies

    June 7, 2010 at 08:17 | Report abuse | Reply
  21. Casey

    "Ethnicity and Disease"... Not exactly the most credible source, no matter the circumstances.

    Down in Miami, the scene is quite different. Latinos/as, at the first sign of sickness, ailment, pain, etc., rush to the emergency room or to a doctor's office. In fact, they are usually very quick to do so, regardless of severity or their own income level.

    Also, in Miami, where Latinos/as are the overwhelming majority (one can go through his or her entire life without speaking a word of English), there are many Latin doctors. They too make up the majority of health professionals.

    Therefore, while I know Miami is not reflective of the rest of the country, this is proof of the existence of Latin doctors and Latinos/as rush to judgment on treatment.

    June 7, 2010 at 08:32 | Report abuse | Reply
  22. aed

    It seems to me another form of racism/discrimination if someone refuses to see a Dr. because of his/her nationality. "I only see spanish doctors." Really? Come on. Shouldn't we be past that kind of attitude? My grandfather assimilated into this country when he came over and was proud of it. I am not saying to disavow your heritage, but you need to learn to speak some basic English if you are going to live in an English speaking country. I would not move to Indonesia and expect them to cater to me. I would have to learn their language.

    June 7, 2010 at 08:56 | Report abuse | Reply
  23. Nancy


    I am surprised the doctors you have gone to haven't attempted to determine the underlying cause of your symptoms. I find the opposite to be true. I went to my primary care physician back in February for severe arthritic-type pain and was tested for multiple disorders as well as being x-rayed. When one of the blood tests came back positive for inflammatory markers, I was referred to a rheumatologist who ordered so many tests (and additional x-rays) that I joked with the lab tech that they might as well take a pint while they were at it. Again only one of the tests was positive so she ordered that test again along with a couple of others. The point being that even though the initial symptoms (severe joint pain) are long gone, my doctors are still trying to figure out what is going on with me. The rheumatologist also took the most extensive medical history I have ever had. So don't paint every doctor with the same brush. Just as in any profession there are good ones and bad ones. As it turns out, from my personal research the positive blood test is probably indicating cardiovascular disease and the gastric symptoms (which came up because of the extensive history I mentioned) are probably due to gall bladder problems and hopefully not cancer. Either way, I will take care of it. As for what initially took me in, I agree with the doctor's suggestion that it was reactive arthritis due to a viral infection I had around the same time.

    As for all of the racist comments, I live in South Central Texas and many of my co-workers are hispanic. Most speak English really well, some speak a little and we have one or two who barely speak any at all. The ones who barely speak any are among our most reliable and hardest-working employees (in a factory that gets unbearably hot in the summer and freezing cold in the winter). Given that we often run 12 hour shifts, the ones who have managed to learn more English than they knew when they started are amazing. I know that most of our employees try to pick up outside work when we are not operating at full capacity so few of them have time to take ESL (assuming they could even find a class that fits their work schedule. In addition, I administer the payroll for our facility and for a facility we have in one of the midwestern states. Guess where the majority of IRS Tax Levies are (meaning some of our employees are not real good about doing their taxes)? Yep, our midwestern facility and they are all American-born and NOT hispanic. I have to say I am not real impressed with the financial habits of our midwestern employees. I cannot remember the last time I processed a tax levy for an hispanic employee. And yes, all of our employees are either citizens or legal immigrants.

    June 7, 2010 at 16:23 | Report abuse | Reply
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