Celebrating Hispanic Heritage Month | Deloitte US has been saved
By Jay Bhatt, D.O., managing director of the Deloitte Health Equity Institute and the Deloitte Center for Health Solutions, Deloitte Services, LP
Over the summer, I joined about 2,000 people at the UnidosUS Annual Conference in my hometown of Chicago. The theme of this year’s event was “The Power of Us.” It’s an appropriate theme, given the organization’s work with affiliates, health care organizations, civil rights groups, and other like-minded individuals and organizations.
UnidosUS, a nonprofit, nonpartisan organization that serves as the nation’s largest Hispanic civil rights and advocacy organization, is working to improve the health of Latino children through its Healthy and Ready for the Future initiative. The program, which largely focuses on migrant and seasonal farmworker families in rural America, envisions a physically, emotionally, and mentally healthy Latino population.1
Latino children who live in states that have strict anti-immigration laws are more likely to experience mental health or chronic physical health conditions than children in other states, according to a study published this month in the journal, Pediatrics.2 The Deloitte Health Equity Institute (DHEI) provides ongoing funding to help UnidosUS as it expands this important program into urban communities.
Rita Carreón, vice president for Health at UnidosUS, leads efforts to improve Latinos’ well-being and access to quality, equitable health care by addressing the social determinants of health and by working closely with affiliates and health care organizations. I recently had an opportunity to talk with Rita about UnidosUS programs, the challenges of improving health equity in Latino and Hispanic communities, and Hispanic Heritage Month, which began September 15. Here’s an excerpt from that conversation.
Jay: The Healthy and Ready for the Future (HRF) program seeks to make health care more accessible and equitable for children, according to your website. What is the approach, and how is this program working to increase health literacy in the Latino community?
Rita: We launched HRF more than eight years ago. It is now in 107 rural communities and three cities across 14 states. We recently expanded into urban communities. We take a holistic approach in how we think about the social determinants of health and the political determinants of health for children of the Latino community. This includes making sure that children and their families have access to timely health care services. The program initially focused on connecting the children of seasonal farmworkers to health care services. We know that 76% of agricultural workers are Latino.3 Agricultural workers are more likely than other people to live below the federal poverty line, and they often have gaps in care. Agricultural and seasonal farm workers often follow the growing and harvesting seasons and might find it difficult to access health care services. Since 2019, about 30,000 children have received behavioral, social, and emotional well-being services, and 110,000 children have received dental health care services, through this program.
Jay: Why did you start out by focusing on rural populations?
Rita: For the pilot, we wanted to reach the most vulnerable population to develop a proof of concept. When we looked at which groups were most vulnerable, it was the children of migrant and seasonal farm workers. They often didn’t have medical, mental, or dental health resources…and proven outreach strategies that work well in rural areas are often underfunded. We started with prevention and well-being and worked closely with HeadStart programs and health centers in rural communities. UnidosUS also has a family engagement program, Padres Comprometidos, which translates to “committed parents.” It helps parents and caregivers navigate the school systems and encourages them to become advocates for their children’s health. Children are the center of the family. If you want to support families, focusing on children is a good place to start.
Jay: Along with your work in improving the health of children, what else is UnidosUS doing to make health more equitable?
Rita: UnidosUS is investing in a few bold ideas. One of them is wealth-building. We recently launched a partnership with our Affiliate Network to transform the economic trajectory for Latinos through homeownership. We see this as a critical path forward that can ensure long-term, sustainable wealth-building for Latinos.
Jay: Homeownership can be such an important economic driver of health. Homelessness among Latinos is rising faster than other demographics in certain parts of the country.4 The average life expectancy for someone who lacks stable housing is 27 years less than those who have stable housing (see Employers can spark healthy aging).5 How can homeownership help to improve health?
Rita: There is a clear connection between having a home and being healthy. The home is where people spend most of their time. It is a safe space. It is an environment that fosters economic stability and well-being. Having stable housing is an important issue for Latinos. It is also important to build generational wealth. Homeownership offers a pathway to that. Through the HOME Initiative, we hope to create 4 million new Latino homeowners by 2030. The initiative provides the tools and resources that people need to successfully navigate the whole home-buying process. When Latinos have economic prosperity, everyone benefits from it…including the health of their families and their community. There is a desire for the Health team to work closely with the HOME Initiative to consider the intersection between health and sustainable housing.
Jay: You have noted that UnidosUS has built a coalition of advocates who are working to advance health equity. Where are they focused?
Rita: A lot of the work that UnidosUS does is in partnership with affiliates, sister organizations, other civil rights groups, and like-minded individuals and organizations. We know that we can't do this alone. There has to be a public-private partnership. Our affiliates, for example, have worked to reduce birth defects by ensuring corn masa flour is fortified with folic acid. Other partners help make sure children in their communities receive all of their vaccinations. During the pandemic, we worked closely with organizations and coalitions to make sure we had the right data to make informed decisions and keep communities informed, particularly communities that are often overlooked. One of our affiliates is a Federally Qualified Health Center in the Coachella Valley of California. With the support of our Healthy and Ready for the Future program, they recently piloted an initiative—called Smiles Inside and Out—that conducts behavioral health screenings for children as young as four during their dental health visits. This combination of oral health and behavioral health is an example of how we think about health holistically. Mental health continues to be an even bigger issue today than at any other time in our lives, especially for the Latino community.
Jay: How can business leaders work with organizations like UnidosUS to help build trust in communities that might not have a high level of trust in the health care system?
Rita: Business leaders need to take the time to listen to, and learn from, community leaders and organizations. Start now if you haven’t already. A lot of new public and private relationships formed during the pandemic. But the relationships that were the most successful were those that had already been established. An existing relationship made it easier to leverage resources and ideas and take risks in a timely manner. We saw firsthand how that paid off around the vaccine equity work.
Jay: What is UnidosUS’ vision for health equity in the Latinx community? Where do you see HRF three to five years from now?
Rita: I don't believe that our work is done. We believe that everyone should have the opportunity to be healthy, no matter where they live, no matter how much they earn, no matter where they were born. A healthier America depends on ensuring that Latino children and their families can live healthy lives. Stress, trauma, anxiety, depression, social isolation, and loneliness were all exacerbated during a pandemic, and we really need to address it. By 2050, nearly one in three children in the U.S. will be Latinx. It is imperative that we act now and address the mental health crisis. For UnidosUS, Healthy and Ready for the Future can be the vehicle that helps us do that, and we have an opportunity to harness other internal assets, like our policy work and our family engagement work, to further strengthen our holistic efforts. We can do better, not only in school systems, but also in the community and in our health care systems.
Conclusion
For more than 50 years, National Hispanic Heritage Month has celebrated the histories, culture, and contributions of American citizens whose ancestors came from Spain, Mexico, the Caribbean, and Central America.6 The Deloitte Health Equity Institute provides funding for UnidosUS and other organizations that are working to make health care more accessible and equitable by empowering people and helping them navigate a complex health care system. The cost of health inequities is $320 billion today, and it will likely reach $1 trillion in 2040 if nothing changes (see, The economic cost of health disparities). Organizations like UnidosUS are working hard to make sure this situation changes.
Endnotes:
1 UnidosUS
2 State-Level anti-immigrant sentiment and policies and health risks in US Latino children, Pediatrics, September 2023
3 Farmworkers in the United States, MHP Salud
4 Increasing Latino homelessness—what’s happening, why, and what to do about it, National Alliance to End Homelessness, January 24, 2023
5 Mortality among homeless adults in Boston: Shifts in causes of death over a 15-year period, National Library of Medicine, February 11, 2013
6 Hispanic Heritage Month 2023, U.S. Department of State, September 15, 2023
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