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UF pediatricians launch Hispanic Health Initiative

Two University of Florida College of Medicine–Jacksonville pediatricians are launching a Hispanic Healthcare Initiative to help the medical community better understand and care for Latino families.

The initiative includes a Jacksonville Hispanic Guide that will be published in English and Spanish this fall, listing contacts for everything from doctors and health insurance programs to food banks and churches.

Laura N. Beverly, M.D. and Patricia A. Solo-Josephson, M.D., both assistant professors in the Department of Pediatrics, saw the complexity of the problem firsthand in their practice at the Beaches Family Health Center where 40 percent of their patients are Hispanic.

Beverly, medical director of the center, Solo-Josephson, and fellow pediatrician Rachel Schare, M.D., would see families that wouldn’t come back to the Duval County Health Department clinic for follow-up appointments or meet with specialists. They’d see parents who never picked up prescriptions and others who wouldn’t bring children for routine appointments and shots.

And that’s if people went to the doctor at all.

Much of the translating fell to Solo-Josephson, who grew up in Miami speaking Spanish, as opposed to Beverly who jokes that she only speaks "southern."

Beverly and Solo-Josephson decided to get to the bottom of the issue and were awarded an $11,000 Community Access to Child Health (CATCH) planning grant from the American Academy of Pediatrics in 2009 to study the issue and develop a plan to fix it.

The doctors joined forces with the health department’s Hispanic Advisory Committee to get a better understanding of the issues facing Hispanic immigrants, especially when it comes to medical care.

Through those discussions, Beverly and Solo-Josephson then identified some of the major barriers Hispanic families have to healthcare, including language, legal status, finances, and simply understanding the American medical system.

During focus group meetings held entirely in Spanish, Hispanic patients revealed stories of fear and distrust – even sending a spy into a doctor’s office to check for immigration officials before the family would walk in.

"How can this be happening in America that they are so fearful?" Beverly questioned.

Hispanic patients said they felt looked down upon for not speaking English and said they were often hung up on when trying to make an appointment over the phone.

Partners supporting the publication of the resource guide include the Duval County Health Department’s Hispanic Advisory Committee, the Mayor’s Hispanic American Advisory Board, Catholic Charities, the Northeast Florida Pediatric Society, Blue Cross-Blue Shield and the AmeriCorps – North Florida Health Corps.

The Hispanic population in Jacksonville (about 7 percent) is smaller than other major Florida cities, but doubled in the past 10 years and is the fastest growing ethnicity in the city, Solo-Josephson said.

For Beverly, she is seeing that little changes can go a long way in treating Hispanic patients. For example, she said she now knows that even when patients or parents did speak what she thought was strong enough English to have the conversation, many people wanted the information in their native language when it came to something as important as their child’s health.

Now, her first question is "Would you like a translator?" instead of trying to get the family member to speak English first.

Beverly and Solo-Josephson said they hope to get the initiative incorporated into some training with medical students and residents, as well as a topic they could present at grand rounds, where physicians and residents discuss the latest advances in medicine.

"It is so important to connect with your patients," Solo-Josephson said. "Part of how you make that connection is showing them you want to be able to communicate with them, even if they speak a different language."

And some of the differences are cultural and relate to the standard of care in a family’s native country. For example, many Hispanic immigrants come from countries where a person did not need to see a doctor before getting antibiotics and where emergency room visits for routine care are common.

"Understanding where they are coming from helps us to deliver better care to them," Solo-Josephson said.