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Addressing Health Care Disparities: Q&A with Leeann Medina-Martinez, LMSW

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In this guest Q&A blog post, and as part of Hispanic Heritage Month, CancerCare’s Disparities Program Coordinator and oncology social worker Leeann Medina-Martinez, LMSW discusses CancerCare’s Spanish language services and addresses health care disparities, including what can be done to overcome obstacles to care and the resources CancerCare offers to improve health care access.

What are some ways CancerCare is celebrating Hispanic Heritage Month this month?
Throughout the month (September 15 – October 15) we are highlighting our Spanish-language support services and resources on social media, our e-news and more. Our services, available in Spanish on our website include support groups, financial assistance, resource navigation and free publications and fact sheets to help anyone navigating a cancer diagnosis. To speak with a master’s prepared oncology social worker in Spanish, anyone residing in the United States, including Puerto Rico, can call us at 800‑813‑HOPE (4673).

What are some examples of health care disparities and who does it impact?
Health care disparities can come up when someone’s individual characteristics or circumstances, including race, ethnicity, sexuality, gender identity, age or health insurance status impact their access to or quality of care. The impacts of disparities can range from who gets an appropriate diagnosis and when, language barriers between the patient and medical team, fear of discrimination, being able to schedule specific appointments around work and life schedules, to access and proximity to affordable and quality treatment. Not everyone has equal access to health care, including the ability to see a doctor or having insurance coverage. Gaps in service can mean delayed diagnosis, not being able to afford treatment or the ability to travel to see doctors. Lack of access to care creates a huge impact on one’s quality of life overall.

Can you discuss your role as CancerCare’s Disparities Program Coordinator and what types of programs, resources and support CancerCare offers to help address some of these disparities?
My role is to address disparities within the oncology world and to help bring attention to the inequalities we notice as our clients report their challenges to us. We work to address the gaps in service that come up by providing and connecting clients to resources – places they can go to get assistance, walking them through how to have certain conversations around getting assistance and access to treatment and also by creating programs within CancerCare that would better help them – whether it’s by providing financial assistance to go to certain treatment centers that provide better care or offering educational workshops and publications for patients, caregivers and health care providers on how to communicate, share information and what questions to ask. All of these things are important and that’s part of my role – bringing these resources to light for all the populations we serve.

In what ways has COVID-19 changed or intensified these disparities for people of color, LGBTQ+ individuals, low-income individuals and others from marginalized communities?
Before the pandemic, there were already gaps in access to care, but COVID-19 intensified the health disparities for many people. A lot of people were not able to go in person to see doctors, which meant delays in routine check-ups, screenings and other early detection exams. Although telehealth appointments became more common, some people weren’t able to access them due to lack of access to a computer, smart phone or internet access. People living in rural areas also had to travel even farther to see doctors – a lot of local places were closed down, so in some areas, only large hospitals or medical centers were open which meant longer travel times for many people. A lot of people also lacked travel access to appointments. Some car services were suspended, there was the fear of taking public transportation during the height of the pandemic and in some places, COVID-19 rules were not implemented, leaving immunocompromised individuals more vulnerable.

How can the medical community and others who provide social support help address obstacles to care for individuals impacted by cancer?
A big thing people can do to address these issues is call it out by name when they witness these barriers. People who have the ability to advocate should see what services can be put into place. Opening more doors to communication is also important. It could be finding a translation service to allow people to communicate in their language with their health care team or developing more support groups – anything that allows people from underserved groups to better communicate. Health care providers should make sure they’re taking the time to sit down and have conversations with patients and their caregivers and make sure that patients understand the information they’re given and that they feel comfortable coming to speak to their medical team. Making patients and caregivers feel welcome, that they can ask questions and share their concerns without feeling judged allows them the space to get the information they need, self-advocate and make important decisions about their health.

What advice would you give to individuals and caregivers who may feel uncertainty navigating a cancer diagnosis and treatment?
A cancer diagnosis is scary. That’s why organizations like CancerCare exist. We’re here to provide help in navigating a cancer diagnosis and treatment. There are a lot of unknowns. Individuals who have been diagnosed with cancer may not know what to expect and they get a lot of information all at once, which can be difficult to process when there are multiple options to consider and decisions to be made. For most people, it’s good to have someone to talk to. Whether it’s calling one of our social workers on our Hopeline at 800‑813‑HOPE (4673) or joining a support group to speak with other people who are in similar situations – I recommend taking advantage of these resources. Having a community who understands what you’re going through, to give you support and more information can make a huge difference.

Learn more about the resources and support CancerCare offers to help people communicate effectively with their health care team and overcome obstacles to care.

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