Growing up in Latin America, I learned early in life that many diseases had serious consequences, but that others could be prevented with the proper intervention. Little that I know that coming to live in the United States would radically change my perception in regards to the causes affecting health: the determinants of health.

Healthcare in the U.S. is not in its best moment, and multiple reasons can be cited, such as high healthcare cost, poor diet, and others. A publication from Harvard University and the Robert Wood Johnson Foundation released early this month gives us an interesting outline.

Are you concerned about your health? It appears that 6 out of 10 people in the US (62%) are indeed concerned about it. Americans think that the top reasons affecting their individual health are lack of access to high-quality health care (42%), personal behaviors (40%), pathogens (viruses and bacteria, 40%), high stress (37%), and environmental conditions (air, water, or chemical pollution, 35%). Interestingly enough, it is people like you and me reporting these factors, which are considered some of the most important social determinants of health and that are being addressed by public health systems around the world.

These are all interesting numbers and information, but this study gives us the opportunity to address some of the major issues affecting health nowadays: culture and language, literacy, health belief, and access to medical care, to name a few.
Culture and Language

Can you access all the information you need to improve your health in your preferred language and acknowledging your culture? Are you able to secure effective communication in English with all of your health providers? Do you rely on friends or relatives to tackle the language barrier? Are you being provided with Professional Medical Interpreters? You have the right to receive free-of-charge linguistic services by Professional Medical Interpreters in your preferred language in health facilities that receive Federal funding (Medicare, Medicaid, CHIP, etc.)? If you need a voice in your language, you can get a professional to facilitate your communication.

Health Literacy

Did you know that when adult patients need to understand the instructions given to them from doctors and hospitals better, it's when they may actually understand it the least? That is due to literacy, specifically in health care. Health Literacy is the capacity to comprehend the message, instructions, and numbers in the different documents you receive as a patient. The latest nationwide assessment about Health Literacy was conducted in 2003. We are overdue for a new assessment especially due to the advent of digital literacy or the capacity to interact with digital information at a click's distance. After all, the web is converging to become the Internet of Everything.

Health Beliefs

Our beliefs largely determine our behavior, and according to County Health Rankings, it accounts for more than clinical care itself (30% vs. 20%). So everytime, that you hear something about health, use it as an argument that needs to be validated. Be critical and skeptical of medical TV talk shows to inform you, as there is also research that indicates that only half of what they recommend is based on evidence. Does that mean that I should rely entirely on my relatives and friends? The answer is no. You should always consult professionals and verify medical information, especially if that information can impact your health. The federal government and its public health agencies and organizations have resources in more than one language. Where should we start? Perhaps by writing down our questions or using this template prepared by the Agency for Healthcare Research and Quality.

Access to Health Care

One of the main differences between the US and other wealthy countries is universal health care access, meaning everybody is having health insurance. Since 2014, a broad attempt to enroll most people in this country in health insurance started. Its name is the Patient Protection and Affordable Care Act. If you have not applied for it and you need health insurance, you should try the Health Marketplace, even though the enrollment period ended on February 15th, you could still enroll in Medicare, Medicaid, and CHIP if you qualify. The application process makes you review many important things in your life (age, habits, family history, etc.). If it "looks" difficult and "not for you", you might be wrong, remember that if you do not have health insurance you will most likely have to pay a penalty when filing taxes. The registration process may not be the simplest of all, but different to other similar application processes, there is effective telephonic guidance in Spanish all the way through. I can tell you it is the truth, I have used the telephonic services for both of my enrollment cycles. A report published early this month, indicates that the ACA's coverage expansions have the potential to reduce, though not eliminate, racial and ethnic disparities in access to care.

This column is intended to assist you from a customer perspective, so your participation is key to create a dialogue and find out about the necessary resources to clear your concerns about navigating the US health system and improving your health.