Milagros Abreu, MD, MPH is the founder and Executive Director of the Latino Health Insurance Program, Inc. (LHIP), and serves as a Chair on the committee for diversity of the Massachusetts Medical Society and the executive committee of the Healthy Aging Collaborative. She recently received the Henry Ingersoll Bowditch Award for Excellence in Public Health.
You founded the Latino Health Insurance Program (LHIP). What is the LHIP?
The LHIP is a nonprofit organization that was founded to address the issue of access to medical care for Latinos in Massachusetts. Latinos are among the most affected populations when it comes to lack of medical coverage.
Working to improve access to medical care has helped us to identify other health-related needs within the community, including access to food and health literacy. We have expanded our scope beyond insurance enrollment to address these issues and others like transportation, chronic disease self-management programs, and care coordination.
What kind of impact has LHIP had on Latinos in Massachusetts?
Since 2006, we have been able to serve about 24,000 families across Massachusetts, which has led to the reduction of the number of uninsured Latino children, their parents, and seniors. One of our successes has been not only helping to enroll individuals and help them maintain coverage, but to improve continuity of medical care so that they are more likely to use preventive rather than emergency services.
We’ve been able to reduce about $30 million in medical costs in the past three years by educating people about the importance of prevention through programs like Mi Vida Mi Salud that help low-income Latino seniors improve their lifestyles, eating habits, and overall health. We’ve been very successful getting seniors enrolled in these programs so they can learn to be more proactive about their health, communicate better with their physicians, and get screened for chronic conditions like diabetes, hypertension, and cancer.
For example, there was a senior couple— a husband and wife, who were living in Framingham. They were retired and not interacting with the community. He had diabetes; she had hypertension. They didn’t have medical coverage, and given what they could afford, they weren’t even thinking about paying for prescriptions. We were able to help them with applying for a Medicare prescription plan and identifying health insurance coverage options so they could see their doctors. They also participated in our Tomando workshop, which is a chronic disease self-management program for Spanish speakers, and now we see them all the time, walking together back and forth to our office.
It is very gratifying because before they were isolated at home, and now they are engaged in physical activity, they go to their providers, they get their screenings, and they are active in their community. That’s what we want from this program.
What kinds of partnerships do you have in order to enhance the work that you do?
Partnership is a key for our success. We work with the Department of Public Health and with different sectors across the state. We work a lot with the faith-based communities, local municipalities, social service agencies, and local healthcare and dental providers. These partnerships allow us to provide free screenings for our seniors and identify medical homes for individuals who don’t have primary care providers.
What’s a project you’re working on right now that you’re excited about?
I am the chair of the committee for diversity for the Massachusetts Medical Society, and one of the purposes of the committee is to improve cultural sensitivity of physicians. I think we need to improve provider-patient relationships because many racial and ethnic minorities have poorer health, and many of these patients report a lack of trust in the medical system. The communication with their providers is broken, and we need to fix it in order to reduce disease and improve health outcomes.
I want also to thank Tuft Health Plan Foundation, which supports our Mi Vida Mi Salud program. It helps us to reach and impact the life of many seniors across Massachusetts. I am excited to see Latino seniors to become very active, change their diet, and improve their health. We are also increasing access to screening and education to reduce cancer rates for breast, cervical and colo-recto in our local communities through the Care Coordination program, as part of Department of Public Health efforts.
What drives your dedication to your work?
My background – as a minority woman and physician of color — has touched me in multiple ways. I believe that when my parents came to this country and identified some of the same issues I’m working on, they didn’t have the educational opportunity that many of us have right now. I think that by getting involved and helping to eliminate healthcare disparities, we will be able to help those who are coming after us to have a better place to live.
What is one thing that you wish other people knew about health and healthcare disparities?
The differences in health based on race and ethnicity and socio-economic status, among other differences, can be eliminated. We have to be aware of these differences so we can improve the care that we deliver to these populations. I think Massachusetts has been a leading state in access to care and many other areas. I think we can also become the leader in eliminating healthcare disparities and achieving health equity.
What are some helpful resources for people who want to know more about Latino health and/or healthcare disparities?
There are resources available from the CDC, the Department of Health and Human Services, the Office of Minority Health, and other sources, but I want people to go a step further and start collecting information from your own organizations and practices about the populations you serve and their needs. Sometimes the national data does not match with the local data. For example, Latinos come from multiple countries, and there are not enough data for understanding Central Americans, South Americans, and Caribbean Americans. I think it is extremely important to learn about these demographic differences so you can understand your own patients and clients and deliver better services to them.
How has being a part of the Healthy Aging Collaborative helped your work?
The Healthy Aging Collaborative has been great to help us to reach out to different partners and share common experiences working with seniors, and to collaborate with different organizations. The website is also wonderful – the distribution of the community profiles data and results has opened the eyes of everyone working with seniors. And the Collaborative’s work to promote age-friendly communities is extremely important. I believe the Collaborative is going to become a model in the nation, an example of a way we can improve the health of our communities by working together. I’m very proud and happy to be part of the Collaborative and to be part of the executive committee.
How can Collaborative members get in touch with you?
They can find the website for the Latino Health Insurance Program at www.lhiprogram.org. You can reach me also to our agency directly at 508-875-1237.