Breaking Language Barriers: Culturally Competent Diabetes Education by Vincent Pepe

As members of the National Health Corps (NHC), we all began our service terms with the goal of promoting the health of each respective community we serve. Part of this role as an NHC member involves first integrating ourselves into the community and understanding who we are serving before we can then make strides towards improving health outcomes. For me, as a Norristown native currently serving at Norristown Regional Health Center (NRHC), I naively thought that I already understood the community well and that my transition would be relatively quick and easy. However, I soon realized how much more there was to learn about the vibrant and complex community of Norristown.

Here at NRHC, we serve a population that is approximately 70% Hispanic, with a large portion being Mexican-American. Though the strong Latin American presence throughout Norristown adds to the beauty of my hometown, there are undeniably many struggles that this community faces on a daily basis. For a variety of reasons, whether they be related to immigration status, poverty, English-proficiency, cultural barriers, or even genetic reasons, there are many health disparities within the Hispanic community, both here in Norristown and throughout the United States as a whole. This inequity is seen very clearly when looking at the prevalence of diabetes, for example. Nationally, approximately 12.1% of Hispanic people are diagnosed with diabetes in comparison to only 7.4% of Non-Hispanic whites.[1] More specifically within the Hispanic community, 13.8% of Mexican-Americans are diagnosed with diabetes, which is particularly relevant to our Norristown community.[2] With almost twice the rate of diabetes between the Non-Hispanic whites and the Hispanic patients we serve, it is clear that there is a health care gap that needs to be addressed.

Consequently, one of my projects as a care navigator is to facilitate monthly diabetes education classes at NRHC. My role involves reaching out to patients who have recently been diagnosed with diabetes or whose hemoglobin A1c values are significantly higher than the recommended value. In addition, during the classes, I assist our diabetic educator in running the event. The classes themselves focus on both the medical basis of the disease and also the practical application of carb-counting and portion control, so that our patients are better equipped and motivated to maintain a healthier lifestyle.

With any act of care provision, it is important to meet the patients where they are and to accommodate their needs, a value which was strongly emphasized during Pre-Service Orientation with NHC Philadelphia. Our classes in Norristown have done a tremendous job in this regard by integrating Hispanic culture directly into the classes. Most notably, we offer a designated Spanish-only version of the class, so that our patients can focus on the content of the conversation rather than the language barrier. Additionally, for our group meals that conclude each class, we prepare culturally-specific dishes, such as arroz con pollo y frijoles (rice with chicken and beans), so that patients can see realistic ways to implement our advice, while still embracing their cultures’ cuisine. By understanding and adapting to our patients in this way, we increase compliance, and ultimately, improve the health outcomes of our diverse Norristown community.

[1] “Statistics About Diabetes.” American Diabetes Association, 19 July 2017, www.diabetes.org/diabetes-basics/statistics/.

[2] ibid.