Utah may be next to experience a physician crisis

Story and photos by Justin Trombetti

The concept of representation in modern society can often be a fickle thing. It’s also becoming a hard conversation to avoid; it was a massive focal point of the most recent midterm elections, it’s garnered both highly positive and staunchly negative critiques of our modern media landscape, and for better or worse, the political climate of 2019 America has thrust an unending array of opinions to the front of our social commentary.

Emotions aside, the reality is that minorities and historically marginalized groups are not represented visibly in proportion to the population percentages they make up.

While this issue is far from exclusive to them, it is especially relevant to Hispanic populations. In fact, it’s a large part of the reason why California is currently facing what has been termed a physician crisis. That is, while Hispanics make up over 40 percent of the state’s population, they account for only 12 percent of graduating physicians.

It’s been posited that this has resulted in disproportionately poor health and community-wide vulnerability that, at its current rate, would take over 500 years to equalize.

It would seem that, upon a deeper dive into the matter, the issue is far from specific to California. Further, while healthcare is an immediate concern, it may well be a problem that extends beyond just a single sector of the service economy.

Utah is experiencing its own tension in the local health sector, as its rapidly growing population has begun to feel the strain of underrepresentation. Yehemy Zavala Orozco, preventive health manager of Comunidades Unidas, has been on the front lines of this reality for eight years.

The West Valley City-based organization’s primary mission is to “keep families healthy and together,” and Zavala Orozco (whose preferred pronoun is they) believes that the odds are stacked against the communities it serves.

They believe the underlying issues of representation are just the beginning of a multifaceted dilemma facing the Hispanic community. “No one gives you a guide,” they said of first-generation immigrants who often struggle to find resources that not only speak their language, but also understand them on a cultural level.

Zavala Orozco recalled a story of a first-generation mother from Guatemala with whom they recently worked. “The doctors found a lump in her breast and she needed surgery. They thought she might have cancer.”

On top of the woman dealing with the gravity of her diagnosis, Zavala Orozco said she found little help with the hospitals and offices she dealt with. Language barriers alone created a back and forth with her care professionals that made treatment more stressful and time consuming. Instances where miscommunications led to hospitals completely missing information along the way were also prevalent.

Zavala Orozco believes that there’s an extreme lack of investment and effort from the government to shift these paradigms. They cited the backpedaling on the 2018 initiative Proposition 3, which dealt with Medicaid expansion that would have had a strong impact on the Hispanic population, as a primary example of this.

They strongly suggest that Utahns must begin bolstering the opportunities available to Hispanics that allow them to ultimately join the professional sectors where their communities are underrepresented.

“We need to ensure they know college is an option, they just don’t see options other than places like [Salt Lake Community College] or trade schools,” Zavala Orozco said. They also believes that access to higher education is often too expensive for minority groups, and helping to remove the financial barriers of access is essential to reversing these trends.

In Utah, physical health is not the only concern Hispanic populations are faced with. In a state where suicide rates among this group are close to double the national average, mental health treatment is just as important.

Brad Drown, a licensed clinical social worker in Murray, has seen some of the same problems in his field that Yehemy Zavala Orozco discussed. He stated that it’s common for Hispanics in Utah to go without mental healthcare. Drown added in his multiple decades as a social worker, he’d only ever treated a small handful of Hispanic patients, and that while this could be a geo-demographic reality, independent research and data from his colleagues show similar trends.

According to Drown, this is very much a cultural issue, and less so a linguistic one. He noted that Utah boasts a higher number of multilingual resources available in his line of work due to the growing population of Latinos and the large number of return missionaries who lived abroad in Spanish-speaking nations.

The issues lie partially in a pattern of cultural stigmas he’s noticed, but more prevalent is the problem of a shared cultural experience that can often make therapy more effective. While he believes it isn’t always a necessity for everyone, many people feel more comfortable seeking treatment when they believe there are providers who understand them on a deeper level.

Perhaps most important to note, however, is that a common experience does not always mean a common result. While it’s crucial to recognize the hardships that many Hispanics face, assigning victimhood to an entire population, especially one with so many positive victories, can be short-sighted.

Andres Rivera, who runs Myo Tensegrity Massage in Draper, provided some context on this. He said he’s been lucky to experience a different side of the matter.

“We moved to California when I was 8, and everyone spoke Spanish [where we lived],” he said. Even in Utah, he lived in areas with a dense Hispanic population, and he believes this made integration easier.

“My mom spoke OK English, but mostly Spanish. It made it a little difficult but going to certain places that were recommended [by other Spanish speakers] was a big thing,” he continued. “It helped to have connections where she felt comfortable as far as speaking Spanish, especially with finding places of employment, things like that.”

However, Rivera felt it important to acknowledge that he does not think that’s how it is for every immigrant family. “Older people that came here is where it’s more of a thing where it makes sense to befriend someone with a shared cultural experience. I can see why someone [that didn’t immigrate as a child] would really want people who understand where they’re coming from.”

The idea of representation is important to minorities and oft-marginalized groups, especially when it comes to health. While it doesn’t necessarily affect everyone equally, it’s a pressing concern that currently has no end in sight for a significant population of Hispanics in Utah and nationally.

Zavala Orozco said that beyond empowerment, investment in local organizations like Comunidades Unidas can have an enormous impact on the day-to-day lives of Utahns. It may not be a problem that can solve itself overnight, but awareness and grassroots effort can go a long way.