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Achieving equity in health care benefits both health care payers and members. Culturally diverse audiences experience disparities in health care access and health outcomes. Patients with limited English proficiency (LEP) experience poor health outcomes across the board, including above-average levels of emergency department visits and hospital stays.

Most healthcare leaders agree that we need to work to improve these outcomes, but we are not yet where we need to be. Although many health systems across the country have developed promising pilot programs, there remains an urgent need to develop systematic approaches to address health disparities among different populations. In LEP communities, these disparities stem in part from an underlying gap in health literacy, including understanding health insurance or access to care and treatment options.

Community engagement approaches can help bridge this gap. Research shows both the efficacy and cost-effectiveness of community-based programs. According to a 2020 survey conducted by University of Pennsylvania researchers, a community health worker initiative provided a return on investment of $2.47 for every $1.00 Medicaid invested in the program, primarily by reducing hospitalizations among program recipients.

For long-term success, it is important to consider how these programs are implemented. Effective community engagement programs cannot be dictated to the community; they must be made with the community. This means working in partnership with community members and adapting your content, both linguistically and culturally, to the community your team serves, reaching them where they are and how they prefer to be reached.

Culturally responsive community engagement programs for enrollment and beyond

A key step in achieving health equity is getting people into a health insurance plan. In addition to providing support for urgent health problems, health insurance provides access to preventive care, allowing members to address problems before they become serious. In many cases, health insurance companies can offer support for social needs such as transport assistance or healthy food vouchers. Support for these social determinants of health is often needed by different populations.

Choosing a health insurance plan and managing the enrollment process can be complicated for many Americans, no matter what language they speak. For people with limited English proficiency, lack of familiarity with health insurance is another common barrier. Last year, our bilingual health navigators reported that 80 percent of the uninsured people they enrolled had never had health insurance before. Meeting these people where they are and educating them improves enrollment.

Health is a personal subject, and health care is complicated. LEP patients need sound advice from someone they trust. Organizations seeking to serve LEP populations must first invest in building this trust. That’s why our team includes enrollment specialists and community health workers who not only speak the language, but also maintain a presence in the community and work from a place of cultural familiarity, creating a connection that resonates.

The importance of working within existing societal structures

Building trust takes time, but is easier if you work within existing societal structures. Learning which organizations serve a given community and partnering with them is critical. Partnerships can be in the form of referrals or by co-hosting community events, such as partnering with a food bank to help community members access health services and alleviate food insecurity.

Another way to build trust is to understand and use the media most preferred by the communities you seek to serve. For example, community-focused organizations can maintain strong ties to local media, including Spanish-language television and radio stations. This community-based approach provides valuable information through trusted messengers in the community.

Don’t just show up, follow through

Enrollment scope is only the first step. Successful community engagement campaigns offer people follow-up opportunities, both to complete plan enrollment and to learn how best to use their benefits.

Hosting in-person events throughout the year where community members can come and ask questions about their coverage or bring insurance documents they don’t understand is one effective strategy. In South Florida, such community events often take the form of Cafecitos, which are smaller gatherings that offer an opportunity to connect with other Spanish speakers in an informal setting to educate community members about health issues. Community outreach events focused on specific health initiatives can also be effective.

Members may require the opportunity to follow up on the information they receive at these events later by taking the information they received at the event and reflecting on it further or discussing it with family or friends. Offering private, pre-scheduled virtual meetings after the event allows them to ask follow-up questions and then act on their own time with more comfort and more information from trusted resources.

Using AI to fill knowledge gaps

These community engagement strategies have one thing in common: Planning is paramount. Culturally tailored interventions can be effective, but you need to know who the community is to tailor these solutions effectively. For payers, there are significant data gaps in the understanding of the languages ​​spoken in a given coverage area or community.

Artificial intelligence (AI) can help fill these gaps. By cross-referencing key identifiers to a global database, AI can compile information on ethnicity and language preferences and identify 180 ethnic groups and 80 languages ​​with over 85 percent accuracy. With this data, health organizations can ensure that all populations are getting the information they need to stay healthy, addressing a key cause of health disparities.

Community engagement approaches provide effective, practical solutions to meet your organization’s health equity goals. Connection and community go hand in hand, and a healthy community is a strong community.

Photo: Andrii Shyp, Getty Images

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