In a small house in South Bend, Ind., a family is getting ready for Christmas. The tree is up and everyone is laughing together, drinking something they call “Christmas Punch.”
Magdalena Hernandez wears a bright orange shirt and dark purple lipstick; her brown hair is pinned on the top of her head. From her appearance and all the laughter, you’d never guess she has an advanced and uncurable form of cancer in her bone marrow.
Hispanics are the least likely racial and ethnic group to see a doctor when they have health problems, according to a study by the Census Bureau. There are several barriers that discourage some from that community from seeking medical attention in the U.S.
Hernandez was diagnosed with multiple myeloma around this time in 2017. As the holiday gathering continues, she talks about her medical issues.
“I honestly didn’t feel anything, I just asked the doctor to take away the pain that I’m feeling right now," Hernandez says in Spanish, through a translator.
But she had symptoms for years before that: fatigue, weakness in her legs and overall pain that was more painful than labor. Hernandez saw a doctor once before, who told her it was inflammation and cleared her to go back to work.
One year later, she was diagnosed with cancer.
“I told the doctor what had happened the previous year and that’s when he told me I had cancer, and that it was advanced and that I didn’t have the care that I should have had,” she recalls.
Part of the reason Hernandez waited so long to get help was because she didn’t fully trust the American health care system. That story is not uncommon.
Susana Lagunas, a family nurse practitioner at a local clinic, sees this all the time.
“Many Latinos are diagnosed, especially with cancer, at a later stage, so a more advanced disease at that point," she says. "The burden of that is obviously mortality.”
Lagunas says there are many barriers that keep Latinos from seeking medical attention, including language. Even though most clinics have translator services, she says sometimes it’s over the phone, which can cause problems.
“Every time I walk into a room and they looked at me and I look Latina and I speak Spanish, they just breathe in relief that somebody’s there and maybe I can be helpful and help them express their medical needs," she says.
Lack of health insurance is a barrier too, one that caused big problems for Hernandez.
“It was very difficult for me to get the assistance here," she says. "There is help and there is assistance, but not for everyone."
Hernandez has lived in the U.S. for more than 20 years. But she wasn’t able to find help in South Bend because she’s undocumented. So family members and friends drive her to Chicago once a week for treatment.
Paul Beltran, who works at Indiana Health Center in South Bend, says Latinos new to the U.S. aren’t always familiar with the health care system and the importance of preventive screenings.
"There’s people that come from villages in their home countries where the doctor was a – they would call them the 'curandero,' which is just a person who knows a thing or two about medicine, but it’s just very basic, herbs and those kind of things,” he says.
Beltran adds that the difference in cultures is as big a barrier as language, insurance, and immigration status. In Latin America, it's important to have a doctor that you connect with personally.
Hernadez says that relationship can be hard to find in the U.S.
“As far as the dignity and respect they can provide, it’s very, very scarce," Hernandez says. "It’s almost like they wait until you’re on your deathbed before they try to do what they really need to do to save you."
This story was produced by Side Effects Public Media, a news collaborative covering public health.