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Outcomes research
From Clinic to Community
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Hispanics account for nearly one-fifth of the US population
By 2045, 1 in 4 Americans are projected to be Hispanic.
Despite this fast population growth, Hispanics continue to face barriers to health care, including affordable health insurance, adequate transportation to medical facilities, and a lack of culturally competent Spanish-speaking providers.
These barriers contribute to a slew of health disparities, including high rates of chronic liver disease and liver cancer. These barriers also contribute to disparities in accessing liver transplantation, which offers the best long-term outcomes for treating these diseases.
Male and female Hispanics have double the rate of liver cancer compared to their non-Hispanic white counterparts.
In response to these disparities, the Houston Methodist J.C. Walter Jr. Transplant Center began a minority outreach program in 2021 to increase the amount of transplant referrals among ethnic patients in Houston and South Texas.
Houston is the nation’s fourth most Hispanic-populated metropolitan area.
A recent research study led by Sudha Kodali, MD associate professor of clinical medicine, revealed that this outreach program is effective.
During the two-year study period, the outreach program organized regular in-person visits to the Houston-metro area and statewide Hispanic communities, including Corpus Christi and the Rio Grande Valley. Community members were educated on liver disease, complications, and risk of liver cancer. Physicians were informed of transplant eligibility and services offered at the transplant center.
Additionally, the transplant center expanded telehealth services, provided Spanish language materials, and hired more bilingual, bicultural staff to help patients navigate the transplant journey.
Through these efforts, the outreach program increased the total number of Hispanic liver transplant referrals from 235 to 405, and recipients from 71 to 82.
However, 38.5% of Hispanic patients that were waitlisted for a transplant were deemed ineligible due to finances – double the number of patients deemed ineligible for medical reasons (19.1%).
“Unfortunately, inequitable access to affordable health insurance is a major barrier to transplantation,” Dr. Kodali explained. “Even with insurance, liver transplants can be costly.”
As chair of the Transplant Equality, Diversity and Access Committee (TEDAC), Dr. Kodali would like to see future research efforts aimed at addressing these financial roadblocks to transplantation. To Dr. Kodali’s knowledge, there are no studies that have examined interventions to address these barriers.
Transplant center outreach program members with City of Conroe collaborators.
Unfortunately, inequitable access to affordable health insurance is a major barrier to transplantation.
Sudha Kodali, MBBS
Associate Professor of Clinical Medicine
In 2022, 18% of non-elderly Hispanics did not have health insurance. Cost is the most common reported reason for being uninsured.
The transplant center plans to continue its outreach program to improve liver transplantation access for all ethnicities.
Members of TEDAC look forward to attending relevant conferences and collaborating with like-minded individuals.
“Your race, ethnicity, and socioeconomic status shouldn’t influence or determine your health outcomes,” Dr. Kodali said. “We look forward to providing unparalleled care, education, and equal opportunities for transplant.”
Callie Rainosek Wren, MS
September 2024
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