Hispanic pharmacists: Advancing health equity

CAH

Throughout Hispanic Heritage Month, we honor the Hispanic community for its considerable contributions to our country. This year, as the COVID-19 pandemic continues to take its toll, we want to specifically recognize Hispanic pharmacists for their work to address health disparities.

According to the Census Bureau estimates, more than 62 million Hispanics lived in the U.S. in 2020 - making them our country's largest minority. They have been hit particularly hard by the pandemic and the economic challenges the pandemic has created. In fact, the KFF COVID-19 Vaccine Monitor reported in December 2020 that about half of Hispanic households had lost a job or income since COVID-19 began spreading across the country.

Hispanics are 1.7 times more likely to contract COVID-19 than non-Hispanic White Americans, according to the Economic Policy Institute, and the Centers for Disease Control and Prevention (CDC) says that Hispanics are more than four times more like to be hospitalized from COVID-19. And, though vaccine hesitancy among Hispanic adults has decreased nationally over the last several months, it remains high in midwestern and southeastern states.

The health of Hispanic communities can be adversely affected by language barriers (more than 28% of Hispanics say they are not fluent in English, according to Census data), as well as by limited access to preventive care and/or a lack of health insurance.

We know from various research, including that from the National Institutes of Health, that patients visit community pharmacists anywhere from 1.5 to 10 times more frequently than primary care physicians. When those pharmacists are Spanish speaking and culturally competent, they can have a meaningful impact in helping their communities achieve better health outcomes - both during the COVID-19 pandemic and beyond.

Across the country, Cardinal Health is proud to support Hispanic pharmacists who tirelessly work to help ensure long-term equitable health outcomes in the communities they serve. A few of their stories are highlighted here.

Julio Molyneaux, R.Ph., The People's Pharmacy Shoppe, Union City, New Jersey

"Pharmacists are here to help - and our patients know it," says Julio Molyneaux (pictured above), who owns two community pharmacies in Union City, a densely populated town of about 68,000 people, 23% of whom live in poverty. More than 76% of the population is Hispanic and Spanish is the predominant language. "This is a good community," he said. "People here support one another and care for each other."

Molyneaux was born in Puerto Rico and grew up in New York City, where he began working as a pharmacy technician while he was still in high school. (New York is one of several states where no training is required to become a pharmacy tech.) "From the beginning, I loved seeing how patients reacted to the pharmacists' advice," he said.

After college, he went on to pharmacy school, and took a job at a chain drug store while he completed his degree.

"After I got my pharmacy license, I was sent to Union City to begin a management program," he said. "I loved the town and never wanted to leave." He did, however, want to work as an independent pharmacist, and left the chain drug store to do so. He bought his own shop in 2004, and called it The People's Pharmacy.

Today, he sees hundreds of patients each day. "We fill more than 300 prescriptions a day, and many more people come in just to talk to me or one of the pharmacists or technicians on staff. Because we're so much a part of the community, our customers know us and trust us."

His customers often visit the pharmacy hoping to avoid a trip to a doctor's office, he said. "But people don't come here because they're okay; something's wrong. We treat them quickly with the best service possible. And if they need to see a doctor, we send them to a doctor."

Molyneaux said his customers have not been reluctant to get a COVID-19 vaccine. "I only wish we'd had vaccines earlier," he said. "Once we got them in May, we began vaccinating about 50 people a day."

Patients do have doubts and questions about their medicines, he said. "We have lots of patients with prescriptions for medications to treat hypertension or high cholesterol. These conditions can occur without obvious symptoms, and often, patients want to quit taking the medications. But the conditions are also significant risk factors for heart disease and stroke, so we take the opportunity to answer questions and educate people about the importance of taking medications as prescribed."

Molyneaux manages one of his pharmacies; his son, Juan, also a pharmacist, manages the other.

"For both of us and for our staffs, the best part of the work is taking care of patients," Molyneaux said, "We try to make a difference in their lives. People come to us feeling sick, and we help them get better. It's very fulfilling work."

Sonia Martinez, R.Ph., Marco Drugs and Compounding, Miami, Florida

Sonia Martinez came to Miami from her native Venezuela when she was 27 and already a pharmacist. "When I arrived, I spoke no English. My Venezuela pharmacy license meant nothing here. I really had to start all over."

She got a job as a pharmacy technician, and learned English on her own, aided by English-speaking TV and radio programs. At the same time, she began studying for the Foreign Pharmacy Graduate Examination Committee Certification, which would allow her to get a license to practice in the U.S. Just three years after she arrived in this country, she was licensed by the state of Florida.

She'd long dreamed of owning a pharmacy, she said, and that dream became a reality when, in 2006, she and her wife bought an established pharmacy called Marco Drugs and Compounding.

But the transition was difficult. "The former owner was an older white man who'd been the pharmacist here for 30 years. I was still young in comparison, and a Latina who spoke with an accent. Many customers left once I took ownership."

However, the location, in an affluent area of the city and close to two hospitals and lots of healthcare providers, was ideal. In addition, the pharmacy had an established compounding practice. (Compounding pharmacies customize medications prescribed by doctors for patients whose needs can't be met by commercially available drugs.)

"Compounding is very rewarding, because in order to get it right, we have to work very closely both with prescribing physicians and with patients. It enables us to help solve patients' health issues," Martinez said. "I felt lucky to be able to buy a pharmacy that already was known for compounding."

The compounding practice continued to bring in diverse patients from all over Miami, even when business was otherwise slow, she said. "We kept compounding, and we kept building relationships with new patients, and we were able to gradually grow the business."

Her early struggles in this country - to learn the language, learn a new way of working and rebuild a business - have given her great empathy for other Hispanics new to this country, she said, something that became especially important once COVID-19 vaccines were available.

"Just 45 minutes to the south of Miami, there are rural areas where many migrants come to work in nurseries, vegetable fields and fruit farms. Many of those workers don't speak English, and many of them don't have access to vaccines."

However, a few nursery and farm owners knew of Martinez' practice. In the spring, she began getting calls from them, asking if she would vaccinate their workers. "The workers are more comfortable because I speak their language," she said. "I can also share my experience: I got COVID-19 before the vaccines were available. I assure the patients that the shot is far preferable to the illness."

Today, when Martinez is not helping patients, she serves as a leader in the pharmacy industry, and sits on the board of directors of American Associated Pharmacies (AAP), a national, member-owned cooperative of more than 2,000 independent pharmacies.

Looking back, she said, though her first years in the U.S. were very difficult, "I would do it all over again. I wanted to create a new life for myself, and I wanted to build a pharmacy practice. I was able to do both here."

Diana Torres, R.Ph., Carolina, Puerto Rico

As a recently licensed pharmacist, Diana Torres works as a freelancer, covering shifts as needed in eight or nine different independent pharmacies.

Prior to pursuing her pharmacy degree, she worked for 11 years in pharmaceutical sales and marketing. "When I was in sales, I got to know many pharmacists; I saw that they have so many opportunities to help people. That was really what I wanted to do," she said. "Besides, my mom and my aunt are both pharmacists, so maybe it was inevitable."

She had a six-month-old child at the time, but she quit her corporate job to pursue her dream. She had to take 19 undergraduate classes before she could get into the pharmacy school at a Puerto Rico campus of Florida-based Nova Southeastern University. As she entered her third year of pharmacy school in 2019, she learned that she was pregnant with her second son. "I was 39 weeks pregnant when I presented my final poster project," she said with a laugh. She gave birth soon after, and got her pharmacy license in October 2020.

"It was a crazy time for me and for my husband," she said. "But I'm so glad I found my way to community pharmacy. I love working with people, and community pharmacy allows such close interactions with patients. So much of the work is just talking with people out on the pharmacy floor and helping them find solutions that help alleviate health issues."

About 43% of the people of Puerto Rico live in poverty, according to the U.S. Census. "We can help them in so many ways," Torres said. For example, when patients are prescribed medications that they simply can't afford, a pharmacist can work directly with the physician to discuss less expensive options. "And then we can work with the patients to make sure they know how to take their medications."

Because of the COVID-19 pandemic, physician access is still very limited in Puerto Rico, Torres said. "For many of the patients I see, pharmacists are the only healthcare providers readily available. Patients, particularly older patients, often have no one else to turn to regarding their health, and they are so grateful when pharmacists take the time to discuss their issues and their medications. We truly help people achieve better health outcomes."

Torres has dreamed of owning her own pharmacy since she left her corporate career, she said. "It's been helpful to work parttime in lots of different pharmacies, because I can experience different service offerings; I've been able to get a sense of the type of pharmacy I want to establish. I'm talking to lots of pharmacy owners to better prepare for the transition to becoming a pharmacy owner."

She hopes to be established as a pharmacy owner within the next three years. In the meantime, she is happy to serve the many patients who need her at the various pharmacies where she works.

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Cardinal Health Inc. published this content on 15 October 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 15 October 2021 14:41:02 UTC.