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Amelie Ramirez

I am director of Salud America! at UT Health San Antonio. I have spent 30 years directing research on human and organizational communication to reduce chronic disease, cancer, and obesity health disparities affecting Latinos.

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Articles by Amelie Ramirez

Family Support Research: Latino Medical Homes


family support future - medical homes

This is part of our Building Support for Latino Families: A Research Review » The Benefits of Medical Homes What can be done to make medical offices more accessible and comfortable for low-income Latino individuals? Recent research has introduced the concept of patient-centered “medical homes” as a model of high-quality primary care that can eliminate disparities.8 Defined by key structural practice features, the medical home provides “enhanced access for routine primary care, improved delivery of preventive services, high-quality chronic disease management, and reduced emergency department and hospital utilization.”120 While still in the early stages of broad application and assessment, the theory behind the medical home model is appealing for application in ...

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Family Support Research: Promotores de Salud


fam support working - promotores promotora

This is part of our Building Support for Latino Families: A Research Review » Language as a Predictor of Use of Health Services Cultural beliefs regarding mental illness are not the only barriers to use of health services. Language is an important predictor of use of mental health services, and the effectiveness of treatment for Latino individuals.19 In the particularly sensitive fields of psychology and psychiatry, a lack of bilingual and bicultural providers severely affects service uptake and outcomes. The problem of language in mental health care has two sides: first, use of interpreters or non-fluent providers can result in literal misunderstandings and loss of nuanced understanding of emotions and reactions; second, lack of genuine understanding of the patient’s ...

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Family Support Research: ECE Programs


fam support working - ece benefits

This is part of our Building Support for Latino Families: A Research Review » Latino Kids Less Likely to Use ECE Programs The use of ECE facilities—including child care centers, day care homes, Head Start programs, preschool and pre-kindergarten programs—has become the norm in the U.S.38 About 61% of children younger than 6 are in a non-parental care arrangement on a weekly basis.38 In 2012, children from higher-income families tended to enroll more in ECE centers (72%) than children from low-income families (45%), 2016 data show.1 In addition, far fewer Latino children (52%) were enrolled in ECE centers than their white (63%), black (68%), and Asian peers (68%).1,39 ECE Programs Stimulate Cognitive Health Benefits However, recent research has demonstrated that early ...

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Family Support Research: Latino Community Schools


school health navigator

This is part of our Building Support for Latino Families: A Research Review » The Concept of Schools as Health Centers Development of school-based health centers (SBHCs) that provide comprehensive care for students, and sometimes their families, has provided a solution for another important barrier to preventive and whole-self health care: access.21,116,127 Maintaining regular well visits and acute care without missing school or work is a challenge in low-income communities, making health care impossible for some students and families.127 The American Academy of Pediatrics has stated that a “medical home” is the ideal form of health care delivery for children and adolescents, and SBHCs strive to meet the AAP definition of a medical home: a system of care that is ...

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Family Support Research: Early Cognitive Development


teacher reading in class library books kids

This is part of our Building Support for Latino Families: A Research Review » Latinos Kids Face a Big Gap in Early Cognitive Development The socioeconomic gap in academic performance has been demonstrated repeatedly, with children from low-income households exhibiting deficits in school readiness and social development upon entering kindergarten. Several studies have shown that early educational gaps are maintained, and can even grow, for children from high-risk communities.12,15,23–26 Risk factors including poverty, low parental education, limited English proficiency, and single-parent homes, many of which are disproportionately present in Latino communities, put Latino children at a disadvantage for cognitive development relative to their non-Hispanic peers.27–30 In ...

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Family Support Research: Future Research


Young Family Playing With Happy Baby Son At Home

This is part of our Building Support for Latino Families: A Research Review » Addressing Latino Subpopulations This research review has emphasized several policies and programs that could benefit Latino families as a whole. However, it is important to point out that future research will need to: Determine how programs need to be catered to fit the different Latino subpopulations that they serve across the United States; Carefully assess community needs and the initiation of collaborations with community leaders, stakeholders, and activists for development of contextually appropriate policies that will be successful in the target population; and Continue reviewing and assessing the inclusion of cultural considerations that will allow final adaptation of programs into a ...

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Family Support Research: Head Start Centers as Resource Hubs


Latino health early childhood development head start

This is part of our Building Support for Latino Families: A Research Review » The Growth of Head Start Given the evidence to support the benefit of organized early childhood education, development of high-quality ECE centers that also promote engagement of Latino parents holds great promise for the future of Latino children. Many programs from the 1960s and on provide evidence for the effectiveness of incorporating parent-targeted elements within early childcare programs, and these family-based approaches form the basis for the two-generation model discussed later in this review. The first explicit family-based program was Head Start, which in 1965 declared the goal of providing low-income preschool children a comprehensive program to meet their emotional, social, health, ...

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Family Support Research: Policy Implications


Latin family sitting in the street

This is part of our Building Support for Latino Families: A Research Review » Conclusions More than one-third of Latino families live in poverty and two-thirds are low-income, and face limited access to high-quality education, community resources, and health care. Latino children excel in cognitive and social development measures when they participate in high-quality center-based early childhood education and public pre-K programs. Single-site ECE and infant care centers partnered with family resource centers offer the highest-impact outcomes for low-income Latino children and parents. Parent resources in two-generation programs must focus on services that aid parents in finding high quality jobs with family-supporting wages. Efforts to minimize the toxic stress associated ...

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Family Support Research: Latinos’ Big Healthcare Gaps


asthma doctor Latino boy

This is part of our Building Support for Latino Families: A Research Review » Latino Families Lack Access to Healthcare Due to high costs, Latinos are less likely to participate in insurance or retirement plans, even if offered by their employers.100 Although the percentage of Latinos with no health care coverage dropped from 26.2% to 15.1% from 2013 to 2016 under the Affordable Care Act (ACA), it is still much higher than the percent drop among uninsured non-Latino white from 14.1% to 6.6% in that same span, according to a report.101 Latinos also continued to perform worse on most measures of access to and utilization of their health care than whites, often due to reasons like citizenship status, language, socioeconomic status, and a lack of awareness of the ACA's provisions, ...

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