Knowledge is power, we’ve heard, but most probably don’t know that a lack of knowledge can have an impact on one’s health and quality of life. Veronica Plaza’s medical Spanish class at the University of New Mexico studied the Spanish language versions of the Affordable Care Act site as well as the state’s version, Yes, New Mexico, and discovered that poor translation can mean poor access that can lead to health disparities.

Health literacy in New Mexico is low because of low educational attainment. “Information and materials need to be presented at a fifth grade level to reach people,” Plaza said, adding, “Under Title VI of the 1964 Civil Rights Act, public agencies are obligated to provide competent language assistance to limited-English-proficient individuals.” 

Plaza and her on campus collaborators are working hard to advocate for improved quality of information and making sure it’s getting into the hands of those who need it most.

On the federal site, the original pages were created properly, with good Spanish. “However, information that was added later appears to have been done with machine translation, which does not promote clarity,” she said. “A translation for the word ‘premium’ is ‘prima,’ which is more commonly used to refer to a female cousin. A better translation would be ‘cuota mensual,’” she said. Context is important in any language.

The New Mexico site features a very small “Español” button in the upper right hand, rendering it less than friendly from the onset. “When you get into the site and click on specific links, it jumps back to English language pages,” she said.

Plaza and her students recognized that those who may be trying to enroll in Affordable Care, at least in New Mexico, may be Spanish speakers, and may not be literate. “We created an audio file in Spanish to walk people through the process of enrolling,” she said. Plaza said that they are trying to identify ways to help people access the audio file. “It should be available already because of the Americans with Disabilities Act,” she said.

In addition to sharing their concerns and offering some fixes for the websites, Plaza, her students, and UNM collaborators from the Office of Community Health, the Community Engagement Center and the Office of the Vice President for Student Affairs, are training students – primarily first generation Spanish speaking students – to enroll and to help their families and community members who are eligible to enroll. 

With Medicaid expansion, about 170,000 New Mexicans will be eligible for Medicaid. “Eligible for the first time are those 26 years of age or older as well as those 18 and independent. This is important for our student population,” Plaza said.

Kiran Katira, program operations director of the UNM Community Engagement Center, said that training students to work with other students is important. “Students need to know how to apply for public benefits. Sharing information student to student interaction works best; it’s about trust. They will then share the information with their families and communities,” she said.