The Role of the University of California

The University of California, as a major provider of health care to the low-income population of the State, as the State's major educator of health care professionals, and as the State's major source of basic and clinical research in health sciences, should assume a leadership position in addressing Latino health issues.

Provision of Health Care

Provision of health care by the University of California to the low-income population is an extremely important issue. While no analysis exists of the precise relationship between the University as a provider and Latino health needs, a large proportion of low-income and uninsured Californians served by University facilities are Latino. It is not the University's responsibility to assume the costs of such care; this responsibility lies with State and local agencies. It is clear, however, that the increasing gap between cost of care and reimbursement is causing a shift of attention in the UC hospitals toward the financially able or the privately insured. This trend has disturbing implications not only for the availability of essential care to low-income and uninsured

groups, but also for the conduct of important clinical research and the training of physicians and nurses.

Health Profession Manpower

The University of California is the major institution in the State that prepares and educates health manpower. With its five medical schools, two dental schools, two public health schools, two nursing schools, one pharmacy and one optometry school, the policies the University adopts will have a far-reaching effect on health manpower development in the State.

In the State of California, health professionals have considerable influence upon private and public health care policies In the education of health professionals, sensitivity to the needs of the Latino population must be raised, both in terms of delivery of services and administration of systems. It is essential that curricula in all of the professional schools be expanded to include material specific to Latino health for all students. Spanish language preparation should form a part of this curriculum change.

To facilitate these changes, increased Latino health sciences faculty will be required. But as with all University faculties, and especially in the sciences, recruitment of qualified Latinos in the health sciences has not been particularly successful. The University can improve this situation by recognizing that increased numbers of Latino health sciences faculty are essential to the University's health sciences programs, and by investing in the development of such faculty through pre and postdoctoral programs, increased research support, and support of faculty development activities.

Health Sciences Research

There are several critical research issues which demand increased attention with respect to the Latino population. These include not only the health problems of particular importance to Latinos discussed earlier in this chapter, but also issues of administration and access to health care. Note that the enumeration of Latino origin and sub-group identifiers in any census studies concerning these topics is particularly important. Occupational health risks for both migrant and nonimmigrant Latino workers, and the changing health care needs of rural to urban migrants need to be addressed. Border health issues, and the effects of transition between two or more health care systems deserve particular attention. Considering the large proportion of Mexican short-term and permanent immigrants to California, research in Latino health should be performed collaboratively with Mexican health scientists.