Acumen
Acumen: Ideas
Published in
7 min readApr 10, 2019

--

Millions of patients who aren’t native English speakers are being underserved by America’s healthcare system.

Picture it: you’ve fallen ill in a foreign country. You’re only somewhat familiar with the language and culture. You get by but lack the vocabulary for a conversation with a doctor. How will you describe how you’re feeling and get the treatment you need?

This is the current reality for millions of people living in America. By 2045, non-whites (African-Americans, Asians, Latinos, and other ethnic and racial minorities) are posed to make up more than half of the U.S. population. The country’s healthcare system — despite being one of the most expensive in the world — doesn’t reflect this 21st-century America. And as a result, millions of patients who aren’t native English speakers are being underserved.

Abner Mason is on a mission to make sure every American gets the care they need. He built ConsejoSano, an Acumen America investment supported by Robert Wood Johnson Foundation, to address language and cultural disparities in the healthcare system. ConsejoSano’s platform leverages the power of mobile technology to help non-English speakers navigate the country’s complex healthcare system and get the treatment they need.

“Our healthcare system has to change to better serve all the people who call this country home,” Abner said. “Right now, our healthcare system is impersonal, inconvenient, unresponsive and confusing — and that’s true for native speakers as well as minorities. An out-of-date system means greater healthcare costs at lower health outcomes and a disproportionate number of patients who delay seeking care, if they seek care at all.”

Abner Mason, Founder and CEO of Acumen investment ConsejoSano, at the office of one its partners in Inland Empire, California.

Learning, then Leading in Health Care

While Abner has become a healthcare innovator, it wasn’t originally on his radar. Raised in Durham, North Carolina, Abner was a smart kid from a lower-middle class family who worked hard to get accepted into Harvard and fell into politics after graduation.

By 2001, he was working as Chief Policy Advisor for the Governor of Massachusetts when he was asked to join the Presidential Advisory Council on HIV and AIDS (PACHA). The council’s role was to advise a nearly sworn-in President George Bush on how to address the AIDS epidemic. Abner, who was no expert on healthcare at the time, felt unqualified so politely declined the offer. The Governor, however, urged him to accept — and it became a decision that would change the course of his life.

Abner became Chair of PACHA’s international committee and helped to establish the President’s Emergency Plan for AIDS Relief (PEPFAR), which at the time was the world’s largest humanitarian relief effort ever proposed. To build on PEPFAR’s work, Abner founded the AIDS Responsibility Project, an organization dedicated to increasing U.S. funding for HIV/AIDS programs in Africa.

He was so successful that a friend working in Latin America reached out to enlist his help with tackling the rise of HIV in Mexico. Mexico’s infection rates were increasing rapidly because people weren’t being open about their status, all because employers discriminated against people who were infected or thought to be and they were afraid to lose their jobs. That realization pushed Abner to establish Mexico’s first business council on HIV/AIDS in 2008 to put an end to stigma and discrimination in the workplace.

As Abner deepened his partnerships with the companies, the council eventually expanded its focus to chronic disease. High cholesterol, high blood pressure and obesity were major risk factors for cancer and long-term diseases, and companies wanted to keep their employees healthy as well as keep costs down. Abner worked with the private sector to establish the Workplace Wellness and Prevention Council of Mexico, and devise a number of solutions, like text messaging with doctors, to educate employees and help them manage their health.

Seeing how people responded and took control of their health made Abner think about how to bring these solutions into another major Spanish-speaking market: the United States.

Building a System that Works

The U.S. is home to roughly 58 million Hispanics, yet Spanish-speaking doctors represent only five percent of the country’s physicians and more than one fourth of Hispanic adults lack a healthcare provider.

“I saw an opportunity to serve the country’s largest underserved segment,” Abner said. “They have poorer outcomes because they feel disconnected from the healthcare system and don’t know how to use it efficiently. I wanted to take what we had learned in Mexico and use the digital tools that had become available. Everyone had a cell phone, making it possible to connect people to health care in ways that were impossible before.”

And so Abner began to build ConsejoSano — which translates to “healthy advice” in Spanish — to bridge the gap between healthcare providers and the multiethnic patients they serve. He designed ConsejoSano’s platform to meet multiethnic patients where they are, culturally and linguistically, by providing them with communication tools and services they can easily understand.

Abner has long known that America was on its way to becoming a majority-minority country. Based in California, with significant populations of immigrants and families speaking two languages, the future had already arrived.While Spanish is the most widely spoken second language in the U.S., it’s clearly not alone. More than 20 percent of Americans speak a language other than English at home. And according to the latest census, at least 8 percent of the population has limited English proficiency, meaning they speak English “less than very well.”

Abner felt significant swaths of the population were likely being underserved by the healthcare system, so ConsejoSano began to expand its offerings to truly reflect 21st-century America. Many of the people the company serves are diverse, low-income patients who receive health care from Medicaid and Medicare. And one of the major problems these patients face is that communication in any language other than English is translated without regard for cultural nuances or beliefs, which means messages don’t often make sense to them.

ConsejoSano offers its services in 22 different languages and is on track to serve 1 million patients by the end of 2019.

ConsejoSano looks at the people healthcare providers are trying to reach, starting with their culture and speaking their language. Where are they from? How does their background affect how they approach health care? And, perhaps most importantly, how can we meet them where they’re at?

For example, the way non-native speakers receive information about preventative health might go something like this:

A pamphlet would be written in English encouraging people to get tested for diabetes. This would then be translated to Spanish for someone who’s Mexican and Arabic for a person from Iraq. For patients from countries other than Mexico and Iraq, the translation falls flat, as it’s lacking the terms used in those specific places. And then, because cultural beliefs weren’t taken into consideration, the messaging hasn’t accounted for the fatalistic attitude among Mexicans or how an Iraqi’s faith might prevent him or her from seeing a doctor. And finally, the pamphlet is mailed, almost guaranteeing its failure, because these groups prefer communicating via text.

What makes ConsejoSano so unique is that it combines technology and touch — the technology for deeper understanding of its patients at scale and the human touch to build trust and connect with underserved patients wary of the healthcare system. This approach allows the social enterprise to strike the right balance — staying culturally relevant with America’s changing population and building their trust to ensure better health outcomes at a personal and national level.

Today, just five years after its founding, ConsejoSano offers its services in 22 different languages and is on track to serve 1 million patients by the end of 2019. Abner and his team are working to partner with more major healthcare providers to ensure that patients are being reached in the languages and modes that will inspire action and get them the care they need.

“The most important thing is to accept that you’ve got to reach out to people in a way that is comfortable for them,” Abner said. “It’s not about the beauty or coolness of the tech; a lot of times we get caught up in that. We’re proving tech is a tool that can build trust and connect people to the healthcare system in a way that will result in better outcomes for them and lower costs for providers. We’re doing both, and that’s what’s exciting.”

--

--

Founded by @jnovogratz, Acumen is changing the way the world tackles poverty by investing in companies, leaders & ideas. Follow us: www.acumenideas.com