Instructor; Senior Research Associate
Cambridge Health Alliance, Harvard Medical School
Dr. Dharma E. Cortés received her Bachelor’s and Master’s Degrees in Psychology from the University of Puerto Rico, and a Doctorate in Sociology from Fordham University. She also completed postdoctorate training in Medical Anthropology at Harvard Medical School’s Department of Social Medicine. She is currently an Instructor at Cambridge Health Alliance, Harvard Medical School, Department of Psychiatry and senior research associate at the Mauricio Gastón Institute for Latino Community Development and Public Policy at the University of Massachusetts Boston, and a member of the Health Literacy Studies Group at the Harvard School of Public Health. She has been conducting research with Latinos in the United States for more than 20 years. Her work has focused on the study of culture, mental and physical health, health literacy and health and mental health service utilization research. Dr. Cortés has extensive experience implementing qualitative research methods such as focus groups, open-ended interviews and cognitive interviews for the purpose of developing survey instruments, theory verification and theory generation. Her past and current research combines qualitative and quantitative research methods.
Dr. Cortés is currently the principal investigator for a study funded by the Center for Medicare and Medicaid Services to evaluate the effectiveness of a low-literacy educational diabetes intervention among Spanish-speaking Latinos. She is also the principal investigator for one study funded by the Robert Wood Johnson Foundation’s Salud America! program to examine how a low-literacy consumer activation nutrition educational paradigm could be used to increase food literacy and change consumer behavior toward healthy eating among Spanish-speaking Latinos.
The project was a qualitative study designed to better understand the personal financial impact of the 2006 Massachusetts Health Care Reform law (Chapter 58 of the Acts of 2006) among low-income Latinos. The study’s aims were to examine the pathways Latinos followed to comply with the law; whether they could or could not afford the subsidized health insurance premiums established by the government; and what they did when they deemed their insurance premium unaffordable.
Twenty interviews were conducted with Latinos who had obtained health insurance coverage after the enactment of the 2006 Massachusetts Health Care Reform law (Chapter 58 of the Acts of 2006). Data from the interviews indicates that once informed about the insurance law, participants became active agents seeking affordable health insurance coverage. However, they felt intimidated by the health insurance enrollment process, and thus sought assistance from a community-based multi-service organization or program that provides case management-like services. Although affordable monthly insurance premiums for low-income residents can be determined by simply using an affordability scale, participants’ views of affordable insurance involved a more complex calculus. Due to changes in their day-to-day financial circumstances, participants continued to reconsider whether their health insurance premiums were affordable. Findings indicate that the health insurance enrollment process is notably complicated for low-income Latinos, and more so for those who face language barriers and lack a familiarity with the use of health insurance. Without the help of community-based organizations, participants’ success at obtaining health insurance coverage was unlikely. As a model for future national health reform, the enrollment experience of Latino residents in Massachusetts described in this report suggests the need to implement communication strategies to inform linguistically diverse populations about the steps to follow to comply with health insurance mandates. Also, findings point to the need to equip community-based organizations with the necessary tools to assist individuals with limited experience with health insurance during their process of obtaining affordable health insurance.
Why I Applied to New Connections
The New Connections program provided me the unique opportunity to conduct research designed to uncover an in-depth understanding of health coverage from a subjective, experiential vantage point. The fact that this program values and supports this kind of research was the greatest incentive to apply for this award.
What New Connections Means for my Career
Being part of New Connections has further expanded my professional network and my career pathway into the important field of policy-making.
Health Services Research; Latino Health and Mental Health; Health Literacy; Health Reform; Acculturation; Patient-Provider Communication.
Psychology; Sociology; Medical Anthropology
- New Connections Status: Mid-Career Consultant
- Award Year: 2008
- RWJF Team/Portfolio: Coverage
- Project Name: “No One Asked Me”: An Emic Perspective on Health Insurance Affordability.Dr. Dharma E. Cortés’ New Connections project is a qualitative study designed to better understand the personal financial impact of the 2006 Massachusetts Health Care Reform law among low-income Latinos. The study examines the pathways Latinos followed to comply with the law; whether they could or could not afford the subsidized health insurance premiums established by the government; and what they did when they deemed their insurance premium unaffordable.