SACRAMENTO, Calif. — At the corner of J and 19th Street in Midtown Sacramento there is a place for people who, for so long, haven't had access to the quality health care they need.
Each Saturday, the Wellspace Health Community Center houses Clínica Tepati, an organization established in 1974 that provides basic health care services and health education to the underserved Latino community. It's one of 13 student-run clinics operating under the UC Davis School of Medicine.
It's a lifeline for patients like Maria Aguilar, whose health care experiences before finding Clínica Tepati were dismissive, superficial and beyond disappointing.
"Like one isn't human, like you're not a person," Aguilar shared in Spanish during one of her visits to the clinic. It was only at Clínica Tepati that the 53-year-old felt heard.
"It's been a very good experience here," Aguilar said.
Translating for Aguilar during her visit was volunteer Alex Pulido. For him, the work is personal.
"When I'm working with these patients, I see my parents," Pulido said.
The majority of patients he sees are Spanish speaking, just like his parents. Pulido recalls helping his parents with everything from ordering food to interpreting legal documents ever since he was in elementary school. And between the language barrier and lack of insurance coverage, many have fallen through the cracks of the U.S. health care system.
"It's one of the biggest motivators that we have as undergraduates to kind of join the clinic and be involved in the patient care," Pulido said.
Pulido is an undergraduate at UC Davis studying pre-med and also a member of Clínica Tepati's all-volunteer student workforce, many of whom come from Spanish-speaking households themselves. For 50 years, the clinic has been committed to providing culturally competent care through health screenings, education, patient advocacy and more. The student volunteers are here to learn and gain valuable clinical experience while providing free care to an underserved community.
Dr. José Alberto Arévalo was previously an instructor of record at Clínica Tepati for 16 years. He's also the founder of the Sacramento Latino Medical Association (SaLMA), a nonprofit established in 2007 to build a network of Latino physicians in the Sacramento Valley area to advocate for culturally competent health care for the Latino community in the region.
SaLMA's advocacy efforts also includes increasing enrollment and retention of Latinos in higher education and health care professions. That includes supporting students at Clínica Tepati, which Dr. Arévalo said is crucial.
"We have such a huge population of Latinos, Latinx and particularly the underserved population, and yet we have very few doctors that are available to serve that population, and we've got to do something about it," Dr. Arévalo said.
Lack of representation
In California, Latinos make up 39.4% of the population, according to 2020 U.S. Census data. Yet, only 6.4% of physicians are Latino and of that, 2.7% are Latina.
"I call it the biggest disparity in health care," Dr. Arévalo said.
Representation is important, whether it's about language access or having a culturally sensitive approach to health care. According to a 2023 California Health Policy Survey, 70% of Latinos said the health system "regularly" or "occasionally" treats people unfairly based on their race or ethnic background. A majority of respondents also said providers didn't listen to them, made assumptions or didn't treat them with respect.
Culturally competent care encompasses meeting the needs of patients' diverse backgrounds, whether that be social, cultural or linguistic needs.
Dr. Arévalo said Clínica Tepati has helped shape the next generation of medical professionals that this population can trust.
"And trust happens a lot easier when it's somebody that looks like you, talks like you, came from the same background environment, because they've walked a mile in your shoes," he said.
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Challenges with health insurance
According to the 2022 California Health Interview Survey, 8.4% of Latino adults are also uninsured. By comparison, just 3.1% adults who are not of Latino origin are uninsured. On top of that, more than 22% of Latino adults report not having a usual place to go when sick or in need of health advice.
Lack of health insurance is one of many factors that impact the health outcomes of Latinos, putting them at particular risk of heart disease, cancer, unintentional injuries, diabetes and more.
52% of Latinos in California said they have medical debt, more than any other racial and ethnic group in the state. Nearly half of respondents said they or a family member have skipped care due to costs. In most cases, skipping care made conditions worse.
"Some of these patients, you know, are kind of faced with a tough issue. Should I go to the emergency department, or should I go to urgent care when they don't have a primary care kind of provider that can provide these services for them?" said Frank Sierra, a student chairperson of Clínica Tepati.
Finding a passion
Sierra describes himself as a "nontraditional student." After getting his undergraduate degree, he took a gap decade before going to medical school. In that time, Sierra provided around-the-clock care for his grandfather near the end of his life.
"My grandfather was a migrant farmworker. He worked a lot in the field. He did have skin cancer, so a lot of those appointments when he had to meet with doctors and surgeons to excise some of these skin tumors was something that I was able to attend with him," Sierra said. "So that kind of manifestation of decades-worth of sun exposure as a migrant farmworker and seeing how that really impacted his health was something that was really eye-opening for me."
Being at appointments with his grandfather is what ultimately led Sierra to realize his goals in the health care field.
"Attending a lot of these appointments and seeing that there was a lack of Spanish-speaking health care providers is something that really inspired me to not only want to serve as a translator, but also kind of be the provider for patients like my grandfather," he said.
Like the other student volunteers at Clínica Tepati, Sierra is gaining valuable hands-on experiences that will serve him well as a doctor. While at the same time, giving a voice to patients like Maria, like his grandfather.
"Even though he's not here, I do know he's proud and especially of the type of work that I hope to do as a future physician to really impact these communities that are otherwise overlooked," Sierra said.
It's about making an impact on an overlooking community and building trust.
"More than just medical care, it's treating people like people and building a connection with them to build trust, right? Essentially, it's what's the end goal," Pulido said.
It's been Clínica Tepati's mission for 50 years: treating people today and training the doctors of tomorrow.
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