Have a question about government service? 13 Kaiser, "A Provider's Handbook," 6-7. Your efforts pay off at the next visit, when Maria expresses much more interest in controlling her diabetes and shows personal warmth that was missing from earlier encounters. Free and confidential support for people in distress, 24/7, Behavioral Health Treatment Services Locator In one survey of Mexican American nurses, family support was identified as one of the most important areas to which health care providers should attend while caring for Latino patients. Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. , may be one strategy to increase treatment . She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. Hispanic refers to people who speak Spanish and/or are descended from Spanish-speaking populations, while Latino refers to people who are from or descended from people from Latin America. They Hear You is SAMHSA's underage drinking prevention campaign that helps parents and caregivers start talking to their children early about the dangers of alcohol. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. 37% of Latinos have. For example . placed on religious beliefs in the maintenance of health and the treatment of illness. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. Although most Latinos living in the U.S. do speak at least some English, 60 percent of Latino adults speak primarily Spanish at home.6 According to the U.S. Census, more than half of U.S. Latino residents age 5 and older speak English "very well," but a nevertheless significant number of Latino adults speak English "not well" or "not at all. 1. Cold linseed tea and hibiscus flower tea for diabetes. Recent immigrants often feel lonely and can have culture shock, fears of deportation, and financial problems; depressed mood may manifest as headaches and somatic symptoms. Methods We conducted a retrospective cohort study of antiretroviral-naive patients 18 years and older attending their first visit at Thomas Street Health Center in . 17.4% were Hispanic, and 49.1% were White. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. 1 The term does not refer only to Spanish speakers, however; many people usually thought of as "Hispanic"-the people of Brazil, for instance, or those from indigenous Mexican communities-often do not speak Spanish at all, or at least not as their primary language. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. dissertation, University of Southern Cali-fornia, 1973. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Such patient activation or motivation for change is more challenging in foreign-born Latinos, but may be achieved through active dialogue and discussion.32 Hopeful involvement in the care plan should replace fatalism or resignation. Obesity and genetic factors increase risk. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. There is ample evidence that Latinos, especially those of Mexican and Central American origin, face significant obstacles to obtaining health care, especially language barriers.4 Many hospitals and offices lack trained interpreters and rely on ad hoc interpretation by bilingual staff or even the children of patients. Latinx/Hispanic Communities and Mental Health Mental Health America Offers information about mental health issues in Latinx/Hispanic communities, including demographics, prevalence, treatment issues, and more. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . Allow extra visit time for patients with limited English proficiency, Hire bilingual staff and physicians, and encourage existing staff to learn Spanish, Make printed and Web-based cultural information available to staff, Offer flexible scheduling: patients may be seen in sign-in order rather than fixed appointments, Post bilingual or Spanish-language signage, Provide cultural sensitivity training for staff (e.g., monthly lunchtime discussions, in-service training, a bulletin board devoted to cultural issues, ethnic food potlucks), Provide culture-specific interventions in nursing care plans, Provide interpretation services for patients with limited English, proficiency (required under Title VI of the 1964 Civil Rights Act); whenever possible, try to avoid using patient's family or friends as interpreters, Provide Spanish-language medical handouts and patient forms, Recognize Latino holidays (e.g., Cinco de Mayo [May 5], Day of the Three Kings [January 6]). In terms of health, on some measures Latinos are better off than other ethnic groups. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. al., "Racial and Ethnic Disparities," Chart 4-1. Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319, Ethical Considerations for COVID-19 Vaccination, Hackworth Fellowships Project Showcase 2021, The Ethics of Going Back to School in a Pandemic, Systemic Racism, Police Brutality, and the Killing of George Floyd, COVID-19: Ethics, Health and Moving Forward, The Ethical Implications of Mass Shootings, Political Speech in the Age of Social Media, Point/Counterpoint: Democratic Legitimacy, Brett Kavanaugh and the Ethics of the Supreme Court Confirmation Process, https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf, Culturally Competent Care for Latino Patients. Cysticercosis is caused by consumption of contaminated with pork tapeworm. Patients should be actively involved in their care rather than passively acquiescing to instructions. Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.1 Latinos comprised nearly 16 percent of the U.S. population in 2009, making them the largest minority group.1 By 2050, it is projected that they will comprise up to 30 percent of the U.S. population.2 The three largest subgroups include Mexican Americans (about 65 percent), mostly settled in the Southwest, Puerto Ricans (9.1 percent) in the urban Northeast, and Cuban Americans (3.5 percent) in Florida.3 However, these demographics are rapidly shifting as Latino populations are increasingly integrated into suburban and rural communities throughout America. Underwriting for these materials was provided by a generous anonymous donor. She has three grown children: two still live in Mexico, and the third lives in a distant U.S. city. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Mexican Americans are much less likely to be treated for hypertension than non-Latino whites (35 versus 49 percent).11 Targeted public health campaigns are needed for hypertension, diabetes prevention, and weight control. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. 7Hyon B. Shin and Rosalind Bruno, "Language Use and English-Speaking Ability: 2000," Census 2000 Brief, U.S. Census Bureau, October 2003, accessed at: www.census.gov/prod/2003pubs/c2kbr-29.pdf. ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. Copyright 2023 American Academy of Family Physicians. needs and experience of less acculturated Latino clients who are mostly from Mexico and Central America, and represent a large segment of the Latino community in Southern California. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. al., "Culture, Illness, and Care," 252. Although this review summarizes findings for U.S. Hispanics, it is important to note that the panethnic term "Hispanics" describes a large, heterogeneous group originating from multiple Spanish-speaking nations and that evidences substantial variability in socio-cultural characteristics, beliefs, behaviors, and attitudes toward health and health These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Adding to the language barrier is the pitfall of false fluency, when physicians mistake the meaning of a Spanish word because of unfamiliarity with cultural or linguistic subtleties.4 Another barrier is inability to afford health insurance; nearly one-third of Latinos (30.7 percent) lack coverage.5 Yet another barrier stems from cultural mistrust coupled with a predisposition to seek alternative care first, thus delaying conventional treatment. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . In fact, the number of Latino physicians dramatically lags behind Latino population growth; and, according to cross-cultural health care expert Larry Purnell, Latinos are the most underrepresented major minority group in the entire U.S. health care workforce.5 This discrepancy contributes to many different linguistic and cultural hurdles for Latino patients, as well as for their health care providers. Older patients should be addressed as seor or seora rather than by their first names. Qualitative data analysis of the 75 symptom and treatment statements was completed, and data were grouped according to symptom and complexity of treatments. 58, Journal of . Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or Some trials examined overall CAM use, whereas others looked at. A mother might use cooling herbs to treat diaper rash, a hot condition. Combination therapy generally uses multiple treatment methods at once. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. Stigma of psychological treatment, belief that problems should be addressed at the family level (familismo), a misunderstanding or belief that treatment will not help with a child's behaviors, a . Visit SAMHSA on Instagram It is the primary method used in hospitals. Spanish language handouts are available from several Internet sources.33 Recruiting Latino physicians and staff, and recognizing Latino holidays at the office (e.g., Cinco de Mayo), will open many doors to the Latino community.34 Office staff, as well as physicians, should be instructed in basic cultural sensitivity (Table 5).34,35 Hospitals can include culturally appropriate foods in their menus. 11Jennifer Aguayo et. Methods Hispanic . Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. 9Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica Smith, "Income, Poverty, and Health Insurance Coverage in the United States: 2006," Current Population Reports, U.S. Census Bureau, August 2007; and Mead et. Latino healing traditions include curanderismo in Mexico and much of Latin America, Santeria in Brazil and Cuba, and espiritismo in Puerto Rico.19 Curanderos, traditional healers, distinguish between hot and cold illnesses (Table 220 ) and occasionally between natural and unnatural (sorcery-related) diseases.19,20 Patients may seek out the care of brujos or brujas (wizards or witches) for the latter conditions. by Marcia Carteret, M. Ed. (Kaiser Foundation Health Plan, 2001): 4. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. Table 3 lists some common Latino folk illnesses, their symptoms, and treatment.19 Therapies for these conditions may seem odd, but most are harmless, with a few exceptions. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. Bilingual posters and medical literature are an important starting point. In an NIMHD-funded study, Hirsh and a graduate student, Nicole Hollingshead, are testing whether a computer-simulated intervention can change doctors' attitudes and lead to better treatment for African Americans. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Additionally, when a woman gets married, her husband's name may be appended to her father's name. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. Text: 435748 These materials focus on the challenges that can confront Hispanics in American health care settings. The U.S. Latino population is also quite young relative to the general U.S. population; in 2007, the median age for the former was 27.6, compared to 36.6 for the latter.2. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). You call the dietitian to alert him to this patient's cultural concerns. Conveying medical instructions to patients with limited English skills can be frustrating. Neurocysticercosis is the most common cause of seizures in Latino immigrants. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Abdominal pain may be attributed to empacho, or food stuck in the intestine. Latinos are far more likely than the overall population to live in poverty; the poverty rate in 2006 was 20.8 percent, compared to 12.3 percent for the overall U.S. population. Again, it is imperative to stress that these values represent broad generalizations that may or may not apply to any individual patient or in any given situation. . 35% less heart disease and 49% less cancer; A lower death rate overall, but about a 50% higher death rate from diabetes; 24% more poorly controlled high blood pressure; 23% more obesity; 28% less colorectal screening.