They are written by health care providers and others who work with the relevant Latino sub-community. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. While not considering Hispanics as a distinct race, the U.S. Census (utilizing federally delineated categories) defines someone "Hispanic" or "Latino" as "a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. To provide an updated understanding of folk and traditional medicine (FTM) among Hispanic parents in the United States, we surveyed 200 caregivers identifying their child as Hispanic in a pediatric primary care clinic about their cultural health beliefs and practices. New Drugs For Treating Fatty Liver Disease And Cirrhosis Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. Responding to health and social needs of aging Latinos in new-growth Copyright 2023 American Academy of Family Physicians. dissertation, University of Southern Cali-fornia, 1973. 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. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. Most Latino immigrants have received the BCG vaccine; although past practice has been to interpret skin test results without regard to BCG status, false-positive tests in this population are common. The progress made in expanding health insurance coverage for Latinos is now at risk, because of the COVID-19 economic recession's disproportionate impact on Latino workers. For instance, a doctor could perceive as evasive a patient who declines to make direct eye contact, when in fact,that patient may be demonstrating respect for the doctor's position and authority. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. Working With Hispanic and Latino Families - Child Welfare 3 percent report that they have trouble navigating the U.S. health care system. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. Her face lights up when you share this. 58, Journal of . Talk. 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. The American Psychological Association (APA) found that only one percent of psychologists identified themselves as Hispanic even though Hispanics represent 20 percent of the U.S. population as a whole. Hispanic Pain Experience - NIMHD Depression education fotonovela for engagement of Hispanic patients in Hispanic cultural health beliefs and folk remedies - PubMed Depression in US Hispanics: Diagnostic and Management Considerations in A significant share of Hispanic adults who lack a regular health care provider are native born, have a high school diploma, speak English and have health insurance. These materials focus on the challenges that can confront Hispanics in American health care settings. They also must beware of the tendency toward "othering"; that is, the penchant to understand non-dominant groups as inferior, exotic, or deviant.17 Some efforts at cultural competence may incline toward these unhelpful postures. Animal-based medicines are also used, including snake oil, which is obtained from the fat of snake skins, and bufo toad medicine, which contains a powerful psychedelic. One way of describing the distinction is that modern Western doctors are primarily trained to diagnose and treat diseases (in a purely biomedical sense), while traditional healers approach the patient as one suffering from an illness-that is, a culturally located experience of sickness.12 Among some Latino subcultures, folk illnesses such as empacho (a digestive ailment), mal de ojo (the "evil eye"), mollera caida (fallen fontanelle), susto (fright illness), and nervios (vulnerability to stressful experiences) are commonly described; and traditional healers range from curanderos (Mexican healers) and sobadores (traditional masseuses and bone setters) to yerberos (herbalists) and espiritistas (spiritual healers).13 Reliance on folk medicine certainly is not to be found in every, or even most, Latino communities; but it does exist as part of the health care landscape and is found among many patients from Mexico, as well as from various other regions within Latin America. 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 . Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. Latinos have disproportionately higher rates of obesity and diabetes mellitus (Table 1).914 Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of the non-Latino white population.12 Diabetes and hypertension are closely linked with obesity; 11.8 percent of Latinos older than 20 years have type 2 diabetes (13.3 percent of Mexican Americans), making it the foremost health issue in this population.14 A higher-calorie diet, a more sedentary lifestyle, and genetic factors contribute to this problem. Rue for earache. 4Center for Disease Control and Prevention, "Leading Causes of Death," accessed at www.cdc.gov/men/lcod/index.htm; and Richard Allen Williams, "Cultural Diversity, Health Care Disparities, and Cultural Competency in American Medicine," Journal of the American Academy of Orthopedic Surgeons, Vol. For example . hispanic methods of treatment Key Facts on Health and Health Care by Race and Ethnicity Yet Latinos are at particular risk for diabetes mellitus, tuberculosis, hypertension, HIV/AIDS, alcoholism, cirrhosis, and death from violence.4 There is also a disproportionately high prevalence of acute care in the treatment of Latinos; that is, too often patients delay medical care until their conditions worsen and necessitate immediate attention. Three types of medications include: (1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. An intention-to-treat approach using a last-observation-carried-forward method was used to analyze outcome data whereby the last available measurement for all participants was then used for all time points through the 12-month final follow-up. 1 (Sept. 2007). The commentaries provide perspective and insight on what went right, what went wrong, and how things might have gone differently in these culturally challenging situations. Combination therapy generally uses multiple treatment methods at once. al., "Racial and Ethnic Disparities in U.S. Health Care: A Chartbook" (The Commonwealth Fund, March 2008), Charts 6-25 and 6-26; and Joseph R. Betancourt, Alexander R. Green, and J. Emilio Carrillo, "The Challenges of Cross-Cultural Healthcare-Diversity, Ethics, and the Medical Encounter," Bioethics Forum 16 (3). Linden tea and lemon grass tea for nerves (anxiety). In spite of the large and rapidly increasing size of the U.S. Latino population, there has been no corresponding influx of Latinos working in the U.S. health care system. Cultural Barriers to Mental Health Treatment Among Hispanics/Latino(a)s Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Exposure to U.S. media is changing traditional Latino perceptions of health, diet, and body image, even as non-Latino Americans are influenced by Mexican cuisine and culture. 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. She says that since her husband died, she has lost interest in what might happen to her in the future. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Compared with non-Latino whites, Mexican Americans have up to a three times higher incidence of diabetes mellitus and a three times higher prevalence of obesity, but hypertension-related mortality is only 4 percent higher (not a significant difference). Hispanic/Latino Resources, Reports, Initiatives & More | SAMHSA Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. Hispanics progress against racism but have long way to go - UNM Newsroom Treatment referral and information, 24/7, Visit the SAMHSA Facebook page Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. Latino/Hispanic cultural influences on assessing and - Parenting A 2020 review study found that those in the Hispanic community may face several barriers that affect access to treatment, including: higher rates of unemployment less likelihood of having. 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. While Hispanic refers to language and those whose ancestry comes from a country where Spanish is spoken, Latino refers to geography. The Impact of Expansion on Chinese Immigrants and Hispanic Citizens Cultural Humility and Counseling Hispanic and Latino Populations - NAADAC Very often they have faced extremely hazardous conditions crossing the border-enduring hunger, dehydration, violence from vigilantes, rape, abuse, severe weather conditions and harsh treatment by border agents. 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. Related letter: Chagas Disease Is a Consideration in Latino Patients. After immigration, some Latios adopt American naming conventions, but others do not. Latino/Hispanic families can provide much support to a child with the disorder and protect him or her from the development of conduct problems (Bauermeister et al., 2005). Apart from these language and socioeconomic disparities and variation in the way health care is envisioned and sought out, differences in the way values are ordered and articulated can also strain the clinical health care encounter for Latino patients. Culturally Competent Care for Latino Patients She might also stop giving her infant vitamins, because they are a hot therapy.24 It is often possible to safely accommodate conventional and alternative treatments (in reasonable doses) if potential conflicts or interactions are identified in advance. As Hispanics continue their ascent as the largest and fastest growing minority group in the U.S., tension points between the healthcare and the Hispanic communities are growing as well, fueled by the lack of outreach from the former to the latter. Thus, when working with diverse populations in the United States . You call the dietitian to alert him to this patient's cultural concerns. Latino culture has several normative values that must be recognized in clinical settings. 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. 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. She agrees to start taking medications, but does not refill her prescriptions or lose weight. Mozote (Bidens pilosa) to refresh and clean the stomach. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. 17.4% were Hispanic, and 49.1% were White. High cholesterol or dyslipidemia (unhealthy blood fat levels) . You use teach back to ensure that Maria understands your directions, and you provide her with Spanish-language handouts about the benefits of controlling her diabetes and hypertension. 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. Identifying Eating Disorders in Latinas - The Society for the 5600 Fishers Lane, Rockville, MD 20857 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. The initial arrival of Chinese immigrants to the United States began as a slow trickle in the 1820s, with barely 650 living in the U.S. by the end of 1849. Delayed immigration protocols and anti-immigration legislation may contribute to stress. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. First among these, of course, is a language barrier. Addiction Demographics: Substance Use in the US | Recovery.org 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. Obesity and genetic factors increase risk. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Rather than operating on the ideal of an informed, active individual who makes decisions based on his or her own personal good, many Latino cultures consider as paramount the individual's obligation to the family and broader community. Because of less access to health care, Latinos with diabetes are often diagnosed later and have a greater risk of complications.15,16 Despite these unfavorable health and socioeconomic statistics, overall mortality is lower than would be expectedan anomaly termed the Hispanic paradox.17 Latinos live an average of 2.5 years longer than non-Latino whites (to 80 years, seven months of age) and 7.7 years longer than non-Latino blacks.1 It is not known what protective factors exist, but immigrant hardiness, social integration, and diet may have a role.1 Raising awareness about the consequences of obesity is necessary in Latino communities, especially because being somewhat overweight (gordito) can be considered healthy. Asian or Hispanic ancestry. Davis Company, 1998): 397-421. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. Census Bureau News, "U.S. Hispanic Population Surpasses 45 Million," Press Release, Thursday, May 1, 2008; U.S. Census Bureau, "Hispanic Americans By the Numbers," accessed at www.infoplease.com/spot/hhmcensus1.html; and U.S. Census Bureau, "State and County QuickFacts: Santa Clara County, California," 2006, accessed at http://quickfacts.census.gov. 37% of Latinos have. . For instance, Latino mothers may determine when medical care is warranted for a family member, though a male head of household may formally make the decision to send the family member to a medical center.16. Methods Hispanic . This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. Because many health beliefs and behaviors are culturally-based, it follows that when two different cultures come together in a health care setting, a collision of expectations often occurs. A chaperone is often appreciated if a same-sex physician is not available. Journals. Association of the End-Stage Renal Disease Treatment Choices Payment Themes common to Latino participants were: "We are put off to one side"; "If I can't work, I can't survive"; and "Without documents, you are no one." Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. (PDF) Grieving and death rituals of Latinos - ResearchGate Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. To sign up for updates or to access your subscriber preferences, please enter your contact information. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Our Future. Latinos often lack access to healthcare and have poor - Brookings Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Still, at the risk of oversimplifying, several trends emerge: -simpatia-politeness and the avoidance of hostile confrontation -personalismo-the value of warm personal interaction -respeto-the importance of showing respect to authority figures, usually including health care providers -familismo-collective loyalty to extended family and commitment to family obligation; -fatalismo-the belief that individuals cannot do much to alter fate15. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Treatment Outcomes in Undocumented Hispanic Immigrants with HIV - PLOS 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. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. The Role of Black and Hispanic Physicians in Providing Health Care for Author disclosure: No relevant financial affiliations to disclose. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Many Latino immigrants experience tremendous stress once they are in the United States. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. Remedies used for common pediatric illnesses and for the traditional folk illnesses: mal ojo(evil eye), empacho(blocked intestine), mollera caida(fallen fontanelle), and susto(fright). Media Contact . Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. This content is owned by the AAFP. This is lower than the average of 43 percent for adults in the U.S. overall. Oregano tea for coughs. Demographics and Addiction. Our Health. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. 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. 8Holly Mead et. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. In this article I will make use of both terms, relying more heavily, however, on "Latino. 12Arthur Kleinman, Leon Eisenberg, and Byron Good, "Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research," Annals of Internal Medicine 88: 251-258 (1978). Objective Breast cancer is the leading cause of cancer death among Hispanic women. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. Switch to Chrome, Edge, Firefox or Safari. Chartbook for Hispanic Health Care (Agency for Healthcare Research and Quality) This Hispanic Health Care chartbook is part of a family of documents and tools that support the 2014 National Healthcare Quality and Disparities Report (QDR). Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. Substance Abuse/Addiction Among Hispanic-Latina/o Americans Still, being aware of these larger values may help health care providers to understand a particular patient's behaviors and actions in the context of larger cultural inclinations. This consortium study defined distinct somatic cancer gene mutation patterns by race/ethnicity and sex among patients with early-onset colorectal cancer (CRC), yielding novel biological clues into early-onset CRC disparities. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . Hispanic Culture - Sydney Ales Grand Canyon University 352: PSY Floren You then schedule a return visit, during which an interpreter will be available. After some negotiation, she agrees to see a dietitian and a bilingual counselor, and agrees to take just two medications, metformin (Glucophage) and lisinopril (Zestril), although she understands that they will not make her feel better right away. 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. Similarly, a patient's silence when presented with a difficult treatment plan, rather than conveying agreement, may in fact indicate that patient's desire to maintain a polite relationship with the health care provider and avoid difficult or conflictual situations. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . National Network to Eliminate Disparities in Behavioral Health, SAMHSA National Survey on Drug Use and Health (NSDUH), AHRQ National Healthcare Quality and Disparities Reports, OMH National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards), 988 Suicide & Crisis Lifeline 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. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. Life expectancy at age 65 has improved since the enactment of Medicare among all older adults but is lower for Black adults than White or Hispanic adults (18.0, 19.4, and 21.4 years, respectively . Innovative Diabetes Interventions in the U.S. Hispanic Population Use of Folk Remedies in a Hispanic Population | JAMA Pediatrics | JAMA Chapter 6 Mental Health Care for Hispanic Americans Her husband died in an industrial accident four years ago, and she is still grieving. Racial Disparities in Hypertension Prevalence and Management: A Crisis Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. PDF Hispanic Culture and Healthcare in the United States Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. These terms are often used interchangeably, including by the U.S. Census Bureau, although "Hispanic" is more often utilized in governmental and market research and statistical record keeping, while "Latino" perhaps enjoys more popular usage today.
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