As with any circumscribed ethnic group, there is, of course, enormous cultural heterogeneity among Latino patients-to the point where it seems almost ludicrous to try to identify broad cultural tendencies across such diversity. Other healing specialties include yerberas (herbalists), hueseros (bone setters), parteras (midwives), and sobradores (similar to physical therapists).21, Symptoms are often interpreted differently based on cultural presuppositions. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. 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. Genetics, environment, and life experiences can all have an impact on . Become an expert on our coaching methods, internal systems, processes, and technology. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. 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. High level of belly fat or metabolic syndrome. These instructions can be studied by the patient or translated when time permits. Delayed immigration protocols and anti-immigration legislation may contribute to stress. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or Davis Company, 1998): 397-421. This content is owned by the AAFP. This reliance does not necessarily replace modern biomedicine; rather, herbal remedies and other non-allopathic treatments often are utilized in conjunction with Western medical care. 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 . Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. 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. Patient activation will help motivate the patient to become involved in his or her own care. Plants are used on their own, or mixed together to form herbal remedies. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Moreover, 32.7 percent (nearly one-third) of all U.S. Latinos completely lacked health insurance that year, compared with 15.3 percent in the general population; and nearly half of Latinos reported being uninsured at some point during the previous year.9 Latinos are nearly two and a half times more likely than whites to report that they have no regular doctor.10 Even among many insured Latinos, coverage and care are far from adequate. . Additionally, when a woman gets married, her husband's name may be appended to her father's name. 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. They are a starting point, not an ending point; in other words, they call practitioners to look more deeply into the particular cultural, linguistic, and socioeconomic contours of their patients' backgrounds and to open themselves to alternative ways of understanding and interpreting their patients' actions and requests. The same is also applies to the substance abuse treatment. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. A few candles were lit in the dark, curtained bedroom. Spanish language handouts are a better option. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Barriers to care have resulted in striking disparities in quality of health care for these patients. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. "7 In the context of a hospital or medical clinic, where medical terminology can be complicated and communication often takes place quickly and amidst elevated emotions, this language barrier can be especially problematic. 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 ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Copyright 2023 American Academy of Family Physicians. Traditionally, conditions may be referred to as either "hot" or "cold". 5600 Fishers Lane, Rockville, MD 20857 She says that she does not feel better when taking the medicine, and says the diet you prescribed does not include tortillas or any of the foods she likes. Rue for earache. 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. 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. 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). To sign up for updates or to access your subscriber preferences, please enter your contact information. 17.4% were Hispanic, and 49.1% were White. 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. Modern Mexicans turn to old ways of childbirth. Hispanics generally use multiple methods to treat themselves which involve prayer, folk medicine, prescription medications left over from friends as well as new medications prescribed by physicians. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. 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. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . After immigration, some Latios adopt American naming conventions, but others do not. 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). She says that since her husband died, she has lost interest in what might happen to her in the future. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . Despite a lack of U.S. studies, a Norwegian study found that although immigrants from tuberculosis-endemic regions did bring more strains of tuberculosis with them, they did not significantly contribute to the spread of tuberculosis within the resident population.18, Non-Latino physicians may be perplexed by references to folk healing and illness in Latino patients. 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 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). 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. Talk. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. In a 2002 report from the Institute of Medicine, more than 175 studies were cited to document this disparity.6 In an attempt to address this problem, the National Standards for Culturally and Linguistically Appropriate Services (CLAS) were released in 2001 by the Office of Minority Health of the U.S. Department of Health and Human Services.7 Fourteen guidelines were published, which were organized around three main themes: culturally competent care, language access services, and organizational supports. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. First among these, of course, is a language barrier. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. Linden tea and lemon grass tea for nerves (anxiety). 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. Neurocysticercosis, a leading cause of seizures in Mexico, and pulmonary tuberculosis are more common in Latino immigrants.10 Interferon gammarelease assay blood testing for tuberculosis is now preferred over tuberculin skin testing in immigrants with a history of bacille Calmette-Gurin vaccination because of a high rate of false-positive results with skin testing (although skin testing is still recommended for children younger than five years).13 Publicized fears of contagion from illegal immigration may be overblown. Author disclosure: No relevant financial affiliations to disclose. 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. high speed chase sumter sc 2021 marine city high school staff marine city high school staff Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. Prayer was reported as helping to reduce stress and anxiety. al., "Racial and Ethnic Disparities," Chart 5-2. Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. This traditional food is high in fiber and pectin and lowers lipid levels by binding bile acids; when eaten with other foods, it reduces the glycemic index of the meal by 50 percent. [4] Keeping these cautionary notes in mind, the cases and commentaries in this section seek to address numerous issues that arise in the course of providing clinical health care for Latino patients of various backgrounds. 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 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. In either case, they are treated with the opposite hot or cold treatment. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. 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. Margaret E. "Group Methods and . Hispanic people are the youngest population, with 33% below age 18, and 57% below age 34 (Figure 4). Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. 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. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. In terms of health, on some measures Latinos are better off than other ethnic groups. About 23 percent of Latinos in the United States live in poverty.2. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. hispanic methods of treatment. Methods Hispanic . 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. Thus, when working with diverse populations in the United States . 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. Religion can be a protective factor for mental health in Latinx/Hispanic communities (faith, prayer) but can also contribute to the stigma against mental illness and treatment (demons, lack of faith, sinful behavior), so targeting religious institutions to help encourage good mental health and treatment-seeking is important. Underwriting for these materials was provided by a generous anonymous donor. The cases and reflections illustrate the kinds of challenges patients and health care professionals face when they come from different cultures and speak different languages. The Bracero program, a guest worker program started in 1942, was designed to bring experienced agricultural laborers to the U.S. from Mexico and led to a huge influx of Mexican immigrants. al., "Racial and Ethnic Disparities," Chart 4-1. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. 17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. 1-877-SAMHSA-7 (1-877-726-4727), SAMHSA.gov, Substance Abuse and Mental Health Services Administration, Buprenorphine Physician & Treatment Program Locator, Early Serious Mental Illness Treatment Locator, View All Helplines and Treatment Locators, Implementing Behavioral Health Crisis Care, Mental Health and Substance Use Disorders, Substance Abuse and Mental Health Prevention, Technology Transfer Centers (TTC) Program, State Targeted Response Technical Assistance (STR-TA), Clinical Support System for Serious Mental Illness (CSS-SMI), Suicide Prevention Resource Center (SPRC), African American Behavioral Health Center of Excellence, Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence (AANHPI-CoE), Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions, Center of 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Individuals, Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S. (PDF | 426 KB), The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue, El alcohol y la depresin: El camino de Jorge hacia una vida mejor, Prevencin de la Sobredosis de Opioides Manual de Instruccin, Publicaciones de SAMHSA disponibles en espaol, quality practice and workforce development, Alcohol and the Hispanic Community from the National Institutes of Health National Institute on Alcohol Abuse and Alcoholism, Chartbook for Hispanic Health Care (Agency for Healthcare Research and Quality), Hispanic-Latino Mental Health (American Psychiatric Association), Latino Mental Health Facts (National Alliance on Mental Illness), Mental Health: A Guide for Latinos and Their Families (American Psychiatric Association) (22 minutes, 13 seconds), National Latino Behavioral Health Association (NLBHA), Behavioral Health Treatment Services Locator, Addiction Technology Transfer Center (ATTC), Mental Health Technology Transfer Center (MHTTC), Prevention Technology Transfer Center (PTTC), U.S. Department of Health & Human Services. 50 percent of those with no usual health care provider are at least high school graduates. Call or text 988 or chat 988lifeline.org. Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Have a question about government service? Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. 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. Low levels of hypertension awareness are a major problem in the Latino community. 3 percent report that they have trouble navigating the U.S. health care system. For example . 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. The cultural value of modestia (modesty), which is related to respect, is often neglected.27 Latinos may be conservative in this area, and physical exposure should be negotiated as the examination warrants. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Information. Media Contact . Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. Visit SAMHSA on Instagram Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. Oregano tea for coughs. Latinos have disproportionately higher rates of obesity and diabetes mellitus. She agrees to start taking medications, but does not refill her prescriptions or lose weight. www.behaviorfrontiers.com. Some states have extremely large Latino populations; for instance, as of 2006, 36 percent of Californians (13.2 million people) identified themselves as Hispanic or Latino, as did 36 percent of Texans (8.6 million people). You then schedule a return visit, during which an interpreter will be available. Lack of third party reimbursement for professional interpreter services exacerbates this problem. 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. 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). Patients should be actively involved in their care rather than passively acquiescing to instructions. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. Get to know your fellow coach managers and direct reports. 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. 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]).
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