Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. 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). 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. Results: Teas were most commonly used for colic, upper respiratory tract symptoms, and abdominal pain. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. For those who have a serious mental health disorder, around 44 percent did not receive treatment. National Prevention Week 2020 is about Our Lives. 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. Latino millennials were also more likely to have already had a conversation about end-of-life care with a family member, a finding that aligns with the norms of outward expression of death and . Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. 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. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Oregano tea for coughs. You call the dietitian to alert him to this patient's cultural concerns. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Contact USA.gov. For instance, 2002 estimates of life expectancy for Latinos was 77.2/83.7 years (male/female) compared to 68.4/75.1 for African-Americans and 74.7/80.1 for non-Hispanic whites.3 Latinos are less likely than non-Hispanic whites and African-Americans to suffer from heart disease (which is nevertheless the leading cause of death in all three groups). Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 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. Lack of third party reimbursement for professional interpreter services exacerbates this problem. In this article I will make use of both terms, relying more heavily, however, on "Latino. Prayer was reported as helping to reduce stress and anxiety. 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). Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. These broad generalizations are just that: broad generalizations. Cold water with lemon for high blood pressure. 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. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. 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). Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Traditionally, conditions may be referred to as either "hot" or "cold". 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. Cysticercosis is caused by consumption of contaminated with pork tapeworm. 11Jennifer Aguayo et. Cold linseed tea and hibiscus flower tea for diabetes. [4] The material in this section is part of a larger project by the Markkula Center for Applied Ethics on culturally competent care; that is, health care that is sensitive to the differing values and needs of cultural subgroups within our pluralistic society. She says that since her husband died, she has lost interest in what might happen to her in the future. Information. al., "Culture, Illness, and Care," 252. 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. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. 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. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. 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. 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. 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. Patients should be actively involved in their care rather than passively acquiescing to instructions. Talk. | Mar 1, 2011. The Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. 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. Natural laxatives such as oil with orange juice (or just oil in some cases). 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. Hispanic and Latino are often used interchangeably though they actually mean two different things. Posttraumatic shock or anxiety may be attributed to susto (soul loss) rather than posttraumatic stress disorder. 17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. "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. America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. This resulted in a rich compilation of remedies that Hispanics use in home treatments, with the emergence of a pattern comparable to the nursing process. 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 . Our Future. 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. Generally speaking, Latino cultures include a more family-centered decision making model than the more individualistic or autonomy-based model embraced by modern mainstream biomedical culture in the United States. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Yet the call for cultural competence can-at its best-urge practitioners to adopt instead a stance of cultural "humility": one which encourages an open mind, and a recognition that each one of us sees the world through our own very distinctive cultural lenses. Hispanics have different degrees of illness or health risks than whites. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. Asian or Hispanic ancestry. 4 Another. 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. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. 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. The Immigration Reform and Control Act of 1986 granted amnesty to immigrants who came to the U.S. before 1982; but the northward trend from Mexico and other parts of Latin America has continued since then, and many who have crossed the U.S.-Mexican border now live in the United States illegally. A mother might use cooling herbs to treat diaper rash, a hot condition. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." 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. Under-recognition of depression in adult Hispanic Americans may be related to language . 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. 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. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. 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. Home remedies, along with "lay healers" are also an integral part of the healthcare regimen for families in this culture. Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. 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. 1. Some trials examined overall CAM use, whereas others looked at. High cholesterol or dyslipidemia (unhealthy blood fat levels) . This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. 1 (Sept. 2007). 50 percent of those with no usual health care provider are at least high school graduates. Switch to Chrome, Edge, Firefox or Safari. 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. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. Hence, the individual's good cannot be neatly separated from his or her community. Media Contact . Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. Garlic and onion are used extensively, as is aloe vera. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . Other health problems include stress, neurocysticercosis, and tuberculosis. She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. 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. SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. 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. High level of belly fat or metabolic syndrome. About 23 percent of Latinos in the United States live in poverty.2. Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . Approximately half (49.6%) of the patients were aged at least 65 years. 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 . She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. 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. Her husband died in an industrial accident four years ago, and she is still grieving. 8Holly Mead et. First among these, of course, is a language barrier. If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. In terms of health, on some measures Latinos are better off than other ethnic groups. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. 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. 13 Kaiser, "A Provider's Handbook," 6-7. While Hispanic refers to language and those whose ancestry comes from a country where Spanish is spoken, Latino refers to geography.