Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . Opioid and Illicit Drug Use Among the Hispanic/Latino Populations Our Future. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. 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. Latinos often lack access to healthcare and have poor - Brookings Abdominal pain may be attributed to empacho, or food stuck in the intestine. Cold water with lemon for high blood pressure. 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 PDF A Guide for Conducting Cultural Assessment of Hispanic and Latino Clients Combination therapy generally uses multiple treatment methods at once. In terms of health, on some measures Latinos are better off than other ethnic groups. 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. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). 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. From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. 13 Kaiser, "A Provider's Handbook," 6-7. | Mar 1, 2011. 58, Journal of . For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. This inequality puts these communities at a higher risk for more severe and persistent forms of mental health conditions, because without treatment, mental health conditions often worsen. Culturally competent care necessitates cross-cultural training, which is increasingly included in medical education, but with the realization that cultural competency is a lifelong learning process rather than an end in itself.8. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. These instructions can be studied by the patient or translated when time permits. Hispanics progress against racism but have long way to go - UNM Newsroom Spanish language handouts are a better option. Latino culture has several normative values that must be recognized in clinical settings. When in doubt, the best policy is to ask the patient how he or she would like to be addressed.26. 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. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. Racial Disparities in Hypertension Prevalence and Management: A Crisis Complementary and Alternative Medicine (CAM) and Healers - Geriatrics Oregano tea for coughs. placed on religious beliefs in the maintenance of health and the treatment of illness. 3 percent report that they have trouble navigating the U.S. health care system. This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. Latinx/Hispanic Communities and Mental Health While this has been a challenge across patient populations, it has been especially pronounced among the U.S. Latino population, which shows a rate of non-adherence almost 40% higher than the rate seen in the U.S. Caucasian population. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 11Jennifer Aguayo et. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). Contact USA.gov. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Related letter: Chagas Disease Is a Consideration in Latino Patients. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Although patients of all cultural backgrounds warrant kindness, a personal connection, and respect, the consequences of omitting these traditional values may be more problematic with Latinos. The Role of Black and Hispanic Physicians in Providing Health Care for 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. Additionally, when a woman gets married, her husband's name may be appended to her father's name. After immigration, some Latios adopt American naming conventions, but others do not. 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. In fact, compared to both white Americans and African-Americans, Latinos generally report feeling less listened to and understood by their doctors, as well as less able themselves to understand their doctors; and they are twice as likely to leave a doctor's office with unasked questions. Mozote (Bidens pilosa) to refresh and clean the stomach. Psychiatry.org - Working with Latino Patients Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . Master the basics of the Virta Treatment and understand the full patient experience. Delayed immigration protocols and anti-immigration legislation may contribute to stress. [4] 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. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. 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. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. Her face lights up when you share this. 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. 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. "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. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. In the LEARN model, which is illustrated in the Case Study below,28,29 the physician should first sympathetically listen to the patient's perception of the problem, explain his or her perception of the problem to the patient, acknowledge and discuss any differences and similarities between the two views, recommend a treatment plan, and negotiate agreement.30 Use of the LEARN technique identifies and helps resolve any cultural differences that may arise. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. al., "Culture, Illness, and Care," 252. Some trials examined overall CAM use, whereas others looked at. 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. Caring for Latino Patients | AAFP Our Health. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). by Marcia Carteret, M. Ed. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. 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. . Folk Cures and Alternative Treatment Are Putting Hispanic Patients At 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. 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. Chapter 6 Mental Health Care for Hispanic Americans Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. 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. Hispanic and Latino are often used interchangeably though they actually mean two different things. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Adherence Barriers to Antidepressants among an Urban Female Latino These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. Lack of third party reimbursement for professional interpreter services exacerbates this problem. Courtney Parker, CC BY. Respondents using these herbs reported never replacing their medical regimens with herbs. PDF Folk Medicine and Traditional Healing Basics - NATIONAL CENTER FOR Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. hispanic methods of treatmentfeminine form of lent in french. 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. Prayer was reported as helping to reduce stress and anxiety. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. She says that since her husband died, she has lost interest in what might happen to her in the future. Approximately half (49.6%) of the patients were aged at least 65 years. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. These numbers include Mexican-Americans, Puerto Ricans, Central and South Americans, Cubans, and many other communities although, throughout California, the vast majority of Latinos identify themselves as of Mexican background. 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. New Drugs For Treating Fatty Liver Disease And Cirrhosis Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. 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. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. Treatment Outcomes in Undocumented Hispanic Immigrants with HIV - PLOS 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. About 23 percent of Latinos in the United States live in poverty.2. Media Contact . US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. 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. Copyright 2023 American Academy of Family Physicians. Hispanic Health | VitalSigns | CDC 50 percent of those with no usual health care provider are at least high school graduates. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. 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). hispanic methods of treatment 14 Kleinman et. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. 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. 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. Poor communication with health care providers is often an issue. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 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. 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. Plants are used on their own, or mixed together to form herbal remedies. 17.4% were Hispanic, and 49.1% were White. Other health problems include stress, neurocysticercosis, and tuberculosis. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. 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. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. 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." "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. 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. Depression education fotonovela for engagement of Hispanic patients in Get to know your fellow coach managers and direct reports. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Hispanic Culture - Sydney Ales Grand Canyon University 352: PSY Floren A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. They are written by health care providers and others who work with the relevant Latino sub-community. 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. High level of belly fat or metabolic syndrome. 15 supp. For example . According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Traditionally, conditions may be referred to as either "hot" or "cold". More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. SAMHSA Blog. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. 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. Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. 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). 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. Latino Culture: Natural Medicines & Alternative Treatments The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. 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. It was developed specially to treat people between the ages of 3 and 18. 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. Objective Breast cancer is the leading cause of cancer death among Hispanic women. 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. hispanic methods of treatment. Information. Cultural Barriers to Treatment and Compliance. 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. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. Addiction Demographics: Substance Use in the US | Recovery.org 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. America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. Addressing patients properly can be another challenge. Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. 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 . 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. 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