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). 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. 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. Many Latino immigrants experience tremendous stress once they are in the United States. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Courtney Parker, CC BY. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. 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. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. . She agrees to start taking medications, but does not refill her prescriptions or lose weight. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. 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 . Methods: Data from the National Mental Health Services Survey conducted in 2014 (N=13,015 facilities) and 2019 (N=12,345 facilities) were used to measure changes in the proportions of facilities that offered treatment in Spanish overall and by year, state, and proportion of Hispanic residents. Call or text 988 or chat 988lifeline.org. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. www.behaviorfrontiers.com. High cholesterol or dyslipidemia (unhealthy blood fat levels) . A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. 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. 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. Copyright 2023 American Academy of Family Physicians. Emotional distress often presents with headaches (dolor de cabeza) or other physical symptoms instead of depressed mood.9 Consequently, a high index of suspicion is needed to recognize adjustment reactions or depression. 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. 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. Cold linseed tea and hibiscus flower tea for diabetes. High level of belly fat or metabolic syndrome. 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. Switch to Chrome, Edge, Firefox or Safari. Neurocysticercosis is the most common cause of seizures in Latino immigrants. There are also differences in drug use within the Hispanic population as shown in Figure 1. [4] 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. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. "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. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Mozote (Bidens pilosa) to refresh and clean the stomach. In today's United States, these terms are often thought . 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. You call the dietitian to alert him to this patient's cultural concerns. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. SAMHSA Blog. The point deserves emphasis: Health care providers must be cautious not to oversimplify the values, customs, and beliefs that characterize any ethnic group-especially one as heterogeneous as Latinos. 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. Topics. 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. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Abdominal pain may be attributed to empacho, or food stuck in the intestine. 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. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 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. 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. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. 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. 3 percent report that they have trouble navigating the U.S. health care system. Traditionally, conditions may be referred to as either "hot" or "cold". dissertation, University of Southern Cali-fornia, 1973. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, Similarly, in a national epidemiological survey of Latino households in the U.S., of those who reported awareness of a problem with at least one symptoms (overweight, binge eating, or weight control), only one fifth to one third of Latinos in this sample reported ever receiving treatment for an eating disorder (Alegria et al., 2007). Among Hispanics who needed but did not receive treatment in the past year, 95.8% did not feel the need for it, 2.2% felt the need for treatment but did not make an effort to get it, and 2.0% felt the need for treatment and did make an effort to get it. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. Her husband died in an industrial accident four years ago, and she is still grieving. Spanish language handouts are a better option. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. Prayer was reported as helping to reduce stress and anxiety. 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. Thus, when working with diverse populations in the United States . 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. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. One exception is the Methods for the Epidemiology of Child and Adolescent . 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. 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. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . Objective Breast cancer is the leading cause of cancer death among Hispanic women. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Methods Hispanic . America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. 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]). Hispanic Heritage Month, September 15 - October 15, is an important opportunity to raise awareness about these trends and more importantly, identify culturally and linguistically appropriate prevention and treatment strategies to reduce mental and substance use disorders in the Hispanic/Latino population. 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. Materials are available in English and Spanish. Her face lights up when you share this. Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 5600 Fishers Lane, Rockville, MD 20857 Cold water with lemon for high blood pressure. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. 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 . 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. 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. | Mar 1, 2011. A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. Although the program ended in 1964, the immigration trend has continued to the present day, and many of these immigrants work as migrant laborers in the U.S. agricultural system. Lack of third party reimbursement for professional interpreter services exacerbates this problem. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. 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. 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. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Margaret E. "Group Methods and . In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. Cysticercosis is caused by consumption of contaminated with pork tapeworm. 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. For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. 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. Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . A chaperone is often appreciated if a same-sex physician is not available. 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.
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