To sign up for updates or to access your subscriber preferences, please enter your contact information. Information. Prevalence, Awareness, and Treatment of Hypertension in Hispanics You recommend a compromise treatment plan for her diabetes and grief. For example . These instructions can be studied by the patient or translated when time permits. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. Media Contact . Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. Among U.S. states, New Mexico has the highest percentage of Hispanic ancestry, at 47 percent (as of July 1, 2012). Latinos often lack access to healthcare and have poor - Brookings America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. 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. She has three grown children: two still live in Mexico, and the third lives in a distant U.S. city. 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 terms are derived from the Spanish verb curar, which means to heal. In terms of health, on some measures Latinos are better off than other ethnic groups. Using don or doa with the given or full name indicates even greater respect for older patients. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. 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. 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. hispanic methods of treatment. "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. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. Latino Culture: Natural Medicines & Alternative Treatments 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. Association of the End-Stage Renal Disease Treatment Choices Payment All Rights Reserved. Hispanics progress against racism but have long way to go - UNM Newsroom "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. 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. The Impact of Expansion on Chinese Immigrants and Hispanic Citizens More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. Barriers to care have resulted in striking disparities in quality of health care for these patients. 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. Chagas Disease Is a Consideration in Latino Patients, http://www.stanford.edu/group/ethnoger/hispaniclatino.html, http://www.rice.edu/projects/HispanicHealth, http://www.hogarhispano.homestead.com/HispanicHealth.html, http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=1&lvlID=3, http://www.ohsu.edu/xd/education/library/research-assistance/patient-education-handouts.cfm/, https://www.aamc.org/download/54328/data/tacctresourceguide.pdf.pdf, http://depts.washington.edu/pfes/CultureClues.htm. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Latinx/Hispanic Communities and Mental Health 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. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. 17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. 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. placed on religious beliefs in the maintenance of health and the treatment of illness. Linden tea and lemon grass tea for nerves (anxiety). 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. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. (PDF) Counseling the Hispanic Client: Cuban Americans, Mexican Older patients should be addressed as seor or seora rather than by their first names. Hispanic and Latino are often used interchangeably though they actually mean two different things. There are also differences in drug use within the Hispanic population as shown in Figure 1. Some cultural barriers may be overcome by using the teach back technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients. Downward National Trends in Mental Health Treatment Offered in Spanish 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. 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). Rue for earache. 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. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. 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. From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. 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. 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. 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. 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. The LEARN technique can facilitate cross-cultural interviews. Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Addiction Demographics: Substance Use in the US | Recovery.org You call the dietitian to alert him to this patient's cultural concerns. hispanic methods of treatment 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. 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. Responding to health and social needs of aging Latinos in new-growth Garlic and onion are used extensively, as is aloe vera. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. savoie's real cajun dressing mix; PURPOSE Though patient variables are likely to play an important role in the undertreatment of depression, little is known of patients' perceptions of standard depression treatments. Hispanic Health | VitalSigns | CDC Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. 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. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Hispanic cultural health beliefs and folk remedies - PubMed 11Jennifer Aguayo et. Copyright 2013 by the American Academy of Family Physicians. In either case, they are treated with the opposite hot or cold treatment. Psychiatry.org - Working with Latino Patients Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). 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. Hypertension in Hispanics/Latinos: Epidemiology and Considerations for Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. What are the treatments for heroin use disorder? Courtney Parker, CC BY. 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. The Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . 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. National Prevention Week 2020 is about Our Lives. 3 percent report that they have trouble navigating the U.S. health care system. Patient activation will help motivate the patient to become involved in his or her own care. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. PDF Hispanic Culture and Healthcare in the United States These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. In an NIMHD-funded study, Hirsh and a graduate student, Nicole Hollingshead, are testing whether a computer-simulated intervention can change doctors' attitudes and lead to better treatment for African Americans. Folk Cures and Alternative Treatment Are Putting Hispanic Patients At There are likely many possible reasons for this, including poverty and lack of health insurance, and thus at best irregular access to health care; cultural factors that might cause patients to delay seeing a doctor, for example, the expectation that one should tolerate pain without complaint; and a belief that certain conditions (such as pregnancy) are natural and do not require medical attention. A little more than 45 percent of all births in Mexico are Cesarean sections, which makes it one of the world's leaders in the practice. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. 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. 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. 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. 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. Complementary and Alternative Medicine (CAM) and Healers - Geriatrics She says that since her husband died, she has lost interest in what might happen to her in the future. Davis Company, 1998): 397-421. Latino culture has several normative values that must be recognized in clinical settings. 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 . 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). Combination therapy generally uses multiple treatment methods at once. 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. Delayed immigration protocols and anti-immigration legislation may contribute to stress. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. 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 . www.behaviorfrontiers.com. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Importantly, many Latinos themselves prefer the latter term, since it avoids reference to the more recent European colonial powers (from "Hispania," or the Iberian Peninsula) that laid claim to Latin America in the fifteenth and sixteenth centuries. Approximately half (49.6%) of the patients were aged at least 65 years. Cysticercosis is caused by consumption of contaminated with pork tapeworm. Asian or Hispanic ancestry. Treatment Outcomes in Undocumented Hispanic Immigrants with HIV - PLOS | Mar 1, 2011. Cold linseed tea and hibiscus flower tea for diabetes. For instance, Latinos highly value family. Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.1 Latinos comprised nearly 16 percent of the U.S. population in 2009, making them the largest minority group.1 By 2050, it is projected that they will comprise up to 30 percent of the U.S. population.2 The three largest subgroups include Mexican Americans (about 65 percent), mostly settled in the Southwest, Puerto Ricans (9.1 percent) in the urban Northeast, and Cuban Americans (3.5 percent) in Florida.3 However, these demographics are rapidly shifting as Latino populations are increasingly integrated into suburban and rural communities throughout America. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. It was developed specially to treat people between the ages of 3 and 18. Opioid and Illicit Drug Use Among the Hispanic/Latino Populations If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. Abdominal pain may be attributed to empacho, or food stuck in the intestine. Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. 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. 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." Topics. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. Neurocysticercosis is the most common cause of seizures in Latino immigrants. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. 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. A mother might use cooling herbs to treat diaper rash, a hot condition. Demographics and Addiction. High level of belly fat or metabolic syndrome. 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. Journals. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. 15Glenn Flores, "Culture and the Patient-Physician Relationship: Achieving Cultural Competency in Health Care," Journal of Pediatrics 136 (January 2000): 14-23; see also Maria R. Warda, "Mexican Americans' Perceptions of Culturally Competent Care," Western Journal of Nursing Research 22/2 (2000): 203-224. 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. 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. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. Obesity and genetic factors increase risk. Switch to Chrome, Edge, Firefox or Safari. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. Our Future. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. Qualitative data analysis of the 75 symptom and treatment statements was completed, and data were grouped according to symptom and complexity of treatments. National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance use and mental health issues. 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 Pain Experience - NIMHD Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. 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. When in doubt, the best policy is to ask the patient how he or she would like to be addressed.26. After immigration, some Latios adopt American naming conventions, but others do not. These materials focus on the challenges that can confront Hispanics in American health care settings. Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Her husband died in an industrial accident four years ago, and she is still grieving. High cholesterol or dyslipidemia (unhealthy blood fat levels) . 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. Working With Hispanic and Latino Families - Child Welfare Missing data was handled using this carry-forward method. 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. "The Egg" in the Twenty-First Century: A Family's Holistic Healing and Substance Use and the Hispanic/Latino Population: What to Do? 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. Other health problems include stress, neurocysticercosis, and tuberculosis. 8Holly Mead et. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Lack of third party reimbursement for professional interpreter services exacerbates this problem. 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.
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