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). hispanic methods of treatment. 15 supp. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. 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. 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. 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. Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). 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. 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. 11Jennifer Aguayo et. Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. 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. 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. All Rights Reserved. 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. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. 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. For example . Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. These terms are derived from the Spanish verb curar, which means to heal. Fluegelman, Andrew, ed. 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. 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. 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. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. Spanish language handouts are a better option. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. 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. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. 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. ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. The LEARN technique can facilitate cross-cultural interviews. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . 4 Another. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. Cultural Barriers to Treatment and Compliance. From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. 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 . 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. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Hence, the individual's good cannot be neatly separated from his or her community. Home remedies, along with "lay healers" are also an integral part of the healthcare regimen for families in this culture. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page Thus, when working with diverse populations in the United States . 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. Hispanic and Latino are often used interchangeably though they actually mean two different things. 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). 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). A chaperone is often appreciated if a same-sex physician is not available. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. 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. 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. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). Author disclosure: No relevant financial affiliations to disclose. Related letter: Chagas Disease Is a Consideration in Latino Patients. 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. 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. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. These materials focus on the challenges that can confront Hispanics in American health care settings. Topics. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 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. 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. 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. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. A few candles were lit in the dark, curtained bedroom. Visit SAMHSA on Twitter Background Patients who are members of minority groups may be more likely than others to consult physicians of the same race or ethnic group, but little is known about the relation between. [4] 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. 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. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. For at least the past century, a relative lack of jobs in Mexico has been driving many Mexicans north in search of work. 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. Visit SAMHSA on Instagram They are also far more likely than whites to feel that they are treated unfairly by providers or by the medical system.8, These gaps and dissatisfactions become even more troubling in the context of significant disparities in access to health insurance and to the health care system in general. 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.
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