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Her husband died in an industrial accident four years ago, and she is still grieving. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. Get to know your fellow coach managers and direct reports. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. 58, Journal of . 4 Another. Hispanic people are the youngest population, with 33% below age 18, and 57% below age 34 (Figure 4). Latino healing traditions include curanderismo in Mexico and much of Latin America, Santeria in Brazil and Cuba, and espiritismo in Puerto Rico.19 Curanderos, traditional healers, distinguish between hot and cold illnesses (Table 220 ) and occasionally between natural and unnatural (sorcery-related) diseases.19,20 Patients may seek out the care of brujos or brujas (wizards or witches) for the latter conditions. 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. 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. 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. For instance, Latinos highly value family. They are written by health care providers and others who work with the relevant Latino sub-community. 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 . 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. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. Underwriting for these materials was provided by a generous anonymous donor. High cholesterol or dyslipidemia (unhealthy blood fat levels) . Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . 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. Plants are used on their own, or mixed together to form herbal remedies. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. Objective Breast cancer is the leading cause of cancer death among Hispanic women. Author disclosure: No relevant financial affiliations to disclose. Neurocysticercosis is the most common cause of seizures in Latino immigrants. 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. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Active Journals Find a Journal Proceedings Series. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). 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. Mozote (Bidens pilosa) to refresh and clean the stomach. 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. 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. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. Missing data was handled using this carry-forward method. 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. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn It was developed specially to treat people between the ages of 3 and 18. Identifying behavioral health problems is very important to the plan. Courtney Parker, CC BY. Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . 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. 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. Spanish language handouts are a better option. 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. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. For those who have a serious mental health disorder, around 44 percent did not receive treatment. Demographics and Addiction. One exception is the Methods for the Epidemiology of Child and Adolescent . 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. 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, Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). Linden tea and lemon grass tea for nerves (anxiety). 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 . 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. Our Health. 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. This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . Our Future. Latinos comprise the largest minority group in 20 of the 50 states. Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). According to a study done at UCLA, 15.7 percent of non-elderly Latinos in either fair or poor health, who are covered under MediCal or Healthy Families (both California low-income health insurance programs), report having no usual source of care but rather obtain their clinical health care on an ad-hoc basis, if at all.11, Some Latinos find their health care in non-clinical places, relying on folk medicine and traditional healers. 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. The cases and reflections illustrate the kinds of challenges patients and health care professionals face when they come from different cultures and speak different languages. Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . Cold water with lemon for high blood pressure. 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. Prayer was reported as helping to reduce stress and anxiety. 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. 14 Kleinman et. Latino culture has several normative values that must be recognized in clinical settings. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. 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. 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. 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. 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. 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. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. Cold linseed tea and hibiscus flower tea for diabetes. 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. 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 materials focus on the challenges that can confront Hispanics in American health care settings. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. In terms of health, on some measures Latinos are better off than other ethnic groups. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." 2U.S. 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. 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. 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. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. High level of belly fat or metabolic syndrome. Become an expert on our coaching methods, internal systems, processes, and technology. 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. 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. 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. 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. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. Visit SAMHSA on Twitter Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. National Network to Eliminate Disparities in Behavioral Health, SAMHSA National Survey on Drug Use and Health (NSDUH), AHRQ National Healthcare Quality and Disparities Reports, OMH National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards), 988 Suicide & Crisis Lifeline Physicians cannot assume that all Latinos share these beliefs; many do not. Patients should be actively involved in their care rather than passively acquiescing to instructions. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. This content is owned by the AAFP. 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. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. Information. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Margaret E. "Group Methods and . Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. 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. Davis Company, 1998): 397-421. 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. by Marcia Carteret, M. Ed. 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. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . 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). Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Garlic and onion are used extensively, as is aloe vera. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). You then schedule a return visit, during which an interpreter will be available. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. 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. 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. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. Low levels of hypertension awareness are a major problem in the Latino community. These terms are derived from the Spanish verb curar, which means to heal. 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. Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. National Prevention Week 2020 is about Our Lives. 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. 17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. SAMHSA Blog. Journals. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Despite a lack of U.S. studies, a Norwegian study found that although immigrants from tuberculosis-endemic regions did bring more strains of tuberculosis with them, they did not significantly contribute to the spread of tuberculosis within the resident population.18, Non-Latino physicians may be perplexed by references to folk healing and illness in Latino patients. 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. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. 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. She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children.
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