Visit SAMHSA on Twitter 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. 13 Kaiser, "A Provider's Handbook," 6-7. Latino/Hispanic families can provide much support to a child with the disorder and protect him or her from the development of conduct problems (Bauermeister et al., 2005). In this article I will make use of both terms, relying more heavily, however, on "Latino. Conveying medical instructions to patients with limited English skills can be frustrating. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. Cold water with lemon for high blood pressure. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. Abdominal pain may be attributed to empacho, or food stuck in the intestine. For at least the past century, a relative lack of jobs in Mexico has been driving many Mexicans north in search of work. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. 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. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. 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. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. 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. Margaret E. "Group Methods and . Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. 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 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. 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). 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. Under-recognition of depression in adult Hispanic Americans may be related to language . She has three grown children: two still live in Mexico, and the third lives in a distant U.S. city. 50 percent of those with no usual health care provider are at least high school graduates. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Free and confidential support for people in distress, 24/7, Behavioral Health Treatment Services Locator Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). 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. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. hispanic methods of treatmentfeminine form of lent in french. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Fluegelman, Andrew, ed. 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. 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. It was developed specially to treat people between the ages of 3 and 18. Talk. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. 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. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. 11Jennifer Aguayo et. 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. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 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. High level of belly fat or metabolic syndrome. 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. Author disclosure: No relevant financial affiliations to disclose. This is lower than the average of 43 percent for adults in the U.S. overall. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Such patient activation or motivation for change is more challenging in foreign-born Latinos, but may be achieved through active dialogue and discussion.32 Hopeful involvement in the care plan should replace fatalism or resignation. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. . By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. To provide an updated understanding of folk and traditional medicine (FTM) among Hispanic parents in the United States, we surveyed 200 caregivers identifying their child as Hispanic in a pediatric primary care clinic about their cultural health beliefs and practices. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. 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. Asian or Hispanic ancestry. 3 percent report that they have trouble navigating the U.S. health care system. Barriers to care have resulted in striking disparities in quality of health care for these patients. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or 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. Contact USA.gov. 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. Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. 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). In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. After some negotiation, she agrees to see a dietitian and a bilingual counselor, and agrees to take just two medications, metformin (Glucophage) and lisinopril (Zestril), although she understands that they will not make her feel better right away. Courtney Parker, CC BY. 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. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. 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. Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. 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 . These terms are derived from the Spanish verb curar, which means to heal. 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 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. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). You call the dietitian to alert him to this patient's cultural concerns. 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. Materials are available in English and Spanish. Physicians cannot assume that all Latinos share these beliefs; many do not. 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. While Hispanic refers to language and those whose ancestry comes from a country where Spanish is spoken, Latino refers to geography. 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. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . Latino culture has several normative values that must be recognized in clinical settings. Using don or doa with the given or full name indicates even greater respect for older patients. hispanic methods of treatment. 14 Kleinman et. Cysticercosis is caused by consumption of contaminated with pork tapeworm. Methods Hispanic . Addressing patients properly can be another challenge. A chaperone is often appreciated if a same-sex physician is not available. 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. Linden tea and lemon grass tea for nerves (anxiety). During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. 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. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. 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.
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