Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. | Mar 1, 2011. 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. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). 50 percent of those with no usual health care provider are at least high school graduates. For example . Treatment referral and information, 24/7, Visit the SAMHSA Facebook page Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). Author disclosure: No relevant financial affiliations to disclose. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). www.behaviorfrontiers.com. This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Azarcon and greta (lead salts) and azogue (mercury) compounds, which are sometimes given for teething or empacho, are contraindicated.22 Some injuries have occurred with curandero treatment of caida de la mollera (fallen fontanel). Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. Cultural Barriers to Treatment and Compliance. 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. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Traditionally, conditions may be referred to as either "hot" or "cold". Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. "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. Genetics, environment, and life experiences can all have an impact on . In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . 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. 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). ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. Low levels of hypertension awareness are a major problem in the Latino community. 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. 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]). The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. 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. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. 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. 15 supp. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. 14 Kleinman et. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. 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. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. Although patients of all cultural backgrounds warrant kindness, a personal connection, and respect, the consequences of omitting these traditional values may be more problematic with Latinos. Objective Breast cancer is the leading cause of cancer death among Hispanic women. She says that since her husband died, she has lost interest in what might happen to her in the future. You recommend a compromise treatment plan for her diabetes and grief. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. Combination therapy generally uses multiple treatment methods at once. Text: 435748 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. Other health problems include stress, neurocysticercosis, and tuberculosis. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. 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. 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. Master the basics of the Virta Treatment and understand the full patient experience. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). High level of belly fat or metabolic syndrome. Copyright 2013 by the American Academy of Family Physicians. al., "Racial and Ethnic Disparities," Chart 4-1. Latino culture has several normative values that must be recognized in clinical settings. 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. 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. Hence, the individual's good cannot be neatly separated from his or her community. Abdominal pain may be attributed to empacho, or food stuck in the intestine. Interferon gammarelease screening tests are preferable to tuberculin skin testing in immigrants who have received the bacille Calmette-Gurin vaccine. 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. 10Mead et. hispanic methods of treatment. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. 58, Journal of . Davis Company, 1998): 397-421. Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. 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. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. 108 17-00084 at Western Philippines University . There are also differences in drug use within the Hispanic population as shown in Figure 1. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. Contact USA.gov. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. Obesity and genetic factors increase risk. 37% of Latinos have. 5600 Fishers Lane, Rockville, MD 20857 Courtney Parker, CC BY. 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. Lack of third party reimbursement for professional interpreter services exacerbates this problem. 13 Kaiser, "A Provider's Handbook," 6-7. 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. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. Remedies used for common pediatric illnesses and for the traditional folk illnesses: mal ojo(evil eye), empacho(blocked intestine), mollera caida(fallen fontanelle), and susto(fright). Thus, when working with diverse populations in the United States . 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. Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Oregano tea for coughs. 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. SAMHSA Blog. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. These terms are derived from the Spanish verb curar, which means to heal. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). hispanic methods of treatmentfeminine form of lent in french. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . Latinos have disproportionately higher rates of obesity and diabetes mellitus.