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. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Other health problems include stress, neurocysticercosis, and tuberculosis. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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. Plants are used on their own, or mixed together to form herbal remedies. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Master the basics of the Virta Treatment and understand the full patient experience. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. 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. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 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. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. These instructions can be studied by the patient or translated when time permits. Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or Similarly, a patient's silence when presented with a difficult treatment plan, rather than conveying agreement, may in fact indicate that patient's desire to maintain a polite relationship with the health care provider and avoid difficult or conflictual situations. 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. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. SAMHSA Blog. 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." She says that since her husband died, she has lost interest in what might happen to her in the future. 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. The commentaries provide perspective and insight on what went right, what went wrong, and how things might have gone differently in these culturally challenging situations. You then schedule a return visit, during which an interpreter will be available. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page 8Holly Mead et. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. 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. [4] Home remedies, along with "lay healers" are also an integral part of the healthcare regimen for families in this culture. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. 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. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. Underwriting for these materials was provided by a generous anonymous donor. 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). Bilingual posters and medical literature are an important starting point. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. 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. Garlic and onion are used extensively, as is aloe vera. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. 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 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. 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. 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. By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Barriers to care have resulted in striking disparities in quality of health care for these patients. Talk. For instance, 2002 estimates of life expectancy for Latinos was 77.2/83.7 years (male/female) compared to 68.4/75.1 for African-Americans and 74.7/80.1 for non-Hispanic whites.3 Latinos are less likely than non-Hispanic whites and African-Americans to suffer from heart disease (which is nevertheless the leading cause of death in all three groups). 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). During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. 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. For at least the past century, a relative lack of jobs in Mexico has been driving many Mexicans north in search of work. 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. 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. Demographics and Addiction. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. 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. 108 17-00084 at Western Philippines University . Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. "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. Media Contact . Additionally, when a woman gets married, her husband's name may be appended to her father's name. 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. Respondents using these herbs reported never replacing their medical regimens with herbs. After immigration, some Latios adopt American naming conventions, but others do not. 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. 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. 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. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. 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 . By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. 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. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. 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. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. 1. The LEARN technique can facilitate cross-cultural interviews. Poor communication with health care providers is often an issue. 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. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Physicians cannot assume that all Latinos share these beliefs; many do not. 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. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. Objective Breast cancer is the leading cause of cancer death among Hispanic women. 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. 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. 58, Journal of . al., "Culture, Illness, and Care," 252. hispanic methods of treatmentfeminine form of lent in french. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. 35% less heart disease and 49% less cancer; A lower death rate overall, but about a 50% higher death rate from diabetes; 24% more poorly controlled high blood pressure; 23% more obesity; 28% less colorectal screening. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. 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 . 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.