. Latino culture has several normative values that must be recognized in clinical settings. 1 (Sept. 2007). Free and confidential support for people in distress, 24/7, Behavioral Health Treatment Services Locator Hispanics' experience with discrimination or being treated unfairly varies greatly by age. For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or Approximately half (49.6%) of the patients were aged at least 65 years. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. 12Arthur Kleinman, Leon Eisenberg, and Byron Good, "Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research," Annals of Internal Medicine 88: 251-258 (1978). 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. Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . 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]). Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. SAMHSA Blog. Media Contact . 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. 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. 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. Mexican Americans are much less likely to be treated for hypertension than non-Latino whites (35 versus 49 percent).11 Targeted public health campaigns are needed for hypertension, diabetes prevention, and weight control. Talk. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . Topics. Hispanic and Latino are often used interchangeably though they actually mean two different things. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page High level of belly fat or metabolic syndrome. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). 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). Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. 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. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. In terms of health, on some measures Latinos are better off than other ethnic groups. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Patients should be actively involved in their care rather than passively acquiescing to instructions. Visit SAMHSA on Twitter 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. needs and experience of less acculturated Latino clients who are mostly from Mexico and Central America, and represent a large segment of the Latino community in Southern California. They Hear You is SAMHSA's underage drinking prevention campaign that helps parents and caregivers start talking to their children early about the dangers of alcohol. 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. 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. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. 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. 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. Journals. Conveying medical instructions to patients with limited English skills can be frustrating. Become an expert on our coaching methods, internal systems, processes, and technology. Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). 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. 3 percent report that they have trouble navigating the U.S. health care system. 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. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. Davis Company, 1998): 397-421. www.behaviorfrontiers.com. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. Barriers to care have resulted in striking disparities in quality of health care for these patients. Keeping these cautionary notes in mind, the cases and commentaries in this section seek to address numerous issues that arise in the course of providing clinical health care for Latino patients of various backgrounds. 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. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. Fluegelman, Andrew, ed. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. 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. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. Hence, the individual's good cannot be neatly separated from his or her community. 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. 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. 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). Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. Underwriting for these materials was provided by a generous anonymous donor. 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. You then schedule a return visit, during which an interpreter will be available. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. Compared with non-Latino whites, Mexican Americans have up to a three times higher incidence of diabetes mellitus and a three times higher prevalence of obesity, but hypertension-related mortality is only 4 percent higher (not a significant difference). Posttraumatic shock or anxiety may be attributed to susto (soul loss) rather than posttraumatic stress disorder. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. To sign up for updates or to access your subscriber preferences, please enter your contact information. Information. While this has been a challenge across patient populations, it has been especially pronounced among the U.S. Latino population, which shows a rate of non-adherence almost 40% higher than the rate seen in the U.S. Caucasian population. . 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). The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." al., "Racial and Ethnic Disparities," Chart 5-2. (Kaiser Foundation Health Plan, 2001): 4. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). 108 17-00084 at Western Philippines University . Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. Older patients should be addressed as seor or seora rather than by their first names. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Among U.S. states, New Mexico has the highest percentage of Hispanic ancestry, at 47 percent (as of July 1, 2012). ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. A few candles were lit in the dark, curtained bedroom. Missing data was handled using this carry-forward method. When in doubt, the best policy is to ask the patient how he or she would like to be addressed.26. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Using don or doa with the given or full name indicates even greater respect for older patients. Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. 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. 1. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes.
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