17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. 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 states have extremely large Latino populations; for instance, as of 2006, 36 percent of Californians (13.2 million people) identified themselves as Hispanic or Latino, as did 36 percent of Texans (8.6 million people). Methods Hispanic . Media Contact . Text: 435748 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. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. 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. 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. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. . This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. Latino culture has several normative values that must be recognized in clinical settings. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Objective Breast cancer is the leading cause of cancer death among Hispanic women. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how . Hispanics progress against racism but have long way to go - UNM Newsroom . A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. 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. Genetics, environment, and life experiences can all have an impact on . 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. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . 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. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. Approximately half (49.6%) of the patients were aged at least 65 years. 37% of Latinos have. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Caring for Latino Patients | AAFP 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]). Garlic and onion are used extensively, as is aloe vera. (PDF) Grieving and death rituals of Latinos - ResearchGate Intense but brief release of emotion thought to be caused by family conflict or anger, No immediate treatment other than calming the patient, Childhood condition characterized by irritability and diarrhea thought to be caused by abrupt withdrawal from the mother's breast, Holding the child upside down or applying gentle pressure to the hard palate, Constipation, cramps, or vomiting thought to be caused by overeating, Abdominal massage and herbal purgative teas; an egg passed over the abdomen supposedly sticks to the affected area, Steam inhalation and herbal treatments, including eucalyptus and mullein (gordolobo), Pelvic congestion and decreased libido thought to be caused by insufficient rest after childbirth, Cold air that is thought to cause respiratory infections and earaches, Steam baths, hot compresses, stimulating herbal teas, A hex cast on children, sometimes unconsciously, that is thought to be caused by the admiring gaze of someone more powerful, The hex can be broken if the person responsible for the hex touches the child, or if a healer passes an egg over the child's body; the egg is then broken into a bowl of water and placed under the child's bed; child may wear charms for protection, Unnatural illness that is not easily explained, Temporary paralysis of the face or limbs, often thought to be caused by a sudden hot-cold imbalance, Posttraumatic illness (e.g., shock, insomnia, depression, anxiety), Barrida ritual purification ceremony (herbs used to sweep patient's body) repeated until the patient improves, Eaten to alleviate hypertension and prevent arteriosclerosis; garlic juice is applied to stings and spider bites, Anticoagulant effect at high doses; avoid high doses in patients taking coumadin (Warfarin); high doses can cause heartburn and bad breath; reduces effectiveness of saquinavir (Invirase), Boiled flowers are used externally on bruises, For topical and homeopathic use only; avoid internal use (except for homeopathic preparations, which are considered safe); increased gastroenteritis and dyspnea risk with ingestion, Hepatotoxicity risk from pyrrolizidine alkaloids (in leaves) with high or prolonged doses, Spice used as antispasmodic and for upper respiratory infections; although promoted as a hypoglycemic agent, recent research is conflicting, Use with caution in patients taking hepatotoxic drugs; safe in usual food quantities, Cilantro (cilantro [leaf] or coriander [seed]), Tea used for anxiety, stomach cramps, and inflamed gums; more recently popularized for increasing the urinary excretion of heavy metals, No safety concerns, although there have been recalls because of salmonella and pesticide contamination, Oil used topically for toothache and bad breath, Eugenol in clove oil may affect blood clotting; toxic if ingested, especially in children, Tea or syrup used as an expectorant, a diuretic, and for constipation, liver problems, and gall stones; also used to induce menstruation, High doses may cause vomiting; avoid in pregnancy; no known interactions, Leaf tea used for anxiety and lethargy, most popular as an aphrodisiac, Theoretical concern of cyanogenic glycoside toxicity with higher doses, Tea used for intestinal parasites; herb is added to beans to prevent flatulence, Chenopodium oil is also used as an antihelmintic but may be toxic (ascaridole content), Tea used for upset stomach and menstrual cramps, and to prevent diarrhea, Long-term ingestion causes absinthism (trembling, vertigo, thirst, delirium); thujone in the essential oil is neurotoxic and may cause seizures, Boiled leaves used for asthma in vaporizers; popular in lozenges for sore throat; also sometimes used as topical disinfectant, Ingesting eucalyptus oil may cause vomiting, diarrhea, delirium, and convulsions; avoid using in vaporizers for children younger than six years, Tea used to treat cough and sore throat; one study reports use for otitis, No known safety concerns (insufficient data) or drug interactions, High doses may cause anticoagulant effects and excess gas or bloating, Fruit juice used for fever, upper respiratory infection (classic cooling herb), and hypertension, Weed leaf used externally for burns, bruises, mouth sores, and hemorrhoids; tea taken orally for respiratory infections, Eaten as part of diet; has antidiabetic, anti-inflammatory, and laxative properties; also used as hangover treatment and for hyperlipidemia, May inhibit drug absorption; excess consumption may cause diarrhea and nausea, Leaf tea used to treat cough, indigestion, and, Safe in small quantities in food, but contains monoterpene ketones, which can cause toxicity (intestinal irritation, kidney damage, abortion, seizures), Toxic herb used to induce menstruation and abort fetuses, Toxic; avoid oral use; may cause renal and hepatic damage; furocoumarins can cause skin photosensitivity, Tea from dried flowers used to relieve cough, Yerba buena (mints, including spearmint and, Mint tea relieves upset stomach and headaches, Safe in usual quantities, but spearmint oil is a mucous membrane irritant and potentially toxic when ingested, Topical use for burns; occasionally ingested, Safe for topical use; juice is relatively safe; ingestion of aloe resin (a purgative) may cause diarrhea, hypoglycemia, hypokalemia, and prolonged bleeding; potential interactions with hypoglycemics and cardiac glycosides, Safe as a food seasoning, toxic alveolitis reported from inhaling lemongrass oil, A Physician's Practical Guide to Culturally Competent Care, Hispanic Center of Excellence (Baylor College of Medicine and University of Texas-Pan American), Language Line Services (interpreter services), Office of Minority Health: Cultural Competency, Office of Minority Health: National Standards for Culturally and Linguistically Appropriate Services (CLAS), Oregon Health & Science University: Spanish education handouts for clinicians, Tool for Assessing Cultural Competence Training (TACCT) Resource Guide, Transcultural Nursing: Diversity in Health and Illness, University of Washington Medical Center: Culture Clues tip sheets. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. Natural laxatives such as oil with orange juice (or just oil in some cases). 13 Kaiser, "A Provider's Handbook," 6-7. Oregano tea for coughs. al., "Racial and Ethnic Disparities," Chart 5-2. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. Using don or doa with the given or full name indicates even greater respect for older patients. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. 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) 1 (Sept. 2007). 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. Low levels of hypertension awareness are a major problem in the Latino community. In today's United States, these terms are often thought . Cold linseed tea and hibiscus flower tea for diabetes. Courtney Parker, CC BY. Methods: Data from the National Mental Health Services Survey conducted in 2014 (N=13,015 facilities) and 2019 (N=12,345 facilities) were used to measure changes in the proportions of facilities that offered treatment in Spanish overall and by year, state, and proportion of Hispanic residents. Get to know your fellow coach managers and direct reports. 15 supp. 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. 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 consortium study defined distinct somatic cancer gene mutation patterns by race/ethnicity and sex among patients with early-onset colorectal cancer (CRC), yielding novel biological clues into early-onset CRC disparities. Hispanic Pain Experience - NIMHD (PDF) Counseling the Hispanic Client: Cuban Americans, Mexican What are the treatments for heroin use disorder? However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. 17.4% were Hispanic, and 49.1% were White. Copyright 2013 by the American Academy of Family Physicians. 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. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. hispanic methods of treatment In terms of health, on some measures Latinos are better off than other ethnic groups. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. 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. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. 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. Very often they have faced extremely hazardous conditions crossing the border-enduring hunger, dehydration, violence from vigilantes, rape, abuse, severe weather conditions and harsh treatment by border agents. Complementary and Alternative Medicine (CAM) and Healers - Geriatrics Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. While Hispanic refers to language and those whose ancestry comes from a country where Spanish is spoken, Latino refers to geography. Davis Company, 1998): 397-421. 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 1. Addiction Demographics: Substance Use in the US | Recovery.org 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. Cultural Barriers to Treatment and Compliance - Dimensions of Culture Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. All Rights Reserved. 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. Adherence Barriers to Antidepressants among an Urban Female Latino JCM | Free Full-Text | Systemic Disease Associations in a Cohort of Hispanic refers to people who speak Spanish and/or are descended from Spanish-speaking populations, while Latino refers to people who are from or descended from people from Latin America. How traditional medicine can play a key role in Latino health care 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. 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. More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Results: Teas were most commonly used for colic, upper respiratory tract symptoms, and abdominal pain. Bilingual posters and medical literature are an important starting point. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. Additionally, when a woman gets married, her husband's name may be appended to her father's name. They also must beware of the tendency toward "othering"; that is, the penchant to understand non-dominant groups as inferior, exotic, or deviant.17 Some efforts at cultural competence may incline toward these unhelpful postures. You then schedule a return visit, during which an interpreter will be available. Racial and Ethnic Health Inequities and Medicare | KFF In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. 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. See permissionsforcopyrightquestions and/or permission requests. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. Job Application for Bilingual Health Coach Manager at Virta Health Materials are available in English and Spanish. A 2020 review study found that those in the Hispanic community may face several barriers that affect access to treatment, including: higher rates of unemployment less likelihood of having. Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). Latinos often lack access to healthcare and have poor - Brookings 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. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. Hispanic cultural health beliefs and folk remedies - PubMed Lack of third party reimbursement for professional interpreter services exacerbates this problem. 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. Some trials examined overall CAM use, whereas others looked at. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. 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. Journals. Asian or Hispanic ancestry. 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. Folk Cures and Alternative Treatment Are Putting Hispanic Patients At The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. Latino/Hispanic cultural influences on assessing and - Parenting 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. 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. Hispanic/Latino Resources, Reports, Initiatives & More | SAMHSA A mother might use cooling herbs to treat diaper rash, a hot condition. Addressing patients properly can be another challenge. 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn 11Jennifer Aguayo et. 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. 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 this article I will make use of both terms, relying more heavily, however, on "Latino. About 23 percent of Latinos in the United States live in poverty.2. National Prevention Week 2020 is about Our Lives. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . Depression education fotonovela for engagement of Hispanic patients in 10Mead et. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. 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. Rue for earache. Abdominal pain may be attributed to empacho, or food stuck in the intestine. 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. Become an expert on our coaching methods, internal systems, processes, and technology.
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