Call or text 988 or chat 988lifeline.org. 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). 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. 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. 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). Spanish language handouts are a better option. She agrees to start taking medications, but does not refill her prescriptions or lose weight. Table 3 lists some common Latino folk illnesses, their symptoms, and treatment.19 Therapies for these conditions may seem odd, but most are harmless, with a few exceptions. This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. "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. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. 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. 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. Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . Treatment referral and information, 24/7, Visit the SAMHSA Facebook page Additionally, when a woman gets married, her husband's name may be appended to her father's name. 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. 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. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. 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. Bilingual posters and medical literature are an important starting point. 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. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. 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. al., "Culture, Illness, and Care," 252. 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 Patients should be actively involved in their care rather than passively acquiescing to instructions. It was developed specially to treat people between the ages of 3 and 18. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Patient activation will help motivate the patient to become involved in his or her own care. It is the primary method used in hospitals. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. This is lower than the average of 43 percent for adults in the U.S. overall. SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. These terms are derived from the Spanish verb curar, which means to heal. 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. 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. 10Mead et. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. Materials are available in English and Spanish. Fluegelman, Andrew, ed. using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. There are also differences in drug use within the Hispanic population as shown in Figure 1. In either case, they are treated with the opposite hot or cold treatment. 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. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. 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. savoie's real cajun dressing mix; PURPOSE Though patient variables are likely to play an important role in the undertreatment of depression, little is known of patients' perceptions of standard depression treatments. Methods Hispanic . A few candles were lit in the dark, curtained bedroom. Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. A mother might use cooling herbs to treat diaper rash, a hot condition. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. 1 (Sept. 2007). Addressing patients properly can be another challenge. In an NIMHD-funded study, Hirsh and a graduate student, Nicole Hollingshead, are testing whether a computer-simulated intervention can change doctors' attitudes and lead to better treatment for African Americans. Courtney Parker, CC BY. 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. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. This traditional food is high in fiber and pectin and lowers lipid levels by binding bile acids; when eaten with other foods, it reduces the glycemic index of the meal by 50 percent. SAMHSA Blog. 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. They are written by health care providers and others who work with the relevant Latino sub-community. 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). Hispanic and Latino are often used interchangeably though they actually mean two different things. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. Identifying behavioral health problems is very important to the plan. Under-recognition of depression in adult Hispanic Americans may be related to language . Using don or doa with the given or full name indicates even greater respect for older patients. Related letter: Chagas Disease Is a Consideration in Latino Patients. 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. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Objective Breast cancer is the leading cause of cancer death among Hispanic women. 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). These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. 8Holly Mead et. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . After immigration, some Latios adopt American naming conventions, but others do not. Life expectancy at age 65 has improved since the enactment of Medicare among all older adults but is lower for Black adults than White or Hispanic adults (18.0, 19.4, and 21.4 years, respectively . | Mar 1, 2011. Latinos have disproportionately higher rates of obesity and diabetes mellitus. 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. Your efforts pay off at the next visit, when Maria expresses much more interest in controlling her diabetes and shows personal warmth that was missing from earlier encounters. As with any circumscribed ethnic group, there is, of course, enormous cultural heterogeneity among Latino patients-to the point where it seems almost ludicrous to try to identify broad cultural tendencies across such diversity. hispanic methods of treatmentfeminine form of lent in french. 15 supp. . 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." 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. To sign up for updates or to access your subscriber preferences, please enter your contact information. 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). She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. 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. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. Cold water with lemon for high blood pressure. 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. 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. 11Jennifer Aguayo et. These broad generalizations are just that: broad generalizations. 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. Visit behavioral health equity resources for select SAMHSA in-language resources and quality practice and workforce development for select SAMHSA OBHE webinars and blog posts. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. Hence, the individual's good cannot be neatly separated from his or her community. Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Lack of third party reimbursement for professional interpreter services exacerbates this problem. 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. dissertation, University of Southern Cali-fornia, 1973. 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. Cultural Barriers to Treatment and Compliance. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. 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. 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). 4 Another. Barriers to care have resulted in striking disparities in quality of health care for these patients. Hispanic people are the youngest population, with 33% below age 18, and 57% below age 34 (Figure 4). The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." 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. 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. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. One exception is the Methods for the Epidemiology of Child and Adolescent . The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 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. Get to know your fellow coach managers and direct reports. Low levels of hypertension awareness are a major problem in the Latino community. Among Hispanics who needed but did not receive treatment in the past year, 95.8% did not feel the need for it, 2.2% felt the need for treatment but did not make an effort to get it, and 2.0% felt the need for treatment and did make an effort to get it. Thus, when working with diverse populations in the United States . About 23 percent of Latinos in the United States live in poverty.2. 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. 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. 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. 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. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Other health problems include stress, neurocysticercosis, and tuberculosis. Her husband died in an industrial accident four years ago, and she is still grieving. 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. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. Plants are used on their own, or mixed together to form herbal remedies. 17.4% were Hispanic, and 49.1% were White. Visit SAMHSA on Twitter Hispanics have different degrees of illness or health risks than whites. 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. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. Census Bureau News, "U.S. Hispanic Population Surpasses 45 Million," Press Release, Thursday, May 1, 2008; U.S. Census Bureau, "Hispanic Americans By the Numbers," accessed at www.infoplease.com/spot/hhmcensus1.html; and U.S. Census Bureau, "State and County QuickFacts: Santa Clara County, California," 2006, accessed at http://quickfacts.census.gov. by Marcia Carteret, M. Ed. Asian or Hispanic ancestry. Combination therapy generally uses multiple treatment methods at once. Our Future. Home remedies, along with "lay healers" are also an integral part of the healthcare regimen for families in this culture. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. She might also stop giving her infant vitamins, because they are a hot therapy.24 It is often possible to safely accommodate conventional and alternative treatments (in reasonable doses) if potential conflicts or interactions are identified in advance. Latino culture has several normative values that must be recognized in clinical settings. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). 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. 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. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. Become an expert on our coaching methods, internal systems, processes, and technology. 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. Linden tea and lemon grass tea for nerves (anxiety). Some trials examined overall CAM use, whereas others looked at. Copyright 2023 American Academy of Family Physicians. 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. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. 5600 Fishers Lane, Rockville, MD 20857 Again, it is imperative to stress that these values represent broad generalizations that may or may not apply to any individual patient or in any given situation. In terms of health, on some measures Latinos are better off than other ethnic groups. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. Oregano tea for coughs. 50 percent of those with no usual health care provider are at least high school graduates. (Kaiser Foundation Health Plan, 2001): 4. 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). Neurocysticercosis is the most common cause of seizures in Latino immigrants. al., "Racial and Ethnic Disparities," Chart 5-2. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). Our Health. 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. Still, at the risk of oversimplifying, several trends emerge: -simpatia-politeness and the avoidance of hostile confrontation -personalismo-the value of warm personal interaction -respeto-the importance of showing respect to authority figures, usually including health care providers -familismo-collective loyalty to extended family and commitment to family obligation; -fatalismo-the belief that individuals cannot do much to alter fate15. Recent immigrants often feel lonely and can have culture shock, fears of deportation, and financial problems; depressed mood may manifest as headaches and somatic symptoms. Media Contact . Underwriting for these materials was provided by a generous anonymous donor. Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity.
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