PDF Hispanic Culture and Healthcare in the United States Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. 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. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. In today's United States, these terms are often thought . The same is also applies to the substance abuse treatment. Latinos comprise the largest minority group in 20 of the 50 states. First among these, of course, is a language barrier. Some trials examined overall CAM use, whereas others looked at. Her face lights up when you share this. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. Davis Company, 1998): 397-421. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. Objective Breast cancer is the leading cause of cancer death among Hispanic women. 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. 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 . Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. 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. 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. High level of belly fat or metabolic syndrome. Behavior Frontiers Announces Data-Driven Treatment Outcomes These instructions can be studied by the patient or translated when time permits. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Conveying medical instructions to patients with limited English skills can be frustrating. 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). "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. 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. 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, Hypertension in Hispanics/Latinos: Epidemiology and Considerations for Physicians cannot assume that all Latinos share these beliefs; many do not. 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. high speed chase sumter sc 2021 marine city high school staff marine city high school staff 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. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. One way of describing the distinction is that modern Western doctors are primarily trained to diagnose and treat diseases (in a purely biomedical sense), while traditional healers approach the patient as one suffering from an illness-that is, a culturally located experience of sickness.12 Among some Latino subcultures, folk illnesses such as empacho (a digestive ailment), mal de ojo (the "evil eye"), mollera caida (fallen fontanelle), susto (fright illness), and nervios (vulnerability to stressful experiences) are commonly described; and traditional healers range from curanderos (Mexican healers) and sobadores (traditional masseuses and bone setters) to yerberos (herbalists) and espiritistas (spiritual healers).13 Reliance on folk medicine certainly is not to be found in every, or even most, Latino communities; but it does exist as part of the health care landscape and is found among many patients from Mexico, as well as from various other regions within Latin America. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. 8Holly Mead et. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. 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." PDF Folk Medicine and Traditional Healing Basics - NATIONAL CENTER FOR al., "Racial and Ethnic Disparities," Chart 4-1. Neurocysticercosis, a leading cause of seizures in Mexico, and pulmonary tuberculosis are more common in Latino immigrants.10 Interferon gammarelease assay blood testing for tuberculosis is now preferred over tuberculin skin testing in immigrants with a history of bacille Calmette-Gurin vaccination because of a high rate of false-positive results with skin testing (although skin testing is still recommended for children younger than five years).13 Publicized fears of contagion from illegal immigration may be overblown. 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. Use of Folk Remedies in a Hispanic Population | JAMA Pediatrics | JAMA 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. PDF Culturally Sensitive and Creative Therapy With Latino Clients Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Respondents using these herbs reported never replacing their medical regimens with herbs. 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. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Latinx/Hispanic Communities and Mental Health We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. hispanic methods of treatment 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. 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. 13 Kaiser, "A Provider's Handbook," 6-7. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). 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. 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. The Role of Black and Hispanic Physicians in Providing Health Care for From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. 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 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. 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. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. 50 percent of those with no usual health care provider are at least high school graduates. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. Other health problems include stress, neurocysticercosis, and tuberculosis. Treatment Outcomes in Undocumented Hispanic Immigrants with HIV - PLOS US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. Her husband died in an industrial accident four years ago, and she is still grieving. 5600 Fishers Lane, Rockville, MD 20857 A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . 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. These numbers include Mexican-Americans, Puerto Ricans, Central and South Americans, Cubans, and many other communities although, throughout California, the vast majority of Latinos identify themselves as of Mexican background. Media Contact . Have a question about government service? Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . Obesity and genetic factors increase risk. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . 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). The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. Poor communication with health care providers is often an issue. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Margaret E. "Group Methods and . Substance Use and the Hispanic/Latino Population: What to Do? 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. 11Jennifer Aguayo et. 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). Volume 13 Issue 3 | Cancer Discovery | American Association for Cancer 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). She says that since her husband died, she has lost interest in what might happen to her in the future. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. Some cultural barriers may be overcome by using the teach back technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients. Responding to health and social needs of aging Latinos in new-growth 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. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. After immigration, some Latios adopt American naming conventions, but others do not. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. "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. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. 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. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. 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. Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. To sign up for updates or to access your subscriber preferences, please enter your contact information. (PDF) Grieving and death rituals of Latinos - ResearchGate 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. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. placed on religious beliefs in the maintenance of health and the treatment of illness. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. Plants are used on their own, or mixed together to form herbal remedies. 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. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. Missing data was handled using this carry-forward method. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Our Health. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Depression in US Hispanics: Diagnostic and Management Considerations in Still, being aware of these larger values may help health care providers to understand a particular patient's behaviors and actions in the context of larger cultural inclinations. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. 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. 1 (Sept. 2007). Prayer was reported as helping to reduce stress and anxiety. hispanic methods of treatment. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . hispanic methods of treatment Our Future. 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. Trauma-Focused CBT for Effective PTSD & Trauma Treatment 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. 1. Complementary and Alternative Medicine Use Among Hispanics - Medscape SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. 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. Among U.S. states, New Mexico has the highest percentage of Hispanic ancestry, at 47 percent (as of July 1, 2012). 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 10Mead et. These terms are derived from the Spanish verb curar, which means to heal. Yet Latinos are at particular risk for diabetes mellitus, tuberculosis, hypertension, HIV/AIDS, alcoholism, cirrhosis, and death from violence.4 There is also a disproportionately high prevalence of acute care in the treatment of Latinos; that is, too often patients delay medical care until their conditions worsen and necessitate immediate attention.
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