hispanic methods of treatment

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. 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. A chaperone is often appreciated if a same-sex physician is not available. National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance use and mental health issues. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . Combination therapy generally uses multiple treatment methods at once. Linden tea and lemon grass tea for nerves (anxiety). . Text: 435748 Identifying behavioral health problems is very important to the plan. 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. 50 percent of those with no usual health care provider are at least high school graduates. 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. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . 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. Latino culture has several normative values that must be recognized in clinical settings. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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, In this article I will make use of both terms, relying more heavily, however, on "Latino. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. Our Health. 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. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page After immigration, some Latios adopt American naming conventions, but others do not. 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. 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. high speed chase sumter sc 2021 marine city high school staff marine city high school staff Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. 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). Neurocysticercosis is the most common cause of seizures in Latino immigrants. Visit SAMHSA on Twitter Courtney Parker, CC BY. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. [4] By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. First among these, of course, is a language barrier. Journals. Demographics and Addiction. Apart from these language and socioeconomic disparities and variation in the way health care is envisioned and sought out, differences in the way values are ordered and articulated can also strain the clinical health care encounter for Latino patients. Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. 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. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. More than half of Hispanic young adults ages 18-25 with serious mental illness may not receive treatment. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. 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. 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. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. 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. 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. These terms are derived from the Spanish verb curar, which means to heal. Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). Lack of third party reimbursement for professional interpreter services exacerbates this problem. al., "Racial and Ethnic Disparities," Chart 4-1. 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. Talk. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Hence, the individual's good cannot be neatly separated from his or her community. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. Materials are available in English and Spanish. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). 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. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or "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. Topics. 3 percent report that they have trouble navigating the U.S. health care system. Using don or doa with the given or full name indicates even greater respect for older patients. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. 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. 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. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. Some trials examined overall CAM use, whereas others looked at. 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. 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. 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. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. Her husband died in an industrial accident four years ago, and she is still grieving. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. 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. 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. Home remedies, along with "lay healers" are also an integral part of the healthcare regimen for families in this culture. It was developed specially to treat people between the ages of 3 and 18. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. A mother might use cooling herbs to treat diaper rash, a hot condition. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). 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. 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. For those who have a serious mental health disorder, around 44 percent did not receive treatment. Cold water with lemon for high blood pressure. Plants are used on their own, or mixed together to form herbal remedies. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. . This is lower than the average of 43 percent for adults in the U.S. overall. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. Results: Teas were most commonly used for colic, upper respiratory tract symptoms, and abdominal pain. 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. 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. Abdominal pain may be attributed to empacho, or food stuck in the intestine. Approximately half (49.6%) of the patients were aged at least 65 years. Active Journals Find a Journal Proceedings Series. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. 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. Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. This content is owned by the AAFP. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. 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). Hispanic and Latino are often used interchangeably though they actually mean two different things. 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. 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. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). Rue for earache. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. 17.4% were Hispanic, and 49.1% were White. 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. There are likely many possible reasons for this, including poverty and lack of health insurance, and thus at best irregular access to health care; cultural factors that might cause patients to delay seeing a doctor, for example, the expectation that one should tolerate pain without complaint; and a belief that certain conditions (such as pregnancy) are natural and do not require medical attention. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. Information. Posttraumatic shock or anxiety may be attributed to susto (soul loss) rather than posttraumatic stress disorder. Older patients should be addressed as seor or seora rather than by their first names. For instance, Latino mothers may determine when medical care is warranted for a family member, though a male head of household may formally make the decision to send the family member to a medical center.16. 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. Interferon gammarelease screening tests are preferable to tuberculin skin testing in immigrants who have received the bacille Calmette-Gurin vaccine. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. 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. Get to know your fellow coach managers and direct reports. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. Genetics, environment, and life experiences can all have an impact on . You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. For example . Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. 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. Prayer was reported as helping to reduce stress and anxiety. Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319, Ethical Considerations for COVID-19 Vaccination, Hackworth Fellowships Project Showcase 2021, The Ethics of Going Back to School in a Pandemic, Systemic Racism, Police Brutality, and the Killing of George Floyd, COVID-19: Ethics, Health and Moving Forward, The Ethical Implications of Mass Shootings, Political Speech in the Age of Social Media, Point/Counterpoint: Democratic Legitimacy, Brett Kavanaugh and the Ethics of the Supreme Court Confirmation Process, https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf, Culturally Competent Care for Latino Patients. | Mar 1, 2011. There are also differences in drug use within the Hispanic population as shown in Figure 1. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. 10Mead et. 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. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. High cholesterol or dyslipidemia (unhealthy blood fat levels) . 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. 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. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). To sign up for updates or to access your subscriber preferences, please enter your contact information. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Yet the call for cultural competence can-at its best-urge practitioners to adopt instead a stance of cultural "humility": one which encourages an open mind, and a recognition that each one of us sees the world through our own very distinctive cultural lenses. Copyright 2023 American Academy of Family Physicians. Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . 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. 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. One suggestion she readily agrees to is to include nopales (prickly pear cactus pads), a favorite from her childhood in Mexico. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. 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. 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. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. "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. 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. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. 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.

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