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. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). Courtney Parker, CC BY. 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. A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Physicians cannot assume that all Latinos share these beliefs; many do not. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. high speed chase sumter sc 2021 marine city high school staff marine city high school staff 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. 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). It is the primary method used in hospitals. Cultural Barriers to Treatment and Compliance. Asian or Hispanic ancestry. 1. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. In either case, they are treated with the opposite hot or cold treatment. 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 teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. 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. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. 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]). Abdominal pain may be attributed to empacho, or food stuck in the intestine. 1-877-SAMHSA-7 (1-877-726-4727), SAMHSA.gov, Substance Abuse and Mental Health Services Administration, Buprenorphine Physician & Treatment Program Locator, Early Serious Mental Illness Treatment Locator, View All Helplines and Treatment Locators, Implementing Behavioral Health Crisis Care, Mental Health and Substance Use Disorders, Substance Abuse and Mental Health Prevention, Technology Transfer Centers (TTC) Program, State Targeted Response Technical Assistance (STR-TA), Clinical Support System for Serious Mental Illness (CSS-SMI), Suicide Prevention Resource Center (SPRC), African American Behavioral Health Center of Excellence, Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence (AANHPI-CoE), Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions, Center of Excellence for Protected Health Information 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Small Conversations Make a Big Impression, How To Tell If Your Child Is Drinking Alcohol, COVID-19 Information for SAMHSA Discretionary Grant Recipients, Training and Technical Assistance Related to COVID-19, Listening Session Comments on Substance Abuse Treatment Confidentiality Regulations, Advisory Committee for Womens Services (ACWS), Tribal Technical Advisory Committee (TTAC), Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), Interdepartmental Substance Use Disorders Coordinating Committee (ISUDCC), Interdepartmental Substance Use Disorders Coordinating Committee Biographical Information, Interdepartmental Substance Use Disorders Coordinating Committee Roster, Asian Americans, Native Hawaiians, and Pacific Islanders, Quality Practice and Workforce Development, The Behavioral Health Barometer: United States, Volume 6, National Survey on Drug Use and Health: Hispanics, Latino or Spanish Origin or Descent Individuals, Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S. (PDF | 426 KB), The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue, El alcohol y la depresin: El camino de Jorge hacia una vida mejor, Prevencin de la Sobredosis de Opioides Manual de Instruccin, Publicaciones de SAMHSA disponibles en espaol, quality practice and workforce development, Alcohol and the Hispanic Community from the National Institutes of Health National Institute on Alcohol Abuse and Alcoholism, Chartbook for Hispanic Health Care (Agency for Healthcare Research and Quality), Hispanic-Latino Mental Health (American Psychiatric Association), Latino Mental Health Facts (National Alliance on Mental Illness), Mental Health: A Guide for Latinos and Their Families (American Psychiatric Association) (22 minutes, 13 seconds), National Latino Behavioral Health Association (NLBHA), Behavioral Health Treatment Services Locator, Addiction Technology Transfer Center (ATTC), Mental Health Technology Transfer Center (MHTTC), Prevention Technology Transfer Center (PTTC), U.S. Department of Health & Human Services. 8Holly Mead et. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). A few candles were lit in the dark, curtained bedroom. SAMHSA Blog. The same is also applies to the substance abuse treatment. 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. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). dissertation, University of Southern Cali-fornia, 1973. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. 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. . 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. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Low levels of hypertension awareness are a major problem in the Latino community. For those who have a serious mental health disorder, around 44 percent did not receive treatment. 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. Garlic and onion are used extensively, as is aloe vera. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Information. A little more than 45 percent of all births in Mexico are Cesarean sections, which makes it one of the world's leaders in the practice. Cold water with lemon for high blood pressure. Latinos comprise the largest minority group in 20 of the 50 states. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 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. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. 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. Under-recognition of depression in adult Hispanic Americans may be related to language . This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. Get to know your fellow coach managers and direct reports. Methods We conducted a retrospective cohort study of antiretroviral-naive patients 18 years and older attending their first visit at Thomas Street Health Center in . 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. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page Other health problems include stress, neurocysticercosis, and tuberculosis. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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. Combination therapy generally uses multiple treatment methods at once. Switch to Chrome, Edge, Firefox or Safari. 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. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Her husband died in an industrial accident four years ago, and she is still grieving. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. by Marcia Carteret, M. Ed. 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. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Prayer was reported as helping to reduce stress and anxiety. 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). "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. The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. 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. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. 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. Hispanic and Latino are often used interchangeably though they actually mean two different things. 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. 1 (Sept. 2007). Hence, the individual's good cannot be neatly separated from his or her community. 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. www.behaviorfrontiers.com. Spanish language handouts are a better option. ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. 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. 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.
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