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Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Culturally competent care necessitates cross-cultural training, which is increasingly included in medical education, but with the realization that cultural competency is a lifelong learning process rather than an end in itself.8. Other health problems include stress, neurocysticercosis, and tuberculosis. Although patients of all cultural backgrounds warrant kindness, a personal connection, and respect, the consequences of omitting these traditional values may be more problematic with Latinos. 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. 5600 Fishers Lane, Rockville, MD 20857 Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. 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, You recommend a compromise treatment plan for her diabetes and grief. 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. "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. 14 Kleinman et. 11Jennifer Aguayo et. If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. Traditionally, conditions may be referred to as either "hot" or "cold". 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. Our Health. 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. Addressing patients properly can be another challenge. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). This inequality puts these communities at a higher risk for more severe and persistent forms of mental health conditions, because without treatment, mental health conditions often worsen. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. , may be one strategy to increase treatment . 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). 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. 1. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. Posttraumatic shock or anxiety may be attributed to susto (soul loss) rather than posttraumatic stress disorder. Cysticercosis is caused by consumption of contaminated with pork tapeworm. 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. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. Demographics and Addiction. Natural laxatives such as oil with orange juice (or just oil in some cases). 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). 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. . Abdominal pain may be attributed to empacho, or food stuck in the intestine. The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. For example . Methods Hispanic . al., "Racial and Ethnic Disparities," Chart 4-1. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. 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. It was developed specially to treat people between the ages of 3 and 18. Case 1: Delinquency or a Mental Health Problem: The Case of Pablo Sanchez, Case 3: From Chronic to Critical: End-of-Life Decisions. A chaperone is often appreciated if a same-sex physician is not available. 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. Latinos have disproportionately higher rates of obesity and diabetes mellitus. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. 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. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Modern Mexicans turn to old ways of childbirth. Latinos comprise the largest minority group in 20 of the 50 states. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. 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. 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. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Lack of third party reimbursement for professional interpreter services exacerbates this problem. Latinx/Hispanic Communities and Mental Health Mental Health America Offers information about mental health issues in Latinx/Hispanic communities, including demographics, prevalence, treatment issues, and more. Materials are available in English and Spanish. 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. 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. Call or text 988 or chat 988lifeline.org. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). See permissionsforcopyrightquestions and/or permission requests. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . 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. Low levels of hypertension awareness are a major problem in the Latino community. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. One suggestion she readily agrees to is to include nopales (prickly pear cactus pads), a favorite from her childhood in Mexico. 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 (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. Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). 7Hyon B. Shin and Rosalind Bruno, "Language Use and English-Speaking Ability: 2000," Census 2000 Brief, U.S. Census Bureau, October 2003, accessed at: www.census.gov/prod/2003pubs/c2kbr-29.pdf. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. 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. 1 (Sept. 2007). Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. 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. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn While this has been a challenge across patient populations, it has been especially pronounced among the U.S. Latino population, which shows a rate of non-adherence almost 40% higher than the rate seen in the U.S. Caucasian population. America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. Courtney Parker, CC BY. Notably, studies that disaggregate Hispanics by their ancestral origin may provide greater insight into the sources of ethnic disparities. Underwriting for these materials was provided by a generous anonymous donor. Older patients should be addressed as seor or seora rather than by their first names. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). 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. 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. 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. 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). The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. The material in this section is part of a larger project by the Markkula Center for Applied Ethics on culturally competent care; that is, health care that is sensitive to the differing values and needs of cultural subgroups within our pluralistic society. Author disclosure: No relevant financial affiliations to disclose. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Visit SAMHSA on Instagram Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. 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. 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. Davis Company, 1998): 397-421. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. Information. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. al., "Culture, Illness, and Care," 252. Linden tea and lemon grass tea for nerves (anxiety). 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. Her face lights up when you share this. Obesity and genetic factors increase risk. 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. Because many health beliefs and behaviors are culturally-based, it follows that when two different cultures come together in a health care setting, a collision of expectations often occurs. 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. 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. 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 . Using don or doa with the given or full name indicates even greater respect for older patients. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Interferon gammarelease screening tests are preferable to tuberculin skin testing in immigrants who have received the bacille Calmette-Gurin vaccine. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. 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. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) 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. 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. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. High cholesterol or dyslipidemia (unhealthy blood fat levels) . 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. 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). Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. Text: 435748 Missing data was handled using this carry-forward method. Visit SAMHSA on Twitter She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. Stigma of psychological treatment, belief that problems should be addressed at the family level (familismo), a misunderstanding or belief that treatment will not help with a child's behaviors, a . High level of belly fat or metabolic syndrome. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. 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. Fluegelman, Andrew, ed. Related letter: Chagas Disease Is a Consideration in Latino Patients. 4 Another. Asian or Hispanic ancestry. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. 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. Patients should be actively involved in their care rather than passively acquiescing to instructions. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). hispanic methods of treatmentfeminine form of lent in french. 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). 15 supp. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. Have a question about government service?