Low levels of hypertension awareness are a major problem in the Latino community. They are also far more likely than whites to feel that they are treated unfairly by providers or by the medical system.8, These gaps and dissatisfactions become even more troubling in the context of significant disparities in access to health insurance and to the health care system in general. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Conveying medical instructions to patients with limited English skills can be frustrating. 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. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. Racial Disparities in Hypertension Prevalence and Management: A Crisis Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. In either case, they are treated with the opposite hot or cold treatment. . Information. 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 . Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. 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. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. 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). . 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. Working With Hispanic and Latino Families - Child Welfare However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. 2U.S. 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). Hispanic and Latino are often used interchangeably though they actually mean two different things. The Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. 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. She says that since her husband died, she has lost interest in what might happen to her in the future. Have a question about government service? Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). 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. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. You call the dietitian to alert him to this patient's cultural concerns. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 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. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. Mozote (Bidens pilosa) to refresh and clean the stomach. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . Media Contact . These broad generalizations are just that: broad generalizations. Neurocysticercosis is the most common cause of seizures in Latino immigrants. Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. They are written by health care providers and others who work with the relevant Latino sub-community. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 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. 4 Another. 37% of Latinos have. 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. Delgado melvin activities and hispanic groups issues (Kaiser Foundation Health Plan, 2001): 4. 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. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. 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. New Drugs For Treating Fatty Liver Disease And Cirrhosis Chapter 6 Mental Health Care for Hispanic Americans Intense but brief release of emotion thought to be caused by family conflict or anger, No immediate treatment other than calming the patient, Childhood condition characterized by irritability and diarrhea thought to be caused by abrupt withdrawal from the mother's breast, Holding the child upside down or applying gentle pressure to the hard palate, Constipation, cramps, or vomiting thought to be caused by overeating, Abdominal massage and herbal purgative teas; an egg passed over the abdomen supposedly sticks to the affected area, Steam inhalation and herbal treatments, including eucalyptus and mullein (gordolobo), Pelvic congestion and decreased libido thought to be caused by insufficient rest after childbirth, Cold air that is thought to cause respiratory infections and earaches, Steam baths, hot compresses, stimulating herbal teas, A hex cast on children, sometimes unconsciously, that is thought to be caused by the admiring gaze of someone more powerful, The hex can be broken if the person responsible for the hex touches the child, or if a healer passes an egg over the child's body; the egg is then broken into a bowl of water and placed under the child's bed; child may wear charms for protection, Unnatural illness that is not easily explained, Temporary paralysis of the face or limbs, often thought to be caused by a sudden hot-cold imbalance, Posttraumatic illness (e.g., shock, insomnia, depression, anxiety), Barrida ritual purification ceremony (herbs used to sweep patient's body) repeated until the patient improves, Eaten to alleviate hypertension and prevent arteriosclerosis; garlic juice is applied to stings and spider bites, Anticoagulant effect at high doses; avoid high doses in patients taking coumadin (Warfarin); high doses can cause heartburn and bad breath; reduces effectiveness of saquinavir (Invirase), Boiled flowers are used externally on bruises, For topical and homeopathic use only; avoid internal use (except for homeopathic preparations, which are considered safe); increased gastroenteritis and dyspnea risk with ingestion, Hepatotoxicity risk from pyrrolizidine alkaloids (in leaves) with high or prolonged doses, Spice used as antispasmodic and for upper respiratory infections; although promoted as a hypoglycemic agent, recent research is conflicting, Use with caution in patients taking hepatotoxic drugs; safe in usual food quantities, Cilantro (cilantro [leaf] or coriander [seed]), Tea used for anxiety, stomach cramps, and inflamed gums; more recently popularized for increasing the urinary excretion of heavy metals, No safety concerns, although there have been recalls because of salmonella and pesticide contamination, Oil used topically for toothache and bad breath, Eugenol in clove oil may affect blood clotting; toxic if ingested, especially in children, Tea or syrup used as an expectorant, a diuretic, and for constipation, liver problems, and gall stones; also used to induce menstruation, High doses may cause vomiting; avoid in pregnancy; no known interactions, Leaf tea used for anxiety and lethargy, most popular as an aphrodisiac, Theoretical concern of cyanogenic glycoside toxicity with higher doses, Tea used for intestinal parasites; herb is added to beans to prevent flatulence, Chenopodium oil is also used as an antihelmintic but may be toxic (ascaridole content), Tea used for upset stomach and menstrual cramps, and to prevent diarrhea, Long-term ingestion causes absinthism (trembling, vertigo, thirst, delirium); thujone in the essential oil is neurotoxic and may cause seizures, Boiled leaves used for asthma in vaporizers; popular in lozenges for sore throat; also sometimes used as topical disinfectant, Ingesting eucalyptus oil may cause vomiting, diarrhea, delirium, and convulsions; avoid using in vaporizers for children younger than six years, Tea used to treat cough and sore throat; one study reports use for otitis, No known safety concerns (insufficient data) or drug interactions, High doses may cause anticoagulant effects and excess gas or bloating, Fruit juice used for fever, upper respiratory infection (classic cooling herb), and hypertension, Weed leaf used externally for burns, bruises, mouth sores, and hemorrhoids; tea taken orally for respiratory infections, Eaten as part of diet; has antidiabetic, anti-inflammatory, and laxative properties; also used as hangover treatment and for hyperlipidemia, May inhibit drug absorption; excess consumption may cause diarrhea and nausea, Leaf tea used to treat cough, indigestion, and, Safe in small quantities in food, but contains monoterpene ketones, which can cause toxicity (intestinal irritation, kidney damage, abortion, seizures), Toxic herb used to induce menstruation and abort fetuses, Toxic; avoid oral use; may cause renal and hepatic damage; furocoumarins can cause skin photosensitivity, Tea from dried flowers used to relieve cough, Yerba buena (mints, including spearmint and, Mint tea relieves upset stomach and headaches, Safe in usual quantities, but spearmint oil is a mucous membrane irritant and potentially toxic when ingested, Topical use for burns; occasionally ingested, Safe for topical use; juice is relatively safe; ingestion of aloe resin (a purgative) may cause diarrhea, hypoglycemia, hypokalemia, and prolonged bleeding; potential interactions with hypoglycemics and cardiac glycosides, Safe as a food seasoning, toxic alveolitis reported from inhaling lemongrass oil, A Physician's Practical Guide to Culturally Competent Care, Hispanic Center of Excellence (Baylor College of Medicine and University of Texas-Pan American), Language Line Services (interpreter services), Office of Minority Health: Cultural Competency, Office of Minority Health: National Standards for Culturally and Linguistically Appropriate Services (CLAS), Oregon Health & Science University: Spanish education handouts for clinicians, Tool for Assessing Cultural Competence Training (TACCT) Resource Guide, Transcultural Nursing: Diversity in Health and Illness, University of Washington Medical Center: Culture Clues tip sheets. PDF Culturally Sensitive and Creative Therapy With Latino Clients Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. 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. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Linden tea and lemon grass tea for nerves (anxiety). Use of Folk Remedies in a Hispanic Population | JAMA Pediatrics | JAMA The term "Latino" has become more commonly used in recent years to describe those whose primary ethnic heritage stems from Latin America. Behavior Frontiers Announces Data-Driven Treatment Outcomes 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. Prayer was reported as helping to reduce stress and anxiety. Treatment Outcomes in Undocumented Hispanic Immigrants with HIV - PLOS 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. "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. 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. 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. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. 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. Depression education fotonovela for engagement of Hispanic patients in For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. 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. Hispanic refers to people who speak Spanish and/or are descended from Spanish-speaking populations, while Latino refers to people who are from or descended from people from Latin America. Increasing Cultural Sensitivity in Existing Treatment Approaches For Latinos, interpersonal warmth is very important, and when a therapist is experienced as "cold" or 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. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) After immigration, some Latios adopt American naming conventions, but others do not. 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. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Physicians cannot assume that all Latinos share these beliefs; many do not. The cultural value of modestia (modesty), which is related to respect, is often neglected.27 Latinos may be conservative in this area, and physical exposure should be negotiated as the examination warrants. Demographics and Addiction. 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). 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. Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. Hispanic cultural health beliefs and folk remedies - PubMed Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. 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. Hispanic/Latino Resources, Reports, Initiatives & More | SAMHSA The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. 3 percent report that they have trouble navigating the U.S. health care system. Copyright 2023 American Academy of Family Physicians. Cultural Health Beliefs and Practices Among Hispanic Parents Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. 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. al., "Racial and Ethnic Disparities," Chart 4-1. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). hispanic methods of treatmentfeminine form of lent in french. Author disclosure: No relevant financial affiliations to disclose. They are a starting point, not an ending point; in other words, they call practitioners to look more deeply into the particular cultural, linguistic, and socioeconomic contours of their patients' backgrounds and to open themselves to alternative ways of understanding and interpreting their patients' actions and requests. Responding to health and social needs of aging Latinos in new-growth For at least the past century, a relative lack of jobs in Mexico has been driving many Mexicans north in search of work. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. 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. The Role of Black and Hispanic Physicians in Providing Health Care for 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. Get to know your fellow coach managers and direct reports. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Fluegelman, Andrew, ed. Active Journals Find a Journal Proceedings Series. PDF Hispanic Culture and Healthcare in the United States Oregano tea for coughs. Three types of medications include: (1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids.
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