hispanic methods of treatment

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. There are also differences in drug use within the Hispanic population as shown in Figure 1. Objective Breast cancer is the leading cause of cancer death among Hispanic women. This is lower than the average of 43 percent for adults in the U.S. overall. 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). The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. 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 . 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). This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. In today's United States, these terms are often thought . These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Have a question about government service? Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. 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. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. 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. Treatment of Various Ocular Manifestation of Systemic Lupus Erythematosus with Therapeutic Plasma Exchange. This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. Methods Hispanic . A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . Importantly, many Latinos themselves prefer the latter term, since it avoids reference to the more recent European colonial powers (from "Hispania," or the Iberian Peninsula) that laid claim to Latin America in the fifteenth and sixteenth centuries. Thus, when working with diverse populations in the United States . The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. Cold water with lemon for high blood pressure. You call the dietitian to alert him to this patient's cultural concerns. 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. www.behaviorfrontiers.com. For Latino/Hispanic adults suffering from any type of mental health disorder, roughly 67 percent did not receive treatment. By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. 108 17-00084 at Western Philippines University . 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). 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. 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. "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. 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." 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. Cold linseed tea and hibiscus flower tea for diabetes. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. 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. . In either case, they are treated with the opposite hot or cold treatment. The Hispanic culture differs from that of America despite the ever-growing integration of both populations. hispanic methods of treatmentfeminine form of lent in french. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . 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. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. 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. 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. Text: 435748 Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. In this article I will make use of both terms, relying more heavily, however, on "Latino. Some trials examined overall CAM use, whereas others looked at. Author disclosure: No relevant financial affiliations to disclose. Switch to Chrome, Edge, Firefox or Safari. 3 percent report that they have trouble navigating the U.S. health care system. 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. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Materials are available in English and Spanish. Copyright 2013 by the American Academy of Family Physicians. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . Our Health. Genetics, environment, and life experiences can all have an impact on . 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. High cholesterol or dyslipidemia (unhealthy blood fat levels) . 50 percent of those with no usual health care provider are at least high school graduates. Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. Barriers to care have resulted in striking disparities in quality of health care for these patients. 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. National Network to Eliminate Disparities in Behavioral Health, SAMHSA National Survey on Drug Use and Health (NSDUH), AHRQ National Healthcare Quality and Disparities Reports, OMH National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards), 988 Suicide & Crisis Lifeline Under-recognition of depression in adult Hispanic Americans may be related to language . Interferon gammarelease screening tests are preferable to tuberculin skin testing in immigrants who have received the bacille Calmette-Gurin vaccine. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . 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. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). . Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. She says that she does not feel better when taking the medicine, and says the diet you prescribed does not include tortillas or any of the foods she likes. Patient activation will help motivate the patient to become involved in his or her own care. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. National Prevention Week 2020 is about Our Lives. Respondents using these herbs reported never replacing their medical regimens with herbs. 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. Information. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 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. Contact USA.gov. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. 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). 4Center for Disease Control and Prevention, "Leading Causes of Death," accessed at www.cdc.gov/men/lcod/index.htm; and Richard Allen Williams, "Cultural Diversity, Health Care Disparities, and Cultural Competency in American Medicine," Journal of the American Academy of Orthopedic Surgeons, Vol. Lack of third party reimbursement for professional interpreter services exacerbates this problem. Results: Teas were most commonly used for colic, upper respiratory tract symptoms, and abdominal pain. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . Hispanic Heritage Month, September 15 - October 15, is an important opportunity to raise awareness about these trends and more importantly, identify culturally and linguistically appropriate prevention and treatment strategies to reduce mental and substance use disorders in the Hispanic/Latino population. Physicians cannot assume that all Latinos share these beliefs; many do not. Fluegelman, Andrew, ed. For example . Talk. If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Visit the SAMHSA YouTube channel, Visit SAMHSA on LinkedIn 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. Courtney Parker, CC BY. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Because of less access to health care, Latinos with diabetes are often diagnosed later and have a greater risk of complications.15,16 Despite these unfavorable health and socioeconomic statistics, overall mortality is lower than would be expectedan anomaly termed the Hispanic paradox.17 Latinos live an average of 2.5 years longer than non-Latino whites (to 80 years, seven months of age) and 7.7 years longer than non-Latino blacks.1 It is not known what protective factors exist, but immigrant hardiness, social integration, and diet may have a role.1 Raising awareness about the consequences of obesity is necessary in Latino communities, especially because being somewhat overweight (gordito) can be considered healthy. 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. 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. 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. 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). Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. Obesity and genetic factors increase risk. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. 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. 14 Kleinman et. 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. Using don or doa with the given or full name indicates even greater respect for older patients. 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. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. 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. 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. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. These may include antioxidants, probiotics, or a combination of medications to target any of the contributing factors. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. 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. 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. Latinos comprise the largest minority group in 20 of the 50 states. Hispanics have different degrees of illness or health risks than whites. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. Journals. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. While not considering Hispanics as a distinct race, the U.S. Census (utilizing federally delineated categories) defines someone "Hispanic" or "Latino" as "a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Additionally, within this family-centric decision making structure, there may be particular gender-based roles. These broad generalizations are just that: broad generalizations. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. According to a study done at UCLA, 15.7 percent of non-elderly Latinos in either fair or poor health, who are covered under MediCal or Healthy Families (both California low-income health insurance programs), report having no usual source of care but rather obtain their clinical health care on an ad-hoc basis, if at all.11, Some Latinos find their health care in non-clinical places, relying on folk medicine and traditional healers. 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. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." Low levels of hypertension awareness are a major problem in the Latino community. There is ample evidence that Latinos, especially those of Mexican and Central American origin, face significant obstacles to obtaining health care, especially language barriers.4 Many hospitals and offices lack trained interpreters and rely on ad hoc interpretation by bilingual staff or even the children of patients. Bilingual posters and medical literature are an important starting point. hispanic methods of treatment. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. 15 supp. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. They are written by health care providers and others who work with the relevant Latino sub-community. 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. Natural laxatives such as oil with orange juice (or just oil in some cases). 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. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. 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. In an NIMHD-funded study, Hirsh and a graduate student, Nicole Hollingshead, are testing whether a computer-simulated intervention can change doctors' attitudes and lead to better treatment for African Americans. 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. These instructions can be studied by the patient or translated when time permits. Identifying behavioral health problems is very important to the plan. Garlic and onion are used extensively, as is aloe vera. Rue for earache. It is the primary method used in hospitals. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. 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 Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. 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. by Marcia Carteret, M. Ed. Modern Mexicans turn to old ways of childbirth. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. 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. 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). In one survey of Mexican American nurses, family support was identified as one of the most important areas to which health care providers should attend while caring for Latino patients. 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).