Compared to White people, Hispanic/Latino people are less likely to receive treatment for depression, anxiety, and other behavioral problems. About 23 percent of Latinos in the United States live in poverty.2. 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. There are also differences in drug use within the Hispanic population as shown in Figure 1. 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. Your efforts pay off at the next visit, when Maria expresses much more interest in controlling her diabetes and shows personal warmth that was missing from earlier encounters. High cholesterol or dyslipidemia (unhealthy blood fat levels) . This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). Respondents using these herbs reported never replacing their medical regimens with herbs. Davis Company, 1998): 397-421. 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. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. Her face lights up when you share this. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. The Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. 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. These broad generalizations are just that: broad generalizations. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. 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. Copyright 2023 American Academy of Family Physicians. 58, Journal of . . 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. Genetics, environment, and life experiences can all have an impact on . 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). However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. 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. 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. Latinos comprise the largest minority group in 20 of the 50 states. needs and experience of less acculturated Latino clients who are mostly from Mexico and Central America, and represent a large segment of the Latino community in Southern California. 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. 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. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. 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. 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. As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. 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. 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 . Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). 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." Cold linseed tea and hibiscus flower tea for diabetes. Text: 435748 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. . 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). Most, although not all, alternative therapies in the Latino community are not harmful and may be combined with conventional care. Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. 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. 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. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. In some cases, discussing personal family issues might feel like a form of disloyalty to a Hispanic recovering addict in a group therapy . In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. In this article I will make use of both terms, relying more heavily, however, on "Latino. Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. 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). Fluegelman, Andrew, ed. 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. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. 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]). bullitt car chase timestamp,
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