hispanic methods of treatment

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. Traditionally, conditions may be referred to as either "hot" or "cold". During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. 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. You then schedule a return visit, during which an interpreter will be available. 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. Additionally, when a woman gets married, her husband's name may be appended to her father's name. You recommend a compromise treatment plan for her diabetes and grief. 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. These terms are derived from the Spanish verb curar, which means to heal. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. Publicaciones de SAMHSA disponibles en espaol (Additional SAMHSA Spanish-language publications). 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. | Mar 1, 2011. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. Margaret E. "Group Methods and . 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. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Latinos are far more likely than the overall population to live in poverty; the poverty rate in 2006 was 20.8 percent, compared to 12.3 percent for the overall U.S. population. 50 percent of those with no usual health care provider are at least high school graduates. ", In 2007, the total U.S. Hispanic or Latino population surpassed 45 million, or 15 percent of the total U.S. population. Underwriting for these materials was provided by a generous anonymous donor. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. 17.4% were Hispanic, and 49.1% were White. Missing data was handled using this carry-forward method. They are written by health care providers and others who work with the relevant Latino sub-community. Information. Get to know your fellow coach managers and direct reports. dissertation, University of Southern Cali-fornia, 1973. For example . 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. Keeping these cautionary notes in mind, the cases and commentaries in this section seek to address numerous issues that arise in the course of providing clinical health care for Latino patients of various backgrounds. Plants are used on their own, or mixed together to form herbal remedies. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. 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. Delayed immigration protocols and anti-immigration legislation may contribute to stress. US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. 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. 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. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. Natural laxatives such as oil with orange juice (or just oil in some cases). Patients should be actively involved in their care rather than passively acquiescing to instructions. Latinos comprise the largest minority group in 20 of the 50 states. 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 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Identifying behavioral health problems is very important to the plan. From the upstairs hallway of our home, I watched my great-aunt prepare for the cleansing. Davis Company, 1998): 397-421. Moreover, 32.7 percent (nearly one-third) of all U.S. Latinos completely lacked health insurance that year, compared with 15.3 percent in the general population; and nearly half of Latinos reported being uninsured at some point during the previous year.9 Latinos are nearly two and a half times more likely than whites to report that they have no regular doctor.10 Even among many insured Latinos, coverage and care are far from adequate. Related letter: Chagas Disease Is a Consideration in Latino Patients. Other health problems include stress, neurocysticercosis, and tuberculosis. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. al., "Culture, Illness, and Care," 252. 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. Latino millennials were also more likely to have already had a conversation about end-of-life care with a family member, a finding that aligns with the norms of outward expression of death and . 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. Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). SAMHSA Blog. Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . 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. Materials are available in English and Spanish. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. 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. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. 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. 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. 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. 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). For instance, Latinos highly value family. These materials focus on the challenges that can confront Hispanics in American health care settings. (Kaiser Foundation Health Plan, 2001): 4. 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). Results: Teas were most commonly used for colic, upper respiratory tract symptoms, and abdominal pain. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Azarcon and greta (lead salts) and azogue (mercury) compounds, which are sometimes given for teething or empacho, are contraindicated.22 Some injuries have occurred with curandero treatment of caida de la mollera (fallen fontanel). 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. 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. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. Hispanic people are the youngest population, with 33% below age 18, and 57% below age 34 (Figure 4). There are also differences in drug use within the Hispanic population as shown in Figure 1. Call or text 988 or chat 988lifeline.org. 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. Addiction is a chronic, yet treatable brain condition similar to other chronic illnesses like diabetes. 9Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica Smith, "Income, Poverty, and Health Insurance Coverage in the United States: 2006," Current Population Reports, U.S. Census Bureau, August 2007; and Mead et. Journals. Barriers to care have resulted in striking disparities in quality of health care for these patients. Abdominal pain may be attributed to empacho, or food stuck in the intestine. Yet the call for cultural competence can-at its best-urge practitioners to adopt instead a stance of cultural "humility": one which encourages an open mind, and a recognition that each one of us sees the world through our own very distinctive cultural lenses. 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. 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. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. 108 17-00084 at Western Philippines University . 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. Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. 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). Specifically, to Latin America, to people from the Caribbean, South America, and Central America. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). It was developed specially to treat people between the ages of 3 and 18. Free and confidential support for people in distress, 24/7, Behavioral Health Treatment Services Locator Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. Genetics, environment, and life experiences can all have an impact on . The same is also applies to the substance abuse treatment. All Rights Reserved. Copyright 2023 American Academy of Family Physicians. 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. 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. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. Combination therapy generally uses multiple treatment methods at once. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. This is lower than the average of 43 percent for adults in the U.S. overall. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. Thus, when working with diverse populations in the United States .

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