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). Spanish language handouts are a better option. Yet Latinos are at particular risk for diabetes mellitus, tuberculosis, hypertension, HIV/AIDS, alcoholism, cirrhosis, and death from violence.4 There is also a disproportionately high prevalence of acute care in the treatment of Latinos; that is, too often patients delay medical care until their conditions worsen and necessitate immediate attention. Poor communication with health care providers is often an issue. Latino culture has several normative values that must be recognized in clinical settings. Latino/Hispanic cultural influences on assessing and - Parenting A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. Her face lights up when you share this. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. 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. Journals. Margaret E. "Group Methods and . 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. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. 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. Mexico's rate of C-sections is 30 percent above the rate recommended by the World Health Organization. High level of belly fat or metabolic syndrome. "The Egg" in the Twenty-First Century: A Family's Holistic Healing and By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. It was developed specially to treat people between the ages of 3 and 18. 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. Web-based resources are available to assist physicians in understanding Latino health beliefs (Table 4). Davis Company, 1998): 397-421. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. JCM | Free Full-Text | Systemic Disease Associations in a Cohort of One suggestion she readily agrees to is to include nopales (prickly pear cactus pads), a favorite from her childhood in Mexico. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. Courtney Parker, CC BY. Racial and Ethnic Health Inequities and Medicare | KFF Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Racial Disparities in Hypertension Prevalence and Management: A Crisis Hispanics generally use multiple methods to treat themselves which involve prayer, folk medicine, prescription medications left over from friends as well as new medications prescribed by physicians. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. Physicians cannot assume that all Latinos share these beliefs; many do not. You call the dietitian to alert him to this patient's cultural concerns. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. About 23 percent of Latinos in the United States live in poverty.2. Become an expert on our coaching methods, internal systems, processes, and technology. 3 percent report that they have trouble navigating the U.S. health care system. 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). This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. www.behaviorfrontiers.com. You recommend a compromise treatment plan for her diabetes and grief. Hispanic and Latino are often used interchangeably though they actually mean two different things. 1-877-SAMHSA-7 (1-877-726-4727), SAMHSA.gov, Substance Abuse and Mental Health Services Administration, Buprenorphine Physician & Treatment Program Locator, Early Serious Mental Illness Treatment Locator, View All Helplines and Treatment Locators, Implementing Behavioral Health Crisis Care, Mental Health and Substance Use Disorders, Substance Abuse and Mental Health Prevention, Technology Transfer Centers (TTC) Program, State Targeted Response Technical Assistance (STR-TA), Clinical Support System for Serious Mental Illness (CSS-SMI), Suicide Prevention Resource Center (SPRC), African American Behavioral Health Center of Excellence, Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence (AANHPI-CoE), Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions, Center of Excellence for 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Alcohol and Other Drugs, Why Small Conversations Make a Big Impression, How To Tell If Your Child Is Drinking Alcohol, COVID-19 Information for SAMHSA Discretionary Grant Recipients, Training and Technical Assistance Related to COVID-19, Listening Session Comments on Substance Abuse Treatment Confidentiality Regulations, Advisory Committee for Womens Services (ACWS), Tribal Technical Advisory Committee (TTAC), Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), Interdepartmental Substance Use Disorders Coordinating Committee (ISUDCC), Interdepartmental Substance Use Disorders Coordinating Committee Biographical Information, Interdepartmental Substance Use Disorders Coordinating Committee Roster, Asian Americans, Native Hawaiians, and Pacific Islanders, Quality Practice and Workforce Development, The Behavioral Health Barometer: United States, Volume 6, National Survey on Drug Use and Health: Hispanics, Latino or Spanish Origin or Descent Individuals, Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S. (PDF | 426 KB), The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue, El alcohol y la depresin: El camino de Jorge hacia una vida mejor, Prevencin de la Sobredosis de Opioides Manual de Instruccin, Publicaciones de SAMHSA disponibles en espaol, quality practice and workforce development, Alcohol and the Hispanic Community from the National Institutes of Health National Institute on Alcohol Abuse and Alcoholism, Chartbook for Hispanic Health Care (Agency for Healthcare Research and Quality), Hispanic-Latino Mental Health (American Psychiatric Association), Latino Mental Health Facts (National Alliance on Mental Illness), Mental Health: A Guide for Latinos and Their Families (American Psychiatric Association) (22 minutes, 13 seconds), National Latino Behavioral Health Association (NLBHA), Behavioral Health Treatment Services Locator, Addiction Technology Transfer Center (ATTC), Mental Health Technology Transfer Center (MHTTC), Prevention Technology Transfer Center (PTTC), U.S. Department of Health & Human Services. Although this review summarizes findings for U.S. Hispanics, it is important to note that the panethnic term "Hispanics" describes a large, heterogeneous group originating from multiple Spanish-speaking nations and that evidences substantial variability in socio-cultural characteristics, beliefs, behaviors, and attitudes toward health and health Other health problems include stress, neurocysticercosis, and tuberculosis. 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). 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. Patient activation will help motivate the patient to become involved in his or her own care. "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. Latinx/Hispanic Communities and Mental Health Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Hence, the individual's good cannot be neatly separated from his or her community. al., "Culture, Illness, and Care," 252. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. hispanic methods of treatment As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Downward National Trends in Mental Health Treatment Offered in Spanish 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. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. 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. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. (PDF) Grieving and death rituals of Latinos - ResearchGate 14 Kleinman et. 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. 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. Combination therapy generally uses multiple treatment methods at once. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. savoie's real cajun dressing mix; PURPOSE Though patient variables are likely to play an important role in the undertreatment of depression, little is known of patients' perceptions of standard depression treatments. 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. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. Approximately half (49.6%) of the patients were aged at least 65 years. The LEARN technique can facilitate cross-cultural interviews. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. 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. Objective Breast cancer is the leading cause of cancer death among Hispanic women. Oregano tea for coughs. Information. 17.4% were Hispanic, and 49.1% were White. Adherence Barriers to Antidepressants among an Urban Female Latino Data Synthesis: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Fluegelman, Andrew, ed. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. Substance Abuse/Addiction Among Hispanic-Latina/o Americans 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. 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. 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. placed on religious beliefs in the maintenance of health and the treatment of illness. Talk. 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.
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