hispanic methods of treatment

For instance, Latinos highly value family. 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). Developing cultural sensitivity to Latino patients entails recognizing and appreciating their diversity. Master the basics of the Virta Treatment and understand the full patient experience. 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. These materials focus on the challenges that can confront Hispanics in American health care settings. 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. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. 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. This is lower than the average of 43 percent for adults in the U.S. overall. America is rapidly changing as a cultural collision between Latino and white culture transforms lives on both sides of the border. 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. Background Patients who are members of minority groups may be more likely than others to consult physicians of the same race or ethnic group, but little is known about the relation between. 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. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. Visit SAMHSA on Twitter This free webinar will discuss a guide for service providers, which includes aspects such as how culture change affects Hispanics and Latinos. Her face lights up when you share this. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. 10Mead et. Under-recognition of depression in adult Hispanic Americans may be related to language . Author disclosure: No relevant financial affiliations to disclose. Recent immigration trends have contributed heavily to the increases in the U.S. Latino population. 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. 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. Guide to Statistics and Methods; Guidelines; Hair Disorders; Health Care Delivery Models; . These terms are often used interchangeably, including by the U.S. Census Bureau, although "Hispanic" is more often utilized in governmental and market research and statistical record keeping, while "Latino" perhaps enjoys more popular usage today. Recent immigrants may face additional obstacles to care, including illegal immigration status (fears of deportation), illiteracy, and a radically different set of health beliefs. Courtney Parker, CC BY. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. Neurocysticercosis is the most common cause of seizures in Latino immigrants. Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. An intention-to-treat approach using a last-observation-carried-forward method was used to analyze outcome data whereby the last available measurement for all participants was then used for all time points through the 12-month final follow-up. Still, being aware of these larger values may help health care providers to understand a particular patient's behaviors and actions in the context of larger cultural inclinations. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. 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. 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. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. High cholesterol or dyslipidemia (unhealthy blood fat levels) . 37% of Latinos have. al., "Racial and Ethnic Disparities in U.S. Health Care: A Chartbook" (The Commonwealth Fund, March 2008), Charts 6-25 and 6-26; and Joseph R. Betancourt, Alexander R. Green, and J. Emilio Carrillo, "The Challenges of Cross-Cultural Healthcare-Diversity, Ethics, and the Medical Encounter," Bioethics Forum 16 (3). 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. 3 percent report that they have trouble navigating the U.S. health care system. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over . 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). 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. Modern Mexicans turn to old ways of childbirth. "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. 108 17-00084 at Western Philippines University . Additionally, when a woman gets married, her husband's name may be appended to her father's name. Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. For those who have a serious mental health disorder, around 44 percent did not receive treatment. 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. They also must beware of the tendency toward "othering"; that is, the penchant to understand non-dominant groups as inferior, exotic, or deviant.17 Some efforts at cultural competence may incline toward these unhelpful postures. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. al., "Culture, Illness, and Care," 252. Conveying medical instructions to patients with limited English skills can be frustrating. (Kaiser Foundation Health Plan, 2001): 4. 50 percent of those with no usual health care provider are at least high school graduates. Visit SAMHSA on Instagram 2U.S. This resulted in a rich compilation of remedies that Hispanics use in home treatments, with the emergence of a pattern comparable to the nursing process. www.behaviorfrontiers.com. For instance, a doctor could perceive as evasive a patient who declines to make direct eye contact, when in fact,that patient may be demonstrating respect for the doctor's position and authority. 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. Many Latinos are accustomed to self-treating because most pharmaceuticals are available without prescription in their home countries. You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. 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. Hispanics have different degrees of illness or health risks than whites. By the year 2050 that figure is expected to rise to 24 percent of the total U.S. population. One exception is the Methods for the Epidemiology of Child and Adolescent . This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. 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. Older patients should be addressed as seor or seora rather than by their first names. 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. , may be one strategy to increase treatment . 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. 58, Journal of . | Mar 1, 2011. 15 supp. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Addressing patients properly can be another challenge. In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). Bilingual posters and medical literature are an important starting point. Hispanic people are the youngest population, with 33% below age 18, and 57% below age 34 (Figure 4). Addiction can affect a person's impulse control, ability to stop using a substance, using despite risks, and physical and mental changes. Topics. Double or hyphenated Latino surnames may seem complicated, with the father's name preceding the mother's. This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. A consequence of these problems is a marked disparity in the quality of care that Latino patients receive. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). 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. Approximately half (49.6%) of the patients were aged at least 65 years. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. Thus, when working with diverse populations in the United States . Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. Materials are available in English and Spanish. We sought to describe the prevalence, awareness, treatment, and control of hypertension in Hispanic/Latino adults with CKD. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Davis Company, 1998): 397-421. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. 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. 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. She says that since her husband died, she has lost interest in what might happen to her in the future. Latinos have disproportionately higher rates of obesity and diabetes mellitus. 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. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. Herbal therapies play a major role in Latino folk medicine, so knowing the Spanish names of common herbs can be helpful (eTable A). Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. She might also stop giving her infant vitamins, because they are a hot therapy.24 It is often possible to safely accommodate conventional and alternative treatments (in reasonable doses) if potential conflicts or interactions are identified in advance. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. 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. 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. Trauma-Focused CBT is one of the most effective types of treatment for a trauma-based disorder, particularly in adolescents and children. National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance use and mental health issues. Lack of third party reimbursement for professional interpreter services exacerbates this problem. Objective Breast cancer is the leading cause of cancer death among Hispanic women. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Other health problems include stress, neurocysticercosis, and tuberculosis. 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. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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. The material in this section is part of a larger project by the Markkula Center for Applied Ethics on culturally competent care; that is, health care that is sensitive to the differing values and needs of cultural subgroups within our pluralistic society. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. Manybut not allfolk and herbal treatments can be safely accommodated with conventional therapy. She agrees to start taking medications, but does not refill her prescriptions or lose weight. Text: 435748 Cold water with lemon for high blood pressure. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure . They Hear You is SAMHSA's underage drinking prevention campaign that helps parents and caregivers start talking to their children early about the dangers of alcohol. 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. National Prevention Week 2020 is about Our Lives. 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. Treatment referral and information, 24/7, Visit the SAMHSA Facebook page 1. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Cultural Barriers to Treatment and Compliance. 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. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. A large selection of herbal teas are available from botanicas or yerberas in most Latino neighborhoods. When in doubt, the best policy is to ask the patient how he or she would like to be addressed.26. 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). 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. 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. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. Copyright 2013 by the American Academy of Family Physicians. There are also differences in drug use within the Hispanic population as shown in Figure 1. 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. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. A 2020 review study found that those in the Hispanic community may face several barriers that affect access to treatment, including: higher rates of unemployment less likelihood of having. This content is owned by the AAFP. 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. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. placed on religious beliefs in the maintenance of health and the treatment of illness. These terms are derived from the Spanish verb curar, which means to heal. Cold linseed tea and hibiscus flower tea for diabetes. 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. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Contact USA.gov. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. To sign up for updates or to access your subscriber preferences, please enter your contact information. Copyright 2023 American Academy of Family Physicians. See permissionsforcopyrightquestions and/or permission requests. 17Delese Wear, "Insurgent Multiculturalism: Rethinking How and Why We Teach Culture in Medical Education," Academic Medicine 78/6 (June 2003): 549-554. dissertation, University of Southern Cali-fornia, 1973. 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.

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