The same is also applies to the substance abuse treatment. 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). 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. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Margaret E. "Group Methods and . The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. 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. These factors have not been studied in Hispanics/Latinos with chronic kidney disease (CKD). Rue for earache. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. A child's failure to thrive may be attributed to mal de ojo (evil eye), a hex conveyed by an envious glance. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." 108 17-00084 at Western Philippines University . 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. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. 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. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications. After immigration, some Latios adopt American naming conventions, but others do not. Other healing specialties include yerberas (herbalists), hueseros (bone setters), parteras (midwives), and sobradores (similar to physical therapists).21, Symptoms are often interpreted differently based on cultural presuppositions. 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. 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 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. Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. In terms of health, on some measures Latinos are better off than other ethnic groups. 17.4% were Hispanic, and 49.1% were White. 10Mead et. 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). All Rights Reserved. A high-carbohydrate and high-calorie diet, a more sedentary lifestyle in the United States, and genetic factors may contribute. 3Pan American Health Organization, "For U.S. Latinos, Shared Heritage Has an Impact on Health," June 9, 2004 (www.paho.org). This is especially (though far from uniquely) true in the agricultural sector of the U.S. economy. 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). 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. 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. 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. These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. 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. Our Health. 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. 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. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. 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. 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. Asian or Hispanic ancestry. 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. 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. Media Contact . 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). Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. 15 supp. Contact USA.gov. Spanish language handouts are available from several Internet sources.33 Recruiting Latino physicians and staff, and recognizing Latino holidays at the office (e.g., Cinco de Mayo), will open many doors to the Latino community.34 Office staff, as well as physicians, should be instructed in basic cultural sensitivity (Table 5).34,35 Hospitals can include culturally appropriate foods in their menus. 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. The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. In Santa Clara County the figure is 25.7 percent-over a quarter of the total population. 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. | Mar 1, 2011. 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. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. 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. One exception is the Methods for the Epidemiology of Child and Adolescent . 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. You use teach back to ensure that Maria understands your directions, and you provide her with Spanish-language handouts about the benefits of controlling her diabetes and hypertension. Spanish language handouts are a better option. Latino culture has several normative values that must be recognized in clinical settings. Older patients should be addressed as seor or seora rather than by their first names. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . 14 Kleinman et. This is lower than the average of 43 percent for adults in the U.S. overall. This is because of barriers to accessing care and stigma surrounding behavioral health problems (Hostetter & Klein, 2018). This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. These materials focus on the challenges that can confront Hispanics in American health care settings. hispanic methods of treatment. These instructions can be studied by the patient or translated when time permits. Rather than operating on the ideal of an informed, active individual who makes decisions based on his or her own personal good, many Latino cultures consider as paramount the individual's obligation to the family and broader community. About 23 percent of Latinos in the United States live in poverty.2. Master the basics of the Virta Treatment and understand the full patient experience. 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. 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. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. Objective Breast cancer is the leading cause of cancer death among Hispanic women. Studies show that Hispanics and Latinos seeking substance use disorders and mental health treatment confront many barriers to accessing culturally and linguistically competent care. She has lost 10 lb (4.5 kg), and for the first time has acceptable blood pressure and fasting glucose levels. 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. 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. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). Patients should be asked if they use alternative therapies, because it is not likely that such information will be volunteered. Significantly, some patients appear to experience greater improvement after meeting with folk practitioners than with Western doctors.14. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. 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. This reliance does not necessarily replace modern biomedicine; rather, herbal remedies and other non-allopathic treatments often are utilized in conjunction with Western medical care. If successful, the intervention could be adapted to other racial or ethnic minorities, such as Hispanic Americans. 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. Plants are used on their own, or mixed together to form herbal remedies. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 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. The Concurrent Integration of Treatment Modali-ties in Social Work Practice." D.S.W. Linden tea and lemon grass tea for nerves (anxiety). . 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. The APA additionally reported that both language barriers and values created barriers to treatment for Hispanics experiencing mental health issues. 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 Protected Health Information (CoE-PHI), Center of Excellence on Social Media and Mental Wellbeing (SMMW-CoE), Rural Opioid Technical Assistance Regional Centers (ROTA-R), Engage, Educate, Empower for Equity: E4 Center of Excellence for Behavioral Health Disparities in Aging, LGBTQ+ Behavioral Health Equity Center of Excellence, National Center of Excellence for Eating Disorders (NCEED), National Center of Excellence for Tobacco-Free Recovery, National Center on Substance Abuse and Child Welfare (NCSACW), National Family Support Technical Assistance Center (NFSTAC), National Institutes of Health (NIH) Training Resources, National Training and Technical Assistance Center for Child, Youth, and Family Mental Health, Providers Clinical Support SystemUniversities, Tribal Training and Technical Assistance Center, National Center of Excellence for Integrated Health Solutions, Mental Illness and Substance Use in Young Adults, Resources for Families Coping with Mental and Substance Use Disorders, Screening and Treatment of Co-Occurring Disorders, FY 2020 Funding Announcements and Grant Awards, FY 2021 Funding Announcements and Grant Awards, FY 2019 Funding Announcements and Grant Awards, FY 2018 Funding Announcements and Grant Awards, FY 2017 Funding Announcements and Grant Awards, FY 2016 Funding Announcements and Grant Awards, FY 2015 Funding Announcements and Grant Awards, FY 2014 Funding Announcements and Grant Awards, FY 2013 Funding Announcements and Grant Awards, FY 2012 Funding Announcements and Grant Awards, FY 2011 Funding Announcements and Grant Awards, FY 2010 Funding Announcements and Grant Awards, FY 2009 Funding Announcements and Grant Awards, FY 2008 Funding Announcements and Grant Awards, FY 2007 Funding Announcements and Grant Awards, FY 2006 Funding Announcements and Grant Awards, FY 2005 Funding Announcements and Grant Awards, National Survey of Substance Abuse Treatment Services, Evidence-Based Practices (EBP) Resource Center, Interagency Task Force on Trauma-Informed Care, Protection & Advocacy for Individuals with Mental Illness (PAIMI) Program, Asian American, Native Hawaiian, and Pacific Islander, Disaster Preparedness, Response, and Recovery, Qualitative and Quantitative Assessment Methods, Early Serious Mental Illness (ESMI) Treatment Locator, Faith-Based and Community Initiatives (FBCI), Historically Black Colleges and Universities Center of Excellence in Behavioral Health, Mental and Substance Use Disorders and Homelessness Resources, Medications, Counseling, and Related Conditions, Pharmacist Verification of Buprenorphine Providers, Become an Accredited and Certified Opioid Treatment Program (OTP), Buprenorphine Dispensing by Opioid Treatment Programs (OTPs), Become a SAMHSA-Approved Opioid Treatment Program (OTP) Accrediting Body, Submit an Opioid Treatment Exception Request, Notify SAMHSA of Opioid Treatment Program (OTP) Changes, About SAMHSAs Division of Pharmacologic Therapies (DPT), Mental Health Awareness and Training Grant (MHAT), National Child Traumatic Stress Initiative (NCTSI), Recognizing and Treating Child Traumatic Stress, Entendamos el estrs traumtico infantil y cmo ayudar, National Children's Mental Health Awareness Day, National Consumer and Consumer Supported Technical Assistance Center (NCTAC), National Network to Eliminate Disparities in Behavioral Health (NNED), Networking, Certifying, and Training Suicide Prevention Hotlines and the Disaster Distress Helpline, Screening, Brief Intervention, and Referral to Treatment, Substance Use Disorder Treatment Providers, Person- and Family-centered Care and Peer Support, Care Provision, Coordination, and Patient Privacy, Developing a Continuity of Operations Plan, Comparta los resultados y retroalimentacin, The Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), The Power of Perceptions and Understanding, What You Can Do To Prevent Your Child From Drinking, Why You Should Talk With Your Child About 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.

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