Specifically, to Latin America, to people from the Caribbean, South America, and Central America. National Prevention Week 2020 is about Our Lives. [4] 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. Poor communication with health care providers is often an issue. 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. Her husband died in an industrial accident four years ago, and she is still grieving. 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. Author disclosure: No relevant financial affiliations to disclose. 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). Table 3 lists some common Latino folk illnesses, their symptoms, and treatment.19 Therapies for these conditions may seem odd, but most are harmless, with a few exceptions. Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. Apart from these language and socioeconomic disparities and variation in the way health care is envisioned and sought out, differences in the way values are ordered and articulated can also strain the clinical health care encounter for Latino patients. Have a question about government service? 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). Latinos have disproportionately higher rates of obesity and diabetes mellitus. However, it may be more likely to mistakenly suspect child abuse than to actually encounter it in patients who use traditional treatments.23. 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. Journals. Traditionally, conditions may be referred to as either "hot" or "cold". 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. A few candles were lit in the dark, curtained bedroom. The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Prayer was reported as helping to reduce stress and anxiety. Call or text 988 or chat 988lifeline.org. Among U.S. states, New Mexico has the highest percentage of Hispanic ancestry, at 47 percent (as of July 1, 2012). Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Patients should be actively involved in their care rather than passively acquiescing to instructions. 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. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). 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. . Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. National Network to Eliminate Disparities in Behavioral Health, SAMHSA National Survey on Drug Use and Health (NSDUH), AHRQ National Healthcare Quality and Disparities Reports, OMH National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards), 988 Suicide & Crisis Lifeline This somewhat short-term therapy model has consistently proven its effectiveness by many clinical studies. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. 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. using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, 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 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. 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. In addition, diet and exercise do not have a prominent place in the daily activities of the Hispanic family. Talk. 7Hyon B. Shin and Rosalind Bruno, "Language Use and English-Speaking Ability: 2000," Census 2000 Brief, U.S. Census Bureau, October 2003, accessed at: www.census.gov/prod/2003pubs/c2kbr-29.pdf. By comparison, only 35% of Hispanics 50 and older say the same - a 30-percentage-point gap. Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. Lack of third party reimbursement for professional interpreter services exacerbates this problem. 2U.S. 15Glenn Flores, "Culture and the Patient-Physician Relationship: Achieving Cultural Competency in Health Care," Journal of Pediatrics 136 (January 2000): 14-23; see also Maria R. Warda, "Mexican Americans' Perceptions of Culturally Competent Care," Western Journal of Nursing Research 22/2 (2000): 203-224. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. 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. 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. 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. 16"Communicating with Your Latino Patient," University of Washington Medical Center, 2007; accessed at https://depts.washington.edu/pfes/PDFs/LatinoCultureClue.pdf. 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. High cholesterol or dyslipidemia (unhealthy blood fat levels) . Asian or Hispanic ancestry. dissertation, University of Southern Cali-fornia, 1973. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Latinos are a multiracial, multicultural group." Some Mexican Americans have been in the US for many generations. 5600 Fishers Lane, Rockville, MD 20857 Her face lights up when you share this. According to Pew Research, a law passed by Congress in 1976 defined Hispanics as . As with any patient, Latinos should be treated as individuals first, while exploring possible cultural distinctions. Barriers to care have resulted in striking disparities in quality of health care for these patients. 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. Cultural Barriers to Treatment and Compliance. 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. When in doubt, the best policy is to ask the patient how he or she would like to be addressed.26. 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.