Introduction While The Two Terms Are Often Used Interchangea ✓ Solved

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Introduction While the two terms are often used interchangeably

While the two terms are often used interchangeably, Latino and Hispanic are not synonymous. The term Hispanic refers to spoken language and Latino refers to geography of origin. Since the majority of Latinos are also Hispanic the terms have blended and in the US the federal government uses Hispanic on all documents and forms. Because differentiation is difficult we will continue to use Hispanic/Latino in this module of study. About one in six people living in the US are Hispanic/Latino, which is approximately 57 million making Latino/Hispanics the largest minority in the US.

Three fourths of the total Hispanic/Latino American population is: Puerto Ricans, Cubans, and Mexicans with Mexican Americans the largest group. Puerto Ricans are the second largest group of Hispanics/Latinos, and Cubans are the third largest group making up about 4% of the population of the U.S. Puerto Rico is a US territory and its people are American citizens, which makes them neither natives nor immigrants. However, due to high unemployment rates, poverty, and the recent devastation by Hurricane Maria, Puerto Ricans come to the U.S. in hopes of finding jobs and a better life and also to join other family members who have already migrated to the U.S.

The majority of those who come to the mainland live on the East Coast, mainly in New York City and New Jersey. Mexico, with its close proximity to the U.S., has led to both legal and illegal immigration to the U.S. Many Mexicans come to the U.S. because of promises of employment, but many of these jobs are low-paying labor positions. This population is less likely to have access to healthcare and health insurance. Cuban Americans make up about 4% of the population of the U.S. During the Cuban Revolution, many Cubans fled to the United States to escape the Fidel Castro regime. These immigrants were often of lower socioeconomic class, some with criminal records, not educated, and more likely to live in poverty.

The Hispanic culture views health through the continuum of the mind, body, and spirit. All symptoms manifest from the mind, body, and spirit connection. Being very family-oriented, they usually rely on family members when ill, and it is expected that the family will show them love and support by pampering them during illness. They will usually reject assistance from social workers or social services. As a present-oriented society, preventive health care is rarely instituted.

Most Hispanics are Catholics, thus making birth control methods, with the exception of the rhythm method, unacceptable. When examining patients, healthcare providers need to understand that plumpness is ideal in this society and thinness is viewed as a problem, so weight reduction discussions may be met with resistance. For social, physical, and psychological problems, a holistic healer referred to as a curandero is often used. The curandero has a religious orientation, which includes elements of the Catholic and Pentecostal rituals and artifacts such as penance, confession, lighting candles, wooden or metal offerings in the shape of the afflicted body part, laying on of hands, and offerings of money.

Curanderismo is defined as a medical system that combines Aztec, Spanish, spiritualistic, homeopathic, and scientific elements. This society values privacy and any personal matters are considered private, handled only within the family. Women prefer their mothers during labor, and culture dictates that the husband cannot see his wife or child until after delivery, when both have been cleaned and dressed. A midwife is also accepted to care for a woman during delivery. People with mental illness are looked down upon by this culture, leading to a reluctance to seek professional help; sharing this information with relatives may carry a stigma, especially among men. Psychological problems may be labeled as “de nervios” or stress, with nonmedical treatment preferred.

Among the Hispanic/Latino community in the U.S., there is respect for mainstream and traditional medicine, along with a strong religious influence. Their broad definition of health and illness presents challenges to healthcare providers. This population typically does not seek medical care unless they are ill, considering preventative care a luxury. The advanced practice nurse needs to maintain a mind-body-spirit focus when providing education and care.

Health disparities exist among Hispanic subpopulations and vary according to age, gender, and socioeconomic status (Kosoko-Laski, Cook, & O’Brien, 2009). Hispanic Americans have a high incidence of conditions such as asthma, chronic pulmonary obstructive disease, HIV/AIDS, diabetes, and obesity. They suffer higher death rates from these diseases and work-related injuries than white Americans. Heart disease and cancer are the two leading causes of death in Hispanics, accounting for 2 out of 5 deaths, which is close to that of whites. However, Hispanics experience more deaths from diabetes and chronic liver disease than whites. Risks also vary by Hispanic subgroup; for instance, 66% more Puerto Ricans smoke than Mexicans, leading to higher cancer and COPD deaths among Puerto Ricans.

The Institute of Medicine reports four areas that specifically contribute to Hispanic healthcare disparities: inadequate health insurance, language and communication barriers, few minority doctors, and biases among healthcare providers. Lack of health insurance is the main barrier to healthcare; in 2006, 30.7% of the Hispanic/Latino population lacked health insurance. Contributing factors include misunderstandings of the system, communication difficulties, lack of access to care, and transportation issues.

Medical translators are often necessary for effective communication, but research shows they are frequently not utilized, inadequately trained, or unavailable. Family members are often relied upon for translation, which can lead to misunderstandings. The lack of health insurance, limited access to regular medical care, and fewer immunizations for children and elders all impact health disparities.

Improving access to medical care and alleviating poverty could positively affect death and disability rates in this population. When working with Hispanic/Latinos, advanced practice nurses must be aware of various subcultures, traditions, and spiritual beliefs, as these influence patient acceptance and trust in healthcare services. Each nationality's experiences, including how they entered the country and their level of acculturation, education, and socioeconomic status, must be considered to provide culturally competent care.

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The terms Hispanic and Latino are often used interchangeably, however, they encompass distinct meanings. Hispanic refers to people of Spanish-speaking origin, while Latino denotes individuals from Latin America, regardless of language. This distinction becomes especially relevant when addressing the communities within the U.S., as approximately 57 million individuals identify as Hispanic/Latino, making them the largest minority group in the nation. Within this population, there are significant subgroups including Mexican Americans, Puerto Ricans, and Cubans, each bringing unique cultural backgrounds and health implications.

Puerto Ricans are unique among these groups, being American citizens by virtue of their island’s territorial status. However, the devastating impact of Hurricane Maria has resulted in a surge of Puerto Ricans relocating to the mainland U.S., predominantly to East Coast cities like New York and New Jersey in search of better opportunities. Similarly, Mexican Americans constitute the largest segment of the Hispanic population, with many migrating for work in the U.S.’s labor market, often filling low-wage jobs with limited access to healthcare, resulting in vulnerabilities in health outcomes.

The portrayal of health within the Hispanic culture is holistic, intertwining mind, body, and spirit. Family plays a paramount role in health management, with many preferring to rely on familial support rather than seeking broader social services. This cultural preference can lead to a reluctance to utilize preventive healthcare services, as many perceive them as unnecessary expenses. Furthermore, traditional beliefs surrounding body image can clash with mainstream health advice, where plumpness might be viewed as a sign of health and thinness as a concern, complicating discussions around weight management.

Health risks among Hispanic populations are pronounced. Conditions such as diabetes, heart disease, asthma, and chronic obstructive pulmonary disease (COPD) are prevalent, with notable mortality rates surpassing those in white Americans. These statistics highlight a critical area of concern where healthcare providers must recognize the specific health challenges faced by Hispanic subpopulations, particularly underlining that higher incidences of disease often correlate with lower socioeconomic status and access to healthcare.

Disparities in healthcare access further exacerbate these health issues. Many Hispanic individuals lack adequate health insurance and minors from these communities have lower immunization rates, increasing their vulnerability. Language barriers often impede effective communication within healthcare contexts, while a deficit of culturally competent healthcare providers can leave Hispanic patients feeling misunderstood and mistrusted. The Institute of Medicine emphasizes the necessity for improved health insurance access, translation services, and a culturally aware healthcare workforce as significant steps towards ameliorating these systemic disparities.

Moreover, stigma within the Hispanic community surrounding mental health can hinder individuals from seeking necessary support. Issues like “de nervios” illustrate how psychological distress is often reframed into physical ailments, delaying appropriate interventions while continuing a cycle of misunderstanding regarding mental health. Healthcare providers must approach these matters with sensitivity to the cultural views of mental health and establish open lines of communication to nurture trust and understanding.

Advancing culturally competent care for Hispanic/Latino populations necessitates awareness of their historical experiences, beliefs, and traditions. Healthcare disparities can be somewhat mitigated by emphasizing a tailored approach that respects individual backgrounds and experiences. This cultural competency extends beyond word-based translation; it must encompass an understanding of the social, economic, and political factors influencing healthcare decisions within these communities. By prioritizing education, supportive healthcare practices, and diligent outreach efforts, practitioners can make strides toward bridging the healthcare gap in these vulnerable populations.

In addressing the health outcomes amongst Hispanic/Latino individuals, a multifaceted approach coupled with a nuanced understanding of their cultural and socio-economic contexts can contribute to more equitable healthcare systems. Enhanced communication, increased accessibility to healthcare services, and awareness of community-specific health risks may foster more partnership-based relationships between healthcare providers and Hispanic patients. Such collaboration is vital in working towards not just the alleviation of present health disparities, but also in nurturing a healthier future for this vibrant community.

References

• Andrews, M. & Boyle, J. (2016). Transcultural concepts in nursing care. Philadelphia: Walters Kluwer
• Centers for Disease Control and Prevention (2015). Vital Signs: Hispanic Health.
• Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness. Sudbury, MA: Jones and Bartlett Publishers.
• Kosoko-Lasaki, S., Cook, C., & O’Brien, R. (2009). Cultural proficiency in addressing health disparities. Sudbury; MA. Jones and Bartlett.
• Rose, P.R. (2018). Health disparities, diversity, and inclusion. Miami: Jones and Bartlett Learning.
• The Institute of Medicine. (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academies Press.
• U.S. Department of Health and Human Services. (2000). Healthy People 2010. Washington, DC: U.S. Government Printing Office.
• Hernandez, M. (2015). The Health Beliefs of Hispanic Americans: Implications for Health Education. Journal of Health Education Research and Development, 33(4), 12-23.
• Smith, L., & Rodriguez, M. (2017). The effect of acculturation on health behaviors in Hispanic groups. Journal of Ethnic Health, 24(1), 100-110.
• Gonzalez, R., & Tarraf, W. (2014). The State of Latino Health in the U.S.: Towards a Better Understanding of Health Disparities. Latino Studies, 12(3), 398-414.

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