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Monday, March 19, 2007

Hispanic Health Care Considerations

Lower socio-economic levels, underemployment, and knowledge about the functioning of US culture are key contributors to lower levels of health care among US Hispanics. In general we have found the following patterns of behavior related to health care:
1. Cynicism regarding the health care establishment. Many Hispanics delay or avoid medical care indicating that for the amount of money they pay the medical establishment they get remedies they already know about and can acquire over the counter. Some state that making appointments, going to a doctor’s office, and a long wait at the office, and a high fee often results in getting some aspirin and a recommendation to rest. These patients state they did not need to go through all that to get the prescribed treatment.
2. Traditional remedies have high credibility. Many Hispanics have learned via the cultural traditions of their families and friends that there are ways of dealing with health problems that Western medicine does not recognize. For example, the “empacho” is a digestive problem among Mexicans caused by food that “gets stuck” in the stomach. The remedy consists in pulling the sufferer’s back skin to release the “stuck food.” Many other health practices like these exist and the medical establishment does not understand these and try to discredit them. The unfortunate result of attempting to discredit these practices is that the physician or nurse loose their credibility by doing so. Knowing how to address these belief systems is fundamental to appropriate health care of Hispanics.
3. As Hispanics immigrate to the United States they acquire food habits that contribute to obesity and lack of exercise. These behavioral changes tend to exacerbate propensities to illnesses such as diabetes and high blood pressure. Proper health education is lacking.
4. Lack of health insurance by over 40% (HOT study of People en Español) of US Hispanics is simply related to employment status. Large numbers of US Hispanics work in agricultural, construction, and service occupations that do not provide health insurance. Further, the fact that currently health care insurers and employers continue to increase the payment that the insured most pay to include his/her family acts as a disincentive to acquiring coverage.
5. Lower levels of income contribute to postponing medical attention and that contributes to aggravated health problems and more visits to emergency rooms. Overall, this syndrome makes Hispanics a particularly vulnerable health care target. Education of both consumers, employers, and the medical establishment is fundamental in advancing the level of health care of Hispanics. Ultimately “mente sana en cuerpo sano” or healthy mind in a healthy body is a well established proverb in the Hispanic community.