Lack of culturally relevant care among medical providers is one of the barriers Latinos in the U.S. struggle with when it comes to health.
What this refers to is medical providers not fully understanding a patient’s beliefs on health and illness, cultural myths and background.
“Language is not the only way to communicate with individuals,” University of Texas Medical Branch Hispanic Center of Excellence Director Norma A. Pérez told Saludify. “It’s also understanding where they come from and who they are.”
A Center for Studying Health System Change’s 2010 study revealed 49 percent of physicians in the United States reported that language or cultural barriers affect their ability to provide quality care.
Data also showed that Hispanics who lack English proficiency in underserved communities are choosing the emergency rooms over preventative visits to primary healthcare providers.
Culturally relevant care: Why being bilingual is not enough
University of Texas Medical Branch Nursing Professor Dr. Yolanda R. Davila told Saludify that going forward, the growing Latino population is going to demand equal care from the healthcare community. However, one of the biggest hurdles facing the industry is the ability to provide culturally relevant care.
“Healthcare providers believe in being very objective, whereas Latino culture is more of an interpersonal relationship kind of thing,” Davila said. “You walk into the room and you should shake their hand and address them as ‘Mr.’ or ‘Mrs.’ until you’re told otherwise. That sets the tone for the interaction. Healthcare providers are very much into the 15-minute appointment with hand-washing, documentation and charting. That’s not what’s important to a Latino patient.”
Davila explained Hispanics need to feel they’re being cherished as individuals and this will not only enhance communication and understanding between provider and patient, but also have a positive effect on treatment going forward.
This is where the term explanatory model becomes very important. It refers to how a person views their illness, as well as how it affects them and how it will make them feel.
“There’s a fear component too,” Davila said. “How long will it influence my ability to earn a living? They also have their own ideas of what the treatment should be. If healthcare providers don’t take the time to understand the differences between their culture and their explanatory models, and the client’s explanatory model, then healthcare interaction is not going to be most effective.
“Patients can tell you, ‘Yes, I will do this,’ but if they don’t believe it, they’re going to walk out of the office and not comply with the medication treatment regime.”
This notion is especially true when it comes to Latino health and folk medicine, which is common among the low-income populations or those who have yet to become assimilated into the U.S. culture. There are plenty of remedies that have been passed on for generations that simply don’t work and can put a sick person in greater danger.
Ensuring culturally relevant care for Latinos
Moving ahead, both Davila and Pérez suggest it’s going to take dedicated medical training to create a sea change approach towards culturally relevant care improving Latino health.
“I’ve seen it more in certain areas where they have bilingual staff and the information is bilingual,” Davila said. “We’ve made a lot of progress but we still have a long way to go.”
Pérez added, “We have come a long way meaning that the medical arena where it used to be very conservative is now more open to learning about the environment and the culture that it surrounds.”
There’s a new trend of late regarding culturally competent training from healthcare providers, services and organizations.
Here are a few key points needed in creating culturally relevant care that improves Latino health.
When a patient enters a medical facility, they need to feel welcomed. This includes signage and brochures promoting the Latino lifestyle, as well as seeing similar people receiving care. It’s one thing to feel discomfort from a medical issue, and another to feel discomfort from surroundings. Personal interaction is a priority for Latinos and specially expected from health providers.
Latino patients need something more than just bilingual healthcare providers. They seek doctors and nurses who not only can speak to them but also understand their culture, beliefs, values and norms.
Medical students who are going to provide topnotch culturally relevant care need to recognize their own biases and stereotypes. This allows them through training to dispel such notions while learning a greater respect for diverse cultures. Latinos need to feel their beliefs and visions on health and treatment are not disregarded.
One of Davila’s techniques with her students is taking groups out for community assessments. This includes experiencing the community’s culture, as well as watching interaction in restaurants, botánicas and pharmacies.
One of the strongest assets for a culturally relevant care provider is simply listening and learning from the patient. Providers must not just dictate to the patient but interact and really listen to concerns.
Many Latino immigrants may have their own treatments in mind that they brought with them. Ultimately, both the patient and doctor want the same outcome. So the healthcare provider is best served with recognizing Latino culture and listening to what they suggest and finding a middle ground.
• Leadership support
Culturally relevant care concepts must not only be embraced by medical schools but heavily incorporated into medical school curriculum.
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