For Hispanic immigrants living in the United States, the obstacles to receiving adequate health care are many: lack of health insurance and language and cultural barriers in addition to immigration status are among the most important.
One example of the cultural differences is the home remedies that many immigrant groups use to treat health complications. In some communities of Colombia, it is common to use garlic to treat hypertension. In some parts of Mexico, it is a common practice to use cactus, aloe vera juice and bitter gourd to treat diabetes. Patients sometimes choose to self-medicate and self-diagnose rather than seek professional medical attention, which can lead to health complications in the future and frequent, last-minute visits to the emergency room.
Health care facilities in the U.S. that serve large immigrant populations are thoroughly examining these health beliefs and their implications with the hopes of increasing patient compliance and improving health outcomes. Dr. Cheryl Willman, director and CEO of the University of New Mexico Cancer Research and Treatment Center, recently told ScienceCentric, “As we continue to move forward with our scientific knowledge and medical treatments, we also need to understand if the potential benefits of what we are learning are being communicated effectively to those most at risk.”
It’s an important point. In the United States, Hispanic immigrants suffer from health disparities when compared to the general population, often as a result of the low-quality and resource-limited health facilities they visit. Hispanic men and women have higher incidence and mortality rates for stomach and liver cancer as well as having higher rates of obesity. In 2005, Hispanics were 1.6 times as likely as non-Hispanic Whites to die from diabetes.
In addition, due to their legal status, immigrants can be reluctant to access health care facilities. Regardless of the progress made in the treatment of diseases, little progress will be made in health care if immigrants don’t feel they can approach facilities for treatment. Women will continue delaying breast-cancer screenings; cancer and HIV/AIDS will be identified in later stages, when they are more difficult to manage; home remedies will continue to be used as substitutes for rather than as complements to other treatments. Also, physicians may understand non-compliance simply and exclusively as negligence, rather than taking into account cultural factors. This makes effective patient-physician communication almost impossible.
Health care facilities are now enacting policies that take these factors, however hard to define and measure, into account. They are going a long way to train both physicians and the general staff in cultural competency, which goes beyond cultural awareness or cultural sensitivity to translate into congruent policies that enable physicians to work with culturally diverse populations. These can be anything from making Spanish-language pamphlets and information available to patients to developing dietary plans for diabetic patients that take into account the foods and dishes prevalent in their cultures to a patient bill of rights, highlighting the privacy that is maintained between the patient and health-care provider. Medical schools are even going as far as including cultural competency courses within their curriculum. The Liaison Committee on Medical Education now requires all medical schools to integrate cultural competence into their curricula.
While not eliminating the many other important factors contributing to health outcomes—lifestyle, dietary and exercise habits, genes—cultural competency goes a long way in establishing trust, one of, if not the most, important basis for building compliance. And it reduces U.S. health care costs in the long run.
