Hispanic Heritage and Increasing Cultural Competence

An important, yet, often overlooked aspect of nursing care is cultural competence. To achieve any level of cultural competence one must be open to learning and accepting other cultures. There are many features of a culture that are key to achieving cultural competence. Below, I plan to delve into some of the predominant factors most beneficial for nurses, and other healthcare workers alike for the Hispanic heritage.

Nutrition

We are often told the way to one’s heart is through their stomach. I believe that simply means love is put into food made for others, in turn, making food for someone is an outward expression of an internal feeling. From what I have learned about the Hispanic culture, they also see this as an affirmation of love for others in their culture. Food preparation was a time for family comradery in Hispanic culture. It was stated “as a collectivist culture, Hispanics tend to be group-oriented and place a strong emphasis on family and community ties” (Marquine, et al., 2015) Preparation for usually include all the women in the family, it is taken as a time to teach traditional Hispanic cooking, “each person performing a different task”.

Like most cultures, the foods Hispanic people to eat food that is available in their environmental area. If they live near the water, they will tend to consume more fish, if they lived more inland their diet consists of more beef, pork, and grains. Most of the Hispanic diet consists of vegetables, fruits, grains, nuts, seeds, legumes, herbs, and spices (Oldways, 2019). Food is typically roasted or fried. Fresh foods and spices are particularly important to the Hispanic diet. In Hispanic countries, there are many fresh food markets available. In the (2018) study the participants mentioned some of the frequently visited markets such as the “veduleria-vegetable store, mercado- fruit and vegetable open air markets, panderias- bakeries, and butchers” (Coe et al., 2018). In the U.S., with a few exceptions, all the markets tend to be one stop shop type of stores.

Healthcare Practices

When it comes to pain medications Hispanic people frequently “express negative attitudes and beliefs about medication. The primary reason for rejecting medication was fear of becoming an addict”. It is common in the Hispanic culture to use “’healers’ also known as courandero/a’s” (Johnson & Farquharson, 2019). They would much prefer natural alternatives such as homeopathic ointments, teas, some even use prayer. Majority of the Hispanic population is Catholic in faith and they place “Great emphasis on religious beliefs in the maintenance of health and treatment of illness (Johnson & Farquharson, 2019)”. Along with homeopathic and folk medicine use, as mentioned above, they tend to have magico-religious beliefs. Although popular consensus is “death is accepted when it comes” due to the ‘It’s in God’s timing’ mentality, they will give offerings to patron saints, light candles with pictures of Saints, use prayer, along with a multitude of other religious activities to cope with hopes of healing those in mind. In the (2015) study by Marquine, the Hispanic culture’s religiosity/spirituality seems to have a positive impact on their health.

Unlike the U.S., the Hispanic populations usually have some medications readily available to them in over the counter form that would otherwise be by prescription only. One of the medications found at their local stores that must be prescribed in the U.S. would be antibiotics. It was reported by the participant in the (2019) article by Johnson and Farquharson that Hispanic culture does not typically practice preventative healthcare. Hispanic people tend to take a reactive versus a proactive approach to medicine. Among the other practices, Hispanic people use self-distraction techniques, which in long term can negatively affect their health. However, the population in general, is thought to not necessarily have a trusting relationship with medical professions as briefly discussed in Torres et al. (2017) study. When there is some distrust in a profession it will typically make those seeking help or care from said profession timid upon meeting the professional and may make disclosure of pertinent information difficult. That too, can negatively influence health among Hispanics.

Healthcare Dysfunctions among Hispanics

The Hispanic population tend to have an increased risk for many health disparities. The health disparities most affecting the Hispanic population include: obesity, hypertension, diabetes, liver disease, heart disease, cancer, STD’s, increased teen pregnancy rates, and unintentional injuries; topping the list for causes of mortality would be cancer, heart disease, and unintentional injuries (Velasco-Mondragon, Jimenez, Palladino-Davis, Davis, & Escamilla-Cejudo, 2016). Of course, all the previously mentioned disparities can intertwine, with obesity being the most common correlation among the referred to disease processes. Per CDC statistics (2020) it is recorded that the percent of men aged 20 and over with obesity is at 41.2% and 48.4% for women. Obesity significantly increases the risk for diabetes, hypertension, heart, and liver diseases. As obesity is not the only risk factor, other notable risk factors mentioned in the research by (2016) Velasco-Mondragon et al. include tobacco use, alcohol intake, and occupation.

Cancer among Hispanics are “more likely to be infection related, but are less likely to be diagnosed with prostate, breast, lung, and colorectal cancer” (Velasco-Mondragon et al., 2016). Compared to other cultures, Hispanics typically have a lower rate of cancer related fatalities but has recently become the leading cause of death among the Hispanic population. Due to the obesity prevalence among the Hispanic population, multiple sources noted, Hispanics are disproportionally affected by diabetes. Hispanics in the U.S. were noted to have a “rate of diagnosed diabetes 66% higher than non-Hispanic whites” (CDC, 2020).

As for the increase risk of STD’s and teen pregnancy one risk factor, that is usually not considered, could possibly be related to religious beliefs. It is common for practicing Catholics to be against contraception, with majority of Hispanics sticking with the more traditional beliefs in the Catholic faith that would include prophylaxis in the form of condoms. However, the CDC (2020) reports between chlamydia, gonorrhea, and syphilis (primary, secondary, and congenital) Hispanic people had tested positive 2.25 times more than non-Hispanic whites in the U.S.. It was also reported by the CDC (2020), in 2018 of newly diagnosed cases of HIV in the U.S. 27% of those were Hispanic.

Summary

In conclusion, majority of disease processes that frequently affect the Hispanic population are directly linked to Obesity. Although there are always exceptions to the rule, such as hereditary factors, it looks as if obesity is the most highly regarded reason for the most common diseases Diabetes is a significant disease process affecting the Hispanic population, along with obesity, it can help produce the majority of other disease processes listed such as heart and liver disease, as well as cancer. Religious beliefs can also be identified as a risk factor in the health of Hispanics, as well as an integral factor of healthcare practices among Hispanics. Homeopathic remedies are the first preference among the culture and family plays a key role in the Hispanic lifestyle especially in the nutritional aspect.

References

• CDC. (2020, January 8). Health of Hispanic or Latino Population. Retrieved October 8, 2020, from Centers for Disease Control and Prevention: https://www.cdc.gov/nchs/fastats/hispanic-health.htm
• Coe, K., Benitez, T., Tasevska, N., Arriola, A., & Keller, C. (2018). The Use of Family Rituals in Eating Behaviors in Hispanic Mothers. Family and Community Health, 41(1), 28-36. doi:10.1097/FCH.0000000000000170
• Johnson, M. J., & Farquharson, H. R. (2019, December). Hispanic culture and healthcare in the United States: One person’s. Journal of Nursing Research and Practice, 3(4), 1-2. Retrieved October 9, 2020
• Marquine, M. J., Maldonado, Y., Zlatar, Z., Moore, R. C., Martin, A. S., Palmer, B. W., & Jeste, D. V. (2015). Differences in life satisfaction among older community-dwelling Hispanics and non-Hispanic Whites. Aging & Mental Health, 19(11), 978-988. doi:10.1080/13607863.2014.971706
• Oldways. (2019). Latin American Heritage Diet. Retrieved October 10, 2020, from Oldways Cultural Food Traditions: https://oldwayspt.org/traditional-diets/latin-american-heritage-diet
• Torres, C. A., Thorn, B. E., Kapoor, S., & DeMonte, C. (2017). An Examination of Cultural Values and Pain Management in Foreign-Born Spanish-Speaking Hispanics Seeking Care at a Federally Qualified Health Center. Pain Medicine, 18, 2058-2069. doi:10.1093/pm/pnw315
• Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J. A. (2016). Hispanic health in the USA: a scoping review of literature. Public Health Reviews, 37(31). doi:10.1186/s40985-016-0043-2