PROVIDING CULTURALLY SENSITIVE MEDICAL CARE

FOR LATINOS

Patricia Téllez-Girón MD

March 13th, 2007

WHY?

STATISTICS

• 2000 census = 291,507,250 – 69.1 White– 12.5 Latinos (36,438,406)– 12.3 African American– 4.2 Asian– 1.5 American Indian/Alaskan Native

WHY?

WHY?

CASE 1

25 yo Latina presenting to your clinic with the following symptoms:

• Recurrent headaches • Insomnia• Decrease appetite and nausea

CASE 2

13yo boy presenting to the visit with his mother because the school believes he is “depress”

CASE 3

60yo man with a known h/o Diabetes, HTN, High lipids with very poor control with complications of end stage renal failure now on dialysis.

By dialysis SW “poor compliance”

CASE 4

7yo girl presenting for well child care.Recently move to Madison from Mexico City

CULTURAL PRESENTATIONS OF ILLNESS

THE OTHER “CULTURE”

THE OTHER “CULTURE”

Social/political/economical environment in Latin America

• Unemployment • Poverty• Safety issues• Natural phenomena • Education

THE OTHER “CULTURE”

Challenges:

Leaving everything behind

Cost

Risks Boat Swimming Walking

THE OTHER “CULTURE”

Challenges:

Language

Housing

Employment Discrimination / Abuse

Transportation

THE OTHER “CULTURE”

Challenges:Immigration status

Changes in family / culture structure MarriageMen/ Women rolesElderly / YouthExtended familyReligion

THE OTHER “CULTURE”

Access to care barriers:Language:

Lack of bilingual-bicultural staff. Lack of health education=language-culture sensitive

Lack of health insurance

Lack of knowledge about health insurance

Lack of knowledge about health care system

CASE 1

25 yo Latina presenting to your clinic with the following symptoms:

• Recurrent headaches • Insomnia• Decrease appetite and nausea

CASE 2

13yo boy presenting to the visit with his mother because the school believes he is “depress”

CASE 3

60yo man with a known h/o Diabetes, HTN, High lipids with very poor control with complications of end stage renal failure now on dialysis.

By dialysis SW “poor compliance”

CASE 4

7yo girl presenting for well child care.Recently move to Madison from Mexico City

CHARACTERISTICS

Family centered

Concept of time

Concept of space

Religion

RELIGION

CHARACTERISTICS

Respect

Dignity

Hard work ethic

Maintenance of language-cultural identity

HEALTH CARE PROVIDER-PATIENT RELATIONSHIP

Notion of social hierarchy

High regard for expert knowledge

Trust and respect for providers

Expect highly directive providers

HEALTH CARE PROVIDER-PATIENT RELATIONSHIP

Distrust in institutions

Tendency toward fatalism, “La voluntad de Dios”

Concept of health=no pain, able to work and perform responsibilities

HEALTH CARE PROVIDER-PATIENT RELATIONSHIP

Expectation about provider behavior:– Evidence of expertise, concrete recommendations,

medications, firm attitude– Friendly, personable and with good verbal

communication

Family involved in making decisions

CHARACTERISTICS

Socioeconomic status

Education

Immigration status

Time in the U.S.

Identification with culture

Language/s spoken

DANE COUNTY

LATINO SUPPORT LATINO SUPPORT NETWORKNETWORK

LATINO HEALTH COUNCIL LUCHA

CENTRO HISPANOCENTRO GUADALUPEBETHEL LUTHERAN CHURCHHARAMBEEUNITED WAY

LATINO HEALTH COUNCIL

The mission of the LHC is to promote and support the health and well being of the Latino community through education, advocacy, consulting, and networking.

LATINO HEALTH COUNCIL

Goals:Provide leadership and guidance to community based organizations planning to reach the Latino community.

Assist in providing and promoting education, screening and early detection programs to the Latino community.

Promote access to quality and affordable health care that is culturally and language appropriate.

Strengthen partnerships among community organizations to address health needs in the Latino community.

HEALTH FAIR

ENTRE FAMILIA

NUESTRA SALUD

CHRONIC DISEASE CONFERENCE

LATINO ADVISORY DELEGATION

Patricia Téllez-Girón MDptellez@fammed.wisc.edu

(608)263-3111