Cultural awareness

COMMON HEALTH PROBLEMS
As immigrants and refugees enter the United States, health care providers need to be
more aware of health problems that they may encounter. Providers must also be aware of
the impact that different backgrounds, environments, and experiences may have on the
occurrence of specific health problems or on the progress of a disease.
The following is the susceptibility to health problems among Hispanics/Latinos3:
• Diabetes is twice as prevalent among Hispanics than among the majority
population.
RI Department of Health Family Planning Guidelines
5
• Hypertension is common in Hispanic populations.
• Overweight and obesity are common in some Hispanic groups: for example,
combined overweight and obesity are found among 63.9% of Mexican-
American men and 65.9% of Mexican-American women. This contrasts to
rates of 61% among European-American men and 49.2% among European-
American women.
• The incidence of cervical cancer in Hispanic women is double that of non-
Hispanic European-American women.
• Although Hispanics have a lower incidence of breast, oral cavity, colorectal,
and urinary bladder cancers, their mortality from these is similar to that of the
majority population.
COMMUNICATION
Spanish is the primary language of many Hispanics. There are numerous dialects and
variations, but little difficulty with understanding among those who have differences.
Among the young, it is common to use a mix of Spanish and English. Newer
immigrants, especially women who do not work outside the home, tend to speak less
English.
About 90% of Mexicans are literate4 and a higher percentage of Hispanics in the U.S. are
literate. This does not mean, however, that reading and writing are common means of
communication among those from lower socio-economic backgrounds. The most
commonly encountered books in many Hispanic homes in the barrio are required
schoolbooks, pictorial novelettes, and the Bible.
Verbal and nonverbal communications from Hispanics usually are characterized by
respect and communications to Hispanics should also be respectful. There is an element
of formality in Hispanic interactions, especially when older persons are involved. Overfamiliarity,
physical (touch by strangers) or verbal (casual use of first names), is not
appreciated early in relationships5. It is uncommon for Hispanics to be aggressive or
assertive in health care interactions. Direct eye contact is less among Hispanics than
among Anglos. Direct disagreement with a provider is uncommon; the usual response to
a decision with which the patient or family disagree is silence and noncompliance. A
brusque health care provider may (1) not learn of significant complaints or problems and
(2) find the patient unlikely to return. Despite a lack of public complaint, Hispanics tend
4 Central Intelligence Agency.