Hispanic Medical Practices, Beliefs, and Perceptions Related to Diabetes
The incidence of diabetes is rising among the residents of California at alarming rates. Approximately 55% of the adults in California are estimated to have either diabetes or prediabetes according to the UCLA Center for Health Policy Research 2016 study on prediabetes (UCLA Center for Health Policy Research, 2016). This is especially concerning for the Hispanic residents within the state as they make up the largest ethnic group in California, at more than 38% of the population (United States Census Bureau, 2015). As the total number of Hispanics in California raises so too has the number of Hispanics diagnosed with diabetes. This literature review explores some of the culture, traditions, and beliefs of the Hispanic population related to diabetes and the need for cultural and linguistic competence to improve health care delivery. Culture, Beliefs, and Perceptions
Addressing the diabetes-related health disparity affecting many Hispanic’s in California involves exploring the culture, beliefs, and perceptions of the Hispanic diabetic community. In the case study by Lemley & Spies (2013), the authors discussed a few of the common traditional beliefs and practices related to diabetes found within the Hispanic immigrant population. The purpose of the case study was to provide an overview of one person’s use and perception of three different traditional practices, common in the Mexican American
The incidences of diabetes are growing annually, and predicted to increase within the coming decades. The number of cases yearly is not only increasing, but the age of onset for diabetes has decreased. This means more individuals are developing diabetes at an earlier age. Diabetes not only affects individuals and communities but countries as well. The prevalence of diabetes has gathered billions of dollars in healthcare costs. [1]Type 2 diabetes also leads to other serious medical conditions such as heart disease, renal failure, blindness, and tissue damage in extremities that will eventually lead to amputation. These illnesses, as a result, result in further costs in the form of disability and the loss of a portion of our workforce. However, incidences of type 2 diabetes are in higher occurrence amongst Hispanic groups. According to the Hispanic Health and Nutrition Examination Survey, Mexican Americans have an unusually high prevalence of diabetes compared to that of the general population [2]. Hispanic females have the highest lifetime risk of becoming diabetic – 52% [3], compared to that of the average risk of
It is well known that the United States is made up of several different cultures and the health care system delivers care to a very diverse population. However, depending on ones culture-receiving care may be a challenge at times. In this paper we are going to take a closer look at the culture of Hispanic Americans. The Hispanic population has grown to over 55 million residents with in the United States in 2015, with an estimated growth rate of 2.1% per year (Krogstad & Lopez, 2015). Making this minority group on of the fastest growing populations within the United States (DeNisco & Barker, 2016).
In this discussion, a Hispanic or Latino group is considered. While the statistic is not available for the city of Cleveland, in Ohio this group represents a 3.7% of the total population as of July 1, 2016 (USCB, 2018). The Hispanic/Latino group represents people from Cuba, Latin America, Mexico, Puerto Rico, Caribbean and other Spanish cultures, regardless of race (Juckett, 2013). While a treatment plan in hospitals is the same for all the patients, the perception varies in different ethnic groups or races. Thus, a health care provider need to be aware of Hispanic/Latino cultural beliefs and implement this knowledge into a daily routine.
Although culturally Mexico closely identifies with Central and South American countries, however, it is situated in North America.
Based on the United States census, it is estimated that by the year 2050 one in three people living in the United Sates will be of Hispanic/Latino origin which include sub groups like Puerto Rican, Mexican, Cuban, Central Americans, and South Americans (Heart Association, 2014). Within those subgroups, the prevalence varied for people of Mexican descent from as high of 18.3 percent to as low as 10.3 percent for people of South American descent, Dominicans and Puerto Rican descent 18.1 percent, Central American descent and Cubans descent 13.4 percent all living in the United States with diabetes type 2. On another commentary being published in the same issue of Diabetes Care, the author wrote, “the differences in diabetes and obesity prevalence among Latinos subgroups are marked when all individuals are combined into a single group” (Heart Association, 2014). Diabetes in Latino Americans has become more prevalence with aging, by the time they reach the age of 70 years, 44.3 percent of Latino men age 70 years old to 74 years old will have develop diabetes. The same study also indicated that the longer Latino Americans live in the United States the more likely they will develop diabetes, that is according to the education and income level of the person. The study also shows
The health issues resulting from health disparities present on the Latinos and Hispanics in America are diverse. In the Hispanic community, diabetes is one of the major causes of death and illness. The language barrier, hard access to health and preventive care and cultural barriers are factors that contribute to this disparity. (Ritter & Hoffman, 2010).
Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, “the 2001 prevalence among Hispanics was significantly higher than among blacks.” (2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as Blacks and Native Americans. The prevalence of diabetes among Latinos is attributed to the social determinants of health such as low socioeconomic status and level of education. Further, this becomes an important public health issue when it costs the
Diabetes as describes by health. NY. GOV is a disease in which blood glucose (blood sugar) levels are above normal ("Diabetes Basics," 2007). This can lead to a range of serious health consequences, “including vision loss, nerve damage and numbness, high blood pressure, kidney disease, heart disease and death” (DiNapoli, 2015). Diabetes is a growing epidemic in New York City among all age group but has grown significantly over the years among adults especially African American and other minority groups. In 2007, data report from the New York City Health Department reported that “diabetes was higher in NYC than in the U.S. overall (9.1% vs 7.5%). (NYC health data).
Approximately 1 in 6 individuals are Hispanic in the United States, and the population is expected to grow to 1 in 4 by 2035 (CDC, 2015). Given that, Hispanics are the biggest minority group in the US (CDC, 2015). The leading cause of death among the Hispanic population is heart disease and cancer responsible for around 2 out of 5 deaths (CDC, 2015). Hispanics have a 50% greater chance of death resulting from diabetes or liver disease than whites (CDC, 2015). Additionally, there are 3 times as more uninsured Hispanics than whites (CDC, 2015). According to the US average, whites are 15 years older than the Latino population, so prevention will greatly benefit the health of the Latino population (CDC, 2015).
The Hispanic population is constantly growing and we have an estimated 13.7% of Hispanics making up the United States. “The annual percentage of patients with prediabetes in whom overt type 2 diabetes develops is about 5% in the general US population and may reach 15% in the Hispanic American population” (Idrogo & Mazze, 2004, para. 7). This a community health issue because of the percentage of Hispanic individuals that may end up with diabetes. These individuals need to be educated to help the promotion, protection, and maintenance of diabetes in this group. That is why I have created the intervention program for this ethnic group.
The Hispanic community in the largest minority in the USA and the fastest growing, it is also one with a high incidence of preventable diseases such as Diabetes, periodontitis, colorectal cancer and HIV. Obesity and teen age pregnancy are significantly more prevalent in Hispanic/Latino population as well. Rate of vaccination is also below that of the majority of the population. Addressing their health care makes good public health and economic sense.
The following is a case study of a 41 year-old Mexican American woman who was recently diagnosed with type 2 diabetes.
Type 2 diabetes is a chronic disease where patient education is imperative and requires education that surpasses the primary care office. According to Cha et al. (2012) basic education and family involvement is an essential component for pre-diabetic and diabetic population to achieve glycemic control. Time management and time constraint are obstacles that are affecting the primary care provider in initiating health promotion topics and disease prevention information (Kowinsky, Greenhouse, Zombek, Rader & Reidy, 2009). Recognizing the time constraint at the EBP change project site for health promotion and patient education a culturally sensitive educational program would be created to promote healthy lifestyle behaviors targeting African Americans with prediabetes.
Participants will be recruited from three community sites in Los Angels city as it is home to tens of thousands of Chinese Americans in the United States. Recruitment will be conducted in three communities which are highly populated by Chinese American residents, including Monterey Park, Alhambra and San Gabriel in the city. 60269 Chinese Americans lived in these areas in 2010 (Stewart, 2015). Thus, there is an adequate amount of Chinese Americans who can be selected as participants in these communities. Community hospitals offer a variety of educational, support and screening programs to help people with diabetes stay healthy and prevent long-term complications such as heart disease, stroke, or conditions of the eye, foot, and kidneys (Comhs,
As well as the higher use of herbal medicines, this will affect the selection of prescription medication (Guerrero & Jones, 2016). In addition, Asian cultures have a lower level of CYP 2D6 a drug metabolism enzyme for antiarrhythmics, antidepressants, and neuroleptics; therefore, they require lower dose of these medications. In contrast, Hispanic cultures are at higher risk for obesity that affects the metabolism and absorption of drugs; and diabetes due to higher levels of insulin resistance and lower level of insulin sensitivity (Guerrero & Jones, 2016). There is also a higher incidence of asthma with Puerto Ricans due to them having a greater response to bronchodilators and Arg16 genotype. In addition, religion plays important role in Hispanic Americans health decisions (Guerrero & Jones, 2016). This is important because practitioner’s lack of knowledge regarding cultural differences contribute health disparities and poor patient outcomes (Hart & Mareno,