Health care barriers for latino children and provision of culturally competent care

Abstract

The demography of the United States is rapidly changing. The impressive growth rate of Latino populations within the United States has great impact on health care. This article includes discussion of a significant increase from 1988 to 2000 in Latino utilization of emergency department and inpatient services at a pediatric medical center in Salt Lake City, Utah, information on health care barriers for Latinos, and suggestions for providing culturally competent care.

The Case for Studying Cultural Competence from the Perspective of the Hispanic Immigrant Patient: A State of the Science

“…The studies included two case studies (Barone, 2010;Derose, 2000), ten qualitative studies using interviews or focus groups (Bergmark, Barr, & Garcia, 2010;Carbone, Rosal, Torres, Goins, & Bermudez, 2007;Clark & Redman, 2007;Collins, Villagran, & Sparks, 2008;Cristancho, Garces, Peters, & Mueller, 2008;Frazier, Garces, Scarinci, & Marsh-Tootle, 2009;Harari, Davis, & Heisler, 2008;Keller, 2008;Nailon, 2004;Warda, 2000); a descriptive correlational study (Castro & Ruiz, 2009); three reviews of the literature (Cooper & Ballard, 2011;Mayo, Sherrill, Sundareswaran, & Crew, 2007;Padilla & Villalobos, 2007); five studies using survey data (Gonzalez, Vega, & Tarraf, 2010;Johnson, Saha, Arbelaez, Beach & Cooper, 2004;Riffe, Turner, & Rojas-Guyler, 2008;Sorkin, NgoMetzger, & DeAlba, 2010;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009), and a mixed methods study (Lassetter & Baldwin, 2004) While the majority of the selected studies focused on the patient's perspective, only a few studied cultural competence as a whole (Barone, 2010;Carbone, Rosal, Torres, Goins, & Bermudez, 2007;Nailon, 2004). The majority of studies focused on investigating aspects affecting cultural competence including themes such as barriers to health care (Bergmark, Barr, & Garcia, 2010;Collins, Villagran, & Sparks, 2008;Cristancho, Garces, Peters, & Mueller, 2008;Derose, 2000;Frazier, Garces, Scarinci, & MarshTootle, 2009;Harari, Davis, & Heisler, 2008;…”

“…The concept of personalismo has been repeatedly found as an important element in culturally competent encounters (Clark & Redman, 2007;Cooper & Ballard, 2011;Keller, 2008). The idea of spending time visiting with a patient on a more personal level and making sure they understand what they need to during each visit often goes against the more time constrained clinical aspects of health care appointments in the U.S., but for the Hispanic immigrant, relationship building and fostering a respectful and sympathetic connection between provider and patient is at the heart of culturally competent health care (Bergmark, Barr, & Garcia, 2010;Castro & Ruiz, 2009;Clark & Redman, 2007;Cristancho, Garces, Peters, & Mueller, 2008;Keller, 2008;Lassetter & Baldwin, 2004;Nailon, 2004;Padilla & Villalobos, 2007;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009).…”

“…Culturally competent health care for the Hispanic patient is often facilitated by community leaders or contacts working as cultural brokers (Barone, 2010;Harari, Davis, & Heisler, 2008;Padilla & Villalobos, 2007). It is also very important that family members be included in health care encounters as they provide a large measure of support to patients (Bergmark, Barr, & Garcia, 2010;Carbone, Rosal, Torres, Goins, & Bermudez, 2007;Lassetter & Baldwin, 2004;Mayo, Sherrill, & Sundareswaran, & Crew, 2007;Nailon, 2004;Riffe, Turner, & Rojas-Guyler, 2008;Warda, 2000). Derose (2000) found in a study to determine the barriers to access Latina patients face and what they do to overcome the obstacles, that English speaking family or community members are heavily relied upon for even gaining entry into the health care system.…”

“…It must also be understood that there are often culturally based beliefs about what may be causing an illness, something that must be assessed during a health care encounter (Lassetter & Baldwin, 2004). Other…”

“…Furthermore, continuing waves of immigration often hinder progress toward cultural competence as cultural differences can abound, requiring further research for each subgroup (Collins, Villagran & Sparks, 2008;Harari, Davis, & Heisler, 2008;Padilla & Villalobos, 2007;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009). Continuing needs assessments with Hispanic communities and families is important to delivering culturally competent care (Lassetter & Baldwin, 2004;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009). Obtaining input from Hispanic immigrant patients on how health care is being or should be delivered is perhaps the only avenue for changes to take place and a measure of cultural competence to be achieved.…”