Issues in the provision of health care to Soviet emigrants

Cronkright, Peter

doi:10.1001/archfami.2.4.425

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…In broad terms, the Russian-speaking population continues to represent a potentially problematic patient population for health care providers in the United States. 20 , 21 Some methods for improving communication and access that we suggest here, such as reliance on interpreters as cultural brokers and language translators, also appeared in previous studies. 21 These continuities in the experiences of Russian speakers in the United States suggest that the cultural practices underlying breakdowns in communication may be relatively stable even as the population of émigrés has changed over time.…”

Section: Discussionsupporting

confidence: 60%

“…20 , 25 A specific area of difference from U.S. norms is that FSU-origin families often prefer to protect a family member to spare him or her stress or despair, a disclosure practice that can complicate the provider–patient relationship. 21 Language difficulties present a significant barrier when providing medical care to the émigré community. 21 …”

Section: Methodsmentioning

confidence: 99%

“… 21 Language difficulties present a significant barrier when providing medical care to the émigré community. 21 …”

Section: Methodsmentioning

confidence: 99%

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Barriers Beyond Words: Cancer, Culture, and Translation in a Community of Russian Speakers

Dohan

Levintova

2007

J GEN INTERN MED

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BACKGROUND: Language and culture relate in complex ways. Addressing this complexity in the context of language translation is a challenge when caring for patients with limited English proficiency (LEP).OBJECTIVE: To examine processes of care related to language, culture and translation in an LEP population is the objective of this study. DESIGN:We used community based participatory research to examine the experiences of Russian-speaking cancer patients in San Francisco, California. A Russian Cancer Information Taskforce (RCIT), including community-based organizations, local government, and clinics, participated in all phases of the study.PARTICIPANTS: A purposeful sample of 74 individuals were the participants of the study. APPROACH:The RCIT shaped research themes and facilitated access to participants. Methods were focus groups, individual interviews, and participant observation. RCIT reviewed data and provided guidance in interpreting results. RESULTS:Four themes emerged. (1) Local Russianlanguage resources were seen as inadequate and relatively unavailable compared to other non-English languages; (2) a taboo about the word "cancer" led to language "games" surrounding disclosure; (3) this taboo, and other dynamics of care, reflected expectations that Russian speakers derived from experiences in their countries of origin; (4) using interpreters as cultural brokers or establishing support groups for Russian speakers could help address barriers. CONCLUSIONS:The language barriers experienced by this LEP population reflect cultural and linguistic issues. Providers should consider partnering with trained interpreters to address the intertwining of language and culture. INTRODUCTIONReflecting the resumption of trans-national migration, the number of U.S. States residents over the age of 5 who speak a language other than English at home exceeded 45 million in the 2000 census.1,2 Addressing the health care needs of LEP patients requires attention to both language and culture, which connect in complex ways among diverse patient populations. [3][4][5][6] Research has documented that differences in language and culture can cause breakdowns in provider-patient communication; that communication may be aided by language and cultural concordance between providers and patients; and that when providers and patients do not share a common language, well-trained providers and professional interpretation services provide the best outcomes. for continued exploration include how language and culture together shape the clinical encounter, how the interaction of language and culture is affected by the presence of a trained interpreter, and how health care delivery systems can best meet the challenge of communicating across the linked landscapes of language and culture.

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Section: Discussionsupporting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

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Barriers Beyond Words: Cancer, Culture, and Translation in a Community of Russian Speakers

Dohan

Levintova

2007

J GEN INTERN MED

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“…The large disparity in HRT use between Soviet immigrants and the other white women in our study may reflect cultural differences or communication difficulties due to language and translation. 52 For some of the Asian and Latina women in this study, cultural and language factors may also play a significant role in deciding on HRT use, but were not possible to address with our design.…”

Section: Discussionmentioning

confidence: 98%

Ethnic differences in hormone replacement prescribing patterns

et al. 1999

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OBJECTIVE:To determine whether prescription patterns of hormone replacement therapy (HRT) differ in African-American, Asian, Latina, Soviet immigrant, and white women. DESIGN:Retrospective review of computerized medical records. SETTING:The general internal medicine, family medicine, and gynecology practices of an academic medical center. PATIENTS:Women aged 50 years or older with at least one outpatient visit from January 1, 1992, to November 30, 1995. MEASUREMENTS AND MAIN RESULTS:Use of HRT was defined as documentation of systemic estrogen use. The main predictor variable was self-identified ethnicity. Age, diagnosis (coronary heart disease, hypertension, diabetes, osteoporosis, or breast cancer), and median income were included in the analysis. Of the 8,968 women (mean age, 65.4 years) included, 50% were white, 20% Asian, 15% African American, 9% Latina, and 6% Soviet immigrants. Whites (33%) were significantly more likely to be prescribed HRT than Asians Studies suggest that the use of postmenopausal hormone replacement therapy (HRT) reduces osteoporotic fractures, 1-7 mortality from coronary heart disease (CHD), 6,8,9 and all-cause mortality. 8,10,11 It increases the risk of endometrial cancer and probably increases the risk of breast cancer. 6,12-15 A recently completed clinical trial showed no overall benefit and some increased risk among women with established CHD randomized to take HRT compared with those taking placebo. 16 The vast majority of women in these studies were white; therefore, little is known about the relation between postmenopausal estrogens and these outcomes in women of color. Similarly, most of the studies that evaluate patterns of use of HRT, physician prescribing patterns for postmenopausal estrogens, or patient or clinician attitudes on HRT either have no data on the ethnicity of the women under consideration or have focused exclusively on white women. [17][18][19][20][21][22][23][24][25][26][27][28][29] Several studies have directly compared rates of HRT use by ethnicity. Two population-based studies found higher rates of HRT use by white women in comparison with nonwhite women. 30,31 Other population-based studies comparing HRT use among African-American and white women have found either no difference or lower rates in African Americans. [32][33][34] Results from studies using clinical samples suggest that African-American women are less likely than white women to be offered or to take HRT. [34][35][36] However, one study from a single academic clinical practice found no differences between 83 AfricanAmerican and 53 white women. 37 The only study to compare HRT use in a multiethnic sample was conducted among women physicians and found that ethnicity was not associated with personal use of HRT. 38 Several studies have evaluated the role of osteoporosis in determining HRT use and prescribing. 19,25,39,40 There is much less information on how other diagnoses, such as hypertension and CHD, affect prescribing patterns for HRT. 41,42 There are no data on the relation between patient r...

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“…Baltimore and Montgomery counties are home to more than 18,000 Russian immigrants [16]. Russian immigrants face multiple barriers to health care systems as they struggle to adjust to a health care system vastly different from the one in their country of origin [17]. …”

Section: Introductionmentioning

confidence: 99%

Genetic Education to Diverse Communities Employing a Community Empowerment Model

Mittman

1998

Public Health Genomics

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Lack of equity in access to health care, in general, and genetic services in particular, places communities of color at a distinct disadvantage when considering the rapidly evolving genetic technology. Much of this disparity is owed to lack of trust and credibility in the genetic care system as well as multiple ethnocultural barriers to services. This paper presents a 3-year community outreach demonstration project in genetic education. The project employed the premise that the empowerment of the target communities to take active part in their genetic education, with attention to a wide array of the community’s health care needs, is the most efficacious manner in which to provide genetic education to underserved communities.

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Issues in the provision of health care to Soviet emigrants

Cited by 4 publications

References 3 publications

Barriers Beyond Words: Cancer, Culture, and Translation in a Community of Russian Speakers

Barriers Beyond Words: Cancer, Culture, and Translation in a Community of Russian Speakers

Ethnic differences in hormone replacement prescribing patterns

Genetic Education to Diverse Communities Employing a Community Empowerment Model

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