Cultural Competency

As Hispanic Heritage Month begins, AzHHA is proud to partner with local organizations that know the Hispanic population and are committed to advancing the health of the Hispanic community in Arizona. Dr. Veronica Vital, President of the National Association of Hispanic Nurses, Phoenix Chapter, is a native of Mesa, Arizona who has dedicated a great deal of her energy and education in addressing the care and health disparities experienced by Hispanics.  She provided the guest blog below to bring attention to some of the staggering statistics regarding health in the Hispanic population.

The U.S. is a country that is rich in cultural diversity. According to the U.S. Census, approximately 33% (>100 million persons in U.S.) self-identified as belonging to a racial or ethnic minority population in 2008 and it is projected that by 2050 minorities will represent approximately 33% of the U.S. population. According to the Pew Research Center (2016), an estimated 57 million Hispanics resided in the U.S. in 2015. They also reported that in 2014 over 2.1 million Hispanics lived in Arizona representing 31% of the population.

Hispanics are the fastest-growing population in the country and it is projected that by 2030 one out of every three children will be Hispanic. Minorities are disproportionately affected by health disparities such as diabetes, obesity and heart disease. According to the American Diabetes Association, the prevalence of Hispanics with diabetes is 16.9% compared to 10.1% for their non-Hispanic white counterparts. Furthermore, Hispanics are at high-risk of developing complications from diabetes as a result of poor glycemic control and inadequate diabetes management.

Hispanics are also negatively impacted by obesity. Approximately 77% of Hispanics are overweight or obese compared to 67.2% of non-Hispanic Whites. An alarming 38.9% of Hispanic children are overweight or obese compared to 28.5% of Whites. These children are at risk of developing chronic diseases at a young age.

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Cultural background, health and religious beliefs, and language can influence health outcomes for minority populations. Therefore, it is important to provide culturally competent healthcare. Cultural competence is a “multidimensional process that aims to achieve culturally congruent health care…that is customized to fit with the client’s cultural values, beliefs, traditions, practices, and lifestyle.”

Barriers to effective communication, which include Limited English Proficiency (LEP) and limited Health Literacy, also contribute to poor health outcomes. Healthcare providers who are unable to communicate with their patients are less likely to provide adequate care. Ineffective communication between the healthcare provider and the patient increases the risk for inappropriate administration of medications, adverse medication reaction, and inability to adhere to the recommended regimen. Hispanics who are LEP can be viewed as non-compliant due to the fact that they may not follow prescribed medical instructions. However, the issue may be that they do not understand what is being prescribed. Patients may be more willing to receive or seek care from a provider who speaks their language and who may share the same culture.

Providing linguistically and culturally competent care can enhance the care provided for the Hispanic population. Providing education /instructions in a language that the patient understands and incorporating the culture when developing a plan of care can promote positive health outcomes. Patients who understand the plan of care may be more willing to adhere to recommend regimens. Healthcare providers must also understand that the Hispanic culture has diverse subgroups.

It is important to recognize that despite the cultural commonalities Hispanics share, there are unique practices and behaviors in each subgroup. Providers must avoid stereotyping and assess their own biases to ensure the delivery of culturally competent care to optimize health outcomes.

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