This impact report is written to address the Hispanic population from Mexico and to describe the health concerns and issues of this immigrant population. The report includes cultural values, traditions and pharmacological treatments used in the Hispanic population. Hispanic populations are spread throughout multiple geographical areas, but the focus on this report is the Hispanic population from Mexico.
The health concerns and issues for this population include a high incidence of diabetes, hypertension and cardiovascular disease. As compared with non –Hispanic whites, Hispanics have a higher incidence of Type 2 Diabetes. Because of this, complications associated with diabetes are greater for Hispanics than for other populations. These complications include heart disease, retinopathy, kidney disease, hypertension, and peripheral vascular disease. Hispanics have a prevalence of hypertension and are less likely than non- Hispanics to have their blood pressure under control. This contributes to the high incidence of cardiovascular disease in this group. There is a higher incidence of ischemic heart disease related deaths in the Hispanic group, especially among women. (Escarce, Morales, Rumbaut, 2006)
The current pharmacological treatment regimens for this group of people for the treatment of diabetes includes oral hypoglycemic and insulin therapy. Because of the high incidence of Type 2 Diabetes in Mexico among Hispanics, oral hypoglycemic will be discussed. The classes of oral hypoglycemic that may be used include biguanides, sulfonylureas meglitinides thiazolidinediones dipeptidyl peptidase IV inhibitors and α-glucosidase inhibitors. (Garber, 2003)
In treating hypertension, the pharmacological treatment includes antihypertensive medications from several classes including beta blockers, ace inhibitors, etc. Also used to treat hypertension are diuretics. For cardiovascular issues such as ischemic heart disease, nitrates, diuretics, antiplatelets and blood thinners are used. Other pharmacological treatment may be needed based on the complications associated with diabetes, hypertension and cardiovascular disease. (Gradman, 2010)
There are traditional beliefs and practices associated with the health concerns and issues among this group of people. The Mexican population believes that being in good health is a blessing and a gift from God. They believe that good health maintains their life equilibrium. This equilibrium is achieved through prayer, rituals, and objects associated with their religion. They believe that treating people fairly contributes to equilibrium as well. The family often gets together to discuss and make decisions concerning healthcare. The family is valued over the individual. The man is the head of the family and makes decisions about healthcare for his family. Hispanics often seek help from family first or turn to a curandero for help. A curandero is a Mexican man who practices healing techniques. (Dewitt, 2014)
This population engages in culturally based methods for treating health concerns. The Hispanics believe in restoring equilibrium and good health through “hot” or “cold” foods. This is not about the temperature of food, but it is a classification of how foods react within the body. They have a list of foods that are in the “hot” or “cold” group based on past illnesses and how they feel. The Hispanic population usually wears religious objects to address and treat health concerns. These include scarves, rosary beads, prayer cloths, etc. They also use a variety of herbs and spices to treat health related issues. (Dewitt, 2014)
Cultural values and traditional practices affect acceptance and use of prescribed pharmacological treatments. The cultural traditions mentioned above often prevent or delay the use of pharmacological treatments. Since good health and equilibrium are associated with their relationship with God, admitting the need for help with pharmacological treatments is seen as a weakness and often avoided. Mexican men are often stoic in their dealing with health related issues. Since the family is patriarchal, this type of behavior flows down through the rest of the family. The strong belief in the use of herbs and spices for preventing and treating illnesses delays treatment with prescribed pharmacological medications. Sometimes, unless life threatening, the Mexican population avoids the use of pharmacological treatment all together. (Escarce, Morales, Rumbaut, 2006)
Relationships exist between quality patient outcomes, patient safety and the appropriate use of pharmacology among Hispanics. Typically, due to cultural issues, financial situations, etc., many Mexicans are noncompliant with medication regimens. For instance, they may take a blood pressure medication only when a blood pressure reading is high and not take it daily as prescribed. The same is true for diabetic medications. It may only be taken when a blood glucose reading is high rather than daily to maintain an adequate glucose level. This type of behavior related to pharmacological therapy decreases patient safety and promotes poor quality patient outcomes. Other times, Hispanics may decide not to use prescribed medications at all and only use herbal medicines and spices as treatment for diseases. The lack of traditional medications can contribute to poor patient outcomes.
There are culturally sensitive strategies the company use to educate this population about the correct use of pharmacology. Because of the ritualistic customs associated with group, the company can incorporate medication dosage times with cultural rituals so that they will be appealing and they will not be forgotten. Teaching can be directed by the company toward the male head of the family in the patriarchal household. Understanding of the importance of using pharmacology and complying with prescribed treatments would be passed down to other family members from there. Being sensitive to cultural communication among this population will enhance teaching in the correct use of pharmacology.
The nurse, too, can employ culturally sensitive strategies to promote health and wellness.
The nurse needs to establish a trusting relationship and involve the family in promoting wellness and health. The nurse should be sensitive to cultural issues and remain nonjudgmental in the care that is given. Encouraging a healthy diet and exercise will help to promote overall health. Obesity is one of the problems in this group that contributes to diabetes, hypertension and cardiovascular disease. The nurse needs to remain sensitive to dietary practices, religious practices, complementary and alternative medicine, family roles, etc. (Juckett, 2013)
- DeWit. (2014) Fundamental Concepts and Skills for Nursing, Cultural and Spiritual Aspects of Patient Care, Elsevier, 4th Edition
- Escarce JJ, Morales LS, Rumbaut RG. The Health Status and Health Behaviors of Hispanics. In: National Research Council (US) Panel on Hispanics in the United States; Tienda M, Mitchell F, editors. Hispanics and the Future of America. Washington (DC): National Academies Press (US); 2006. 9. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19899/
- Garber AJ. Benefits of Combination Therapy of Insulin and Oral Hypoglycemic Agents. Arch Intern Med. 2003;163(15):1781-1782. doi:10.1001/archinte.163.15.1781
- Gradman, A., (2010). Combination therapy in hypertension. Journal of the American Society of Hypertension, Volume 4, Issue 1, 42 – 50
- Juckett, G. (2013). Caring for Latino patients. American Family Physician, 1; 87 (1):48-54.
