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Background

The “Latino community” refers to people who have familial roots in Latin America but are currently living in the United States. The term “Latino” was reintroduced to the English in the 1970s, while the community underwent many changes to how they are referred to as a community such as the term “Spanish-speaking” [1].  For this article we will refer to the community as Latino, with the use of the word Latina to refer to female individuals within his community. We will not use these terms Latinx or Hispanic, but we recognize their values to some people within the community.     

 

  • “Hispanic”: A term utilized by the American government in the 1980 census to recognize the unique needs of this community in politics and advocacy. Refers to people from Spanish-speaking countries specifically, excluding countries that predominantly speak other languages that are located in Latin America such as Brazil. Noticeably, this term includes Spain, which is located in Europe.

  • “Latino”: A term that arose as Latin American countries gained independence between 1808 and 1821. Refers to people from or who have ancestry in Latin American countries. This term intentionally distances these countries from Spain, due to the history of Spanish colonization in this region [1].

  •  “Latino” and “Hispanic” are not interchangeable; people may identify with one or both of these categories. However, these terms are still used interchangeably in government official documents [1,2]. 

  • “Chicano”: A term that gained traction in 1960s as a means for some Mexican-Americans to signify their cultural identity [1].

  • “Latinx”: A term created by the queer Latinx community in the 2000s to be more gender neutral and away from the default masculine nature of the term “Latino” [1]. It is important to note that many people may be unaware of this term because gender neutrality is a relatively new topic in this community [3].

 

Many countries make up the region of Latin America with varying beliefs regarding health. This profile will summarize significant differences compared to Western culture with specifications to country-specific beliefs when necessary. Regarding the Latino community, there are a few definitions that are critical to know:


Spanish is the main language of this community, although some of the countries within this community predominantly speak French, English, Portuguese, or Dutch. Catholicism is the common religion, resulting from Spanish colonization, although there are variants of Christianity and Protestantism also practiced [4].

Health Beliefs

  • Cultural remedies like medicinal teas, oils/ointments, and massage are often utilized for childhood illnesses.

    • Gastrointestinal complaints are often treated with teas or herbs [5].

    • The article “Cultural Health Beliefs and Practices Among Hispanic Parents” by Dr. Fowler provides a great resource into folk illnesses, remedies, and healers that could provide substantial insight into this topic

  • Some Latinos may associate physical and mental health with religion and spirituality [6].

    • Some Latinos view gratitude towards God as a source of strength in coping with their diagnosis and as a way of understanding the meaning of their disease.

  • Latino patients may be more likely to incorporate opinions from family members regarding medical and health decisions due to the collectivist nature of the culture.  

Social Traits

  • Patriarchal 

  • Age hierarchy 

  • Collectivist

  • Multigenerational living

  • Gender roles (“Machismo” and “marianismo”)

  • Spanish terms referring to the traditional ideal traits ascribed to men and women, respectively.

  • ‘Personalismo’

Implications for Health Practitioners/Health Questions

Greeting:  Physical interaction signifies friendliness and approachability [7]. A firm handshake along with eye contact is appropriate to greet Latino patients. If you are a female physician treating a male patient or vice versa, it is expected in some cultures that the female initiates the handshake if she would like to shake hands. Older patients should be treated with heightened respect [7]. 

 

Many Latinos may have two surnames: the father’s paternal family name followed by the mother’s paternal family name. This can be abbreviated to addressing the patient by the father’s paternal family name. Some countries may not adhere to this norm, such as Brazil and Argentina [7].

 

Mental Health: Mental health illnesses and treatments may be stigmatized within the Latino population. Individuals may view mental health illnesses as religious punishment or a direct burden to their families, resulting in dismissal and neglect of these symptoms. Outreach through religious institutions to promote mental health services can be beneficial to encourage well-being and treatment-seeking.  Interpretation services can also be useful in raising awareness of mental health, as some Latinos may experience difficulties in finding mental health resources given the language barrier [8].

 

Diet: The Latino diet has a wide variety of foods including meat, vegetables, legumes, and grains. In a cross-sectional analysis of Hispanic/Latino diet practices, it was found that women typically had a healthier diet than men, most likely due to men working long hours and eating more meals outside of the home [9].

Psychologist Session

Questions

  • Healthcare challenge:

    • In regard to your family history, are there any diseases/ conditions that you are concerned about? 

      • Approach this topic with sensitivity and pay special attention to coronary artery disease/cardiovascular disease and diabetes.

    • Ask patients about additional treatments that they might be using outside of medications.

      • At home, in addition to the treatment we are giving right now, is there another treatment that you are planning to follow? 

  • Social History:

    • What are your thoughts about smoking?

    • In one day, how often do you smoke? Do friends, family, or other people around you smoke? 

    • Have others expressed concern about your smoking habits?

    • It is encouraged to screen all patients for domestic violence, especially women of reproductive age. 

      • Many patients will not address this topic until asked. These questions can be asked in an indirect manner, but can also be asked directly when the situation is framed appropriately (i.e. when the patient is ALONE and their partner/family/roommate is not present). 

      • Direct questions: 

        • Unfortunately, domestic violence is common in our society, so it is recommended to ask all patients about these questions.

        • Do you feel safe at home? 

        • Has anyone at home hit or threatened you in any way?

      • Indirect questions:

        • Do you live with anyone right now?

        • How are things going at home?

    • Sample Screening and Framing Questions for Domestic Violence: 

  • Diet:

    • Tell me about your diet. What does a healthy diet look like to you?

Health Challenges

  • The Latino population suffers from worse health outcomes related to the use of commercial tobacco products when compared to other ethnic populations [10].

  • The Latino community, especially immigrants, may avoid discussions and recording information about family health history. This may be due to family dynamics, stigma, and fear of illnesses [11].  

  • Studies showed that Latino patients have the poorest medication adherence when compared to other populations [12].

  • Causes of medication adherence disparities may be influenced by health beliefs and attitudes toward the Western healthcare system. 

  • Latino patients experience significant disparities in cardiovascular disease, depression, HIV, and asthma [12].

  • Recent research in 2019 shows Hispanic patients have a 66% higher risk of developing type II diabetes when compared to non-Hispanic whites [13].

  • The lack of health insurance coverage, low family income, and the shortage of Latino healthcare professionals are all factors that exacerbate the disparities experienced by some Latino patients [14].

Women's Health

  • Conversations regarding sexual and reproductive health may be viewed as a cultural taboo in Hispanic families [15].

  • There are insufficient educational resources in school regarding sexual and reproductive health for Latina women. 

    • This makes them more vulnerable to sexually risky behaviors and have a more negative subsequent outcome such as unintended pregnancy and sexually transmitted infection [15].

  • Medicinal plants from Mexican traditional medicine are common in the management of women’s reproductive health.

    • Fennel, an aromatic plant, has traditionally been used to treat dysmenorrhea or menopause symptoms [16].

  • Studies suggest that female Latina immigrants experience higher intimate partner violence and lower self-esteem [17].

  • Latina women experience of higher mortality rate of breast and cervical cancers compared to non-Latina counterparts [18]. 

    • Rates of mammography and cervical cancer screenings among Latinas are significantly lower compared to other ethnicities.

Family Culture

  • Latino families are strongly nuclear, but it is common to see multigenerational living [7].

  • It is also common for there to be strong ties to one’s extended family. Family contributes a significant role for support for each member [1].

  • “Machismo” and “marianismo” gender roles are largely still followed.

  • In these roles, men are expected to be responsible for financial matters whereas women are expected to care for children and provide the majority of domestic labor.

  • In more recent years, countries such as Argentina and Brazil are beginning to challenge these gender roles [1].

Conclusion

  • The “Latino” community is diverse. While we describe healthcare challenges in this profile, our goal is to inform healthcare providers and to encourage further conversations with patients are necessary to identify additional healthcare needs.

  • Use of medicinal herbs and teas should be covered in a patient’s history to ensure that there is no interaction with other medications.

  • Importance of medication adherence even when patients do not feel sick (i.e. for hypertension, diabetes, etc.) should be emphasized.

  • This population is at greater risk of developing non-communicable diseases, such as hypertension, diabetes, and asthma.

  • Reproductive health is a stigmatized subject within the Latino community. Additional resources are needed for Latina women to increase access to education regarding this topic to avoid unintended pregnancy and limit exposure to STIs.

  • Patients may neglect their mental health symptoms given the stigmatization of mental health illnesses and treatments within the Latino population. Interpretational services or outreach to religious organizations may be beneficial in connecting patients to appropriate resources. 

Resources for Patients

  • Casa de Salud

    • A center to facilitate and deliver high quality medical and mental health services for uninsured and underinsured patients, focusing on new immigrants and refugees who face barriers to accessing other sources of care.

    • Address: 3200 Chouteau Avenue St. Louis, MO 63103

    • Phone Number: 314-977-1250 - Mon to Fri: 9 am - 4 pm; Sat: 9 am - 12 pm; Sun: 1pm - 5pm

    • Link: https://www.casadesaludstl.org/

  • Hispanic Chamber of Commerce - Metro St. Louis

    • An organization that focuses on strengthening Hispanics’ participation in the St. Louis community.

    • Address: 20 S. Sarah St. St. Louis, MO 63108

    • Phone Number: 314-664-4432

    • Link: https://www.hccstl.com/

  • Therapy for Latinx

    • An online service to provide resources for the Latinx community to heal, thrive, and become advocates for their own mental health.

    • Link: https://www.therapyforlatinx.com/

  • Sample Screening and Framing Questions for Domestic Violence: 

  • Link: https://domesticabuse.stanford.edu/screening/how.html 

This information was collected and organized by our team. As of this time, we have not yet been able to connect with any individuals in this community that could review this article. If you are interested in reviewing this article, please contact kaitlynn.borik@health.slu.edu 

References

(1)Simon, Y. (2023, September 25). Latino, Hispanic, Latinx, Chicano: The History Behind the Terms. History. Retrieved April 28, 2024, from https://www.history.com/news/hispanic-latino-latinx-chicano-background 

(2)Lopez, M. H., Krogstad, J. M., Passel, J. S. (2023, September 5). Who is Hispanic?. Pew Research Center. Retrieved April 28, 2024, from Pew Research Center. https://www.pewresearch.org/short-reads/2023/09/05/who-is-hispanic/ 

(3) Britannica, T. Editors of Encyclopaedia (2023, August 11). What’s the Difference Between Hispanic and Latino?. Encyclopedia Britannica. https://www.britannica.com/story/whats-the-difference-between-hispanic-and-latino 

(4) Pew Research Center . (2023, April 13). Among U.S. Latinos, Catholicism Continues to Decline but Is Still the Largest Faith. Pew Research Center . https://www.pewresearch.org/religion/2023/04/13/among-u-s-latinos-catholicism-continues-to-decline-but-is-still-the-largest-faith/

(5) Fowler, A. F., Mann, M. E., Martinez, F. J., Yeh, H., Cowden, J. D. (2022, January). Cultural Health Beliefs and Practices Among Hispanic Parents. https://journals.sagepub.com/doi/full/10.1177/00099228211059666

(6) Gast, J., Peak, T., Hunt, A. (2017, June 23).  Latino Health Behavior: An Exploratory Analysis of Health Risk and Health Protective Factors in a Community Sample. American journal of lifestyle medicine, 14(1), 97–106. https://doi.org/10.1177/1559827617716613 

(7) Evason, N. (2018). Mexican Culture. Cultural Atlas. https://culturalatlas.sbs.com.au/mexican-culture

(8) Mental Health America (2024). Latinx/Hispanic Communities and Mental Health. Retrieved April 13, 2024, from https://www.mhanational.org/issues/latinxhispanic-communities-and-mental-health

(9) Overcash, F., & Reiks, M. (2021, February). Diet Quality and Eating Practices among Hispanic/Latino Men and Women: NHANES 2011–2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908517/

(10) Perez-Stable, E. J., Ramirez, A., Villareal, R., Talavera, G. A., Trapido, E., Suarez, L., Marti, J., McAllister, A. (2000, October 10). Cigarette Smoking Behavior Among US Latino Men and Women From Different Countries of Origin. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.91.9.1424

(11) Corona, R., Rodríguez, V., Quillin, J., Gyure, M., & Bodurtha, J. (2013). Talking (or not) about family health history in families of Latino young adults. Health education & behavior : the official publication of the Society for Public Health Education, 40(5), 571–580. https://doi.org/10.1177/1090198112464495 

(12) Zagaar, M., & Ndefo, U. A. (2017, January). Medication Nonadherence in the Latino Population: A Challenge and an Opportunity for Specialized Services. https://www.pharmacytimes.com/view/medication-adherence-in-the-latino-population

(13) Fortmann, A. L., Savin, K. L., Clark, T. L., Philis-Tsimikas, A., Gallo, L. C. (2019, November 1). Innovative Diabetes Interventions in the U.S. Hispanic Population. https://diabetesjournals.org/spectrum/article/32/4/295/32396/Innovative-Diabetes-Interventions-in-the-U-S

(14) Valdez, R. B., Giachello, A., Rodriguez-Trias, H., Gomez, P., de la Rocha, C. (1993). Improving access to health care in Latino communities. https://pubmed.ncbi.nlm.nih.gov/8416110/

(15) Larson, K., Sandelowski, M., McQuinston, C. (2011, July 8). “It’s a Touchy Subject”: Latino Adolescent Sexual Risk Behaviors in the School Context. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193909/

(16)Cabada-Aguirre, P., López López, A. M., Ostos Mendoza, K. C., Garay Buenrostro, K. D., Luna-Vital, D. A., Mahady, G. B. (2023, February 16). Mexican traditional medicines for women’s reproductive health. https://www.nature.com/articles/s41598-023-29921-1.

(17) Gonzalez-Guarda, R. M., Vermeesch, A. L., Florom-Smith, A. L., McCabe, B. E., Peragallo, N. P. (2013, January 29). Birthplace, culture, self-esteem, and intimate partner violence among community-dwelling Hispanic women. https://pubmed.ncbi.nlm.nih.gov/23363655/

(18) Paz, K., & Massey, K. P. (2016, July). Health Disparity among Latina Women: Comparison with Non-Latina Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955974/

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