There are so many hurdles to receiving health care for many Americans. These issues are often regarding things that well-off Americans take for granted. Things like being able to visit a primary physician when something’s not right or turning over a health insurance card to the assistant behind the desk at a hospital. These, and many other things, are struggles that minorities all over the country face; however, not all for the same reasons. It is so important for not only healthcare professionals but for all people to be aware of the cultural differences that reside all around them.
Being an immigrant can be a very stressful situation. To leave everything that is comfortable and having to learn a whole new way of life can be a very tough adjustment. Latino/Hispanic Americans are often migrant, seasonal workers. This often puts them at a disadvantage financially (HHS office of minority health, 2016). According to a 2000 study, Hispanic men were making 17.8% less in hourly wages and Hispanic women were making 35.1% less than their white counterparts (Paul, 2018). Since then, these numbers have dropped slightly but there have been no significant changes. Paul explains that for men the gap in wages is based solely on education; however, for women, studies have shown that the gap exists due to gender and racial discrimination (2018).
Wages are not the only social injustice that Latino/Hispanic American see. Considering that the earliest Hispanic immigrants came to America and worked as unskilled workers there are a lot of stereotypes that affect Hispanic Americans today. More educated Hispanic Americans actually report experiencing more stereotyping and discrimination than unskilled workers. It is suspected that this is because educated Hispanic Americans have greater interaction with Non-Hispanic Americans (Ortiz & Telles, 2013). Although discrimination is a thing that many people like to pretend doesn’t exist, it is very real and impacts minorities every day. Latino and Hispanic Americans face many barriers and risks that can make their lives more difficult. One barrier is one of language. 48.6 million people in the United Stated speak fluent Spanish (Carter, 2018). While many of those people are bilingual, there are still those who are not. Lacking the ability to speak English, the most popular language in the U.S. can make it incredibly difficult for one to participate in social activities, receive education, or find work. Education is a barrier in and of its self for Latino and Hispanic Americans. 57% of Hispanic voters prioritize education as one of the biggest issues for the population (Krogstad, 2014).
Education is a difficult barrier to overcome because of the discrimination associated with it. Educated Hispanic Americans encounter more discrimination because they have greater interaction with Whites. According to Ortiz and Telles, “having greater contact with Whites leads to experiencing more stereotyping and discrimination” (2013). This level of discrimination can make it hard to participate in a learning environment. Studies have shown that Latino children are 60% more likely to attempt suicide as a high school student than non-Hispanic white children (Families USA, 2014). Another barrier associated with Latino and Hispanic Americans is finding work. Because Hispanic Americans have lower levels of education the Whites and Blacks, finding good work can be challenging (Ortiz & Telles, 2013). Lack of education means that Hispanic Americans mainly work as unskilled labor.
The most common unskilled labor jobs for Hispanic and Latino American are construction, road work, and seasonal farming and harvesting (Paul, 2018). These jobs are often extremely labor intensive and often pay very little. These jobs are also contingent on the amount of work that needs to be done or on the time of year. Seasonal work can be difficult to find and can be more difficult depending on what state they live in. One risk that Latino and Hispanic American face is deportation. In 2015, there were about 11 million illegal or undocumented immigrants living in the United States (Robertson, 2018). Many immigrants will refrain from certain social actives, educational opportunities, and receiving healthcare for the fear of being deported.
Aside from the general barriers listed above, there are also barriers faced by Latino and Hispanic American as related to health. Compared to non-Hispanic whites, Latino adults are 65% more likely to be diabetic, 6 times more likely to have tuberculosis, 2.5 times more likely to have and die from HIV, and are 45% more likely to develop cervical cancer and 40% more likely to die from it (Families USA, 2014). Hispanic American also have higher rated of obesity (HHS office of minority health, 2016). Many of these conditions are preventable or manageable with proper medical care. However, many Latino Americans avoid receiving healthcare due to language barriers, lack of health insurance, legal status, privacy concerns. The Latino community is a very private one and people don’t often discuss their issues in public (NAMI, 2018). Another reason one may not seek out proper treatment is lack of information. Many Latinos are not able to recognize the signs and symptoms of most conditions because they are things that were never taught to them (NAMI, 2018).
One of the biggest things that may hold one back from receiving health care is legal status. According to the NAMI, even though children of undocumented immigrants are eligible for health care under the Affordable Care Act, most families refuse to register for these services due to fear of separation and deportation (2018). Also, in 2015, 19.5 percent of the Hispanic population did not have health insurance (HHS office of minority health, 2016). This is in part due to legal status, but also is a direct result of lower education levels and unskilled labor positions. Most positions that require a higher level of education allow access of health insurance which is typically cheaper than seeking out individual health insurance. As a healthcare professional, an OTA can use their knowledge of cultural differences to engage with the client as effectively as possible. For example, Latino and Hispanic American place a great value on their extended families (Early, 2017). Being able to integrate family involvement and interaction into the interventions for the client may help create better outcomes. However, as privacy is also important in the Latino community, it is critical to understand how much involvement is appropriate. When working with a client who either does not speak English or may not speak it well, it may be helpful to remember that most facilities have access to interpreters and many medical documents can be printed in Spanish (NAMI, 2018).
It is also very important to make sure that instructions, goals, techniques, and expectations are communicated in a way that is easy to understand. Due to the lower education rates, it is crucial that information is given in a way the client can understand. However, it is so important to ensure that the client is not treated as though they are incompetent because that is most likely not the case. Laymen’s terms can be very helpful in this area. As an OTA, one should always remember that the client is of no less value than the clinician, they are equals and it would be unethical to act any differently. Discrimination is not okay under any circumstances.
As a clinician, it is vital to be aware of the client’s culture and how it may impact treatment. There may be many things that an OTA may not just know, but many cultural aspects can become apparent just by observing. Body language is a great thing to be vigilant of. Although an OTA may not be familiar with every culture and all that they may entail, it is a great skill to learn how to ask about these things respectfully. If an OTA were to offend or make a client uncomfortable due to a cultural difference it is so important to be humble and modest enough to apologize and try to make things right by the client. Overall, it comes down to respect. Respect reflects across all cultures and is always appreciated, no one likes to be treated poorly. Clinicians owe it to their clients to treat them to the best of their abilities, this includes being aware of cultural differences.