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Hispanics are the fastest growing ethnic group in the United States over the last 10 years. The year 2000 Census will soon confirm whether or not Hispanics outnumber African Americans as the majority minority. Available statistics reveal that health problems of the three main groups of Hispanics in the United States (Mexican Americans, Puerto Ricans, and Cubans) include diabetes, injuries and violence, substance abuse, HIV/AIDS, limited access to health care, and many other problems shared by the poor and disenfranchised. Evidence also indicates that Hispanics are under immunized, delay seeking care when ill, and seldom obtain screening health examinations. The health care provider may intervene with Hispanic clients and communities in culturally sensitive ways such as viewing culture as an enabler rather than a resistant force, incorporating cultural beliefs into the plans of care, stressing familialism, taking time for "pleasant conversation", refraining from harsh criticism, and involving the community in
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preventive health care programs. Such interventions require providers who are knowledgeable about the culture, customs, beliefs, and language of the Hispanics within their practice area.
Health care providers need to determine how the client has been treating the problem at home. Simple remedies, such as teas or mint, are often used for perceived ailments. For serious complaints other family members or a curandera (folk healer) may be consulted. Clients may not feel satisfied with treatment and therefore may be less likely to comply with the prescribed regimen if personal conversation, simpatia, is avoided. Simpatia refers to a Hispanic cultural need for positive, smooth, interpersonal relations. The provider who recognizes and uses simpatia will be polite, respectful, and will refrain from harsh criticism or confrontation. At the same time, simpatia makes it important that Hispanics appear to agree even if they do not understand the message. Personalismo refers to the Hispanics' preference for health care providers that use "pleasant conversation" or who are Hispanics with similar backgrounds.
(Continued on Page 2)
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