Published in UAB Insight, Winter 2008
Two-way Street Calls for Cultural Awareness
Estimates are that by 2017 the Latino immigrant community will grow to 10% of the population in Alabama and other southern states. Physicians already face significant challenges to understand their Latino patients’ feelings about the American health care system as well as cultural differences that can affect their care. Language is one problem, of course, but not the only one, says preventive medicine researcher Isabel Scarinci, PhD, MPH, a member of the UAB Minority Health and Research Center. Through funding from the National Cancer Institute, Scarinci and colleagues are implementing Sowing the Seeds of Health, an educational program to reduce breast and cervical cancer disparities between Alabama Latinos and whites.
In partnership with UAB’s Continuing Medical Education program, Scarinci’s group has created a free DVD to help physicians and other health care providers overcome the cultural divide that can interfere with immigrant patients’ care.
“The DVD grew out of our program to reduce breast and cervical cancer incidence by helping Latinos navigate our health care system and gain the benefits of preventive medicine,” Scarinci says. “We saw that educating physicians and others about the nuances of communicating with Latinos would help bridge their differences. We hope viewing the DVD makes health care providers more comfortable in their interactions with this community.”
The need to improve communication is apparent, says Scarinci. Approximately 80% of immigrants do not have a regular health care provider. She notes:
- Latinas have cervical cancer at twice the rate of whites.
- Latinas have a 40% higher mortality rate from cervical cancer than white women, primarily due to lack of screening and a delay in seeking care for symptoms.
- Breast cancer is the leading cause of cancer deaths among Latinas. Among non-Latinas, lung cancer is the most common cause.
Many issues arise from differences between the Latin American and US health care systems and the major role that culture plays in patient-provider interactions. Scarinci says immigrants often prefer to pay cash for medical services if possible, as they can find the US health care billing system confusing and sometimes threatening.
“Latino patients are used to going to the doctor without an appointment and expect a long wait. They often find US doctors distant. For example, Latinos are used to physicians rather than nurses drawing blood and taking blood pressures,” she says.
In Latin America nonnarcotic medications are sold cheaply over-the-counter. Alternative medicines, including herbal remedies, are common, as is sharing unused medications. Knowing that many US physicians disapprove of these customs, immigrants often hide such practices from their physicians.
“Latino immigrants often fear test results and may not comply with follow-up treatments — especially for a cancer diagnosis, which still carries a heavy stigma in Latin America,” she says.
View the DVD at www.dopm.uab.edu/sowingtheseeds. For copies contact Allison McGuire at 205.996.2923 or amcguire@uab.edu.
For more information:
Isabel Scarinci
1.800.UAB.MIST
mist@uabmc.edu