Language and Cultural Barriers in Health Services

Although this subject veers off a little from my market, I do find it important to discuss it here too. We tend to speak of the Hispanic market as a big marketing billion dollar potential, but there is however, other Hispanic communities that do exist that seem to fall through the wayside.

So is the case of immigrant Hispanic communities in most of the U.S. Unlike the acculturated Hispanics where they have far greater access to services and programs, these immigrant communities go extremely underserved   in one of many of their basic needs.

One of them is not only access to healthcare but also when they do; the ability to communicate effectively with their doctor is difficult when the person has limited English proficiency.

The issue of cultural and linguistic barriers in healthcare among Hispanic immigrant communities is  far too common in the US  and although by law a language interpreter needs to be provided for them, one is usually very difficult to find or not readily available. For this reason, and more often than not, parents rely on their children-usually a child or a teenage child to fill that need.

This of course has major repercussions not only because the child  or adolescent  does not have full understanding of what the doctor is asking but also  because that  puts the child in a position of relaying to the parent a serious diagnosis or interpreting to the parent what procedures will and will  not be covered by insurance. I do believe that that takes on extreme responsibility when you are a minor child.

I personally do not interpret, have tried many times, and to me it is the most difficult task there is so I cannot imagine that responsibility delegated to a child.

Therefore many go untreated and just see a doctor when the situation gets critical.  These facilities themselves are not staffed with professional interpreters that could help in the communication process and when they do the miscommunication makes matters even worse.

On the other hand, when parents need to care for special needs children their access to services, information and treatment becomes extremely difficult.   Funding for these programs comes from federal, state and local governments and usually does not get adequate funding for these services. Not only are they extremely undeserved because of lack of funds, they are readily available for people with very limited English proficiency. Most of the information (if at all) is available and written in English leaving these parents with very little access to them. When you have to navigate educational services, therapists, educators, and special placement in a language you are not fully proficient, the task is daunting for these parents.

 This is an area where I would participate simply because that information should be available to those that need it and in particular when special needs are concerned. Actually, through a family member I have become aware of this situation and with certain organizations that work with special needs to help others with this language barrier gets the services and information they need.

Finally, when it comes to elder care cultural and religious barriers play a role too. Generally, Latinos have a large sense of community and the care they receive is highly centered on not only in the nuclear family but well beyond the extended family.  The decision making process also extends well beyond the nuclear family and it is generally arrived through a consensus. Should they be ill and in a hospital, the patient would much rather hear the bad news from a family member than from a physician, or if the case may be to hear it with a family member present.

There is a traditional feeling of piety, where one sacrifices their own wellbeing for the care of the terminally ill. Women generally take this role and actually perceive it as more of a privilege rather than obligation or duty.  Latino extended families tend to be involved from birth to death and even care for the family even after the member has passed.

These customs tend to disappear in this society where both parents work and having to care for an elderly parent at home; it is usually ends up with a caretaker at home or a nursing home.  Here is gets worse when the elder person cannot communicate with her caregivers (in a nursing home in particular) and usually does not get the proper care she needs. So they are usually neglected and extreme cases abused. It is a cultural thing as well to never complain to the family so many keep quiet about their needs and even abuse which is rampant among the elderly.


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