Hispanic American Health Care Manpower
As seen in Table 12–10, it is evident that the numbers of Hispanics or Latinos enrolled in the health professions’ schools is well below the percentage (16.3%) of Hispanic or Latino people in the American resident population.
Recent nursing data are not included in the overall health professions enrollment data in Table 12–10. However, the National Sample Survey of Registered Nurses 2008 prepared by the Bureau of Health Professions of the Health Resources Administration provides relevant information regarding the demographic profile of American Registered Nurses. It estimates that the reg- istered nurse population in the United States in 2008 was 3,063,162, with
318 ■ Chapter 12
Table 12–10 Percentage of Hispanic or Latino Americans Enrolled in Selected Health Professions Schools Compared with Non-Hispanic Whites: 2007–2008
Number Enrolled
Non-Hispanic Whites (%)
Hispanic or Latino American (%)
Dentistry 19,342 60.6 6.3 Allopathic medicine 74,518 62.4 3.1 Osteopathic medicine 15,634 70.5 3.6 Optometry 5,556 60.3 4.6 Pharmacy 50,691 59.5 4.0 Podiatry 2,095 62.2 5.4 Public Health 22,604 59.3 8.8
Source: U.S. Department of Health and Human Services & National Center for Health Statistics. Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD. 2011: Author, pp. 352–353. Retrieved from www.cdc.gov/nchs/data/hus/hus10.pdf, December 11, 2011.
2,596,599 registered nurses employed in nursing. Of this number, 83.2% were White non-Hispanic and 3.6% were Hispanic or Latino American (United States Department of Health and Human Services, Health Resources and Ser- vices, 2010). Given that in 2010 the White alone population was 63% of the total population and Hispanic or Latino American people comprised 16.3% of the resident population, this is a clear indication that there is no demo- graphic parity in the percentage of Hispanic or Latino American people in nursing. This demographic picture and the percentages in the tables demon- strate a situation that is an ongoing concern. Somnath and Shipman (2006), who reviewed a total of 55 studies, found that minority patients tend to re- ceive better interpersonal care from practitioners of their own race or ethnicity, particularly in primary care and mental health settings, and that non–English speaking patients experience better interpersonal care, greater medical compre- hension, and greater likelihood of keeping follow-up appointments when they see a language-concordant practitioner. They concluded their study by stat- ing that “the findings indicated greater health professions diversity will likely lead to improved public health by increasing access to care for underserved populations, and by increasing opportunities for minority patients to see prac- titioners with whom they share a common race, ethnicity or language.” They also stated that “race, ethnicity, and language concordance, which is associ- ated with better patient-practitioner relationships and communication, may in- crease patients’ likelihood of receiving and accepting appropriate medical care” (Somnath & Shipman, 2006, p. 17).
HEALTH and ILLNESS in the Hispanic Populations ■ 319
RESEARCH ON CULTURE
Much research has been conducted among members of the Hispanic American population. The following article describes one such study:
Whittemore, R. (2007). Culturally competent interventions for Hispanic adults with type 2 diabetes: A systemic review. Journal of Transcultural Nursing, 18 (2), 157–166.
Significant research has been conducted in the past several decades with the goal of reducing health disparities in Hispanic adults with type 2 diabetes. The purpose of this study was to describe and synthesize the research on cultur- ally competent interventions aimed at improving outcomes in the target popula- tion. The author used an integrative review method to describe the intervention components of culturally competent interventions; the efficacy of interventions in terms of clinical outcomes, behavioral outcomes, and knowledge; cultural strat- egies of interventions; and factors associated with attendance and attrition of interventions. She analyzed 11 studies conducted between 1994 and 2005 on this topic and found that most culturally competent interventions were efficacious. The culturally competent interventions included community-based education in the language—Spanish—understood by the patients. Other strategies included family involvement, translation as needed, bilingual professional staff, emphasis on types of food, and support groups.
Other interventions that were examined included the following:
• Clinical outcomes. Improvements in glycemic control with education were documented.
• Behavioral outcomes. Evaluation of dietary and exercise behaviors and sig- nificant improvements were found.
• Diabetes-related knowledge. A significant increase in diabetes-related knowledge was reported for participants who received culturally compe- tent interventions.
The author notes that the development of culturally competent interventions requires attention to countless cultural factors, is complex, and requires a multi- disciplinary and multifaceted approach.
Go to the Student Resource Site at nursing.pearsonhighered.com for chapter-related review questions, case studies, and activities. Contents of the CULTURALCARE Guide and CULTURALCARE Museum can also be found on the Student Resource Site. Click on Chapter 12 to select the activities for this chapter.
Explore MediaLink
320 ■ Chapter 12
■ Internet Sources DeNavas-Walt, C., Proctor, B. D., & Smith, J. C. (2010). Income, Poverty, and
Health Insurance Coverage in the United States: 2009. United States Census Bureau. Retrieved from http://www.census.gov, July 7, 2011.
Ennis, S. R., Rios_Vargas, M. and Albert, N. G. (2011). The Hispanic population in the United States. Retrieved from http://2010.census.gov/2010census/data/, July 11, 2011, p. 3.
Humes, K. R., Jones, N. A., & Ramirez, R. R. (2011). Overview of Race and Hispanic Origin: 2010. U.S. Department of Commerce, U.S. Census Bureau, Census 2010. Retrieved from http://www.census.gov/, June 27, 2011.
Lee, J. (2011). Annual Flow Report U.S. Naturalizations: 2010. U.S. Department of Commerce, Economics and Statistics Administration, Office of Homeland Security, Office of Immigration Statistics. Retrieved from http://www.dhs. gov/files/statistics/publications/gc_1302103955524.shtm, June 1, 2011.
Monger, R., & Yankay, J. (2011). Annual Flow Report. U.S. Legal Permanent Residents: 2010. U.S. Department of Commerce, Economics and Statistics Administration, Office of Homeland Security, Office of Immigration Sta- tistics. Retrieved from http://www.dhs.gov/files/statistics/publications/ gc_1301497627185.shtm, June 1, 2011.
Somnath, S., & Shipman, S. (2006). The Rationale for Diversity in the Health Professions: A Review of the Evidence. Washington, DC: U.S. Department of Health and Human Services, Health Resources and Services Administra- tion, Bureau of Health Professions. Retrieved from http://www.hrsa.gov/, January 5, 2008.
Box 12–2 Keeping Up
It goes without saying that much of the data presented in this chapter may be out of date when you read this text. However, at this final stage of writing, it is the most recent information available. The following resources will be most helpful in keeping you abreast of the frequent changes in health care events, costs, and policies:
1. The National Center for Health Statistics publishes Health, United States, an annual report on trends in health statistics. It can be retrieved from http://www.cdc.gov/nchs/hus.htm. Health, United States, 2011 is not available and Health, United States, 2012 will be published in May, 2012.
2. Health-related data and other statistics are available from http:// www.cdc.gov/DataStatistics/.
3. To follow immigration information—U.S. Department of Commerce Economics and Statistics Administration, Office of Homeland Security, http://www.dhs.gov/.
HEALTH and ILLNESS in the Hispanic Populations ■ 321
Texas Department of State Health Services. (2011). 2008 Health Facts Profiles for Texas. Retrieved from http://www.dshs.state.tx.us/chs/cfs/2008/2008- Health-Facts-Profiles-for-Texas/, July 11, 2011.
Texas Department of State Health Services. (2011). Midwife, Direct Entry (DEM) by County of Residence 2010. Retrieved from http://www.dshs.state.tx.us/chs/ hprc/tables/Midwife,-Direct-Entry-%28DEM%29-by-County-of-Residence— September,-2010/, December 11, 2011.
U.S. Census Bureau. (2011). Statistical Abstract of the United States: 2012. Re- trieved from http://2010.census.gov/2010census/data/, December 4, 2011.
U.S. Department of Health and Human Services & National Center for Health Statistics. (2011). Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD: Author, pp. 146–147. Retrieved from www.cdc. gov/nchs/data/hus/hus10.pdf, December 11, 2011.
U.S. Department of Health and Human Services, Health Resources and Services. (2010). The National Survey of Registered Nurses 2008 Documentation for the General Public Use File, 2006. Bureau of Health Professions, Health Resources and Services Administration. BHPr/HRSA and the National Sample Survey of Registered Nurses. Retrieved from http://www.hrsa.gov/data-statistics/index. html, June 28, 2011.
■ References Carmack, R. M., Gasco, J., & Gossen, G. H. (1996). The legacy of Mesoamerica.
Upper Saddle River, NJ: Prentice Hall. Castillo, J. Former director, Division of Health Related Professions. (1982, April 6).
Personal Letter. Brownsville: Texas Southmost College. Cohen, R. E. (1972, June). Principles of preventive mental health programs for
ethnic minority populations: The acculturation of Puerto Ricans to the United States. American Journal of Psychiatry, 128(12), 79.
Currier, R. L. (1966, March). The hot-cold syndrome and symbolic balance in Mexican and Spanish-American folk medicine. Ethnology, 5, 251–263.
Dorsey, P. R., & Jackson, H. Q. (1976). Cultural health traditions: The Latino/ Mexican perspective. In M. F. Branch & P. P. Paxton (Eds.), Providing safe nursing care for ethnic people of color. New York: Appleton-Century-Crofts.
Egan, M. (1991). Milagros. Santa Fe: Museum of New Mexico Press. Flores-Peña, Y., & Evanchuk, R. J. (1994). Santeria garments and altars. Jackson:
University of Mississippi Press. Flores-Peña, Y. (1991). Personal interview. Los Angeles, CA. Gonzalez-Wippler, M. (1987). Santeria—African magic in Latin America.
New York: Original. Greenhaw, W. (2000). My heart is in the earth. Montgomery, AL: River City. Harwood, A. (1971). The hot-cold theory of disease: Implications for treatment
of Puerto Rican patients. Journal of the American Medical Association, 216, 1154–1155.
Kearney, M., & Medrano, M. (2001). Medieval culture and the Mexican American borderlands. College Station: Texas A & M University Press.
Lucero, G. (1975, March). Health and illness in the Mexican community. Lecture given at Boston College School of Nursing.
322 ■ Chapter 12
Maduro, R. J. (1976, January). Curanderismo: Latin American folk healing. Conference, San Francisco.
Mumford, E. (1973, November–December). Puerto Rican perspectives on mental illness. Mount Sinai Journal of Medicine, 40(6), 771–773.
Nall, F. C., II, & Spielberg, J. (1967). Social and cultural factors in the responses of Mexican-Americans to medical treatment.Journal of Health and Social Behavior, 8, 302.
Riva, A. (1990). Devotions to the saints. Los Angeles: International Imports. Rubel, A. J. (1964, July). The epidemiology of a folk illness: Susto in Hispanic
America. Ethnology, 3(3), 270–271. Saunders, L. (1958). Healing ways in the Spanish southwest. In E. G. Jaco (Ed.),
Patients, physicians, and illness. Glencoe, IL: Free Press. Schilling, B., & Brannon, E. (1986). Health-related dietary practices. In Cross-
cultural counseling: A guide for nutrition and health counselors. Alexandria, VA: U.S. Department of Health and Human Services.
Spector, R. (1996). Cultural diversity in health and illness (4th ed.). Stamford, CT: Appleton & Lange.
Spencer, R. T., Nichols, L. W., Lipkin, G. B., et al. (1993). Clinical pharmacology and nursing management (4th ed.). Philadelphia: Lippincott.
Welch, S., Comer, J., & Steinman, M. (1973, September). Some social and atti- tudinal correlates of health care among Mexican Americans. Journal of Health and Social Behavior, 14, 205.