The Latino Patient

1. The Latino Patient Berta Alicia Bejarano, M.B.A., C.I. Diversity Director Kaiser Permanente

2. What Is Diversity? - Race - Language • Ethnicity - Employment • Age - Gender • Income - Sexual Orientation • Education - Social Status

3. Cultural Competence Is the delivery of health care services that acknowledges and understands cultural diversity in the clinical setting, respect member’s health beliefs and practices, and values cross-cultural communication.

4. How Many Languages Do Our Kaiser Members Represent? • 120 Different Spoken Languages • 110 Written Languages • 80% of KP hospitals & clinics encounter LEP patients • 63% daily/weekly • 17% monthly

5. Latinos in the U.S. • 50 million today • 20 years • 150 million • Demographic revolution • Health Care Reform

6. Latinos & Diabetes • 2000 2 million of the 30 million Hispanics in America had diabetes • 1/3 unaware • 5% of Latinos between the ages of 20 and 44 have diabetes • 20% of Latinos between the ages of 45 and 74 have diabetes • Half of all Latinos with diabetes have not been diagnosed.

7. Why Resistance? • Do not feel sick • Interruption of their lifestyles • Interruption of their work • Side effects of medication • Home/natural remedies instead of medication

8. Challenge • Latinos with diabetes often are labeled as "resistant to treatment" when the real problem may simply be that the majority of health information provided to the Latino community often lacks language and cultural sensitivity, making it hard to understand.

9. Develop Your Cultural KnowledgeUnderstand Beyond Language • Not all Latinos in California are Mexicanos • Learn about the community you will serve • Alameda County • San Jose County • Marin County • San Francisco County/Daly City

10. Develop Your Cultural KnowledgeUnderstand Beyond Language • Family Issues • Religious Beliefs & Customs • Folk Medicine Practices • Dietary Practices • Pain • Fatalism • End of Life Decision Making

11. Cultural Views • Can strongly influence how individuals understand and practice health care, including: • What is considered a health problem • How systems and concerns are addressed • The type of treatment to be provided • Who should provide treatment • Who is involved in the decision-making process

12. Tips for Working With Interpreters • Choosing an interpreter is critical to obtaining the best health outcome • Avoid using children, friends, and family • Avoid using jargon. Use short statements with adequate pausing. Ask one question at a time. • SB 775: Prohibits any child under 17 to interpret

13. Interpreter Vs. Translator • What is the difference? • Is there a difference? • Interpreter • Translator

14. Translation Errors • Kaiser Permanente Consent Form • Sign Here:___________ • Cantonese Translation: • Spit Here: ___________ • Gerber Baby Food: French Vomiting • Ford Pinto-Brazil: Slang for Male Genitals

15. CLAS Standard 4Office of Minority Health, US Dept. of Health and Human Services Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.

16. Cultural Attitudes • Sometimes communication can be difficult. • At times patient’s knowledge about their bodies or medical history is less than optimal, needing further explanation. • Patient’s expectations, based on cultural attitudes regarding their health, may affect the outcome of the medical treatment.

17. Diversity

18. Understanding Beyond Language “Having a better understanding of culture will enhance your ability to provide patient care. Language alone does not serve much if you do not understand the culture”

19. Questions? Berta.a.bejarano@kp.org Email 415.491.3132 Office