The Latino Patient

Berta Alicia Bejarano, M.B.A., C.I. Diversity Director

Kaiser Permanente

- Race - Language - Ethnicity - Employment- Age - Gender- Income - Sexual Orientation - Education - Social Status

What Is Diversity?

Is the delivery of health care services that acknowledges and understands culturaldiversity in the clinical setting, respectmember’s health beliefs and practices, andvalues cross-cultural communication.

Cultural Competence

- 120 Different Spoken Languages- 110 Written Languages- 80% of KP hospitals & clinics encounter LEP

patients- 63% daily/weekly- 17% monthly

How Many Languages Do Our Kaiser Members Represent?

- 50 million today- 20 years- 150 million - Demographic revolution- Health Care Reform

Latinos in the U.S.

- 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.

Latinos & Diabetes

- Do not feel sick- Interruption of their lifestyles- Interruption of their work- Side effects of medication- Home/natural remedies instead of medication

Why Resistance?

- 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.

Challenge

- 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

Develop Your Cultural KnowledgeUnderstand Beyond Language

- Family Issues- Religious Beliefs & Customs- Folk Medicine Practices- Dietary Practices- Pain - Fatalism- End of Life Decision Making

Develop Your Cultural KnowledgeUnderstand Beyond Language

- 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

Cultural Views

- 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

Tips for Working With Interpreters

- What is the difference? - Is there a difference?

- Interpreter - Translator

Interpreter Vs. Translator

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

Translation Errors

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.

CLAS Standard 4Office of Minority Health, US Dept. of Health and

Human Services

- 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.

Cultural Attitudes

Diversity

“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”

Understanding Beyond Language

Berta.a.bejarano@kp.org Email

415.491.3132 Office

Questions?