Empowering Women in Chiropractic - Health Disparities and the Hispanic/Latino CommunityJul 24, 2022
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Hi, this is Dr. Charmaine Herman here for another edition of Cultural Competence, 1 0 2 for the Chiropractor. First, I want to thank ChiroSecure for taking the time to make this type of programming available to all of us, doctors of chiropractic. And I thank you so much for joining me today. So let's go to the slide. Again, Dr. Charmaine Herman. And this is again a series I've been working with ChiroSecure of talking about cultural competence. I am a licensed chiropractor in Atlanta, Georgia practicing for the past 10 years, Alpharetta, Georgia. I'm also a faculty member at Life University where I've been teaching for about 13 years. I've been an educator for about 20 years. So it was exciting being able to give back to our community. So many of the things that I've learned as an intern. So let's go ahead and today's goals are to actually. Look at the African-American I'm sorry. Today's the Latin American community, Hispanic and Latino communities. And look at things such as health disparities. We've been talking about health disparities for African-American kids in the last episode. So what should chiropractors know about health disparities in Hispanic or Latin community? So we're going to talk about. That information, maybe a little boring cause statistics normally are, but it's things that we should know as we try to serve our diverse community. So the Latin American community when we talk about health disparities, we're looking at those things that are prevalent, those health issues, those concerns that are prevalent in the Hispanic or Latino community conditions, and also things such as health equity and their access to care. So we're going to discuss these types of things. When we talk about health disparities. So this these few minutes. So health disparities are usually people that have issues based upon certain types of adversely affected situations they've experienced throughout their lives, whether due to their race, ethnic group, religion, socioeconomic status, gender, sexuality, gender identity, things like that tend to. Alienate or marginalized people into areas of of diversity of I'm sorry of disparities because of how the community in itself has treated people in these various categories. Poverty's a big reason why we see a lot of health disparities as well as lack of education, understanding how the health system works or how people need to take care of themselves. Homelessness. We see that a lot in our country and these can be unconscious contributing factors to help disparate. They're also non-biological factors of health disparities, such as gender. When we talk about health is very, those non that biological factors can be socioeconomic status. Gender. So many women are suffer from abuse, from various with the males and other females. Some things cause non-biological health disparities that are not related to their biology, but related more to the situations that they find themselves. So we, as doctors of chiropractic who want to serve diverse communities should definitely be aware of health disparities in order to monitor them and our patients, because we may see them more often than others. If they have pre-existing conditions, when they come into your practice. I don't have some patients who have things like diabetes and hypertension, and I'll ask them if they're taking their medication, how they, how they're feeling, how they're doing. I have one patient that was experiencing dizziness after changing her brand of Metformin. The pharmacy changed it into let her know, and she started experiencing dizziness. And I told her to inform her health provider, what was going on based upon the medication. And recently they changed it back to the brand that she was using. So we see patients more often and it's good to be able to understand what those pre-existing conditions are and how we can help facilitate their care even better. And definitely make referrals when necessary to other providers. If we feel that our care is always calm is always great, but they may need something else based upon a condition that they're experiencing. So we talk about the Hispanic and Latino community, or we're looking at an ethnic group that consists of people from Cuba, Mexico, Puerto Rico, south and central America, and other people who have Spanish origin in there. And their history, regardless of their race. This is an ethnic group. So you may have white Hispanics or you may have black Hispanics. So it was regardless of race. And it's 2019 census will determine that our Hispanic and Latin community, or about 60.5 million Hispanics living in the United States their population is about 18.4% of the United States population. And they are the largest minority or ethnic group in. Country at this present time, 2019 the cities where you found states, where you found more people who are Hispanic or Latino, or California, Texas, Florida, as well as Arizona, New Mexico, New Jersey, Colorado, and Georgia. In 2019, it was noted that. 30% of Hispanic Latinos were actually under the age of 18 compared to 18% of our nonwhite population. So that means they're growing. There's still young people. They're going to still grow and they're going to have children. So this is our largest and fastest growing minority group. Language and literacy among Hispanics tends to be an important issue. Understanding our Hispanic community, whether we have someone in our office that can speak the language or our documents are translate or translate into their language. It's important for people to feel comfortable in our practices. So language is really important with. Hispanic and Latino Americans. According to the census, the majority of Hispanics do not, who is ID? United States are in the mainland United States. 71% of Hispanic speak a language other than English at home. 70%. Are being met are Mexican 58.9% are Puerto Rican, 77.7 Cuban and 86.2 or central American. So roughly 28.4% of Hispanics are not fluent in English, but I do want to clarify this because people speak a different language at home does not mean that they're illiterate many of the read Spanish very well. So even if we decided. Translate our documents into Spanish. They can also read those documents. So that's something to consider in your practice. If you have, if you're serving as Spanish, all the tap Latino patients. It's also when we look at economics and economics is always important because economics drives, whether people can come, go will, can have access to healthcare. I think that's really very important as far as their financial situations are concerned. According to our census in 2019 24.4% of Hispanics, compared to 14.5% of non-Hispanic whites work within service occupations they also. 23% placing 0.8% also worked in managerial positions and professional occupations compared to 44% of non-white Hispanics. So we see many of our Hispanic population and our service organism and our service occupations, whether they're migrant workers or they're working in our cities and our counties cutting trees or I'm working as plumbers. They are more often found in those types of occupation, but that does not mean that we don't have a significant number of Hispanics working in professional or professional occupations as well. As far as their currently. Income household incomes are at 55,000 compared to 71,000 nonwhite households. We also see the unemployment rate for Hispanics is at 5.1% compared to three. But 7% compared to our regular populations of non-Hispanic whites. And according to the census, 70.2% of Hispanics in comparison to 9% of non Hispanics, I actually live in below the pub at the poverty level or below the poverty level in this country. I always think it's a big disservice when we see that people in our country, this most wonderful country in the world to have so many people living at or below the poverty level. Does it affect us when we're dealing with pricing and how we going to take care of our patient, what we're going to charge? All of those things are important to take that in account. When we start seeing Hispanic and Latino patients, as far as insurance, right now we have public insurance, but it's apparent in our data that Hispanics have the highest rates of. Uninsured in the United States, they had higher or highest racial and ethnic group would be uninsured in our country. Despite of the fact that insurance is quote unquote more S accessible today, whether it's because cultural differences language, many Hispanics do not obtain. Insurance. So you may think about how I'm going to, how am I going to treat them if they don't have insurance? Again, in my practice, I do see people I'm with, I'm not on anyone's. I'm not a provider under any insurance. So I do have different rates for patients who don't have insurance, because so many people, despite of affordable care act still don't have insurance and our Hispanic and Latino patients, or some of them. As far as life expectancy of, as of 2020 life expectancies for Hispanics, we're actually at age 82, which is actually great women at age 84 and minutes, 79.9 is the average compared to 80 for a non Hispanic whites. And 82 for women and 78 or a non Hispanic. So they're living long and there we want to help. So they stay healthy. They do, they are at the risk of many conditions, such as cancer, diabetes, asthma. We'll see. A lot of that in the community. Strokes are very common and also common in the community. To origins in order to get the best care for these individuals, infant mortality rate is also high. Incrementality rate tends to also be high. In this population, we see them on Hispanic Americans. The mortality rate ranges from 3.8 per 1000 births. Cuban is as high as 5.6. Cubans are 3.8 and Porter regular at 5.6, as far as when we talk about the. Mortality rate of infants for the 20% higher infant mortality rate than non Hispanic whites as far as 2018. So it's really important to pay attention when we get these patients to get them on a prenatal care adjusting and checking them and making sure they're getting the vitamins that they need in 2019 Hispanic mothers were 80% more likely to receive late or no prenatal. Compared to non-Hispanic whites. So as doctors of chiropractic, we get them in our offices. It's great to have him there, but we also need to help them while they're in our practice. So this as well. So that's going to be an important aspect that we want to pay attention to. Heart disease is still in a one killing many populations. And it's so in the Latino and Hispanic population, 2018, Hispanics were actually 10% less likely to have a coronary heart disease compared to non-Hispanic whites, which is actually a lower level for that population compared to the mainstream population. As we know it today, Hispanic men and women are 30% less likely to die from heart disease, which is a great. Oh, great demographic to be in. We see how hard this is the number one killer of many individuals in the United States. So they are lower in heart disease, as well as adults are also less likely to have a heart attack. And, but if they do have a heart attack, they do, they may not survive the heart attack. Okay. We was looking at coronary heart disease, or also look at high hypertension. So if you look at this chart, it shows that Hispanics are second, as far as hypertension to to the black non-Hispanic black population. They're at 28% for women. It's 23% for men. You have an overall amount of 27 for the total population of Hispanics and Latinos. So they still have hypertension, but they're not high. They're not as high as other populations, especially non-Hispanic whites. When it comes to coronary heart disease. So we'll look at cancer, which is a big factor in our country. Always a concern about that. Between 2014, 2018, Hispanic men were 20% less likely to be diagnosed with prostate cancer than non Hispanic, white males. Also Hispanic women were. 30% less likely with desire, be diagnosed with breast cancer compared to non Hispanic whites Hispanic women and men are twice as likely to be diagnosed with things like stomach cancer and twice as likely to die from stomach cancer. Also Hispanic women are also 30% more likely to die from cervical cancer. So there are cancers that affect this population and things that we all. Pay attention to, again, when they're in offices, when we're taking care of them, we're going out to doing screenings. We want to always look out for our patients to see those things that may be prevalent to that population that we can actually make a difference in as doctors of chiropractic. Asthma. I tend to see a lot of asthma patients and I noticed that our Hispanic, Latino, as well as our black communities, the children have a higher rate of asthma in 2018, 2.3 million Hispanics. We're diagnosed and reported as currently having asthma Puerto Rican's had twice the amount of asthma rates compared to other overall Latinos in 2018, and children tend to die from asthma in this population. So we need to definitely pay attention. We use chiropracticy great results with with asthma in our practices, from adjusting the thoracic spine. So it's something we need to pay attention to if we are seeing Hispanic and Latino children, especially as well as adults. Obesity among Hispanic Americans. Women are 78.8%. Most likely to be overweight or obese compared to 64% of non-white Hispanic women. 2018 is Hispanic Americans. 1.2 times likely more likely to be obese as well as suffer from being overweight with issues such as hypertension, such as hyper local goes to meet Nemea and diabetes are at risk. Putting them out. For those types of issues 2017 Hispanic high school students were 50% more likely to be obese. And when we talk about obesity in our country, we tend to link obesity to people being lazy, or I'm not getting enough exercise. Having and having poor diets and things like that. But we also have to pay attention to where our patients come from, the communities that they live in, the foods that they can purchase. I always talk about that sick, that the area where we have lack of nutritional foods, not every grocery store has a whole, has an organic. And not having a grocery store and every community has the best quality of meats. Some weeds are more fatty and things like that. So based upon where our patients are coming from, the communities that they live in, that will also affect whether or not obesity is there. I always tell people if my patients shop at places like dollar general or dollar tree places like a family or family dollar, they're not buying healthy foods, they're buying what they can afford. So 10 meats, sorry, 10 packs. It was a noodles and all types of soups, which are high-end in salt for a dollar, is what they can afford at that time. They're not trying not to eat healthy, but they're trying to feed their families. So I think we need to also have more compassion and empathy. When we talk about our patients who may be obese or the children on their way to obesity and have a conversation, think about things such as community gardens places that are maybe outside of even getting a bus to take them to these areas. Where they can get more healthy food. So it's good to be more proactive as well as healthy and not judgmental with them, with the patients who may have obesity issues or not be able to have healthy diet. Mental health is always an issue among Hispanic Americans, 70%. I'm sorry, I'm going to have Pranic Americans. The death rate from suicide is four times higher in Hispanic women in 2000. We also see that suicide rate among Hispanics is less than half compared to non whites, but we still have issues of suicide was in the population. Suicide is the leading cause of death between ages 15. And 34 though, in our younger population, as well as the young girls, we see 30%, but in the grades nine through 12 have attempted suicide. So mental health issues usually linked to poverty are things that we should pay attention to with these patients that we see from the Hispanic and Latino community. It's noted that poverty allows probably causes maybe you see twice the number of. Of suicidal attempts of suicides, where people who are poor situations with can lead to psychological distress, especially concerned for their families and how they're going to make it through the day. So again, being empathetic and paying attention to the signs are going to be very important for us as doctors of chiropractic, when working with patients in this population. How do I find out more about the Hispanic or Latino population in my community will definitely go to your website and contact the minority office of minority health. There hss.gov is dedicated to telling us what's going on and looking at the numbers and helping us be better health providers and offering more health equity for our patients. The CDC also has a site just to discuss what we call minority health and health equity. And it's dedicated to getting the information out there to we who are doctors to know how better to serve our communities, maybe volunteering and helping to reach these communities. Let us know how chiropractic can help strengthen and encourage and just make them a healthier population overall. So that's it for today. Our next episode, we'll be looking at the Asian and Pacific Islander community, looking at health disparities in those communities and what the chiropractor should know.. Thanks again for your time. And thank you again, ChiroSecure for making this type of programming possible. We will. I really appreciate you. And I hope that you got some information out of these presentation and that you can actually use it in your practice, right?
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