By Waldman, H. Barry; Perlman, Steven P.
The Exceptional Parent , Vol. 40, No. 2
"Hispanics are the fastest growing ethnic minority group in the country, and by 2050, one in every four Americans (more than 100 million residents) will be Hispanic." (1,2)
In the 2000 Census, approximately 35.4 million people (13% of the population) living in the United States identified themselves as Hispanic/Latino; more than a 140% increase over the 1980 Census count. This rapid growth is among one of the most important demographic trends shaping the future of the United States. (3) (As noted in Census Bureau reports, Hispanics may be of any race.)
A series of recent government and private agency surveys reveal an array of values, attitudes, experiences, economic realities, and health issues that in many instances are distinct from those of non-Hispanics. As in the care of any individual, an appreciation of these underlying factors is essential in assessing the needs of the particular person (and their family) and developing an acceptable program of treatment which has a realistic potential for success. An appreciation of these dynamics is critical particularly in the care of youngsters and the not so young with intellectual/developmental and other disabilities.
"Assimilation is not a simple, all-encompassing process, and even Latinos whose families have been in the United States for several generations express attitudes distinct from white and African Americans." (4)
Significant differences on a range of issues are apparent depending on whether Hispanics were born in the United States or abroad and whether they are primarily Spanish or English speaking. Although large-scale ongoing immigration keeps the Spanish language as a major presence in the Hispanic population, English is gaining rapidly, even in immigrant households. Among native-born U.S. Hispanics and those who are fully fluent in English, views on a wide range of issues often are closer to those of non-Hispanics. An overwhelming majority (89%) of Hispanics believe that immigrants need to learn English. (4)
* Spanish is the dominant language among 47% of foreign-born Hispanics. But Spanish is the dominant language for only 7% among second generation Hispanics.
* English is the dominant language among 61% of native-born Hispanics.
"Verbal and nonverbal communication from Hispanics usually are characterized by respeto (respect) and communications to Hispanics should also be respectful." (5)
There is an element of formality in Hispanic interactions, especially when older persons are involved. Over-familiarity, physical (touching by strangers) or verbal (casual use of first names), is not appreciated early in relationships.
It is uncommon for Hispanics to be aggressive or assertive in health care interactions. Direct eye contact is less common among Hispanics. A brusque health care provider may, 1) not learn of significant complaints or problems, and/or 2) find the patient unlikely to return. Hispanics often perceive failures in communication to be due to prejudice. Interpersonal comfort is a critical component of the relationship between the person who is ill and the healer. It is this orientation that places folk healers in a place of importance among Hispanics living in this country. 5
Many patients seeking health care will already have sought help from family resources. Family involvement in health care is common and health care providers are advised strongly to encourage such involvement and to include the family as a resource. "Showing respeto to all adults is important." (5) Health providers should understand and comply with patient and family gender roles.
A majority (56%) of Hispanics prefer to be identified as Hispanics or Latinos rather than by a racial category. (6) When asked whether they ever use certain terms to describe themselves, a majority of Hispanics (88%) indicate that they identify themselves by the country where they were born. …