Academic journal article American Journal of Pharmaceutical Education

A Spanish Language and Culture Initiative for a Doctor of Pharmacy Curriculum

Academic journal article American Journal of Pharmaceutical Education

A Spanish Language and Culture Initiative for a Doctor of Pharmacy Curriculum

Article excerpt

INTRODUCTION

As of 2008, 15.4% of the approximately 300 million residents of the United States were Hispanic/Latino. From 2000 to 2008 the total US population increased 8% while the US Hispanic/Latino population increased 33%. States with large Hispanic/Latino populations include New Mexico (45.1%), California (36.6%), Texas, (36.2%), Arizona (30.2%), Nevada (25.9%), Florida (21.0%), Colorado (20.1 %), New York (16.6%), New Jersey (16.4%), and Illinois (15.2%); and Hispanic/Latino migration patterns over the past decade have been from gateway areas such as the east and west coasts, south and southwest, into the Midwest. (1) In 2010,15% of the graduates of Butler University College of Pharmacy and Health Science, located in Indianapolis, IN, secured employment in 1 of the 10 states with Hispanic/Latino populations exceeding 15%.

In 2008, 5.4% of Indiana's population was Hispanic/ Latino, representing significant growth from 1.8% in 1990 and 3.5% in 2000. (2) Historically, the Lake County, Indiana, cities of Gary, East Chicago, and Hammond have had a large Hispanic/Latino presence, reflecting pioneer settlements of mostly Mexican workers who were recruited by the area's steel mills in the World War I era. (3) However, from 1990 to 2008, Marion County (Indianapolis), Elkhart County (Elkhart), and Allen County (Fort Wayne) experienced the largest growth of Hispanic/Latino residents in Indiana. (1) Representing 7.4% of the county's population, Hispanic/Latinos are the fastest growing population group in Marion County, home of Butler University. (4)

In their review of the quality of health outcomes that result from communication between pharmacists and Spanish-speaking patients, Dilworth et al concluded that the level of English language literacy of Spanish-speaking patients correlates with the quality of pharmaceutical care these patients receive, and that limited English proficiency among Spanish-speaking patients is associated with decreased patient access to pharmacy services and increased patient-perceived discrimination by pharmacy service providers. (5) They recommended that colleges and schools of pharmacy develop curricular strategies to improve pharmacists' abilities to provide quality care to Spanish-speaking patients.

In a survey of almost 2000 Atlanta, Georgia, pharmacists, nearly two-thirds of the survey respondents reported they had recently counseled a Spanish-speaking patient, but only about one-fourth felt their communication during the encounter had been effective. (6) A survey of 300 North Carolina community pharmacists found that the majority of responding pharmacists believed that English-speaking patients received better oral and written prescription medication information than Spanish-speaking patients. Forty-eight percent of these respondents felt that Spanish language skills were needed in their pharmacy practice, and 22% indicated they were extremely interested in improving their Spanish language proficiency. (7) In this same survey, 28% of respondents indicated they felt that Spanish should be part of the curriculum of pharmacy schools, and 75% believed that pharmacy students should be encouraged to take Spanish as a curricular elective. In an oral survey of 93 Latino patients who were interviewed in Spanish, 52% of respondents indicated they preferred to receive verbal information about their medication in Spanish without an interpreter, and 70% preferred written medication information in Spanish. (8) Focus group interviews of 36 elderly Hispanic/Latino patients in Massachusetts revealed that limited English proficiency was associated with feelings of being discriminated against in pharmacy settings, and that communicating directly with a health professional in a common language was associated with enhanced levels of trust and confidence in the health care provider. (9) Consequently, there is ample and convincing evidence that the quality of health care that pharmacists can provide to Spanish-speaking patients is related directly to the pharmacist's ability to communicate in Spanish with these patients. …

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