Spanish-Speaking People in America

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1. What obstacles do Spanish-speaking people in the United States face when it comes to receiving and accessing healthcare services?

The relationship between doctors and patients is one of the most important in the United States. Despite the fact that America is a land where cultural diversity is at its peak, it is impossible to provide quality services to every individual, and this is usually due to a variety of factors. The language barrier that exists between Spanish-speakers and doctors is the most serious issue. The relationship between language proficiency and the provision of health care to Spanish-speaking patients was investigated in this paper. According to Jacobs, Chen, Karliner, Agger-Gupta, and Mutha (2006) Spanish-speaking people living in the United States of America face a number of challenges as they struggle for healthcare services. A number of residents in the US that speak little English often at times face language barriers in their plight for medical healthcare. It is known for a fact that the conversation between the physician and the patient has throughout history been one that has been recognized as having a therapeutic benefit. However, with the increasing diversity in the society, there have been limited modifications on the medical part to cater for such manifold. According to Jacobs et al. (2006) study, the US census of the year 2000, more than forty-six million people in the US did not speak English as their primary language. As a result, the increasing rate of diversity since that period, as a result of immigration, and the stagnant platform in cultural competence in the healthcare system, language barrier became a straining factor affecting the relationship between clinicians and Spanish-speaking individuals.
Jacobs et al. (2006) stated that issues such as language barrier have had an effect on the quality of care since Spanish-speaking patients have a high rate of re-admission. This comes from the fact that only a limited number of healthcare practitioners are bilingual, hindering effective communication between the patient and the clinician. Additionally, there were no organizations providing any form of assistance in the provision of healthcare. For instance, yet still, despite the limited language barrier between Spanish-speakers and medical practitioners, there is still a huge rate of dissatisfaction among the Spanish-speaking patients as they argue that they do not receive better treatment. In addition to that, there may be possibilities of clinical malpractices that are a result of the language barriers that may go unnoticed by both the clinician and the patient.
Spanish-Speaking individuals have a high rate of dissatisfaction as compared to English-speakers because of the number of tests performed on them. This is a common phenomenon evident in Jacob et al. (2006) study as they state that Spanish-speaking patients often visit the hospital more times than English-speaking people due to the communication barriers existent in the doctor-patient interaction. It is further evident that Spanish-speaking patients are at most times, less satisfied with the communication they received from the healthcare practitioners. As such, they are more likely to complain about the quality of care they receive as compared to English-speaking patients. In contrast, healthcare practitioners are usually less satisfied with the interactions they have with the patients as a result of the language barrier.

2. What cultural and social factors influence the practitioner-patient communication with Spanish-speaking people living in the United States?

There are a number of cultural and social factors that influence communication between the practitioner-patient with the Spanish-speaking people in the United States. According to DuBard and Gizlice (2008), the nature of health disparities between Hispanics and US citizens is reliant on the increasing diversity and adaptation of the Hispanics to the US population. According to statistics, it is determined that more than one in every ten people can speak Spanish at home. Additionally, half of these people report that they have the ability to speak English well (DuBard & Gizlice, 2008). And yet, language preference and the English language proficiency have been known to be associated with the health-related behaviors such as disease prevalence and the receipt of health care services among Hispanics.
Language, among other factors, has a correlation to the social and cultural factors affecting health among Hispanics. For instance, research asserts that more than half of all the Hispanics in the US attained high school education (DuBard & Gizlice, 2008). While a rare percentage of them maintained college degrees. Additionally, the income among Hispanics was below the $15,000 threshold while that of Americans were above below $25,000 (DuBard & Gizlice, 2008).
In the sense of employment, studies show that a larger percentage of Hispanics are employed either as homemakers or other minor jobs compared to most white people with only a limited number of the claiming to be unable to attain jobs (DuBard & Gizlice, 2008). All this has a significant role in the health care of Hispanics, as most of them lack health insurance and are unable to afford a personal doctor. Clinical check-ups were very rare among them and most may have been unable to see a doctor as a result of the cost of care. According to research by DuBard and Gizlice (2008), Spanish-speaking patients generally states that they rarely went to see a doctor for a routine checkup. A number of them could spend more than a year without feeling the need to go for a checkup. Resultantly, the medical practitioners would label them as being most likely to report poor to fair health. Additionally, there were limited chances of Hispanics being involved in preventive services such as screening and examinations.

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3. What are some cultural differences in the health perceptions of Spanish-speaking patients, when compared to the dominant culture in the United States?

There are cultural differences in the health perceptions of Spanish-speaking patients as compared to that of the dominant culture in the United States. According to Parés-Avila, Sobralske, and Katz (2011), Spanish-speaking patients perceive that the government does not provide adequate support for their needs in the healthcare setting. This is evident in that there is a systematic lack of funding for interpreters and a lack of local language training program in addition to the lack of state agency support as the principle obstacles in the surrounding ethnic minority. This implies that the government has not put in place systems that can improve healthcare service delivery for those the minority in the nation. Another point to note is that research data relating to one subgroup, be it Hispanics, Latinos, Mexicans, Cubans, Puerto Ricans and other Spanish-speakers from Central and South America may not apply to another subgroup. Yet, despite the difference in the cultural, historical and immigration background of these cultures, they are most often categorized in a similar group when it comes to health statistics. This is a problematic situation in that every subgroup has its own distinct cultural difference and varies in terms of history and immigration and their settlement in America. Yet, despite the difference in their size and numbers, the groups have and still continue to be categorized in the same class in relation to health statistics. As a result, medical practitioners overlook certain factors while treating Spanish-speaking individuals as they take the general assumption that a Spanish-speaking patient and thus, doctors tend to make inaccurate conclusions. This is partly the reason why Spanish-speaking individuals tend to have more diagnostics performed on them as compared to English speakers. It is not only caused by their inability to give clear explanations that can assist the doctor make accurate decisions, but the fact that the doctors are culturally biased in their decision regarding the patient.
On the contrary, Americans are usually dichotomized in different subdivisions on the basis of the families or traits. They are also assumed to be healthier as compare to the Spanish-speakers as they observe and track changes in the diet. Their routine checkup and registration with insurance companies creates a database that can improve monitoring of a patient’s vitals.
It is unfortunate that a patients’ health data is heavily reliant on the history of the patient. Thus, doctors in most cases fail to make any distinction in their diagnostics as it is in most cases biased towards the general perception of the Hispanic culture. In other words, heath care providers tend to have compromised perspective of the patient, in the event that he or she is not an English speaker. Therefore, the patients are automatically grouped as a Hispanic. Furthermore, despite the fact that they may not be misinterpreted by a doctor who understands the language, doctors and medical staff among them may be in a position to have a bias.
Regardless of the proficiency in the language, it is important for racism to be taken into deep consideration when determining the ethnic and racial background of the patients. Since this is not usually the case, most Hispanic speaking patients usually prefer their doctors from their own race to provide medical service. Hispanics share the concerns of the nonprofessional or untrained interpreters.

4. What are some differences and similarities between your own culture, and the culture of Spanish-speaking people living in the United States? And how will these differences determine your direction in providing care as a nurse for Spanish-speaking people in healthcare settings?

There are more differences than similarities between Spanish-speaking people and the American culture. The first and most common factor is the fact that most Spanish-speakers struggle with the English language.
Second is the kind of foods consumed by Spanish-speakers. Spanish-speakers have a diet that is determined by the season or occasion. Additionally, they usually have meals in large quantity, unlike my culture where we have meals a number of times in a day. The kind of food they consume is usually heavy in proportion to the typical American meal that is comprised of light foods such as cereals.
One feature that stands out between my culture and Spanish-speaking people is the social life. Both cultures like to socialize and like to enjoy the social part of life. Spanish-speaking people mostly appreciate socializing after work or in the evenings, whereas, in my culture, we can socialize at any given time.
This differences and similarities increase the challenge for delivering culturally competent health services. There is thus a need to improve the interaction between the medical personnel and Spanish-speaking individuals. As a nurse, I would individually speak with the patients when they arrive at the hospital. This would help me determine the method or technique required in making the patient understand and also help remove the feelings of fear or humiliation that may result from being singled out.

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References

Jacobs, E., Chen, A. H., Karliner, L. S., Agger-Gupta, N., & Mutha, S. (2006). The need for more research on language barriers in health care: a proposed research agenda. Milbank Quarterly, 84(1), 111-133.
DuBard, C. A., & Gizlice, Z. (2008). Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics. American Journal of Public Health, 98(11), 2021-2028.
Parés-Avila, J. A., Sobralske, M. C., & Katz, J. R. (2011). No comprendo: Practice considerations when caring for Latinos with limited English proficiency in the United States health care system. Hispanic Health Care International, 9(4), 159-167.

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