Latinos Lives and Health, a poll released last month by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health, found diabetes is the top health concern of Latinos.
With 19 percent of Latinos reporting diabetes as the foremost health concern facing their families, it far outranks the next most reported health issue, cancer, which ranked number one by 5 percent of Latinos. The results of the survey show the significant differences among diverse populations in this country and can help nurses address the specific needs and concerns of their Latino and Hispanic patients.
As is always the case, healthcare tensions involve much more than just physical ailments. The poll also reported significant amounts of stress around healthcare costs and employment issues. More than one in two Latinos are concerned that if a major illness struck, they wouldn’t have the funds or health insurance to cover the resulting bills. And in many Latino and Hispanic cultures, family comes first which can have significant impact on treatment adherence. There could be a very real reluctance among patients to take money from the family funds to pay for their own healthcare or to set aside time to care for themselves, even if it can improve their health.
According to the Office of Minority Health, rates of diabetes in Hispanic and Latino populations are high, so families have a right to be concerned. Hispanics and Latinos over the age of 18 are diagnosed at a rate of 13.2 percent compared to 7.6 percent of non-Hispanic whites. They also die of diabetes complications at a higher rate than non-Hispanic whites, so clear health information about diabetes management is essential.
As a nurse, one of the most important things is to make patients aware of diabetes as a serious disease with potentially life-threatening, and certainly life-altering, complications. Follow through on medications and lifestyle changes are essential, but when you are talking about changes and treatment, you must take cultural expectations into account, too. Various traditions around family dynamics, food, and celebrations can wreak havoc on trying to control diabetes, so making yourself familiar with some patient expectations can lead to positive treatment and care outcomes.
The Agency for Healthcare Research and Quality listed a few suggestions in their Diabetes Disparities Among Racial and Ethnic Minorities report. Involving the family in new approaches to diabetes management with medication, eating, and exercising helps. Show patients how to read labels and what to watch for. Exercise can be a family walk after dinner.
Above all else, listen to the patient and the family to see what approaches they might have and then try to work within that framework.