¡Salud Se Puede! (Good Health Is Possible!)

1. ¡Salud Se Puede!(Good Health Is Possible!) Reaching Out To The Latino/Hispanic Community With Health Information

2. Introduction • Gail Kouame • Consumer Health Coordinator • NN/LM, PNR • University of Washington • Serve 5 states: • Alaska, Idaho, Montana, Oregon, and Washington

3. Introduction • Services/Resources We Provide: • Promote NLM resources • Provide training – like today! • Provide training materials you can use • Fund health information projects • Ex: Community Choice in Wenatchee, WA • Promotional materials for health fairs, etc • Consult on proposed outreach efforts

4. Introduction • Who we serve: • Health Professionals • Medical Libraries – hospital and other • Public Libraries • Academic Libraries • Community-Based Organizations • Faith-Based Organizations • You! • Emphasis on underserved, underrepresented groups

5. What We’ll Cover Today • Demographics – Why We Need This Session • Perceptions About Health • Health Literacy Issues

6. What We’ll Cover Today • Spanish Language Health Resources • Cultural Health Information Sites • Evaluating Spanish Language Health Sites

7. Demographics • Let’s clear the air: • “Hispanic” - a government term, but it’s what is used • Latino or Spanish-speaking is preferred. Others? • In 2000, 12.5% of U.S. population Hispanic • 1 in 8 Americans Hispanic in 2000 • Largest minority population in the U.S. • By 2050, Hispanics = 25% of U.S. population

8. Demographics • Hispanics in every US state • Percentage of NW state population that is Hispanic: • Washington – 6.1% • Oregon – 5.9% • Idaho – 7.1% • Alaska – 3.8% • Montana – 1.7%

9. Perceptions About Health • Cultural Values – regulate behavior and social interactions • Cultural Beliefs – attach meanings to events, things, people • In Mexican-American culture – health is holistic: mind, body, spirit • Ex: Full moon and pregnant woman • >500 years of oral tradition

10. Cultural Beliefs Influence: • Etiology/cause of illness • How one communicates health problems • How one presents symptoms • When and to whom one goes for care

11. Cultural Beliefs Influence: • Congruency of illness with a medical diagnosis • Willingness (or not) to adhere to plan of care • Use of possible combinations of Western & Folk medicine • Restoration of health – as important as etiology

12. Cultural Beliefs - Example

13. Cultural Beliefs • Curanderismo: • Term for entire Mexican Folk system of disease and healing • Coherent world view of healing with deep historical roots • Modern Curanderismo is syncretic, holistic, and eclectic • Derived from Aztec, Spanish, Judeo-Christian, Spiritualism, and modern biomedicine

14. Cultural Values • Cultural values drive help-seeking behaviors: • Familiarismo – familiaism • Fatalismo – “will of God” – I have to endure this • Spirituality/Religiosity • Orgullo – pride/saving face • Machismo • Marianismo – “saintly woman” – everyone else first

15. Cultural Values • Interactions need to incorporate: • Carino – caring • Personalismo • Confianza • Dignidad • Respeto • Simpatia • Communicacion – closer personal space, less eye contact = giving respect

16. Cultural Values • Cultural Identity and Ethnic Pride • Spanish Language as a cultural value for many Mexican Americans • Essential in communication • Conveys symptoms – e.g.: “dolor” • It includes how we share knowledge, customs, beliefs – e.g.: “dichos”

17. Importance of Language • Limited English Proficiency Patients: • Receive less information about therapeutic regimens • Understand less instructions related to medications • Are less likely to keep subsequent appointments • Are more likely to make ER visits

18. Importance of Language • Limited English Proficiency patients: • Are less likely to receive preventive services • May receive misdiagnoses due to lack of communication • May receive poor medical care • May be prescribed inappropriate medications • May perceive less quality in health care received • Ask if people prefer to read in English or Spanish

19. Health Literacy • Definition - The degree to which individuals have the capacity to: • Obtain • Process • Understand basic health information and services needed to make appropriate health decisions. Healthy People 2010

20. Health Literacy • Poor health literacy is a stronger predictor of a person’s health than • Age • Income • Employment status • Education level • And race JAMA, Feb 10, 1999

21. Health Literacy • Patients with inadequate health literacy: • Have less health-related knowledge • Receive less preventive care • Have poorer control of their chronic illnesses • Are hospitalized more frequently Journal of General Internal Medicine 2004; 19:1228-39 • Look familiar?

22. Health Literacy • Healthy People 2010 - goal to improve health literacy • Institute of Medicine - Health Literacy is high-priority are for improvement in health care quality

23. Responses – Spanish Language Health Information MedlinePlus.gov/spanish

24. Responses – Spanish Language Health Information • NOAH – New York Online Access to Health

25. Responses – Spanish Language Health Information • National Center for Farmworker Health

26. Responses – Spanish Language Health Information • Healthy Roads Media

27. Responses – Cultural Health Sites • Ethnomed

28. Responses – Cultural Health Sites • RHIN – Refugee Health Information Network

29. Evaluating Spanish Health Sites • You know more than you think! • Alphabet is almost the same • Language is similar • Photos and Graphics are clues • Look for “About Us” • Sobre Nos • Sobre • Acerca de… • ¿Quienes Somos?

30. Evaluating Spanish Health Sites • Other clues: • Fecha = Date • Actualizado = Updated • Modificado = Modified • Use “quick and dirty” translation – babelfish, Altavista

31. Evaluating Spanish Health Sites • Let’s give it a try!

32. Want to Know & Do More? • Join the NN/LM PNR • It’s easy – and FREE! • http://nnlm.gov/pnr • HLIB-NW listserv • Funding Opportunities • Training & Promotional Materials • Connections with others interested in health information

33. Thank You! Gail Kouame gmarie@u.washington.edu 206-221-3449 1-800-338-7657