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SimpatiaRespeto

FamilismoUnderstanding the Culture

of Hispanic Seniors

While “Hispanic” and “Latino” are often used interchangeably, Hispanics are people living in the U.S., whose origins are from Mexico, Central and South America, Cuba and the Caribbean.2 Latino refers to those from Latin American countries, including Brazil where Portuguese is spoken.3

By 2020, Hispanic seniors are expected to make up nine percent of the U.S. population 65 and older.4 They differ from their Caucasian counterparts in several ways. More than 60 percent of Hispanic seniors have fewer than eight years of formal education, compared to 10 percent of Caucasians, and they are less likely to have health insurance.3

Hispanic seniors tend to live longer, despite higher levels of morbidity, requiring ongoing medical care.5 In order to provide healthcare for this growing demographic, it is necessary to speak their language—figuratively and sometimes literally.

Hispanic seniors are one of the fastest-growing population groups in the U.S., and hundreds of thousands are aging-in to Medicare every year.1

A Profile of Hispanic Elders

Nearly half of Hispanic seniors do not speak English well or at all, and access to adequate healthcare information can be challenging.3

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In order to reach Hispanic seniors, it is helpful to offer bilingual patient education materials.

A Growing Culture, Rich With Language and TraditionsMost Hispanics 65 and older arrived in the U.S. through immigration from one of more than 20 different countries,6 bringing their native Spanish language and their deeply cherished cultural traditions.

How these traditions intersect with the U.S. healthcare system can vary, based on a senior’s insurance coverage, general health and ability to access the medical services they need.

Many Hispanic seniors came from regions in which the local hospital was the main source of medical care. Medicare is often the first and sometimes the only health insurance coverage that they have ever had.5

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Seeking a Balance Between Two Diverse Cultures Hispanic seniors live with one foot in their native culture and the other foot stepping into the U.S. lifestyle.

This idea of living in two worlds is known as acculturation, in which Hispanics adopt new behaviors and attitudes, while still holding on to key Hispanic values.

Acculturation impacts the way Hispanics view the world, in addition to how they respond to ideas and issues including health.

While many Hispanic seniors may consider themselves “techno-phobes” and still prefer TV over other media, most have become comfortable with computers, and are learning how to use mobile devices.7

Simpatia

Hispanic seniors are bicultural, which impacts their preferences, beliefs and behaviors, in addition to the way they view the world.

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There can be an expectation that their doctor is in charge and sometimes an unwillingness to work in tandem on their healthcare.

Hispanic seniors are less likely to have health insurance than other seniors.8 They make fewer preventive care visits to a primary care doctor, resulting in more trips to the emergency room.9 This can be due to lack of familiarity with the healthcare system, language barriers and limited access to transportation.9

Another aspect of the Hispanic culture that affects healthcare is a hesitation to discuss the more personal aspects of their condition with a professional.10 Understanding and respect can help bridge these cultural differences and enable Hispanic seniors to benefit from the U.S. healthcare system.

Showing Respect for Authority Figures Such as Doctors

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Bilingual staff members can be helpful in getting older Hispanics to open up about their healthcare needs.11

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Loyalty to FamilyThe Hispanic family is focused on its values and well-being rather than on individual opportunities. Parents create a family environment where blood ties are prioritized above all others.12

It is more common in a Hispanic family for multiple generations to live together. The belief is that when aging parents can no longer live on their own, it’s the children’s responsibility to act as caregivers.1

Family members play an important role in helping seniors make decisions regarding healthcare and Medicare. In Hispanic families, living together is more than just sharing a household. Seniors look to their children and even grandchildren to help them navigate a very complex system.11

Familismo

The caregiver often acts as a liaison and translator between the healthcare system and the senior patient.

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Gaining Trust In the Healthcare System Hispanic seniors are generally less trusting of intangible products and services like insurance and healthcare.13

Healthcare and insurance are complicated subjects, even for seniors who grew up in the U.S. Many Hispanic seniors never had access to insurance or an organized healthcare system, and consequently they have less experience with how it all works.14 They may be confused about their healthcare options and not understand concepts like the difference between Medicare and Medicaid.3

They are suspicious of hidden or unforeseen costs, and have a well-founded concern about their lack of understanding of how the healthcare system works.

In order to build trust, in-language healthcare information is needed, especially regarding how to make choices about Medicare.

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Hispanic seniors have health needs just like any other senior.

Hypertension and diabetes are two chronic conditions to which Hispanic seniors are predisposed that need to be understood and managed. They are 50% more likely to die from diabetes than non-Hispanics, and 73% of U.S. Hispanic Medicare patients suffer from hypertension.10

In order to reach this growing demographic, it is necessary to go beyond simple translation and deliver information that resonates on a cultural level. Often the most compelling messages are developed for the Hispanic market from the start.

An Aging Population Facing Unique Challenges

Relationships are important to Hispanics. Offering resources that can help seniors mitigate their health challenges will go a long way toward building trust. An example of this could be providing healthy recipe alternatives to their traditional diet.

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1https://www.ncpssm.org/our-issues/medicare/hispanics-and-medicare/ 2 Census-Bureau U. profile America facts for features: Hispanic heritage month 2015. Washington: U.S. Department of Commerce,

Economics and Statistics Administration; 2015. p. 1–6 3 Valdez, Burciaga, Ph.D., and Carlos Arce, Ph.D. A Profile of Hispanic Elders. Rep. N.p.: n.p., n.d. Nationwide Demographic Report.

HORIZONS Project, May 2000. Web. 14 July 2017. 4 Melissa Talamantes, M.S., Robert Lindeman, M.D., and Charles Mouton, M.D., M.S., “Health and Health Care of Hispanic/Latino

American Elders,” Stanford Ethnogeriatric Curriculum Module 5https://www.ncbi.nlm.nih.gov/books/NBK19910/ 6Heinrich, Developing a Hispanic Healthcare Marketing Strategy, 2017 7https://www.emarketer.com/content/us-hispanics-and-digital 8U.S. Census Bureau, Current Population Survey 2015 March Supplement – Reflects Health Insurance Status for 2014 9Colorado Health Access Survey, 65 and Older Not All the Same: Latino Aging in Colorado, April 201710 Machado, Amanda. “Why Many Latinos Dread Going to the Doctor.” The Atlantic. Atlantic Media Company,

07 May 2014. Web. 14 July 2017.11https://www.apa.org/monitor/jan05/closingthegap 12Epsilon Health, 2016, How health insurance providers can reach and engage Hispanic customers13Marketing to Hispanics: Why It’s Not Just About Speaking Spanish, By Matthew Harris, June 6, 201714U.S. Census Bureau, Current Population Survey, 2015 and 2016 Annual Social and Economic Supplement

“ La salud es mejor que la riqueza.”Health is better than wealth.

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