Narrowing the cultural divide in diabetes mellitus care: A focus on improving cultural competency to better serve hispanic/latino populations

Abstract

Background: The number of people who belong to minority groups is increasing, in the United States. Many of these groups are more prone to diabetes mellitus (DM), possibly due to a genetic predilection for DM and perhaps as a consequence of a disproportionate lack of access to adequate health care. Understanding different cultural perceptions is pivotal in providing health care (and DM care specifically) for people in the Hispanic/Latino community, currently the largest minority group in the United states. Objective: The objective of this article was to discuss how to improve health outcomes for patients in minority groups, with specific emphasis on Hispanic/Latino populations with DM. Methods: English-language articles were identified through an online search of MEDLINE/PubMed and Google (1990-2006) using the search terms prevalence, diabctcs, Hispanic/Latino, and cultural barriers. Results: DM is a growing, epidemic among the Hispanic/Latino population in the United States. Research has shown. that genetically driven insulin resistance, high rates ut aLduminal uLmtv, increased visceral fat, and various lifestyle factors contribute to this epidemic. The fact that many Hispanic/Latino inclivicluals lack access to adequate health care (cads to health disparities. Another reason for such discrepancies in DM care may be the ~vay different cultures view DM. These differences may include a stronger emphasis on family support in DM management; a fatalistic view of life and a belief that DM is the result of divine intervention; the predominant use of Spanish, rather than English, as primary language; and having fewer economic resources, including adequate health insurance. These factors can lead to increased DM complications because health care providers are missing opportunities to enhance communication of health information to their patients from certain minority populations. Specific strategics to reduce racial and ethnic disparities include providing interpreters, hiring bilingual staff members, and becoming more familiar with the cultural factors that may impact on the delivery of health care services. Efforts to increase health literacy among patients also are important. Conclusions: Understanding and reducing disparities in health care can help improve health outcomes for patients who belong to minority groups. Effective communication by DM care providers and efforts to improve health literacy among patients can often lead to improvements in DM management, with an emphasis on achieving glycemic control and reducing the risk for DM-related complications. A better understanding of cultural differences and their impact on health care can influence how clinicians treat their minority patients with DM, leading to effective interventions that may help patients better manage their DM and narrow the cultural divide in DM care. © 2006 Excerpta Medica, Inc.