Other minorities face own health hurdlesHispanics, American Indians, Asian-Americans in area face obstacles that may differ from blacks
http://www.ohio.com/mld/ohio/news/15610211.htm?source=rss&channel=ohio_news'By Elizabeth SuhBeacon Journal medical writer
Sylvia Reyes, an Akron resident who is an American Indian, might seek the advice of a shaman or healer when she is sick. Laura Luo, who emigrated from China 10 years ago, might try an herbal remedy for a sore throat. Maria Hurtado, who is from Colombia, might bring an interpreter with her when she sees a doctor.
In the United States, differences in health care aren't simply a matter of white versus black.
A wide range of cultures creates many health disparities -- both bad and good for minority Americans.
In Summit County, African-Americans are by far the largest minority group, accounting for 13.9 percent of the population, according to the Census Bureau's 2005 American Community Survey. But Asian-Americans make up 1.7 percent of the county's residents, followed by Hispanics at 1.1 percent and American Indians and Alaska natives at 0.1 percent.
= [100.0]In general, Asian-Americans enjoy some of the nation's best health.
According to a 2006 federal report, Asian-American women have the highest life expectancy of any ethnic group, living an average of 85.8 years, compared with a national average of 77.5 years.
Asian-American women are about 30 percent less likely to have breast cancer than white women.
However, they are 1.5 times more likely to have cervical cancer.
And disparities can vary markedly within larger ethnic groups. Vietnamese-American women, for instance, are five times more likely to have cervical cancer than white women.
Among Hispanic Americans and Indian-Americans, two major health conditions of concern are obesity and diabetes. Mexican-Americans are twice as likely as whites to be diagnosed with diabetes. The same is true of American Indian adults.
These disparities are a result of a variety of factors, including diet, attitudes toward health care, language barriers and lack of health insurance.
Luo, Hurtado and Reyes all say they regard their health as important but have found American health care different from their cultural experiences.
The cost of health care has been an issue for all three, and, for Hurtado, language has been an obstacle to care.
Adjustment from China
Luo, a 36-year-old software engineer who lives in Copley Township, emigrated from Guangzhou, China, near Hong Kong in 1996.
Although she seeks conventional health care at the doctor's office, she supplements that with traditional Chinese cures.
For example, one traditional Chinese belief describes certain illnesses as ``hot'' and calls for treatments that are identified as ``cool.''
Luo and her family are generally healthy, so if she, her husband, Hang Li, or her daughter, Kara Li, 6, comes down with something mild such as a sore throat, they might turn to a Chinese herb syrup to cool the ``hot'' condition in the throat.
Because Luo spoke enough English to communicate with doctors when she arrived in the United States, she has not needed to use an interpreter. But she still finds the American health care system harder to use than the system in China was.
Although patients in the United States must schedule appointments and wait to see their doctors, doctors' visits in China were first-come, first-serve and usually were in hospitals that included pharmacies.
Care also was generally cheaper in China, Luo said. College students could get free care at their school's clinic. Insurance through her employer in China covered all but a co-payment of about 10 cents for doctor visits.
Luo said she didn't have the time or money to visit the doctor regularly when she came to the United States. But now that she's working in the Akron office of the software company Softmed Systems, Luo has health insurance and goes to the doctor for regular visits and screenings.
``I just want to know my health status,'' she said.
May Chen, executive director of Asian Services in Action Inc., a social service agency for immigrants and refugees in Northeast Ohio, said it's important for area health care providers to reach out to more people of different cultures, to learn about other cultures and to account for different races and ethnicities in data collection.
Statistics from area health departments usually include numbers only for white and black populations, and hospitals generally do not keep a record of a patient's race.
Although many minority populations in the area are small, Chen said, disparities are exacerbated by lack of attention to these groups. ``As long as you're not'' a statistical category, she said, ``your needs are not going to be recognized.''
Language barrier
Victor and Maria Hurtado emigrated as Spanish speakers from Colombia in 1975. The couple work at Village Discount Outlet and live in Cuyahoga Falls with their 13-year-old daughter, Liceth.
Although the Hurtados speak English, they've often found it difficult to communicate effectively with U.S. doctors -- even with the aid of an interpreter.
Area hospitals generally use interpreters hired through the International Institute of Akron or Asian Services in Action. Hospitals also often use family members or telephone interpreter services.
The Hurtados have basic health insurance through their employer, but the plan often does not cover much of their health care costs.
A year or two ago, Maria Hurtado said, a doctor told her she needed an operation to treat pain in her knee. But she had trouble communicating with the doctor and couldn't understand why such a drastic measure was needed. She declined the surgery.
In general, Maria, 48, and Victor, 58, don't go to the doctor. They think they're doing all right and said they can't afford to take the time off work.
``We know we have to visit the doctor,'' Victor Hurtado said. ``But we think we are healthy.''
So he tries to re-create the healthful lifestyle of his father and family in Colombia, where he grew up on a farm.
``Good food is good medicine,'' Victor Hurtado said.
The family eats fresh food without preservatives and never consumes canned food or soda.
Rose U. Baker, a research nurse at Akron Children's Hospital, is also the parish nurse at St. Bernard Catholic Church, where the Hurtados attend the Spanish Mass. Baker said Hispanics generally have a positive view of the Akron area but want more help, including finding affordable health care.
Long trips for free care
Reyes, 38, said it's hard for American Indians who live in Ohio to get access to the health care they receive for free through their tribes on reservations. There are no reservations in Ohio.
Reyes' Kiowa tribe has a reservation in Oklahoma. Because her fast-food restaurant job does not offer health insurance, she sometimes travels to the reservation just to get health care. She believes the herbs and remedies passed on from her family and from healers in the tribe often work better than conventional medicine.
Cora Munoz, a nursing professor at Capital University in Columbus who provides cultural competency training, said that although it is impossible for every health care provider to learn about every culture in the United States, it's important to make an effort to learn about different cultures and for institutions to continuously train staff on diversity and cultural sensitivity.
Health care workers need to recognize that they have biases, Munoz said, and they should include patients' cultural beliefs in treatment plans.
``It will take a whole society to change for (health disparities) to be completely resolved,'' Munoz said. ``But the health care arena is very committed to making the changes.''
