Culture and Healthcare: A Crucial Connection for Healthy Patient Populations

By Ryan Almodovar, OMS II, Philadelphia College of Osteopathic Medicine Georgia Campus, Latino Medical Student Association Chapter President

The goal of the medical community is to bring health to the whole patient population. Being a Cuban Puerto Rican American born and raised in Miami, Florida, where the majority population is Hispanic, Hispanic culture and health were always at the forefront of the medical community. After moving from Miami to Suwanee, Georgia to attend the Philadelphia College of Osteopathic Medicine Georgia Campus (PCOM Georgia)’s DO program, I recognized what being part of a minority population is like. Having lived in Georgia for a year now, I have found myself explaining Hispanic culture, diet and expressions to many curious healthcare professionals and students. In the spirit of celebrating National Hispanic Heritage Month, I look to share the Hispanic culture with my colleagues. Understanding the culture of Hispanic patients can make an immense difference in building a healthy patient population.

The interconnectedness of culture and health makes this a great starting point for the medical community to cater to the Hispanic population. As President of the Latino Medical Student Association (LMSA) at PCOM Georgia, our club’s mission is to provide a better understanding of Hispanic culture. This started with an on-campus event organized by PCOM Georgia LMSA: “Inclusion in Medicine: Understanding Hispanic and LatinX Culture.” We discussed cultural differences in the Hispanic/LatinX community, how they lead to healthcare bias, solutions to these biases and, most importantly, culturally sensitive health recommendations. In reflecting on this year’s theme for National Hispanic Heritage Month, “Building Prosperous and Healthy Communities,” the topics from our student-led event go hand-in-hand. When we better understand Hispanic culture, we can better understand how to bring health to the whole patient population.

While there is great diversity within the Hispanic community, some recurrent themes remain true across most nationalities that can impact health: tight-knit families and diet and nutrition.

Hispanic families are particularly tight-knit. I lived in a three-generation household with my parents and grandparents, where we all took care of each other. Separation is nearly unimaginable, particularly in the setting of hospitalization. The anxiety created by separation has manifested into a term used by healthcare professionals: “Hispanic Panic.” This is a term I have heard as a scribe working outside of Miami. By ignoring the cultural aspects of Hispanic tight-knit communities, many members of the Hispanic patient population are turned off from accessing healthcare if it means being separated and isolated from their family members.

Moreso, putting a grandparent in a “home” is never an option. Healthcare professionals will often persistently recommend putting a loved one in an assisted living facility or hospice center when it appears to be the best medical advice, However, it must be understood that this can appear as an insult to the capabilities of the family unit to take care of that family member. The options of in-home assistance and how to take care of a loved one should be stressed, aligning with the mission of the Hispanic family unit. In understanding these cultural differences, healthcare professionals can create an atmosphere that fosters open dialogue and willingness to access healthcare when necessary.

When I see preventative diets recommended to the Hispanic population, I cannot ignore that the recommendations are inequitable. Much like Western diets, the typical Hispanic diet is often deficient in fruits and vegetables that are high in fiber. Furthermore, the Hispanic diet often consists of desserts containing mass quantities of sugar and the use of seasonings high in salt, espresso consumption 3+ times per day and a high emphasis on rice with every meal. Without a doubt, this could explain the CDC’s reporting of a higher prevalence of diabetes and uncontrolled hypertension in the Hispanic community. However, many of the dietary recommendations commonly cited are non-existent in Hispanic culture. I could never recommend a switch to brown rice to any of my family members and expect them to keep to it. Interestingly, new studies have shown that when white rice is cooled overnight and reheated, it forms a resistant starch that decreases the post-prandial blood glucose spike in Type I diabetes in comparison to eating freshly cooked white rice (Strozyk et al., 2022).

At our Inclusion in Medicine event, we also discussed combining the regular espresso brands with decaffeinated versions to avoid increases in blood pressure, using less pre-made high sodium seasonings with more fresh herbs (e.g., oregano, cilantro, garlic, onion) and incorporating more familiar vegetables (e.g., okra, chayote, peas, green olives, beans, artichokes, tomatoes, avocado, peppers). In essence, a healthcare community that is familiar with the Hispanic diet can make more effective preventative dietary recommendations.

While there are many drivers of suboptimal health across any population, understanding Hispanic culture is the best starting point to more effectively treat the country’s largest minority group, comprising 20 percent of the U.S. population. This National Hispanic Heritage Month, I advocate for healthcare professionals to openly discuss customs and traditions with members of the Hispanic population with an open mind to cultivate an insight of Hispanic health and to promote a healthier patient population.

Citations:

Strozyk, S., Rogowicz-Frontczak, A., Pilacinski, S. et al. Influence of resistant starch resulting from the cooling of rice on postprandial glycemia in type 1 diabetes. Nutr. Diabetes 12, 21 (2022). https://doi.org/10.1038/s41387-022-00196-1