2. Large & Growing population
– 24% of people ages 0-17 (~18million Hispanic/Latino kids)
– ~17% of people ages 18-64 (~33 million Hispanic/Latinos)
– 7.6% of people age 65+ (3.4 million Hispanic Latinos)
– 44% of people age 65+ in a Medicare Risk HMO were Hispanic/Latinos
Concentrated in key markets
– Over 75% of Hispanic/Latinos are in 7 States
– CA, TX, FL, NY, AZ, IL, NJ, CO
2
Demographics
7. The term ‘Hispanic’ was made up by the U.S. government in the 1970s in the
U.S. census 48
The term ‘Latino’ was a term used by the U.S. government in the 2000 census;
however the term ‘Latino’ has roots referencing Latin America – countries with
language rooted in Latin and in America which included Spanish, Portuguese
and French speaking countries48
In 2006 the Latino National Survey surveyed preference
– 35% preferred Hispanic
– 13.1% preferred Latino
– 32% were okay with either
– 18.1% didn’t care
7
Latino v Hispanic
8. Hispanic/Latino is considered an ethnicity-
not a race
– This means that Hispanics can be White,
Black, Asian, Etc..
In the 2010 Census Hispanics identified as
the following48
– 53% White only
– 2.5% Black/African American
– 1.4% Indian
– 0.4% Asian
– 0.1% Pacific Islander
– 36.7% Some other race
– 6% 2 or more races
– 4% No response
8
Ethnicity v Race Race status can influence health19
Studies show that race is a
determinant social economic
status which can have an
adverse effect on health.
For example: Hispanic blacks
are more likely to live with
non-Hispanic blacks and be
exposed to an array of
disadvantages such as lower
quality of education and
higher possibility of
environmental exposures
9. Que significa a ser latino?
?
Be LOUD
Be Proud
Dance
Eat
Family &
Community
9
10. Hispanics are loud and excited people
–Both volume and physical expressions tend to
be more colorful than their non-Hispanic
counterparts
– Caribbean Hispanics are known to be louder than South Americans,
Central Americans, and Mexicans
10
To be LOUD!
Verbal26,61
Elderly are to be treated with respect. It is culturally preferable to
address senior members in society as Mr./Mrs. Last Name
The use of Senora can be considered offensive in many Hispanic
countries as it implies the client is old. The English Mr. Ms. Are
preferred.
Hispanics are tend to be non-confrontational and respect authority
figures. They also may tend to accept but not always agree with
/understand authority figures.
Hispanics like to establish warmth and trust prior to addressing issues
11. • Hispanic nonverbal communication styles tend to be different from
Anglo individuals
11
To be LOUD!
Non-verbal26,61
Proximity- Hispanics tend to stand closer and provide less personal
space than Anglos
Greetings- Hispanics often greet with kisses on the cheek and hugs
Eye-contact - prolonged uninterrupted eye contact is considered
rude and disrespectful
Hispanics tend to be present focused as opposed to future focused
Hispanics tend to be polychronic time oriented meaning they engage
in multiple activates at one time- causing occasional tardiness
Puerto Ricans and Salvadorians use verbal cues such as pursing their
lips to call over/beckon someone
12. Hispanics
remember English
language commercials
as well as the general
population
The same
commercial shown in
Spanish bumps up
ad recall by as much
as 30%
Hiring Spanish-
speaking talent to
deliver the script
resonates 30%
better with Latinos
UNDERSTANDING THE BILINGUAL BRAIN54
90% of Hispanic parents want their children to be bilingual
Communication in a way that will Resonate
Know what resonates with Hispanic consumers
Source: Nielsen Neuro Nielsen State of the Hispanic Consumer
12
14. • Hispanic/Latino teens respond best to bilingual ad messages,
especially from English - language celebrities “who happen to slip in
some Spanish”—because it mirrors their own usage patterns21
• Language is an important aspect that one should be sensitive
because it has less to do with competency and more to do with the
cultural meanings people attach to language. For Hispanics/Latinos
in the U. S., Spanish is a key marker of personal, social and political
identity. As a result, Spanish-language TV remains important for
even those who are fluent English speakers and who regularly
watch English-language TV. In communicating with Hispanics, it is
not an either/or question but a matter of carefully integrating both
languages to best communicate with the Hispanic/Latino consumer
in the U. S. 59
14
Communication
15. • Family plays a big role in the Hispanic household
– Hispanics do not distinguish between immediate and
extended families5
• Hispanic families spend more time doing things
together than their non-Hispanic counterparts
– Leisure activities occur mainly in the context of family and
friendship groups51
• Hispanic families are more likely to live in a
multigenerational household14
– Hispanic children are 2x as likely to have grandparents or
adult (non parent) relatives living in their homes5
15
To have family and community
16. • Household roles often depend on gender and
age
– Male head- financial decisions
– Female head– makes food and pharmaceutical choices
• Although the matriarch often determines when a family member
needs medical care, the male head still gives permission to seek
treatment52
– Children – children of un-acculturated Hispanics often
act as cultural and linguistic broker between their
parents and ‘industry’
• ‘industry’ can be either healthcare provider or customer service
representative 16
To have family and community
17. • Machismo- traditional patriarchal structure where
father or eldest male relative is granted the most
power where women are expected to be
submissive28
– Understand that it is important to target health messages to
men as well as women. Hispanics typically subscribe to
values of “machismo” and “marianismo” which culturally
define the desirable male and female qualities. True to these
values, men are often reluctant to consult physicians for
health problems until someone is so ill that they must visit an
emergency room. Fathers/husbands may make other family
members, especially their wives and daughters, to wait until
the last minute for care or take an uncooperative stance on
the health care needs of family members.41
17
To have family and community
18. • Hispanics are very social people
– Latinos are more likely to be eating socially with family
or friends and less likely to eat alone. Even those who
have to eat alone because various constraints aspire to
eat socially whenever possible56
• Hispanics hold collective values and group
orientation permeates Hispanic life
• Individuals often look to one another for opinions
• It is not uncommon for Hispanics to stay with
family or family friends while traveling
18
To have family and community
19. • Community involvement is essential to gaining the
trust of the Hispanic community
• When less acculturated Hispanics immigrate or
migrate to an area they rely on more acculturated
Latinos to serve as advocates and counselors30
• The grass roots development of Latino communities
create tight knit social groups that tend to be less
trustworthy of unfamiliar business3,30
19
To have family and community
20. • “Relationships are extremely important in the Hispanic culture.
If you treat Hispanic customers with both respect and cultural
understanding, they will remain loyal to your business and tell
their friends and family that you have gone the extra mile to
make them feel welcomed”2
• “Politeness toward all is essential because the decision-maker
– the only one whose approval counts- may be a less than
obvious person”3
20
To have family and community
21. • Food is a cultural identifier for Latinos
– Hispanics allocate more money to food than non-
Hispanics ($452 more per year)66
– Food varies between countries and is a way Latinos help
distinguish between each other
• Despite differences between countries, freshness is
something 82% of Latinos actively seek56
– The embracing of prepackaged foods increases with
acculturation
• Hispanics tend to cook from scratch67
• Fresh fruit is a staple in most Latino households
21
To eat
22. FRESH CENTER-STORE
• Chicken
• Pork
• Fin Fish
• Avocados
• Citrus
• Bananas
• Tomatoes
• Herbs,
Spices,
Seasonings
• Ethnic Grocery
• Dry Pasta
• Pasta sauce
• Yogurt
• RTE Cereal
• Cream Cheese
• Dry Soup &
Noodles
• Mayonnaise &
Spreads
FRESH CENTER-STORE
• Specialty Fruit
• Beans
• Sapote
• Cactus Leaves
• Rice
Hot Pasilla
Peppers Guava
Hispanic Specialty
Cheese
• Hispanic Sweet
Goods
• Tortillas and
Wraps
• Ethnic Dairy
• Ethnic Frozen
• Canned Meat
• SS Milk Products
What foods are Hispanics buying?67
High-indexing Staples In The
Hispanic Basket
Additional High-indexing
“Basket Building” Hispanic
Products
22
26. Values
• Cost takes precedence over quality for the Hispanic consumer34
• In addition to cultural attitudes, cost is a factor in Hispanics
using ‘traditional medicine’
26
27. • “The average diabetes patient visits our [Walgreens]
pharmacists 30 times a year while they visit their PCP 2-
4 times a year…” CEO of Walgreens34
• In many Latin American countries the pharmacy is a
source of care including being prescribed medications
27
Convenience is a factor
28. • Hispanics less likely to trust others with personal
information
• Hispanic males are less likely to share personal information
than Hispanic women
• Puerto Ricans less likely to share personal information
regardless of benefits received in exchange34
28
Privacy Concerns
29. • Hispanics use social media as a tool to communicate
with family and friends more often than non-Hispanics
• Mobile information is more readily utilized by Hispanics
including access to health information34
29
Internet THE forum for Hispanic health
30. • Spirituality is central to the way Hispanics interact with the
health care system
– Spirituality is not always religion
• It is common for Hispanics to believe in an interconnection
between ‘good acts’ and health28
– Many believe that bad health can be caused by bad acts
– In contrast, many also believe that bad health can be overcome by
good acts
• The tie between spirituality and health can be illustrated by
the following ‘diseases’ and traditional remedies
– A reliance on traditional healing system is common not only
because it is culturally approved but also because of the lower costs
30
Spirituality, traditional medicine, and health
31. • Mal ojo or evil eye is caused by a person with a "strong
eye" and occurs when someone admires a child without
touching them.52
– The cure involves passing an egg over the body and then placing it
in a bowl under the child's pillow overnight. If the egg is cooked in
the morning then the child had "mal de ojo".52
• Mal puesto is when someone uses witchcraft to put a bad
disease on a person. The hex can be placed by a bruja
(witch) or someone who knows about witchcraft.
Symptoms can be varied.52
– The cure involves prayers, massages, herbs, making crosses on the
arms with olive oil and chili powder, and medicinal enemas.52
31
Traditional Diseases and Cures
32. • Envidia- Many Mexicans believe envidia, or envy, causes illness
and bad luck. Envy can be provoked by success, but can result
in misfortune and illness. Some research concludes that low
economic status is associated with the belief in envidia.63
• Susto- Also known as fright sickness, susto arises from a
traumatic or frightening experience and is thought to cause
soul loss, whereby the soul leaves the body and wanders
freely.63,64 Symptoms include anxiety, depression, insomnia,
introversion, irritability,lethargy, and anorexia. Tuberculosis is
sometimes classified as susto. 63,64
32
Traditional Diseases and Cures
33. • Humoral Imbalance- In general, physical and mental
illness is thought to result from an imbalance between a
person and the environment, expressed as either “hot”
and “cold” or “wet” and “dry”.64 The four humors
contained in the body include blood (hot and wet),
yellow bile (hot and dry), phlegm (cold and wet), and
black bile (cold and dry).63 To correct an imbalance,
people consume foods or herbs with the opposite quality
(e.g., “cold” conditions are treated with “hot”
medications).52
33
Traditional Diseases and Cures
34. • Empacho - Illness can also result from a “dislocation”
of different parts of the body. Empacho, an example
of dislocation, is a form of upset stomach or
indigestion, thought to be caused by eating the
wrong food at the wrong time of day, eating
undercooked food, or swallowing gum. The most
common treatment is rubbing the stomach or back
gently with cooking oil and pinching the spine.52,63
34
Traditional Diseases and Cures
35. Vicks - In Latino culture, Vicks Vapor
Rub is a cure all
35
Traditional Disease and Cure
37. • Hispanics live longer. Despite having a lower
income than white Americans, Hispanics live
longer than whites. Hispanics have an average
life-expectancy of 75.1 years for men and 82.6
years for women compared to white Americans of
74.8 years for men and 80.1 years for women (U.
S Census Bureau, 2008a).
37
Hispanic Paradox
38. • Hispanics show
higher incidences
of Diabetes
versus Non
Hispanics.
• The sub-segment
of Puerto Ricans
show higher
incidences of
chronic illness,
than the Mexican
sub-segment, All
Hispanic and All
Races.
38
Disparities - Incidence
Disparates All
Races
All
Hispanic
P.Rico Mexican
Current Asthma
Prevalence
8.0 6.6 16.5 5
Asthma Attack
Prevalence
4.2 3.3 7.8 2.3
Lifetime Asthma
Diagnosis
12.7 10.8 23.6 8.5
Coronary Heart
Disease
6.3
White/
6.6 Black*
5.5 7.7 5.5
Heart Attack 3.1 2.4 4.0 2.4
Heart Disease 11.1 8.1 11.5 8.1
Stroke 2.6 2.7 3.4 2.7
Diabetes 8.5 12.3 14.3 13.3
Cancer 8.0 3.8 4.3 3.5
Arthritis 21.4 16 21.9 15.7
Source: NHIS Ages 18+ 1998-2012
39. 1. Cancer
2. Heart Disease
3. Unintentional Injuries
4. Stroke
5. Diabetes
6. Chronic Liver Disease & Cirrhosis
7. Chronic Lower Respiratory Diseases
8. Alzheimer's Disease
9. Nephritis, Nephrotic Syndrome & Nephrosis
10. Influenza & Pneumonia
National Vital Statistics Reports, Vol. 62, No. 6, December 20, 2013, Table 2, Page 55.
39
10 Leading Causes of Death for Latinos
40. 40
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