We are living in a time of growing ethnicdiversity and a call to improve cultural competency awareness among healthcare providers and organizations is a “must.” To work with the Latino population you need to know where you are. These are some numbers you should know . . .
By 2013 the population in the three largest ethnic groups will be more than 109 million ,and Latinos will represent nearly half of that population and have more than doubled since 1990. This is called… The Latino BoomWhat you are observing here is calledthe Latino Boom.
The question is . . . are we aware of and ready for this ? A very important thing you need to observe when working with minorities is the statistics . . . those “sexy” numbers -as Bryan uses to say- that give you a picture about where are you . . . Let’s see Illinois for example.From 2000 to 2008Nearly 12 million additional Latinos34% growth during this period50% of the total population growthFrom 2008 to 20131,440,087 new Latinos Americans per yearThe question is… are we aware of and ready for this? A very important thing you need to observe when working with minorities is the statistics… those “sexy” numbers – as Bryan usually says- give you a picture of the Latino population in your particular state.Let’s see Illinois, for example
What I would like to highlight is that Latinos are the 15% of the State population; 79% of them are of Mexican origin and 21% are of non-Mexican Origin. Now let’s see this population density growth in the metropolitan Chicago area . . .
Imagine how it will be in the year 2050 consideringthe Hispanic growth rate.Something you need to know about Latinos is . . .
You need to reach out to the Latino community in a culturally sensitive way.You will learn that…
Reaching the Latino community ISNOT about translating from English to SpanishOnly translating existing ideas and press materials into Spanish: That’s just loco!There is too much lost in translations You will do more harm than good by trying this approachHispanic public wants messaging developed by minds that understand themNow let’s see our challenges . . .
When trying to reach out to the Latino community, this is an important thing to keep in mind. Why? Because we have different levels of acculturation. So remember, Not All Hispanics are the Same
Acculturation is the modification of the culture of a group or individual as a result of contact with a different culture.Acculturation involve the social and psychological exchanges that take place when there is constant contact and interaction between individualsfrom different cultures (Berry, 1997; Redfield, Linton, & Herskovits, 1936;Ryder, Alden, & Paulhus, 2000). These changes can be observed across a number of different domains such as attitudes, values, behaviors, and sense ofcultural identity (Cuéllar, Arnold, & Maldonado, 1995; Ryder et al., 2000).
This is from a conference given by David J. Perez Co-Founder & Chief Executive Officer of Latin Force GroupNow let’s see the challenges…
Here’s the first---Communication! This communication barrier is one of the factors that accentuates Latino health disparities among others.. according to the U.S. Department of Health and Human Services.That is why we should: Have Spanish speaking people to directly communicate with them andAvoid using friends, family or children for medical interpretation (Kaiser Permanente, 2001)Now let’s see what is going on in Illinois regarding Latinos and language?
Latinos in ILOnly English Spoken at Home (19%)Language Other than Only English Spoken at Home (81%)You need to look how these numbers play in your state to be effective delivering your message. I recommend you to use this web site to learn about it in your state.And remember . . . You have to tie it to the level of acculturation. Let’s see some other challenges we face in reaching out to the Hispanic community . . .
The flow of unauthorized immigrants into the U.S. is on the decline. But it is still a major challenge in connecting with the Latino community and communicating the message about organ and tissue donation.
Undocumented Latinos:Nearly 12 million undocumented immigrants were living in U.S. in 2008: From them 76%, were Latinos In 2009, 59% of unauthorized immigrants lived in California, Texas, Florida, New York, Illinois and New Jersey.I really feel that the top 6 States should work toward having a donor registry that allow people without documents to become organ donors if that is what they want to do. I know in CA they can do it, TX is trying to do the same…
The unducumented are: Ineligible for Illinois Organ & Tissue Donor RegistryIt is important to know that many Latinos want to register but do not because they cannot get a driver’s license or state ID in ILThe most important message we give to overcome the challenges presented by the undocumented immigrant population is to talk tofamily members about their wishes to become organ and tissue donors so those wishes can be honored.At Gift of Hope we have developed a special brochure with a card to be kept in the wallet where one can express the wish to donate.Let’s talk about the next challenge…
Many members of the Latino community are uninsuredIt is difficult for them to access the health system in general and transplant system specifically16% of the US population were uninsured in 2006Versus 34% of the Latino population in 2006The important thing to remember here is to have a clear understanding that the reason why undocumented individuals cannot have a transplant is not because they are undocumented but because they are uninsured or do not have resources to pay the transplant costs. There is no regulation that says that undocumented individuals cannot have a transplant.But wait! There is another challenge to face . . .
A fourth challenge we face is one we have to confront with nearly all populations we deal with---the myths of organ and tissue donation.But in dealing with the Latino community, this challenge can be more difficult to address, because many immigrants bring with them beliefs and myths about organ and tissue donation from their native countries for situations that really happen there and also, acquire new ones here.Even though these myths are shared by people from all races and ethnic groups, they seem to be even more prevalent among minorities.So now that you know the challenges . . . Let’s see what Gift of Hope is doing to confront them and what you may be able to do to replicate our efforts in your states.
Here are some of the things we aredoing to enhance awareness of organ and tissue donation in the Latino community through strategic outreach and the development of wise partnerships.The Hispanic Hospital & Community Council is one of our most important and most effective initiatives. I want to spend some time telling you about it, but before I do let me talk about a few other things we do to reach out to the Latino community.
We are very active in community health fairs and community events. We have been involved in more than a 100 public programs so far this year. They include such grassroots community events as:FightingAgainstCancer- Vive tu Vida, Diabetes Expo, and several health fairs asStateRepresentative Susana Mendoza Healthfair; Casa Central, Benito Juarez and Hubbard HS,Senator Delgado healthfair. Younameit… wewerethere! I personallyattendedalmost 100% of them.
We attend donor drives at the majority of the hospitals that serve the Latino population in our donor service area. Also, when hospitals ask for help in outreach, we givethem tips about how to contact and attract Latinos in their areas. I also developed a program to educate ICU nurses about cultural competency with the hope that this will improve the organ and tissue donation consent rate for Latinos and all otherminority populations.
Participation in Mexican Independence Day has been a positive program for us. These huge events provide a great opportunity to meet and educate people in the Latino community . . . especially undocumented immigrants. These events featured horses, cows, rodeo, music, food . . . and organ donation because we have made a commitment to be wherever our community is and do what we can to get people to register as organ and tissue donors in Illinois.
Another powerful program we have developed is our outreach during National Donor Sabbath,(No to read when sharing w/OPOs an annual interfaith celebration of the gifts of hope provided through organ and tissue donation held in November each year. )In this annual event we have the opportunity to give our message and share testimonies about organ donation right after the Gospel.For the Sabbath we develop a campaign which includes visiting 11 Christian churches and talking to their members about organ and tissue donation.We estimate that we reach about 5,000 people a year with this program and get valuable media coverage, too.
Other things I do are:Testimonials, PSAs for broadcast and print mediaScripts for the Univision/ Telefutura TV interviewsStories about donors and recipients pitched to the mediaPR/marketing programs targeted to the Latino community assisted by The San Jose GroupWe are also very active in the traditionalmedia. Print media, Radio and TV will be mentioned by our co-presenters Edna Uribe and Jim Legg
And to keep pace with change, we are now also very active in the social media. media.
Now let me talk with you more in depth about our Hispanic Hospital & Community Council. The HHCC is composed of leaders from the healthcare and the Latino community. We work together to increase the number of Latino registrations in the state’s organ and tissue donation consent registry and to educate the community about the importance of organ and tissue donation.The goals of the HHCC are to: Provide a global vision and direction for addressing issues in the Hispanic community and encourage people in the community to support for organ and tissue donation. Identify efficient ways to educate the Hispanic community about organ and tissue donation through TV campaigns, health fairs, Donor Awareness Month, workshops, etc. Increase the number of Hispanic registrations in the Illinois organ and tissue donor registry. Increase the donation rate among Hispanics.
Here are the groups and individuals who participate in the Council. All of the representatives are Latino.We ask them: Provide guidance: advisory role Provide community contacts, opportunities for interactionActively participate in “spreading the word” about organ and tissue donation Open outreach opportunities for usHelp us debunk the mythsPublish articles about Hispanics and organ and tissue donationOpen doors to grass root community events Link with the Mexican Consulate
In addition to all of the outreach initiatives I have talked about to this point, here are some other things we are doing to reach out to the Hispanic community and persistently enhance our community outreach efforts.HRSA: 2010 and 2011 Hispanic calendarASMHTP: Co-chair of the Multicultural Committee; creating Resource Faith Guide… a work in progress.AOPO: Part of Latino Multicultural Group; creating best practices for the Latino community outreach.
As member of the AOPO Latino group I have presented four best practices.The partnership with the Mexican Consulate can take time to develop, but they will give you ample time to talk about your programs and their goals. I established a relationship with specific staff: The Consul of Community Programs and the Coordinator on Health Affairs through the Hispanic CouncilWith regard to the donor family surveys, I don’t do this. I just benefit from this great tool we use at Gift of Hope because I often get my stories for the media from it. The surveys are sent to an outside agency for tabulation, and we receive an annual report about the survey results. We believe that it is crucial to receive feedback from donor families to succeed with of our mission and to identify areas of strength and areas needing improvement.Also it is very important to contact each Latino family that answers the survey. This is helpful to potentially form a professional relationship with the donor family. I may discuss the donation process with the family and answer any questions they may have. We are mindful of the importance of cultural sensitivity. The feedback we receive helps ensure we are using our best practices. I also present the family with opportunities to share the story of their loved one in various media. They may also discuss promoting the importance of donation in their community and workplace by membership in the Latino Task Force. You are welcome to email me if you would like to see a sample of our survey.
To bring Gift of Hope to each Latino home and become part of their everyday life, not to hear about Gift of Hope for the first time in the ICUTo work tirelessly until every member of the Latino community knows the facts about organ and tissue donationTo talk with as many families as possible about becoming an organ and tissue donorOur mission with regard to reaching out to the Latino community is consistent, and we are untiring in our efforts to carry it out.
If you . . . Create a Hispanic Hospital & Community CouncilEstablish a trusting relationship with the Mexican ConsulateApply the information taken from donor family surveysKeep an active presence in the communityFeel passion for what you do and transmit your enthusiasmReach out to the Hispanic community in a culturally sensitive way,andYou have support for your initiatives as I have from David BoschIn summary, then . . .
I will now introduce my co-presenters . They will talk about what we do in TV, Radio and print media.
Enhancing Awareness In the Hispanic Community Through Strategic Outreach & Wise Partnerships
Population by Ethnicity/Race 1940-2013Asian & PI*Black*Hispanic-10,000,00020,000,00030,000,00040,000,00050,000,00060,000,0001940 1970 1980 1990 2000 2008 2013Source: Latin Force Group LLC; American Marketscape DataStream: 2008 Series and the U.S. Census Bureau. *2000-2008-2013 numbers for Asian and Black are for non-Hispanic; 2008 and 2013 estimates as of July 1, 2010.
The Latino Boom• From 2000 to 2008– Nearly 12 million additional Latinos– 34% growth during this period– 50% of the total population growth• From 2008 to 2013– 1,440,087 new Latinos Americans per year• 120,073 per month• 3,943 per day• 164 per hourSource: Latin Force Group LLC; American Marketscape DataStream: 2008 Series. 2008 and 2013 estimates as of July 1, 2010.
Hispanics in IllinoisPopulation and National Origin U.S. Rank1• Total Hispanic Population in Illinois: 1,952,000 6• Hispanics as % of State Population: 15% 10• Hispanics as % of U.S. Hispanic Population: 4.3%• Native-Born Hispanics (% of Hispanics): 57% 36• Foreign-Born Hispanics (% of Hispanics): 43% 16• Mexican Origin (% of Hispanics): 79% 4• Non-Mexican Origin (% of Hispanics): 21% 8
Challenges of reaching Latinos• Reaching the Latino community IS NOT abouttranslating from English to Spanish• Only translating existing ideas and press materials intoSpanish: That’s just loco!• There is too much lost in translations• You will do more harm than good by trying this approach• Hispanic public wants messaging developed by mindsthat understand themSteve Cody is chairman of the PRSA Counselors Academy
Challenges of reaching LatinosWhen talking about Latinos . . .One Size Does Not Fit All!
Not All Hispanics are the Same“Acculturation is the process whereby immigrants acquire a new culturethrough language, customs, lifestyle, media usage and other practices—theyretain elements of their home culture as well. For Hispanics, Geoscape callsthis characteristic Hispanicity.”• HA1: Americanizado.– English Dominant (nearly no Spanish).– Born in US; 3rd+ generation.– Few Hispanic practices.• HA2: Nueva Latina.– English Preferred (some Spanish).– Born in U.S. 2nd generation.– Some Hispanic cultural practices;often “retro-acculturate”.• HA3: Bi-cultural.– Bi-Lingual (equal or nearly).– Immigrant as child or young adult.– Many Hispanic cultural practices.• HA4: Hispano.– Spanish Preferred (some English).– Immigrant as adult, in U.S. 10+ years.– Pre-dominant Hispanic cultural practices.• HA5: Latinoamericana.– Spanish Dominant (nearly no English).– Recent Immigrant as adult (less than 10 years ago).– Primarily Hispanic cultural practices.– Identify with home country more so than U.S. Hispanic.HA4: Hispano17.0%HA2: NuevaLatina26.4%HA1: Americanizado15.1%HA5: Latinoamericana14.1%HA3: Bi-Cultural27.4%
Always multicultural…even if we wouldn’t admit it.Native + British + Spanish + Mestizo + Euro + African + Mulatto + AsianThe Great Immigration Debate.Popular Music.Blues, Jazz, Rock-n-Roll, Hip Hop, Latin Rock, Reggaetón.Classic American Cuisine.Hot Dogs, Hamburgers, Pizza, Burritos, Sushi, Wraps….Entertainment.Popular TV shows.I Love Lucy, Good Times, Cosby’s, George Lopez, Ugly Betty.David J. Perez, Latin Force GroupAmerica’s Cultural [r]evolution
Challenge #1: CommunicationLanguage and communication barrier• Most foreign-born Latinos (52%) speak only Spanishat home• Half of adult children of Latino immigrants speak someSpanish at home• Nearly three-quarters of Mexican immigrants (71%)speak little to no English• People born in South America (44%) and Puerto Rico(35%) are the least likely to say they speak little to noEnglish
Challenge #1: Communication• Only English Spoken at Home– 328,000 (19%)• Language Other than Only English Spoken at Home– 1.41 million (81%)http://pewhispanic.org/states/?stateid=ILLatinos in IllinoisLanguage at Home Age 5 and Older
Challenge #2: Undocumented Latinos• Nearly 12 million undocumentedimmigrants were living in U.S. in2008:– 76%, were Latinos– 11% were Asian– 8% were white– 5% were black• In 2009, 59% of unauthorizedimmigrants lived inCalifornia, Texas, Florida, NewYork, Illinois and New Jersey.Unauthorized Immigrants• CA: 2.55 million• TX: 1.6 million• FL: 675,000• NY: 650,000• IL: 525,000• NJ: 475,000• GA: 425,000• NC: 275,000• WA: 200,000• MI: 140,000• WI: 120,000• IN: 120,000
Challenge #2: Undocumented Latinos• Ineligible for Illinois Organ & Tissue Donor Registry• It is important to know that many Latinos want toregister but do not because they cannot get a driver’slicense or state ID in IL
Challenge #3: The uninsured• Many members of the Latino community are uninsured• It is difficult for them to access the health system ingeneral and transplant system specifically• US: 16% uninsured– 47 million in 2006• Latino: 34% uninsured– 15 million in 2006
Challenge #4: Myths and native beliefs• Doctors won’t save me if they know I’m an organ donor.• They will take my organs before I am dead.• Only the rich and famous receive transplants.• The healthcare system can’t be trusted.• There is a black market for organs.• I want to be buried complete.• And so on . . .
Gift of Hope’s Outreach Efforts• Hispanic Hospital &Community Council• Health fairs• Univision• Telemundo• Radio• Lunch wagons• Hospitals donor drives• Presentations about organand tissue donation• Churches donor drives• Supermarket advertisingcampaigns• Un Buen Doctor magazine/Catolico newspaper• The San Jose GroupActive in the Latino community
Outreach to the Latino communityCommunity health fairs
Outreach to the Latino communityHospital donor drives
Outreach to the Hispanic communityMexican Independence Day
Outreach to the Hispanic communityNational Donor Sabbath• Golden Trumpet AwardWinner/Publicity Club ofChicago/1ABC Award• Relationship with 11leading Hispanic churches/5,000 Hispanics reached• 20 media placements: 8print hits, 6 online, 2 TVsegments
Outreach to the Hispanic community• Testimonials, PSAs forbroadcast and print media• Scripts for the Univision/Telefutura TV interviews• Stories about donors andrecipients pitched to themedia• PR/marketing programstargeted to the Latinocommunity assisted by TheSan Jose GroupActive with Hispanic media
Outreach to the Hispanic community• Gift of Hope Spanish language Facebook page• Gift of Hope: Red de Donantes de Órganos y TejidosActive in Hispanic social media
Hispanic Hospital & Community CouncilGoals of the HHCC:• Provide a global vision anddirection for addressing issuesin the Hispanic community andencouraging support for donation• Identify efficient ways to educate the Hispaniccommunity about organ and tissue donation through TVcampaigns, health fairs, NDLM, workshops, etc.• Increase the number of Hispanic registrations as organand tissue donors, as well as the donation rate.
Hispanic Hospital & Community Council• Transplant surgeons• ICU nurses• Social workers• Catholic priests andchaplains• Media representatives• Community leaders• Immigration attorney• Donor recipient anddonor family member• Gift of Hope staff• The Mexican ConsulMembers of the HHCC:All Latinos
Other outreach and partnership efforts• HRSA: 2010 and 2011 Hispanic calendar• ASMHTP: Member of the Multicultural Committee• AOPO: Part of Latino Multicultural Group; creating bestpractices for the Latino community outreach• Gift of Hope: Monitor donor family surveys• Training about Cultural Competence to ICU nurses andGift of Hope staff
Best Practices at AOPO Portal Hispanic Hospital & Community Council “Ventanillas de Salud” (Health Counter)/MexicanConsulate Donor Family Surveys/To obtain donors’ stories Partnering with American Diabetes Associationto register in the First-Person Consent Registry
My personal goals…• To bring Gift of Hope to each Latino home andbecome part of their everyday life, not to hear aboutGift of Hope for the first time in the ICU• To work tirelessly until every member of the Latinocommunity knows the facts about organ and tissuedonation• To talk with as many families aspossible about becoming anorgan and tissue donor
Recipe for successIf you . . .• Create a Hispanic Hospital & Community Council• Establish a trusting relationship with the Mexican Consulate• Apply the information taken from donor family surveys• Keep an active presence in the community• Feel passion for what you do and transmit your enthusiasm• Reach out to the Hispanic community in a culturally sensitiveway , and• Have support for your initiatives as I have from David Bosch