State of Addiction Policy

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State of Addiction Policy: Behavioral health care challenges in the Hispanic community

State of Addiction Policy: Behavioral health care challenges in the Hispanic community

The Pew Research Center notes in 1980, there were 14.8 million Hispanics in the U.S. – 6.5 percent of the population. In 2014, there were 55.3 million Hispanics – 17.3 percent of the population. Despite being the fastest growing minority population in the country, Hispanics are largely shut out from or fail to take advantage of drug abuse treatment services. This article examines the plight of substance users of Hispanic heritage, how much of a barrier language poses to their receiving treatment and what is being done to rectify the problem.

Drug use among the Hispanic population

According to a study published by the Partnership for Drug-Free Kids, Hispanic teens experiment with drugs more than do their Caucasian or African-American peers:

  • 54 percent of teens report having used an illicit drug compared to 45 percent of African-Americans and 43 percent of Caucasians
  • 13 percent of Hispanic teens used Ecstasy compared to 8 percent of African-Americans and 6 percent of Caucasians
  • 13 percent of Hispanic teens used cocaine compared to 8 percent of African-Americans and 3 percent of Caucasians
  • Alcohol consumption is roughly the same: 62 percent for Hispanics, 59 percent for Caucasians and 50 percent for African-Americans.

Drug abuse rates are guardedly more optimistic for Hispanic adults. The 2013 National Survey on Drug Use and Health (NSDUH) Summary of National Findings notes for Hispanics 12 and older, illicit drug use was 8.8 percent, lower than for African-Americans and Caucasians. Binge drinking among Hispanics 12 and older was higher than every other ethnic group save for Native Hawaiians or Other Pacific Islanders.

An unmet need

A NSDUH report found that, between 2003 and 2011, Hispanics 12 and older needed substance abuse treatment more than non-Hispanics of the same age group (9.9 versus 9.2 percent). But among Hispanics needing treatment, just over 5 percent admitted to a need for it.

Two contributing causes are economic status and health care use. According to a Northeastern University study, in 2002, three times as many Hispanics were living in poverty compared to non-Hispanic Caucasians. In 2003, Hispanics had the highest unemployment rate in the U.S., at 34 percent. The rate for African-Americans was 21 percent; for Caucasians, 13 percent. About 9 out of 11 Hispanics come from working families but are less likely to receive health insurance through their employers.

State of Addiction Policy: Behavioral health care challenges in the Hispanic community

A lack of health insurance

The Affordable Care Act requires every adult to carry health insurance. But it excludes undocumented workers from its provisions. The Institute on Taxation and Economic Policy found these individuals paid over $11.6 billion in state and local taxes in 2014, but were largely shut out from standard health care. In a 2012 report presented to the Commonwealth Fund, the UCLA Center for Health Policy Research notes between 1999 and 2007, 57 percent of undocumented workers immigrants did not have health insurance.

The language barrier

There is a high likelihood that individuals who enter the U.S. illegally are not fluent in English. Health care statistics – and statistics in general – peculiar to Spanish-only speakers are scarce.

There are a number of ancillary reasons why this population avails itself of health care – and, by extension, substance abuse treatment – at significantly lower rates than does the general population. A 2015 study by Stanford Hospital found native Spanish speakers are more comfortable with and prefer to be seen by Spanish-speaking physicians. But they are under-represented by Hispanic physicians.

According to the National Hispanic Medical Association, there are 50,000 licensed Hispanic physicians in the United States, which stands in contrast to the 914,000 total licensed physicians reported by the Federation of State Medical Boards. The ratio of 50,000 physicians to a population of 55 million works out to 1 physician for over 1,000 potential patients.

According to the Northeastern study, the situation will not improve anytime soon. Hispanics make up just 3 percent of the nation’s full-time faculty in the health, natural and social sciences. In 2000, only 4 percent of doctoral degrees – 669 – were granted to Hispanics.

Reversing the tide

The Northeastern study suggests four strategies for improving treatment policy as it pertains to Hispanics and native Spanish speakers:

  1. Neuroscience and biology. Hispanics should be recruited to participate in genetic, genomic, pharmacological and physiological studies to determine whether biological variations exist among Hispanic subgroups.
  2. Prevention. Research must target the stressors peculiar to immigrants and minorities. These include social isolation, the division of families, poverty, discrimination and lack of access to treatment. Study authors suggest that a greater understanding of these factors can lead to effective prevention strategies.
  3. Behavioral treatment. According to the study, family-based treatments have proven effective in controlled studies with adolescents. More research is needed to determine whether this approach can be delivered at the community level. Community providers must be trained in proven treatment methods. The study authors note there has been no research regarding the use of evidence-based practices at the community level. Access to services entails more than egress. It involves the promotion of health literacy, integration of case management strategies, insurance and the judicious use of substance use funding in the Hispanic community.
  4. Training and mentorship. There needs to be a significant increase in the number of Hispanic physicians to meet the demands of the community. The authors note this lack of representation has a trickle-down effect: It hampers the progress on Hispanic drug abuse research. Established organizations such as the National Hispanic Science Network on Drug Abuse provide avenues for mentorship and research.

Both monolingual and English-fluent speakers are not receiving (or seeking in many cases) adequate drug abuse treatment. As with most prevention strategies, the key components to reversing this situation are education, funding and accessibility. Until one or more of these components is adopted at the state level, Hispanics will continue to be marginalized with respect to drug abuse treatment.

Sovereign Health understands the importance of reaching out to the Hispanic community to meet their special behavioral health needs. Our facility in El Paso, Texas, provides bilingual care in both English and Spanish for patients in need of substance use and dual diagnosis treatment.

State of Addiction Policy: Behavioral health care challenges in the Hispanic community

Follow this series

Check back regularly for updates on the State of Addiction Policy editorial series at SovHealth.comFacebook or LinkedIn. You can also follow us on Twitter and track the discussion by searching for #StateOfAddictionPolicy and #SovTalk. All articles in the series are available here.

Stay tuned for the next installment of the series on the first Sunday of September, which will take an in-depth look at the drug policies of the major presidential candidates.

About the author:

Darren Fraser is a content writer for Sovereign Health. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at news@sovhealth.com

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