There’s A Difference Between The Terms Hispanic, Latino, and Spanish

As someone who’s learned some Brazilian Portuguese (and still has a lot to learn), something like this has been on my mind for a while. One of the things that us physicians are supposed to have is cultural competence. I think that before I started learning Portuguese, when I heard the term Latino/a or Hispanic, Spanish speakers typically came to mind. Though I’ve also recently read something arguing for treating those from Portuguese speaking countries as a distinct group (though in the US they’re often lumped in with those from Spanish speaking countries). Granted I realized that encompassed people from many places as cultures (a patient of Puerto Rican decent who’s family has been in the U.S. Mainland for a generation or two might not have all of the same concerns as people who came from Columbia, Peru or Mexico).

Even people who come from the same country might be very different, though more similar to each other than they are to the ‘average’ american. In this I think of people from China where there are many languages and dialects spoken. Even in the U.S., someone who grew up in New England might have a much different outlook than someone who grew up in the Mid West or South East of the U.S. They might have different dietary proclivities as well.

Does that mean it’s useless or futile to try to be culturally competent? No. But it does make it more interesting at times. I think it just means keeping an open mind and remembering people from other cultures might have different expectations of time, needs from their physicians, etc. It is also helpful to know who a patient might – or would – rely on for decisions and for help. What might be considered to be “on time” for an appointment for a physician, might not be for someone where the sense of time is more fluid.

Another reason for being culturally aware – and here I am also including having a knowledge of a country’s or ethnic groups history – is risks for certain diseases. For example, if one doesn’t know much about the colonization of Cape Verde, one might not know to test a patient for Cystic Fibrosis mutations in a couple who are concerned about genetic diseases before getting pregnant. In Jewish populations, one might think of Tay Sachs as being a “Jewish Disorder”. However the genetic disorders jewish patients who trace their ancestry to Spain prior to 1492 (Sephardim) or to the near east (E.G., Persia) actually mirrors the countries they come from (For example,they can carry mutations for certain forms of Muscular Dystrophy). Knowing this kind of history helps inform decisions about testing and treatment.