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Culture is the key to improving health 

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On Feb. 7, a prestigious task force of health, social service, religious, legislative and business leaders will unveil a groundbreaking report on the unmet health-care needs of North Carolina's burgeoning Latino population. The report marks only the second time anyone's attempted such a comprehensive look at the health status of Latinos--the first was done by the North Carolina Center for Public Policy Research in 1998.

Drawing from the work of expert panels that began meeting last April, the new report describes the general health of the state's Latino population and explores such issues as systems of care, access to care, health insurance and "health literacy." Among its major findings are that in North Carolina--which has one of the fastest-growing Latino populations in the country--Latinos are less likely to have health insurance and more likely to experience language barriers than other groups.

Task force members hope their work will lead to some clear-cut changes in state health-care policy, including vigorous efforts to reduce language barriers, extend health insurance and improve services for Spanish-speaking newcomers. Among the report's major recommendations is to make bilingual providers the norm in North Carolina.

An early chapter contains a startling fact that's likely to be overshadowed by some of the more negative news in the report: Although they have less prenatal care and are more likely to be living in poverty, Latinas have the healthiest babies in North Carolina.

The existence of what's known as the Mexican Paradox is one of the little-known positives of the Latino community. If such advantages are to be preserved, task force members say, health-care services must be redesigned so that they acknowledge cultural differences.

For example, the report lists specific beliefs such as respecto (interpersonal respect), familismo (family), machismo (male authority) and fatalismo (fatalism) as traditions that influence the way Latinos view health and interact with health-care providers. It also describes how owners of Latino tiendas in North Carolina have taken on the role that pharmacies play in their home countries, dispensing folk medicines and advice to Spanish-speaking customers.

Efforts to expand access to the existing health-care system will need to acknowledge the role such practices play in the lives of the state's Latino residents, the report states. "When making and implementing health policy for Latinos, we must design strategies to bridge the cultural gap that may exist between patient and providers so that common goals can be achieved," it says. "Health policies should capitalize on the cultural strengths of the Latino community."

For more information on the task force and its report, call The N.C. Institute of Medicine, 401-6599, or El Pueblo, 835-1525.

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