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Hispanics, health care providers perceive different barriers to screening and preventive medicine

SEATTLE — Sept. 15, 2001 — Although nearly half of a group of Mexican-Americans who responded to a survey didn't have a regular physician, community health providers did not know this was a problem.

The survey, published in the October issue of Health Education & Behavior, also found mismatches in perceptions between Hispanic patients and their health care providers when it comes to cancer screening.

Although Hispanics in this study reported lower cancer screening rates than non-Hispanics of the same socioeconomic level, two-thirds of health care providers surveyed believe that the main cause is socioeconomic.

"Only a minority of health care providers and about half of representatives of community organizations mentioned different beliefs and attitudes toward cancer as an important factor for improving screening behaviors among Hispanics," says lead author Beti Thompson, Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle.

"In contrast, this population-based survey and other studies suggest that Hispanics have less knowledge about cancer, tend to avoid the disease and have a more fatalistic attitude toward cancer than non-Hispanics. These differences in beliefs and attitudes appear to be independent of socioeconomic status," she says.

Hispanics were more likely than other community members to believe that they needed to be screened for cancer only if they had symptoms or if cancer runs in their family. Most Hispanics also said they would "rather not know if they had cancer," and more than half believed a diagnosis of cancer was a death sentence.

"These beliefs need to be addressed when Hispanics are counseled to have cancer screening tests," says Thompson.

The survey included interviews with 380 community members (75 percent of whom are Hispanic), 40 health care providers and 14 representatives of community organizations serving Hispanics in the Lower Yakima Valley of Washington state.

Hispanics also said that long waiting times at clinics were a problem, while none of the health care providers or organization representatives said they thought that was a barrier to health care. Many health care providers thought lack of transportation made it difficult for Hispanics to get health care, but Hispanics were no more likely than non-Hispanic community members to identify transportation as a problem.

Language and lack of translators were other barriers that health care providers in the community underestimated, this study shows. Along with Hispanics, representatives of community organizations were likely to identify it as a problem.

"Interventions devised by health care providers and representatives of community organizations serving Hispanics may be based on perceptions that are inconsistent with the beliefs and practices of Hispanics," says Thompson.

The key to improving health care for Hispanics may be to identify and address the barriers to care that are not recognized by those who can change them, the researchers say.

The study was funded by the National Cancer Institute.

Media Note
Health Education & Behavior, a bimonthly peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. SOPHE is an international, non-profit professional organization that promotes the health of all people through education. For information about the journal, contact Elaine Auld at (202) 408-9804.

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Fred Hutchinson Cancer Research Center
Fred Hutchinson Cancer Research Center, home of three Nobel laureates, is an independent, nonprofit research institution dedicated to the development and advancement of biomedical technology to eliminate cancer and other potentially fatal diseases. Recognized internationally for its pioneering work in bone-marrow transplantation, the center's four scientific divisions collaborate to form a unique environment for conducting basic and applied science. Fred Hutchinson, in collaboration with its clinical and research partners, UW Medicine and Children's Hospital and Regional Medical Center, is the only National Cancer Institute-designated comprehensive cancer center in the Pacific Northwest and is one of 40 nationwide. For more information, visit the center's website at