Healthy InSights^® Informativo
Celebrating the Holidays With Your Hispanic Patients

We all know that healthy sight is especially important to a child's ability to experience the world. Despite this, results from a recent American Eye-Q survey conducted by the American Optometric Association (AOA) indicate that roughly one in five Hispanic children have not received a comprehensive annual eye exam.

The survey revealed that nine in 10 Hispanic kids did not receive their first eye exam within their first year of life, as recommended by the AOA. Results showed that just 9 percent of Hispanic children received their first eye exam between the ages of one and two, and 43 percent between the ages of three and four.

Additionally, the survey revealed alarming results about Hispanic parents' consideration of UV-blocking eyewear for their children. While children's developing eyes are more susceptible to permanent damage from UV rays, one-third of Hispanic parents said they did not purchase sunglasses for their children.

These results reinforce the need to educate your Hispanic patients about beginning eye health regimens – such as regular eye exams and UV-blocking eyewear – early in life.

Click here to view more detailed results from the American Eye-Q survey.

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A common thread among different Hispanic cultures such as Mexicans, Puerto Ricans and Cubans is the use of herbs and home remedies to cure illnesses and ailments. This is important to keep in mind when assessing your Hispanic patients' health and current use of medications that could affect vision.

Often, using herbs is a first line of treatment among Hispanic consumers. Why? This is a practice with a long tradition that is passed down from generation to generation. In fact, using "natural" elements to treat medical issues can be traced as far back as the time of the Aztecs, in Mexican culture for example, who used cactus (nopal) for various ailments.¹

There are several reasons why it remains popular within the culture, even among acculturated and assimilated Hispanics. Oftentimes, Hispanics depend more on the family circle for support and advice than they do on health professionals. Hispanics will consult other family members about health matters, and word-of-mouth is very impactful in this community. Most Hispanics will listen to feedback and referrals from family and peers foremost.² Additionally, many prefer herbal remedies because they believe it is "natural," and due to the often high cost of traditional medications, they choose a homeopathic solution as an alternative.¹ Also, there is a popular belief that a person becomes ill as a result of an imbalance between hot and cold principles in the body. Examples of "hot" diseases or states are pregnancy, hypertension, diabetes and acid indigestion. Some "cold" disease examples are menstrual cramps, pneumonia and colic. Hispanics believe the goal of treatment is to restore harmony and balance.

This cultural tradition can affect the relationship between you and your patient and vision care. When you are asking about your patients' medical history and treatments, take note that they may not readily share what herbs they may be using; Hispanics can be afraid of being "scolded" by medical professionals because they believe most doctors trained in the United States do not believe in herbs.¹ Therefore, you may not be able to obtain the full spectrum of medical information from your patient, at least initially. However, your respect of this practice and open-mindedness to their usage of homeopathic medicine will help build your relationship with your Hispanic patient so that they feel comfortable sharing their usage. Also, as you learn about what remedies your patient may be using, be aware that they may be taking herbs without the benefit of expert guidance and advice. This can create potentially dangerous situations when herbs are used for the wrong indications, or when herbs are combined with traditional medications.¹ Share with your patients if you are concerned about the combination of herbs and medications they are using, as they may not know about possible negative effects.

Culture can shape a patient's concept of disease, treatment and even the existence of certain illnesses. An increased awareness of cultural differences can improve communication between you and your patient and improve patient compliance with other medical procedures and treatments. While there is limited knowledge regarding herbs or remedies used specifically to cure vision problems, it is important for eye care professionals to recognize that patients may be consuming herbal remedies for other issues, which could affect their eye or overall health.

1. Home Remedies for Type 2 Diabetes Used by Mexican Americans in El Paso, Texas,University of Texas at El Paso/University of Texas at Austin Cooperative Pharmacy Program
2. Health Issues in the Chicano/Latino Community taught by Seline Szkupinski Quiroga in the Chicana & Chicano Studies Program at the University of California at Davis, Fall 1998.

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In addition to Thanksgiving and Christmas, your Hispanic patients may also celebrate two native holidays before and after the New Year: Las Posadas and Three Kings Day. Recognizing these holidays in your practice is an opportunity for you to connect with your Hispanic patients, letting them know you are taking the time to understand their unique culture.

Las Posadas (the Inns) is a Catholic, Mexican festivity that consists of nine consecutive days of celebrations, starting December 16 and ending December 24. Las Posadas represents the challenges that Joseph and Mary faced in finding a room when traveling to Bethlehem to give birth to their son, Jesus. The holiday is typically celebrated on one particular evening with larger group activities held at a community center or street festival. The celebration may include formal performances – such as a re-enactment of the search by Joseph and Mary – with characters including angels, the Three Kings and a host of shepherds and shepherdesses. The characters usually wear colorful costumes from that time period and carry brightly decorated báculos (walking staffs) or faroles (paper lanterns).

Some communities may also practice the traditional manner of commemorating Las Posadas with groups of children and adults going from house to house, singing a traditional song requesting lodging (posada). At each house, the owner responds with refusal (also in song), until the group reaches the designated site for the party, where the owner recognizes Mary and Joseph and allows them to come in. Typically, each family in a neighborhood will schedule a night for the Posada to be held at their home until the celebration is complete.

Another Hispanic holiday is Three Kings Day (Día de los Tres Reyes), also known as the Epiphany. Held every year on January 6, this holiday is recognized more widely among Hispanic cultures such as Puerto Ricans and South Americans, in addition to Mexicans. It celebrates the day in Christian tradition when the Three Wise Men visited the baby Jesus. Traditionally, children put their shoes under their bed or in the living room so that the Wise Men can fill them with gifts. Some families also place hay and a bucket with water outside their home for the Wise Men's animals, and even some cookies and milk for the Wise Men: Melchor, Gaspar and Baltasar. A food that is traditionally eaten is Rosca de Reyes, an oval sweetbread decorated with candied fruit.

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