Exploring Health Beliefs and Care Seeking Behaviors of Older Latinos

Purpose: As a group, Latinos in the U. S. suffer from poorer health outcomes than non-Latino Caucasians (Kaiser Family Foundation, 2005). Factors contributing to health disparities include advancing age, language barriers, and poor health literacy (U.S. Department of Health and Human Services, 2004). However, socioeconomic characteristics like these only partially explain why Latinos in general, and older Latinos in particular, have higher mortality rates and poorer access to health care than non-Latino Caucasians. Health beliefs, practices, and cultural norms likely contribute to disparities, but little is known about how these factors influence health attitudes and behaviors. The purpose of this study is to examine health beliefs and behaviors of older Latinos using the Theory of Planned Behavior (TPB; Ajzen, 1991) as a conceptual framework to generate culturally relevant information that informs efforts aimed at decreasing health disparities for older Latinos.

Method: For this exploratory study, quantitative and qualitative data were collected through in-depth interviews with 30 older (50+) Latinos in the Portland, Oregon metropolitan area. Convenience sampling was employed to recruit participants from local senior centers. Interviews consisted of demographic items, the Bidimensional Acculturation Scale for Hispanics (BAS; Marín & Gamba, 1996), and questions exploring beliefs about health and health care using the TPB as a guide (Frances et al, 2004). Data analysis was approached in three steps: 1.) a group of professional Latina women examined transcripts to identify important concepts that could be used for coding purposes in subsequent thematic analyses; 2.) using these codes, two independent coders analyzed participants' beliefs about the use of traditional (oils, herbs, healers, etc.) and conventional (western medicine) care using Atlas-ti; 3.) from a phenomenological approach, thematic analyses were conducted to detect themes for beliefs about health care use across interviews.

Results: Participants' average age was 68; the average age of migration to the U.S. was 39. Most (87%) participants were female and Catholic, and most (84%) earned less than $10,000 per year. Roughly half (52%) of the participants had a primary school education or lower, and almost all (90%) identified with the Hispanic culture with regard to acculturation. Salient belief themes that emerged included: 1.) Traditional methods of care work and people have faith in them, but conventional methods are superior even though they may prolong suffering; 2.) Significant others don't unduly influence participants' decisions to use certain types of care; and 3.) Traditional methods are accessible and many barriers exist that prevent use of conventional care.

Conclusions and Implications: This study provides insightful information about health care beliefs that directly impact health care behaviors for older Latinos. The findings illuminate some of the cultural considerations regarding health care behaviors for this population, which have been understudied but that contribute to higher mortality rates for older Latinos. These findings can be used by social work practitioners, health care policy makers, and those in allied professions to help promote positive health care behaviors and decrease mortality rates among those in this population.