Hispanic Underrepresentation in Addiction Treatment
To complete this four-part series concerning population underrepresentation in addiction treatment, we’re going to address the underrepresentation of Hispanics, who could be considered uniquely disenfranchised for several reasons. While the previous three blogs articulated the importance of program competency and responsiveness regarding culture, gender, and sexuality for blacks, women, and the LGBTQ community, many within the Hispanic and Latinx population endure another hurtle to treatment – citizenry status and a fear of reprisal.
Hispanics have long suffered the arrows of political targeting and societal scapegoating. From wall-building to child separation to shadowy, exploitive business models, the practices that affect immigrants also affect their relationship to both behavioral health and their likelihood to seek addiction treatment. So, if we’re going to talk underrepresentation of Hispanics in addiction treatment, we also need to speak on how society interacts with the Hispanic community.
In full disclosure, I lived in Guatemala for years. It’s difficult (if not enraging) to witness the U.S. consistently disenfranchise Hispanics. Worse yet, it’s difficult to witness an unadulterated system of secrecy and oppression in America that works to exploit Hispanics while denying them the benefits, safeguards, and social resources enjoyed by U.S. citizens, which includes access to addiction treatment.
Social Barriers are Causing Hispanic Underrepresentation in Addiction Treatment
As with the last three articles, I strive not to generalize. Individuals are individuals, but broad strokes are sometimes necessary to form a thesis. However, it’s important that I create a distinction between sociological trends and individual situations or outcomes. Regarding barriers to addiction treatment for the Hispanic community, I’m going to primarily speak on undocumented immigrants.
If you’re an immigrant worker, the barriers to receive addiction treatment would likely seem insurmountable. Consider the average immigrant farm worker with a family of four. Many immigrants work and live on or near the farmed property with their family. In some cases, housing and household goods are provided by the employer. Within this self-contained environment, the farm worker does his job to feed his family (while feeding America) but secrecy in this situation is paramount. Without this secrecy, the farm worker constantly faces the risk of deportation. Seeking help for a mental or behavioral concern, for himself or a loved one, would jeopardize this secrecy – along with his housing, employment, and current country of residence. Within this social construct, how could an undocumented worker even fathom seeking behavioral or mental health treatment?
A 2019 survey by Substance Abuse and Mental Health Services Administration (SAMSA) indicated 7% of the Latin community struggled with a substance abuse disorder and 18% struggled with mental health. I, personally, feel these numbers are well-short of the reality. However, I also feel these numbers do accurately reflect the hesitancy that Hispanics feel to seek treatment. According to one report, various sample studies of Latin migrant workers indicated an 80% prevalence for regular binge-drinking, nearly 40% rate of alcohol dependency, and 25% rate of methamphetamine and/or cocaine use. These numbers are a far cry from the estimated 7% of Latin Americans who struggle with a substance use disorder.
Overcoming Barriers to Assist Hispanics Receive Addiction Treatment
Let’s be very clear, 18% of the total U.S. population is Hispanic, which constitutes 60 million individuals. According to a 2018 survey by the Department of Homeland Security, an estimated 11.4 million individuals in the U.S. are undocumented. For the intention of this article, I’m speaking about that marginalized Hispanic community of eight million undocumented individuals from Latin countries. One 2007 study seemed to reflect the difference between Hispanic citizens and non-citizens who enter addiction treatment.
The study found that Hispanics were significantly less likely than whites to complete a treatment program, due largely to employment and housing challenges. With that said, when the study adjusted for socioeconomic status, the completion disparity between whites and Hispanics was eliminated. For argument’s sake, we could equate this adjusted socioeconomic status to citizenship. In other words, it could be surmised that citizenry’s inherent safeguards, such as fair housing and employee rights, allowed a Hispanic who didn’t require secretive housing and employment to enter treatment and complete treatment.
To overcome the barriers many Hispanics face to receive treatment, treatment programs may need to engage with civic organizations, employers, local legislatures, and law enforcement to implement programs specifically for immigrants. With safeguards and assurances in place, the undocumented Hispanic community may begin to consider substance and/or mental health treatment as a viable option – an option without the fear of reprisal. Without an acknowledgment of system-level barriers, many undocumented Hispanics will continue to enter treatment through the emergency room or court room.
Fighting Biases for Hispanics in Addiction Treatment
As indicated among other specific demographics, culturally responsive programming for Hispanics would likely also improve recovery rates. Along with a need for bilingual or Spanish-speaking programming, treatment providers could address other aspects unique to the Hispanic community, such as spirituality, a family-centric social makeup, any legal concerns regarding citizen status, and past traumas related to immigration, racism, and discrimination.
A recent article by the Washington Post outlined the recently proposed U.S. Citizenship Act, which would offer a pathway to citizenship for millions of immigrants. While anti-immigration politicians have already begun to decry the proposal – resurrecting their usual, baseless talking points – it’s important to remember the human beings caught in this seemingly endless political discourse.
These are the people who prepare your food; the Mayan mothers who loom unworldly garments; the overworked and underpaid construction workers in our neighborhoods; the farmworker with a family of four in constant fear of deportation; and every other Hispanic who the U.S. recently classified as “essential” to the American economy.
These are also people who deserve access to quality, culturally responsive treatment, just like any other U.S. or global citizen. If you or anyone you know needs to enter a bilingual or Spanish-speaking treatment program, help and hope are available.