TODOS is a network and a professional community of occupational therapy practitioners and students who have as their mission to support and mentor one another; to support the exploration of careers in occupational therapy by Hispanics/Latinos; and to promote issues of diversity, inclusion, and multiculturalism within the occupational therapy Profession.
The purpose of TODOS is to:
- Provide a consistent voice to AOTA, and state and local professional organizations regarding the needs and concerns of Hispanic/Latino practitioners, students, and consumers
- Support and mentor one another, and promote Hispanics/Latino representation and leadership in local, state, and national decision-making bodies
- Promote the exploration of careers in occupational therapy by Hispanics/Latinos
- Support Hispanic/Latino practitioners who immigrate from other countries, through the process of adjustment and transition into the occupational therapy profession in the USA.
Email co-chairs Sirley Marin, MOT or Dahlia Castillo, MS, OTR
The Hispanic (Spanish speaking) population in the United States has experienced considerable growth and has become the largest minority group, representing 17.1% of the population (U.S. Census Bureau, 2011). The Hispanic population migrating to the United States faces multiple challenges, with language proficiency and health literacy among the most common. These deficiencies result in socioeconomic disadvantages related to high poverty levels and limited access to health care services. The economic, social, and psychological burdens imposed by poor health on populations that are already disadvantaged can be particularly devastating (Kington & Nickens, 2001).
An article in the AMA Journal of Ethics (Volandes & Paasche-Orlow, 2007) presented this conceptual suggestion: Should all U.S. physicians speak Spanish? Even though the role of the physician is to direct and provide medical care to individuals, inadequate communication contributes heavily to disparities in health care quality (National Academies Press, 2002), and language concordance between patients and physicians has been shown to reduce the overall costs to hospitals (Jacobs, Sadowski, & Rathouz, 2007). The article makes the case that it would be in the best interests of physicians to learn Spanish in order to facilitate health learning and promote healthier habits in individuals. Furthermore, there are fewer physicians than Spanish-speaking individuals, with a ratio of physicians to patients who speak English less than “very well” of approximately 22:1 (U.S. Census Bureau 2011; U.S. Department of Labor, 2012).
Similarly, these language attributes could be generalized to occupational therapy practitioners in the United States. The AOTA Centennial Vision calls for occupational therapy to become a profession that is globally connected, with a diverse workforce that meet society’s occupational needs (AOTA, 2007). On August 11, 2000, then- President Bill Clinton signed executive order 13166, “Improving access to Services for Persons with Limited English Proficiency (LEP) (see http://lep.gov). Yet clearly there is still a broadly recognized need for better communication in health care.
There are several tools available to occupational therapists to communicate with Spanish-speaking individuals:
1) Interpreters—This option will ensure the most accurate translation and facilitate discussions with clients.
- The National Standards for Interpreters in Health Care is a reference for interpreters and those who employ them.
- The National Council on Interpreting in Health Care is a multidisciplinary organization whose mission is to promote and enhance language access across the U.S.
- The Cross Cultural Health Care Program serves as a bridge between communities to advance access to health care that is culturally and linguistically appropriate.
2) Language Applications—These should be used with caution, because literal translations from available apps may not accurately convey information, due to changes in connotations and denotations of words and phrases. Apple and Android offer a variety of apps to assist with communication and translation
- Google Translate: Free
- Itranslate: Free
- Ispeech Translator: Free
- Occupational Therapy Spanish Guide by Mavro: Free or Upgrade for $
3) Courses/Books—Jacqueline Thrash, OTR, has published Common Phrase Translation: Spanish for English Speakers for Occupational Therapy, Physical Therapy, and Speech Therapy.
Health Disparities and Access to Health Services
According to a report of the National Research Council, without good health an individual may not be able to experience, participate in, and enjoy different dimensions of life such as the ability to learn, attend school, work, be steadily employed, participate in social activities, be part of a community, have a sense of belonging and well-being, and engage in relationships. Hispanics have lower age-adjusted mortality rate despite disparities in employment, education, and level of poverty (National Research Council, 2002).
American Occupational Therapy Association. (2007). AOTA’s Centennial Vision and Executive summary. American Journal of Occupational Therapy, 61, 613–614.
Jacobs E. A., Sadowski, L. S., & Rathouz, P. J. (2007). The impact of an enhanced interpreter service intervention on hospital costs and patient satisfaction. Journal of General Internal Medicine, 22(Suppl. 2), 306–311.
Kington, R. S., & Nickens, H. W. (2001). Racial and ethnic differences in health: Recent trends, current patterns, future directions. In N. J. Smelser, W. J. Wilson, & F. Mitchell (Eds.), America becoming: Racial trends and their consequences II (pp. 253–310). Washington, DC: National Academy Press.
National Academies Press. (2002). Front matter . Guidance for the National Healthcare Disparities Report. Washington, DC: Author .
National Research Council. (2002). Emerging issues in Hispanic health: Summary of a Workshop. In Joah G. Iannotta (Ed.), Committee on Population, Division of Behavioral and Social Sciences and Education (pp. 1–8). Washington, DC: National Academies Press.
U.S. Census Bureau. (2011). Language use. Retrieved from http://www.census.gov/population/www/socdemo/lang_use.html.
U.S. Department of Labor, Bureau of Labor Statistics. (2012). Occupational outlook handbook. Retrieved from http://www.bls.gov/cps/cpsrace2011.pdf
Volandes, A. E., & Paasche-Orlow, M. K. (2007). Health literacy, health inequality and a just healthcare system. American Journal of Bioethics 7(11), 5–10.