Cultural Competency Key to Meeting the Health Needs of Latino Veterans
Treating Post-Traumatic Stress Disorder Requires Culturally Sensitive Care
SOURCE: Flickr/U.S. Army Garrison-Miami
Unlike other U.S. wars, the recent wars in Iraq and Afghanistan have relied on a relatively small number of volunteers deployed multiple times. This combination puts an extreme mental toll on the women and men who serve and has put a spotlight on the increase in post-traumatic stress disorder, or PTSD, cases among service members. The U.S. Department of Veterans Affairs recently reported that 15 percent of veterans from Afghanistan and Iraq currently suffer from post-traumatic stress disorder.
The situation is even more severe for Latino veterans. There are more than 1.2 million Hispanic veterans and the Department of Veterans Affairs reports that 39 percent of Hispanic veterans suffer from post-traumatic stress disorder—a condition they will have to cope with for the rest of their lives. Despite this prevalence, however, the needs of Latino veterans are often overlooked. With more and more Latinos serving in the military, it is important that we understand the circumstances confronting this population so we can better support every veteran.
In this column we will look at the reasons behind the recent rise of Latinos serving in the military and at the unique social and cultural barriers they face in receiving post-traumatic stress disorder treatment that is often a result of their service.
Rise in Latinos in the military
As the nation’s Latino population has increased at unprecedented rates, so has the percent of Latinos in the U.S. Armed Forces. Between 1994 and 2008 the percentage of Latinos in the military grew from 6 percent to 13 percent. In 2004 Hispanics made up 12.1 percent of the U.S. Army. This increase holds true for Latinas as well who now make up a larger share of military women than Latino men make up of military men. Latina veterans account for 7 percent of female veterans compared to 6 percent for Latino men. And in the coming years, Latinos are projected to make up even more of the veteran population: By 2020 Latina women will make up 9 percent of military veterans and Latino men will make up 7 percent.
This rise in military enrollment is due to more than just the growing number of Latinos in the U.S. population. First and foremost, Latinos continue to join the military out of a deep commitment to serve their country—40 percent of Latinos who joined the U.S. Marine Corps stated that patriotism was a major factor. Likewise, 24 percent of Latinos serving in the Army put “desire to serve my country” as their top reason for enlisting.
Another factor related to Latinos’ growing presence in the military is the fact that the Army has been actively recruiting Latino youth with Spanish advertisements in magazines, television, and radio in addition to placing Latino recruiters with potential Latino recruits. More importantly, over the last decade there has been an increase in incentives (not just monetary bonuses) to joining the military, which, according to RAND Corporation research, further drives Latino enrollment.
Not surprisingly, obtaining a higher education is cited by many Latinos as a reason for enlisting in the military. About 12 percent of Hispanics identified educational benefits as the major reason for enlisting and 88 percent of all Hispanics agree that a college degree is important to advancing in life. The Post-9/11 G.I. Bill signed by President Barack Obama in 2009 is the largest investment in veterans’ education since World War II, providing financial support for education to veterans who have served at least 90 days on active duty after September 10, 2001. With the Post-9/11 G.I. Bill, military veterans can receive full tuition at state universities, housing allowances, and book allowances. For low-income Latinos who have limited postsecondary education options, joining the military can be the key to social and financial mobility.
Post-traumatic stress disorder among Latino veterans
Given the increase in the numbers of Latinos serving, it is important that we understand the unique circumstances they face. Even when we control for factors like hazardous combat experience, Hispanic veterans have higher rates and severity of post-traumatic stress disorder than their white or African American counterparts. “Citizenship & Service: A 2004 Survey of Army Personnel” found that one-fifth of all Hispanics enlisted reported being discriminated against in their current unit due to their race or ethnicity. According to the report this discrimination was found to come from various levels: “27% of Hispanics said they had been discriminated against in current unit by an officer and 19% of Hispanics said by enlisted and warrants.” Overall, Hispanics and their black counterparts were less likely than their white fellow soldiers to feel that the Army was doing better than civilian society in terms of racial discrimination.
Studies say that prejudice and racial discrimination experienced during deployment is likely to worsen post-traumatic stress disorder. In addition to discrimination worsening post-traumatic stress disorder, Latinos have been found to disproportionately suffer more severe symptoms. Flashbacks, intense cognitive perceptions, and back or stomach problems are more likely to be experienced by Latinos than by the average veteran.
Considering the severity of their post-traumatic stress disorder experiences, it is important that Latino veterans are able to seek and access treatment. Unfortunately, many cultural barriers within the Latino community can impact a veteran’s willingness to seek treatment.
First, the stigma associated with needing mental health services can make it difficult for many Latinos to come forward with their post-traumatic stress disorder. Secondly, Latino-family norms of solving problems internally (familismo) may influence how Latinos fare in treatment. Trusting an outside therapist is a step Latino veterans might not take, especially since many Latinos have reported that they perceived Veterans Affairs staff as not able to relate to their personal matters. Thus, individual therapy, which is a common form of treatment for post-traumatic stress disorder, may not be as effective for a Latino veteran who has a strong sense of collective identity. Therefore, family therapy is one approach that could be explored as an option to address the mental health needs of Latino veterans. In order for Latino veterans to have equal and comparable post-traumatic stress disorder treatment, cultural norms must be understood by those providing treatment.
Cultural competency is important to ensuring all communities of color have equal care but it is especially important for Latinos who are one of the fastest-growing populations in our country. Like all veterans, when a Latino veteran returns home with post-traumatic stress disorder, their entire family is impacted. We must be able to adequately care for our veterans and this will demand understanding the unique circumstances veterans face due to their racial and ethnic identities. Failure to consider cultural norms will prevent Latino veterans from having adequate care when they return home, and that is a situation that is unacceptable.
Amy Navvab is an intern with Progress 2050 at the Center for American Progress.
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