Data just a piece
And narrative lurks closely
So Latinx thrives
--FRANK CLARK, MD
According to the 2019 US Census Bureau population estimate, Hispanics comprise 18% of the total US population (61 million), with 31% aged less than 18 years, making them the nation's largest and youngest racial and ethnic group. (1) Since more than half of mental health disorders begin by age 14 years, and 75% by age 24 years, (2) the role of culturally humble, curious, and attuned child and adolescent mental health professionals is critical.
Although we will use the terms Latino/Latina/ Latinx and Hispanic interchangeably, there are distinctions between them: "Hispanic" refers to a common language and describes those whose ancestry derives from Spain or Spanish-speaking countries; "Latino/Latina," most recently replaced by the gender-neutral alternative "Latinx," refers to geography and indicates a Latin American origin. (3) The federal government recognizes just 1 ethnic group in its classification system: according to the 2010 and 2020 Census, "Hispanic or Latino" is defined as "a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race." (4) This one-size-fits-all definition of "Hispanic or Latino" and collective labeling of several self-sustained ethnicities can lead to overgeneralizations, misconceptions, and stereotyping of the diverse Latinx community. The prevalence and clinical presentation of mental illness, the willingness to seek and accept care, and lived experiences can vary significantly among Latinx subgroups. Given this heterogeneity, clinicians should embrace such diversity, recognizing the clinical importance of providing respectful subgroup-specific care (Table 1).
Latinx individuals often face inequities in education, socioeconomic status, insurance coverage, and even risk of death related to police intervention. Unfortunately, disparities are further exacerbated among Hispanics due to language barriers and undocumented immigration status. Patients with limited English proficiency or English as a second language struggle during mental health visits; communication of abstract concepts such as emotions and psychiatric symptoms in a language other than one's mother tongue is extremely challenging, especially during times of internal distress. (5)
According to the US Census Bureau, Hispanics on average hold a lower educational level in the United States compared with other racial and ethnic groups. (1,6) Hispanics also have the highest uninsured rates of any racial or ethnic group within the United States (19% of the Hispanic population was not covered by health insurance vs 6% of the non-Hispanic White population). (1) Similarly, the unemployment rate and the percentage of individuals living at or below the poverty level are higher for Hispanics as compared with non-Hispanic Whites. (1)
Further compounding such disparities, food insecurity is associated with a heightened risk of past-year mood, anxiety, and substance use disorders in children. (7) Poverty and mental illness interact in a negative cycle: Individuals who live in poverty are at increased risk of mental illness and, in turn, there is an increased likelihood that those living with mental illness will drift into or remain in poverty. (8)
Hispanics have the highest prevalence 17% of type 2...