Organ donation in the Hispanic population: dondé estan ellos?

Few studies have investigated organ donation among Hispanics, although in major US cities, Hispanics, like African Americans, make up a large percentage of the general population. In fact, the 1990 census reports that of all Hispanics in the country, 90% live in urban areas. The tendency for Hispanics to use hospital emergency rooms rather than visit a physician's office may result in an inadequate exchange of information between minority patients and health-care providers. Hospitals that serve minority populations have been reported to have the lowest organ procurement rates. These hospitals are often funded by local, county, or state funds and are usually dedicated to a patient mix that is largely indigent. The heavy work load of health-care providers who often have limited resources does not lend itself to an adequate exchange of information between patients and health-care providers. The existence of this type of environment impacts on patient communication, increases the fear of complication, and may diminish the discussion of potential organ procurement. There are multiple individual and structural reasons for the high family refusal rates among Hispanics. Procurement specialists may see a proportionally small number of Hispanic families, mainly due to a lack of referrals from hospital staff concerning possible Hispanic donors. White procurement workers may not be familiar with the Hispanic family makeup and cultural attitudes. Organ procurement workers may not pursue the issue of donation with Hispanic families as much as they do with white families. Whatever the reason, if we are to increase organ donation in the Hispanic community, these complex issues will need to be addressed.