Skip to main content

Advertisement

Log in

Understanding Service Utilization Disparities and Depression in Latinos: The Role of Fatalismo

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Research demonstrates a disparity between need and utilization of mental health services for Latinos. Cultural variations in perceptions of mental illness may be partially responsible for this discrepancy. Past research with Latinos has shown links between fatalismo, a cultural value similar to external locus of control, and both depression and lower service utilization in medical care, while links to psychiatric care have not been investigated. The current study therefore aimed to explore the associations between fatalismo, depression, and past year mental health service utilization by Latinos. A community sample of 83 Latino adults were recruited during local cultural events. Participants completed self-report measures of depression, fatalism, and past year service utilization. Analyses using structural equation modeling showed fatalismo was directly negatively related to past year medical service utilization (β = −.35). In contrast, the link between fatalismo and past year mental health service utilization was mediated by self-reported depressive symptoms (indirect β = .19, p < .001). We conclude that while fatalismo is associated with depression in Latinos, other barriers likely serve as more salient deterrents of service utilization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Alegría M, Canino G, Shrout PE, Woo M, Duan N, Vila D, Meng X. Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. Am J Psychiatry. 2008;165:359–69.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Vega WA, Lopez SR. Priority issues in Latino mental health services research. Ment Health Serv Res. 2001;3:189–200.

    Article  CAS  PubMed  Google Scholar 

  3. Keyes KM, Martins SS, Hatzenbuehler ML, Blanco CC, Bates LM, Hasin DS. Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences. Soc Psychiatry Psychiatr Epidemiol. 2012;47:383–94.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Lagomasino IT, Dwight-Johnson M, Miranda J, Zhang L, Liao D, Duan N, Wells K. Disparities in depression treatment for Latinos and site of care. Psychiatr Serv. 2005;56:1517–23.

    Article  PubMed  Google Scholar 

  5. Workgroup on Adapting Latino Services. Adaptation guidelines for serving Latino children and families affected by trauma. San Diego: Chadwick Center for Children and Families; 2008.

    Google Scholar 

  6. Lopez C, Bergren M, Painter SG. Latino disparities in child mental health services. J Child Adolesc Psychiatr Nurs. 2008;21:137–45.

    Article  PubMed  Google Scholar 

  7. Kouyoumdjian H, Zamboanga BL, Hansen DJ. Barriers to community mental health services for Latinos: treatment considerations. Clin Psychol Sci Pract. 2003;10:394–422.

    Article  Google Scholar 

  8. Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974;2:328–35.

    Google Scholar 

  9. Henshaw EJ, Freedman-Doan CR. Conceptualizing mental health care utilization using the Health Belief Model. Clin Psychol Sci Pract. 2009;16:420–39.

    Article  Google Scholar 

  10. Añez LM, Paris MR, Bedregal LE, Davidson L, Grilo CM. Application of cultural constructs in the care of first generation Latino clients in a community mental health setting. J Psychiatr Pract. 2005;11:221–30.

    Article  PubMed  Google Scholar 

  11. Antshel KM. Integrating culture as a means of improving treatment adherence in the Latino population. Psychol Health Med. 2002;7:435–49.

    Article  Google Scholar 

  12. Neff JA, Hoppe SK. Race/ethnicity, acculturation, and psychological distress: fatalism and religiosity as cultural resources. J Community Psychol. 1993;21:3–20.

    Article  Google Scholar 

  13. Cuéllar I, Arnold B, González G. Cognitive referents of acculturation: assessment of cultural constructs in Mexican Americans. J Community Psychol. 1995;23:339–56.

    Article  Google Scholar 

  14. Levenson H. Distinctions within the concept of internal-external control: development of a new scale. Proc Am Psychol Assoc. 1972;7:261–2.

    Google Scholar 

  15. Roncancio AM, Ward KK, Berenson AB. Hispanic women’s health care provider control expectations: the influence of fatalism and acculturation. J Health Care Poor Underserved. 2011;22:482–90.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Espinosa de los Monteros K, Gallo L. The relevance of fatalism in the study of Latinas’ cancer screening behavior: a systematic review of the literature. Int J Behav Med. 2011;18:310–8.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Keeley B, Wright L, Condit CM. Functions of health fatalism: fatalistic talk as face saving, uncertainty management, stress relief, and sense making. Sociol Health Illn. 2009;31:734–47.

    Article  PubMed  Google Scholar 

  18. Bell AV, Hetterly E. “There’s a higher power, but He gave us a free will”: socioeconomic status and the intersection of agency and fatalism in infertility. Soc Sci Med. 2014;114:66–72.

    Article  PubMed  Google Scholar 

  19. Florez KR, Aguirre AN, Viladrich A, Cespedes A, La De, Cruz AA, Abraído Lanza AF. Fatalism or destiny? A qualitative study and interpretive framework on Dominican women’s breast cancer beliefs. J Immigr Minor Health. 2009;11:291–301.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Kennedy CA, DeVoe D, Ramer-Henry K, West-Kowalski J. Influence of self-care education on illness behaviors and health locus of control of Mexican American women. Women Health. 1999;28:1–13.

    Article  CAS  PubMed  Google Scholar 

  21. Derogatis LR. Brief Symptom Inventory 18: administration, scoring and procedures Manual. Minneapolis: National Computer Systems; 2001.

    Google Scholar 

  22. Achenbach TM. Child behavior checklists for ages 6 to 18. Burlington: University of Vermont, Research Center for Children, Youth, and Families; 2001.

    Google Scholar 

  23. Bridges AJ. Service utilization interview. In: de Arellano MA, editor. Trauma, psychological sequelae, and service utilization rates in Hispanic adults. Charleston: Medical University of South Carolina’s Health Disparities Research Pilot Program; 2008.

    Google Scholar 

  24. Derogatis LR, Fitzpatrick M. The SCL-90-R, the Brief Symptom Inventory (BSI), and the BSI-18. In: Maruish ME, editor. The use of psychological testing for treatment planning and outcomes assessment: volume 3: instruments for adults. 3rd ed. Mahwah: Lawrence Erlbaum Associates Publishers; 2004. p. 1–41.

    Google Scholar 

  25. Andreu Y, Galdón M, Dura E, Ferrando M, Murgui S, García A, Ibáñez E. Psychometric properties of the Brief Symptoms Inventory-18 (BSI-18) in a Spanish sample of outpatients with psychiatric disorders. Psicothema. 2008;20:844–50.

    PubMed  Google Scholar 

  26. Bridges AJ, Andrews A, Deen TL. Mental health needs and service utilization by Hispanic immigrants residing in Mid-southern United States. J Transcult Nurs. 2012;23:359–68.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Benassi VA, Sweeney PD, Dufour CL. Is there a relation between locus of control orientation and depression? J Abnorm Psychol. 1988;97:357–67.

    Article  CAS  PubMed  Google Scholar 

  28. Roberts RE, Roberts CR, Chen I. Fatalism and risk of adolescent depression. Psychiatry Interpers Biol Process. 2000;63:239–52.

    CAS  Google Scholar 

  29. Drew EM, Shoenberg NE. Deconstructing fatalism: ethnographic perspectives on women’s decision making about cancer prevention and treatment. Med Anthropol Q. 2011;25:164–82.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth A. Anastasia.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Anastasia, E.A., Bridges, A.J. Understanding Service Utilization Disparities and Depression in Latinos: The Role of Fatalismo. J Immigrant Minority Health 17, 1758–1764 (2015). https://doi.org/10.1007/s10903-015-0196-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-015-0196-y

Keywords

Navigation