In America, we live in a vast melting pot of cultures and communities, filled with different types of knowledge and traditions that can enhance each other. Still, our healthcare system only meets the needs of some people. Health and access to healthcare are not equal among different populations in the United States. To cite a few examples from Carratala and Maxwell in 2020, Hispanic adults are 8.5% more likely to be diagnosed with diabetes, and 9.8% less likely to get mental health services than non-Hispanic white adults. Hispanic women are 40% more likely to be diagnosed with cervical cancer and once diagnosed, the cancer is 20% more likely to be fatal than that of non-Hispanic white women. Such health inequities reflect a systemic inequality prevalent within our country. This inequality can be found in wealth, opportunity, and within our healthcare system. In 2003, the Institute of Medicine found that racial/ethnic minorities often receive a lower quality of care, even when factors like income and insurance coverage are considered. Our healthcare system lacks diversity in its workforce, treatment approaches, and language accessibility (Abuelo, 2020; AMSA, 2020; Xierali & Nivet, 2018). The integration of curanderismo into the American healthcare system would promote culturally sensitive care and ultimately could improve healthcare outcomes for Hispanic communities in the United States.

Curanderismo is a Hispanic folk medicinal system. This system holds particular importance for those living in the border state of New Mexico, as well as a significant portion of the population found throughout the United States. I argue that the cultural medicinal practices of curanderismo should be integrated into the U.S. healthcare system in areas with significant Hispanic populations as one strategy of working toward the goal of providing more equal access to healthcare for all populations, as well as relieving some of the stress of the currently overburdened medical system.

This paper will first examine what curanderismo is as a practice, including its history, before analyzing the reasons and potential concerns for integrating curanderismo into the U.S. healthcare system. Finally, possible approaches to this integration will be discussed.

Definitions of Terms

Cultural competence is the capacity of individuals or organizations to adjust and engage effectively with persons of different backgrounds and cultures. Culturally competent persons and institutions can appropriately communicate with, respect, and serve culturally diverse populations.

Cultural sensitivity is the awareness of different cultural norms and values of individuals and communities that are from varied cultural backgrounds. It encompasses the understanding of the distinct points of view and narratives of various cultural groups, as well as of one’s own biases and perspectives. Unlike competence, sensitivity does not involve action (CDC, 2021).

Cultural appropriateness is the term used to describe any actions, practices or interventions that are well designed and applicable to a particular culture. It means choosing among various approaches, techniques, and strategies that harmonize with the norms, values, and expectations of the intended population.

What is Curanderismo?

Curanderismo is a Latin American holistic folk healing practice that splits care into three levels: material, spiritual, and mental. Curanderos or curanderas are healers who live and work in their community and treat ailments within their scope of knowledge. There are more specialized curanderas/os, such as parteras or midwives and espiritualistas or spiritualists (Torres & Hicks, 2016). Originating from the Spanish word “curar,” meaning “to heal,” curanderismo is a blend of Catholic and American Indigenous beliefs and practices that most likely originated from the Aztecs in the 1400s, and especially started in the 1500s when the Spanish arrived in the Americas (Maduro, 1983; Ragan, 2015). Curanderismo can also vary among individual curandera/os themselves as they reflect and incorporate the influences of their regional or religious beliefs.

At the core of curanderismo is that idea that the mind, spirit, and body are inseparable, and must be addressed to foster healing in an individual; illnesses are a manifestation of problems in the interaction between these three dimensions (Maduro, 1983; Torres & Hicks, 2016). Use of curanderismo and other complementary and alternative medicine, known as CAMs, amongst Mexican Americans and other Hispanic populations in the United States is high, with studies indicating somewhere between 50 and 90% of Hispanics using some form of CAM in 2007, according to Ortiz et al. A 2002 study by Rivera et al. with an 83% Hispanic sample population indicated that 77% of people in the El Paso, Texas, region used some form of CAM at the time, even alongside conventional treatments; 66% and 69% of participants also reported continued use of “CAM providers,” herbal products, and home remedies because those treatments worked for them. Further from the border, a study by Padilla et al. at the Denver Health Medical Center in Denver, Colorado, found that almost 30% of the Hispanic population that had been to the medical center in 2001 – survey population being roughly 88% patient/patient relatives and 12% DHMC employees – had been to a curandero at some point.

Why Integration?

Why should some of the traditions of folk medicine like curanderismo be integrated into healthcare here in the United States, especially places like New Mexico? As of 2022, Hispanics make up an estimated 50.2% of the population here in New Mexico, according to the U.S. Census Bureau, yet the medical systems here and in other areas of America with significant Hispanic populations do not reflect that culture. There is also increasing displeasure with Western medicine’s compartmentalized and relatively reactive approach to healthcare that often neglects mental health, treating preventable diseases and mental health problems only after they occur or become too big to ignore. The COVID-19 pandemic exasperated and revealed the United States’ mental health crisis (McPhillips, 2022). Conventional medicine’s theoretical separation of mind and body and absence of familiar cultural tradition can be jarring, and can feel contrary to Hispanic culture (Maduro, 1983; Tafur et al., 2009). Western medicine excels at surgery, diagnosis, and other physical treatments; traditional practices like curanderismo could provide the spiritual and full-body care that is missing. As noted by Torres and Hicks in 2016, the core conditions proposed by psychologist Carl Rogers for therapists to create a growth-promoting climate like “congruence,” “unconditional positive regard,” and “accurate empathic understanding” are already present in curanderismo. Curandera/os establish these conditions with their patients through their treatments, creating a therapeutic environment similar to that created by a therapist or counselor. Curanderismo’s strong suit is mental and spiritual support, as pointed out by Karen Garcia for the Los Angeles Times in 2023. A few curanderas’ clients are interviewed and speak to the positivity and clarity they feel post-session, not dissimilar to testimonials for therapists or other mental health professionals (Garcia, 2023). This potential for culturally competent treatment that can provide therapeutic benefits should not be ignored.

Cultural competency is fostered by practices, mindsets, and knowledge that allow for effective cooperation with and care of different cultural groups. One of its important principles is to value the cultural beliefs of those people the system or professional serves. To improve the quality of care in an underserved population, Hispanics in the United States in this case, the system needs to accommodate the specific cultural and linguistic needs of that population. The CDC has noted that competency requires that systems “adapt to diversity and the cultural contexts of the communities they serve,” among other things (2021). Integrative care, a coordinated implementation of both conventional and complementary approaches to healthcare, particularly through multimodal interventions with a focus on whole person health, is what can help achieve this competency. Whole person health, as defined by the NCCIH, is improvement of health in multiple spheres, such as physical, social, and environmental (2021).

Considering this, a curandera/o trained to work within a hospital could act as a mediator between the patient and/or patient’s family and medical provider, creating a meaningful connection for building of trust and proper communication while also providing that missing spiritual element, particularly during significant and potentially stressful events, like births or major medical diagnoses.


One might object that alternative medicinal practices like curanderismo risk providing treatments that are inaccurate, uninformed, and potentially harmful to certain patients. We might ask: what business do we have encouraging or even incorporating these practices if they could lead to patient endangerment? According to a 2001 Denver hospital survey by Padilla et al., it is important to recognize that despite currently lacking support from the U.S. healthcare system, curanderismo is still being practiced by Hispanic populations with relatively high client satisfaction, with about 73% of those who had been to a curandero feeling that they benefitted. Our goal is to have a better understanding of these practices, and to be able to integrate and provide them as safely as possible to individuals who may want them and are already seeking out these services independently. What curanderismo offers for the system we already have in place is not a single ritual or plant that can treat or fix physical ailments, but a spiritualistic and ritualistic element that can bridge cultural gaps and give comfort to those who want it. Even a mere increase in acceptance and understanding of these cultural practices could make a positive difference in care. Based on a 2004 study in Southern California by Mikhail et al., a marked number of Hispanics, about 78%, reported not disclosing their use of curanderismo or other forms of CAM to their medical providers. With many potential interactions between traditional remedies and Western medicine, as noted by Rivera et al. in 2002, destigmatizing curanderismo in the American healthcare system could not only lead to increased trust, but also greater communication and disclosure of alternative treatments received by patients, so healthcare providers can make safer and more informed decisions for their patients. That alone would help increase patient safety, contrary to concerns, and would allow counselors and other mental health professionals to be able to better connect to and treat their clients.

A paper by Tafur et al. in 2009 explains why Hispanics lean into cultural traditions over Western medicine, but an especially important point to consider from their review is that even with reduced access to traditional healers here in the United States, Hispanic populations are still finding ways to follow cultural practices by relying on familial knowledge and advice. Past healthcare coverage issues, and even deportation risk for undocumented persons, could push them to turn to curanderismo for culturally appropriate delivery of care, with its emphasis on tradition, community, and holism. It can be inferred that language and cultural barriers are preventing Hispanic populations from getting equal levels of care in America. Ignoring or attempting to dissuade people from using these practices does not improve patient safety. In fact, such efforts may worsen the problem by further alienating Hispanics from getting necessary care.

The Way Forward

Establishing how this integration could be done is beyond the scope of this paper, but in what follows, I gesture at some ideas. One strong element of curanderismo in Mexico is its communal structure. Thus, it would make sense for curandera/os to be affiliated with hospitals, but to work within communities in the United States, to provide counseling, midwifery, and other general services on a daily basis. This would allow patients to have regular access to trusted care that is not only culturally appropriate, but likely significantly more affordable than a doctor’s office. Such regular attention is also likely to prevent serious medical conditions from progressing and allow curandera/os access to a network of medical specialists through the hospital as needed. As mentioned above, curandera/os could also help facilitate patient-medical provider connections, serving as patient advocates with hospitals when necessary. Involving curandera/os in the hospital or outpatient setting may also help to avoid overburdening current healthcare workers, as medical professionals across the country are under a lot of stress. Around 80% of U.S. physicians report being at capacity or overextended; meanwhile, 84% of nurses report being underpaid, and 80% say their units are understaffed (Gaines, 2022; Hawkins, 2018).

Increased training in medical and nursing programs could also be implemented, and/or optional incentivized training and certifications, to increase cultural competency in both the existing and upcoming medical workforces. Doctors, nurses, and mental health professionals could be certified in working alongside curandera/os for integrative health programs, or even specialize in integrative care themselves. Mexico has begun experimenting with traditional healing integrated within the hospital setting; the Universidad Intercultural del Estado de México offers a bachelor’s program in Intercultural Health where students are trained in curanderismo practices, among other methods of traditional healing, as well as conventional medicine, and participate in research on integrative health interventions (n.d.). Graduates are certified and now officially working in hospitals and communities in Mexico (Garcia, 2023). Here in New Mexico, the University of New Mexico (UNM) has a course on curanderismo, Curanderismo: Traditional Medicine without Borders, that teaches the history and various practices of the Mexican folk healing tradition and was even utilized in an experimental education program for preventive medicine residents at UNM (Kesler et al., 2015; Peat, 2023). There may already be a provider-side demand for more education and access to services. A 2021 survey in the northwestern United States by Schwartz et al. showed that more than 78% of the surveyed primary care providers indicated interest in learning more about “complementary and integrative healthcare” practices, and over 40% indicated their patients could possibly benefit from these practices.

Of course, these general ideas leave a lot of questions unanswered. Where would curandera/os fall in the chain of command? How much medical training would they receive; what certifications, if any? Besides improved healthcare for all, what would incentivize hospitals, schools, and the government to incentivize multicultural healthcare professionals and cultural competency training, in a country and healthcare system with many other problems? A study group of qualified professionals and stakeholders would be a good first step toward developing and implementing a pilot program of integration here in the United States. Most likely the best approach would be two-way, with current medical professionals having the options to certify and specialize in this kind of integrative care, and traditional healers having the opportunity to certify so they can work to some extent within or alongside the healthcare system.


To summarize, an integrated system in which medical providers either receive education on curanderismo or include practicing curandera/os as partners in patient care, could aid in narrowing the quality-of-care gap between Hispanics and other demographics in the United States. Not including or even considering these practices does not prevent their use outside of the hospital doors, and it fails to recognize the importance of accessibility and cultural traditions and exacerbates the lack of communication and understanding between Hispanic populations and the U.S. healthcare system. The exact methods or integrative health system that would work to achieve this goal is currently unclear and there are questions that need to be addressed. However, the importance of increasing diversity in our healthcare system remains valid. Creating a culturally competent healthcare system that acknowledges practices and beliefs that have meaning for a significant portion of the American population is essential for better serving all individuals and prioritizing the mental component of patient health.