The Hispanic/Latino Community in Cincinnati: Culture and Health Febrero,2011 Ligia Gómez,MA.
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Transcript of The Hispanic/Latino Community in Cincinnati: Culture and Health Febrero,2011 Ligia Gómez,MA.
The Hispanic/Latino Community in Cincinnati: Culture and HealthFebrero,2011
Ligia Gómez,MA
Why is Cultural Competency Important? Illness and disease perception vary by culture Diverse belief systems exist on health, healing and
wellness Cultural attitudes affect physician-patient
relationships Patients may seek complementary and alternative
health therapies which are unfamiliar to the physician or health care professional
Health disparities exist…
Immigrants and their descendants constitute the majority of the population of the U.S.
They arrive with suitcases full of dreams…
The U.S. and Immigrants
Immigrants to the U.S. Hopes of…
-New economic opportunities-Good schools for their children-More money-Greater peace of mind
They also bring…-Their own lifestyles-Habits-Dietary Customs-Genes
Demographics
~46MM Hispanic/Latinos in the US: 16% of total
Largest U.S. Minority Fastest growing
minority: By 2020, 1 in 5 people in
U.S. will be Hispanic or Hispanic descendant
By 2050, 25% of U.S. will be Hispanic
Distribution of Hispanics in USA
Hispanics in the Cincinnati Area
>50,000 Hispanic/Latinos in Cincinnati region (8 counties)
Almost half of Cincinnati area Hispanics (20,000) are under age of 18
Source: Center for Family and Demographic Research, BGSU
Hispanics in the Cincinnati Area
Most are from Mexico and Guatemala
Areas of concentration: Springdale, Hamilton, Sharonville, Norwood, Fairfield, Lower Price Hill, Covington, Florence.
Why Hispanics are coming
Seeking economic opportunities
War, oppression Political instability
in their countries
Where They Come From
Hispanic immigrants have diverse origins: cosmopolitan cities and rural areas
Mexicans Since 1948 migration
to and from the U.S. has continued largely uninterrupted
Mexicans make up over 66% of the U.S. Hispanic population
2 million seasonal workers
Primarily work in agriculture, restaurants, construction
Puerto Ricans
2nd Largest group U.S. citizens at birth 4% of the Hispanic
Population in U.S. Come to U.S. seeking
employment, higher education, better quality of life
Cuban-Americans
4% of Hispanic Population
First wave had high level of education and income
Cuba 90 miles from Key West
Main reason for immigration: Desire for personal
freedom Political exiles
seeking refuge Promise of economic
opportunities
Central Americans
Economy tends to be unstable: depends on few
agricultural exports owned by small segment of society
Immigrate to: Find refuge from
violence: El Salvador, Nicaragua
Seek economic stability
South Americans Colombia, Venezuela,
Ecuador, Peru, Chile, etc. Longer journey than from
Mexico and Central America: Arrive via plane: tend to
have higher socioeconomic level
Migrate because of: economic opportunities political instability Pursuit of higher
education
Photographs: Ronald de Hommel
Hispanic Culture Culture is the sum of beliefs, practices, habits,
customs, rituals and so forth that are passed to us by our families and society
Core Values of Hispanic/Latino Cultures
La Familia (Family)
Respeto (Respect)
Personalismo (Personal relationships)
Confianza (Trust)
La familia (family):the most important social unit Include parents,
grandparents, siblings, aunts, cousins, compadres (close friends), godparents (padrinos)
Emphasize interdependence over independence, cooperation over competition
Respeto
Dictates appropriate behavior towards others base on age, sex, social position, economic status and authority.
Health providers are given a high level of respect.
Elders are highly respected
Personalismo Personal rather than
institutional relationships Hispanics expect health
providers to be warm, friendly and to take an active interest in the patients life
Closer physical space Attuned to non verbal
messages When the provider shows
respect for the culture and shows personal interest wins their confianza (trust)
Integrated Health Hispanics tend to view
health from a synergistic point of view The body, mind and spirit
represent a continuum: all play important roles in health
Illness and death seen as normal part of life Strong belief in fate: Lo que
Dios quiera Curanderismo (folk healers)
and home remedies are highly respected
Acculturation The process of adopting aspects of the
mainstream culture. External acculturation: Changing food habits,
clothing, learning/adapting to the majority language.
Internal acculturation: Values and more complex patterns of behavior.
The Impact of Acculturation level: Diet
Low Acculturation
Related to healthier diets: Higher fiber, low fat diet
Higher consumption of fruits, vegetables, rice, meat, beans, whole milk
More likely to breastfeed
High Acculturation
Higher consumption of sweetened drinks
High levels of refined sugar
Higher consumption of fats
Lack of breastfeeding
Low intake of fruits and vegetables
Highly processed convenience foods
The Impact of Acculturation level on health indicators and outcomes Low
acculturation: Lower rates of
high blood pressure
Favorable cholesterol profiles
Low type 2 diabetes
Low mortality rate
Bicultural: Avoidance of high
energy food, saturated fats, cholesterol
Higher level of physical activity
High acculturation: Higher risk of
being overweight or obese.
Higher mortality.
Type 2 diabetes
Hispanic Paradox
-Higher poverty rates
-Less access to health care
-Worse health and nutrition outcomes: obesity and type 2 diabetes
-But: high life expectancy! Latinas:83.7; Latinos:77.2
Specific cultural factors may buffer the negative influence of poverty
Feeding in a cultural context
Mexican women place high value on child nutrition: important part of being a good mother
Chubby or overweight children are consider healthy
Skinny infants are unhealthy or sick
Eating Habits Meals are the central social activity of the family,
with family/community news and discussion:
Desayuno (breakfast): light meal that includes tortillas, coffee, chocolate, eggs, bread, etc
Almuerzo (lunch): main meal of the day; full menu followed by a siesta
Merienda (snack): coffee, tea, rolls
Cena: A light supper; may be as late as 9 pm
Teaching feeding practices While Hispanics share the
same language, their cultures frequently vary
Things to consider when planning educational programs:
Educational levels Language skills Income levels Cultural values
Barriers to Health Care and Health Services Cultural differences: concept of time Language Lack of health insurance Education Poor understanding of U.S. care system Poverty Transportation Immigration status Limited knowledge of resources Work schedule
Barriers: Insurance
44 million Americans are uninsured 14% of all Americans 12% of all children 40% of Hispanic adults 31% of Hispanic children
Barriers to health insurance: Employers don’t offer insurance Unaffordable Inability to complete paperwork (language, education) Immigration status
“We have to get beyond the cultural stereotypes
of the media and recognize that all our
patients are human beings. We all come
from the same place and have the same
dreams for our families and our future, and
we have to base our actions as health care
professionals on trying to provide the best
possible vision of healing in the very sacred
places where we do our work.”
-Pete Duarte, CEO Thomason Hospital, El Paso, TX