In 2000, the US Census reported 20.6 million documented
Mexicans in the US, representing 60 percent of the Hispanic/Latino population.
Most Mexican immigrants reside in California, Arizona, and Texas.
Social Structure
Traditional Hispanic/Latino families include extended family
members, such as grandparents, aunts, uncles, cousins, godmothers, and
godfathers. In the US, acculturation, assimilation, and separation of family
members based on economic needs have changed family roles. The man is the
traditional head of the household, although today with the increase of single
parent homes, many women take on that role. The intergenerational connection
that characterized earlier generations is no longer the norm, although workers
in the US tend to send money home to support family members in their countries
of origin.
Many cultural behaviors and practices are shared by people
from Latin America and the Caribbean. Spending time with family and friends are
vital parts of life. Children are highly valued and elders are respected and
cared for. Friendliness and treating others with respect is important.
Maintaining eye contact and friendly physical contact, such as touching the
shoulder or arm is common.
Diet
The diet in Latin American countries is healthy with high
amounts of fruits, vegetables, corn tortillas, whole grains, and eggs. The diet
of assimilated Hispanics/Latinos in the US tends to be low in fruits and
vegetables and high in flour tortillas, white rice, and processed foods; and
Hispanics/Latinos in the US usually do not get as much exercise as they did in
their native countries. Traditionally, meals are often eaten with the nuclear
and extended family, with a large meal at noon and a lighter meal in the
evening. Many acculturated Hispanics/Latinos are beginning to replace
traditional meals with fast food meals, contributing to an increase in obesity,
diabetes, and hypertension in this population. Over consumption of alcohol is
also a health consideration. Preferred drinks include coffee with breakfast and
aguas frescas (fresh fruit coolers), made with tamarind, cataloupe, or
watermelon. Some traditional Hispanics/Latinos believe in treating a cold with
hot foods and in preserving health by balancing hot and cold foods.
Religion
The majority of immigrants from Latin America are Roman
Catholic Christians, who attend church regularly, pray to God, Jesus, the
Virgin Mary, and saints. They light candles, observe baptisms and
confirmations, maintain home shrines, and visit shrines throughout Mexico or
Latin America when possible. Catholic Hispanics/Latinos celebrate religious
holidays, including Christmas, Easter, and holy days.
Medical care
Diabetes is twice as prevalent in the Hispanic/Latino
population as in the white population. Hypertension, overweight, and obesity
are common in some groups. For example, 63.9 percent of Mexican- American men
and 65.9 percent of Mexican-American women are considered to be overweight or
obese, compared to 61 percent of European-American men and 49.2 percent of
European-American women. The incidence of cervical cancer in Hispanic/Latino
women is double that of European American women. Although Hispanics/Latinos
have a lower incidence of breast, colorectal, oral, and urinary bladder
cancers, their mortality from these is similar to that of the majority
population.
Hispanics/Latinos may consult folk healers or spiritualists,
especially if they lack health insurance. Herbal teas are popular remedies for
some conditions, including yerba buena (spearmint) and te de manzanilla
(chamomile).
Take advantage of the following tips to help you provide the
most appropriate, culturally competent care for your Hispanic/Latino patients:
• Be
gracious. Acknowledge the patient’s arrival and offer them a seat. Building
respect is essential. Address patients by their preferred name, such as Mr. or
Señor, Mrs. or Señora, Miss or Señorita (e.g., Señora Fernandez for Mrs. Susana
Fernandez-Ruiz ).
• Establish
a relationship with the family before care begins. Use a non-confrontational
tone. Be receptive to family suggestions.
• Friendly
physical contact, such as touching the shoulder or arm, is appropriate between
a female clinician and a female patient or between a male clinician and male
patient.
• Ask
patients if they would like to have family members present during their visit.
Provide a room large enough to accommodate the family.
• Acknowledge
male family members who are present. Males are typically the head of the
household, especially in the older generation, and often answer all questions
and sign papers. Listen to male family members, but try to direct questions to
the female patient (or the mother in pediatric situations). Recognize that
grandmothers often play a central role in child care, giving advice to the
mothers and advocating use of traditional remedies and cures.
• Explain
why you use trained medical interpreters, not family members. Never use
children as interpreters.
• Ask
open-ended questions, such as, “please describe what you are feeling,” rather
than “do you have pain?”
• Assess
the importance of religion and the health care beliefs of your Latino patients.
• Ask
patients what they believe caused their illness, and explain the medical reason
for their illness. Recognize that they may not agree with you about the cause.
• Ask
patients if they use home remedies and assess the safety of the remedies they
use.
• Ask
patients to repeat back health information you provide to ensure understanding.
Repeat information and offer reassurance frequently during long procedures.
• Provide
written educational materials with pictures or a video in Spanish to
accommodate non-English speaking patients and family members.
• Educate
patients about diet and exercise and the importance of mammograms and pap
smears.
• Establish
a child’s care plan with the assistance of the father and mother.
• Explain
how to navigate your health care facility.
• Kindly
explain why being on time for visits is important and affects other patients.
Assist in scheduling appointments and arranging for transportation if
necessary.
Death and dying
Families may consult a senior male or female, or one who is
most educated or influential in the community when deciding on health care
treatment and making end of life decisions.
Religious beliefs influence perceptions of death and dying.
Roman Catholics may request a visit by a priest or the hospital chaplain to
anoint the sick. Rosary beads and religious medallions are often kept near the
patient. If the patient dies before the priest arrives, a sacrament still takes
place before the body is removed. The elderly especially may wish to die at
home. Some Mexicans believe that the spirit may become lost in the hospital.
The family requires a supportive atmosphere and may need time and a private
place to deal with the loss.
Culture in context
Culture is essential in assessing a person’s health and
well-being. Understanding a patient’s practice of cultural norms can allow
providers to quickly build rapport and ensure effective patient-provider
communication. Efforts to reduce health disparities must be holistic,
addressing the physical, emotional, and spiritual health of individuals and
families. Also important is making connections with community members and
recognizing conditions in the community. Get to know your patients on an individual
level. Not all patients from diverse populations conform to commonly known
culture-specific behaviors, beliefs, and actions. Generalizations in this
material may not apply to your patients.
Source: www.stratishealth.org
Source: www.stratishealth.org
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