Cultural Considerations : M e x i c a n Americans Cultural Competence in Healthcare

1. Cultural Considerations :Mexican AmericansCultural Competence in Healthcare By Furqan Khan RN NURS 503 Liberty University

2. Objectives • By reviewing this presentation reviewer will be able to: • Identify Mexican population from different Hispanic groups. • Identify religious, spiritual, cultural beliefs that affect health • promotion and disease prevention. • Identify common health problems. • Identify strategies beneficial in promoting health practices. • Identify possible barriers in health promotional activities. • Identify importance of social support needed for this population.

3. Introduction • Institute of Medicine (IOM) report reveals that racial and ethnic minorities experience a lower quality of health services, and are less likely to receive even routine medical care than Caucasian Americans, (Smedly, Stith & Nelson, 2002). • 8.4million of the 10.3 million undocumented individuals in the United States are Latino, including 5.9 million from Mexico and 2.5 million from other Latin American countries, (Passel, 2006).

4. Introduction HIV infection among Hispanics/Latinos is approximately three times that of whites and, among other racial/ ethnic populations. The National HIV/AIDS Strategy calls for increased focus on interventions for Hispanics/Latinos, such as culturally and linguistically appropriate interventions that include effective communication strategies, expansion of HIV testing and diagnosis, and improved access to prevention, care, and treatment services to reduce the number of new HIV infections in the United States, (CDC, 2008).

5. Demographics • Mexico borders the Caribbean Sea and the Gulf of Mexico, located between Belize and the United States. • Border countries: Belize 250 km, Guatemala 962 km, US 3,141 km • Population : 113,724,226 (July 2011 est.) • Birth rate : 19.13 births/1,000 population (2011 est.) • Major Infectious diseases: bacterial diarrhea, hepatitis A, and typhoid fever. • Religion : Roman Catholic (76.5%) • Language : Spanish (92.7%) • Mexican Population in the U.S. 12.7 Million https://www.cia.gov/library/publications/the-world-factbook/geos/mx.html

6. Map of Mexico https://www.cia.gov/library/publications/the-world-factbook/geos/mx.html

7. Religious, Spiritual & Cultural Health Practices & Perceptions • In Mexican American culture, health is perceived as spiritual • and holistic. Curanderismo is a term to describe the entire • Mexican Folk system of disease and healing. • Basic tenets of Curanderismo is that illness is the result of the • punishment for a sin. • Curanderos provide Curanderismo which involves ritual prayers, • massage, reassurance, and herbal preparations. • Common cultural and herbal preparations include use of plants, • metals, stones, and perfumes. Padilla et al.(2001)

8. Common Health Problems • Headaches • Hypertension • Diabetes Mellitus • Pseudo-intestinal Obstruction • Arthritis • Allergies • Kidney Disease • Back pain • Fatigue • Diabetes Retinopathy – (Dubard & Gizlice, 2008) • Padilla et al. (2001)

9. Strategies Beneficial in Promoting Health Practices • All staff shall provide effective, understandable, and respectful care that is provided in a manner compatible with patient’s cultural health beliefs and practices and preferred language. • Implement Strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area. U.S. Department of Health and Human Services, 2001.

10. Strategies Beneficial in Promoting Health Practices • Staff at all levels shall receive frequently education and training in culturally and linguistically appropriate service delivery. • All care providers shall provide educational and service related material in Spanish and English. • Cultural, social, spiritual and religious aspects must be considered during care delivery. U.S. Department of Health and Human Services, 2001.

11. Strategies Beneficial in Promoting Health Practices • Health care organizations should ensure that data on the individual patient’s/consumer’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated. • Health promotion and community outreach programs shall be made available to focus common health issues i.e. immunizations, diabetes management etc. U.S. Department of Health and Human Services, 2001.

12. Barriers in Promoting Health Practices • Use of home remedies for illness. • Cultural, spiritual and religious beliefs. • Lack of education. • Lack of fluency in English language. • Poverty • Lack of Health Insurance • Illegal immigration status U.S. Department of Health and Human Services, 2001.

13. Social Support System Needed • Social influence can play an important role in motivating individuals to engage in health screenings.Older individuals to provide encouragement to younger individuals should be explored as a means to increase motivation. • Quality of social support from family, a practice highly driven by culture, has been shown to have significant consequences for health. Ashida, S., Wilkinson, V., Koehly, M. , 2010

14. Social Support System Needed • Quality of social support from family, a practice highly driven by culture, has been shown to have significant consequences for health. • Among Mexican American immigrant women, social support is a major factor predicting their excellent birth weight outcomes in spite of very low socioeconomic levels and poor use of prenatal care. Padilla, Y., Villalobos, G. , 2007

15. Conclusion • Cultural values and religious / spiritual beliefs influence many aspects of health and wellness , as well as: • Can facilitate better health care interactions and outcomes. • Can be used to increase cultural sensitivity among health care providers. • Can be used to encourage people to minimize risk behaviors implicated in disease causation. • Can potentially reduce health disparities.

16. References • Ashida, S., Wilkinson, V., Koehly, M. (2010). Motivation for health screening: evaluation of social influence among Mexican-American adults. American Journal of Preventive Medicine. 2010 Apr; 38(4):396-402 • Centers for disease control (CDC, 2008). Estimated Lifetime Risk for Diagnosis of HIV Infection Among Hispanics/Latinos 37 States and Puerto Rico. http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/index.htm. • Dubard, C., Gizlice, Z. (2008). Language Spoken and Differences in Health Status, Access to care, and Receipt of Preventive Services Among US Hispanics. Journal of Public Health.(11) 2021-2028 • Padilla, R., Gomez, V., Biggerstaff, S., Mehler, P. (2001). Use of Curanderismo in a Public Health Care System. Archives of Internal medicine Journal. 2001;161:1336-1340 • Padilla, Y., Villalobos, G. (2007). Cultural Responses to Health Among Mexican American Women and Their Families. Family & Community Health Volume 30 Number 1 - Supplement: January/March 2007 . S24 - S33 • Passel, S. (2006).Unauthorized migrants: numbers and characteristics. Retrieved from Pew Hispanic Center; June 14, 2005. http://pewhispanic.org/files/reports

17. References • Smedley, D., Stith, Y., Nelson, R. (2002). Unequal Treatment: Confronting Racial and Ethnic Health Disparities in Health Care. Institute of Medicine Report. Washington, DC: National Academy Press. • The world fact book. Central Intelligence Agency (CIA). Retrieved from: • https://www.cia.gov/library/publications/the-world-factbook/geos/mx.html • U.S. Department of Health and Human Services, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services in Health Care, Final Report. March, 2001.