Mexican American Culture

Mexico is a Latin American country with a complex culture reflecting various phases in the history of Mexico. The language spoken is Spanish and remains the principal if not the sole language of almost all Mexicans. During the Mexican Revolution Mexicans sought refuge in the United States. They left their small villages and set out to “El Norte”, the north, as they called the United States. They travelled in mass numbers by railroad system built under the Diaz regime to the American South East. Hundreds of thousands of Mexicans made the trip across the Rio Grande. They settled in states like Texas, Arizona, San Antonia, San Diego and Los Angeles in California, Chicago, Illinois, and New Mexico. (Alma M Garcia pages 21)

Like all immigrant groups the Mexicans who entered the United States brought with them their cultural traditions and ways of life. Their Mexican culture provided them with a strong sense of community, an important survival strategy, as they lived, worked and raised their children in the new country. (Alma M Garcia page 21). Mexican culture thrived within the immigrants’ families, religion and community activities. Mexican Americans are sensitive and emotional people by nature. They try to avoid any kind of confrontation, and argument which are thought to be rude and disrespectful. Eye contact has special importance to some Mexican American especially when children are involved.

Mal ojo (“evil eye”) is a folk illness that affects infants and children (Dorsey and Jackson, 1976). This condition is believed to occur when an individual who possessed special powers stares at a child without touching the child. (Foster 1978) It is believed that the only way to break the spell is for the individual who has the” evil eye” to touch the child.

Mexican Americans exhibit strong family ties. They take care of their family and love to socialize among the vast extended family. They like to live around each other and go through much trouble finding housing nearby family and friends. They are hard working people and are not hard to please. In most Mexican families the men are the breadwinner. He makes the important social and economic decisions. The women take care of the domestic chores and are expected to be obedient and submissive to their husbands. (Alma M Garcia page 103).

Religion plays an important role in Mexican lives. Most of them follow Roman Catholicism, and are ardent believers. Most of their family celebrations revolve around their religion, for example, baptism, first communion, confirmation, marriage and funerals. Baptism is one of the major ceremonies practiced by Christians. A large number of Mexican Americans also follow other religions like Evangelical, the Church of Latter-Day Saints and Jehovah’s Witnesses.

During times of crisis some Mexican Americans may rely on the priest and family for prayers. When a family member is ill, they practice rituals including offering candles, visiting shrines and offering prayers. Illness and death are considered as “God’s will”. (Lawson, 1990) Traditional social and religious practices passed from one generation to the next are virtually unchanged because they are perceived as basic values to the family’s heritage.

Mexican food is more of a style or statement. It is known for its flavors, beautiful colors, decorations and a variety of spices and herbs. Their foods are very appetizing. Festivals are colorful, they love to dance and play loud music. Mexican Americans are fun loving and music is an essential part of their existence. Corridos, Mariachis and many other kinds of singing have evolved over many hundreds of years. Their various dances include Jarabe Tapatoi known as tap dancing and salsa have gained much popularity all over the world. Mexican Americans have a rich tradition of folk art for example crafts, like clay pottery, are very famous.

Mexicans believe in education based on the role of learning. The Mexican academic system emphasizes the gathering of knowledge through memorization. Mexican Americans consider title and position as their status symbols rather than money.

Mexican Americans believe that health is the result of good luck or a reward from God for good behavior. Some believe that health is a state of equilibrium in the universe where the forces of “hot,” “cold,” ”wet,” “dry” must be balanced. This concept is thought to have originated with the early Hippocratic theory of health and the four humors.

According to the Hippocratic theory the body humors, blood, phlegm, black bile and yellow bile vary in both temperature and moisture, thus health can be maintained by diet and other practices to keep the four humors in balance. Illness on the other hand is believed to be misfortune or bad luck, a punishment from God for evil thoughts and actions or a result of imbalance of hot and cold or wet and dry. Good health infers that one is in proper balance with God, the family, fellow men and the church.

A majority of Mexican American rely most frequently on traditional medical beliefs and practices to resolve their health problems. In some situations a physical ailment might easily be alleviated or eliminated by herbs or other natural remedies or medicines. These cures prescribed most often by mothers and grandmothers. The family healer is usually female and is respected for her knowledge of folk medicine. On occasions when relief is not achieved through home remedies, individuals or families seek assistance from a Curandero (folk healer) or other type of folk healer. The jerbero is a folk healer who specializes in using herbs and spices for preventive and curable purposes. Black magic is practiced by both male and female witches and is not sought out until other forms of healing have been tried.

Hispanics are usually characterized as having a present time orientation and of being unable or reluctant to incorporate the future into their plans. The Mexican custom of siesta in some ways represents the belief that rest (or the present) has a priority over work. Some Hispanics may be late for an appointment not because of reluctance or lack of respect, but because they are more concerned with current activity than with planning ahead to be on time. Mexican Americans value physical presence, including the presence of family members. It is important for some Hispanics to see relatives face to face, to embrace, to touch and just to be with each other.

Leading health objective: Substance abuse

Alcoholism affects Hispanics at two to three times the national average. Mexican Americans suffer the highest rates. Alcohol abuse is eight to 12 percent higher for all age group among Mexican Americans as compared to non Hispanic Whites. (The Statistical Record …page 434) The highest frequencies occur in those families of low economic stability. Among Mexican Americans alcohol is the most common substance of abuse (36% DASIS Report 2002). Cirrhosis of the liver is the most common cause of death for these specific individuals.

Alcohol use, patterns and prevalence vary among the different ethnic groups. Among the elements thought to account for these ethnic differences are social norms and attitudes and in some cases genetic factors. Hispanic men strive to appear strong and masculine and their ability to drink large amounts of alcohol manifests this masculinity.

Excessive alcohol consumption can cause abuse and dependence, social problems such as divorce and job loss and legal problems such as driving while intoxicated. Among Hispanic men unemployment had a higher likelihood of alcohol related problems than those who were employed. Hispanic men with income of $40,000 or more had a lower likelihood of reporting alcohol related problems than those whose income was less than $10,000. (Caetano and Clark 1998)

Alcohol abuse and dependence are associated with several medical problems. Cirrhosis of the liver mortality for example usually serves as an indicator of the effects of heavy alcohol consumption. (Makimoto 1998) Heavy alcohol use can also increase the risk of hemorrhagic stroke in Mexican Americans. Hispanics have a higher prevalence of Hepatitis C, a serious infectious liver disease that greatly increases the risk of liver damage in heavy alcohol drinkers. (Lieber 2001) According to Caetano and Clarke, United States born Mexican American women have higher rates of alcohol dependence than Mexican American women born outside of the United States.

Hispanic men have a higher rate of been arrested for driving under the influence of alcohol. (19 % compared to whites, Segal 1998) Hispanics also seem to have more extreme attitudes toward alcohol than whites and blacks. Their views are usually both positive and negative about the consequences, associated with drinking. Machismo, an exaggerated view of masculinity plays an important role in the heavy drinking patterns of Mexican Americans. (Caetano and Clarke 1998)

To make alcohol treatment more culturally sensitive for Mexican Americans, family involvement is very crucial. Interventions with this ethnic group can be developed to target the wider community in addressing environmental factors such as friends, schools and families affected by alcohol related problems.

Specific consideration for the interview and health history for Mexican American:

1.  Prior to interviewing the patient the nurse must take time to reflect on own cultural beliefs and practices, review clinical behavior and appearance, and review the patient’s chart. Consider the client’s view of health and illness. Consider factors which could influence the interview such as environmental factors (privacy, space, noise, timing and lighting), personal factors (age, cognition) special needs (language barrier, sources of learning and sensory deficits). (Bates page 24-30, 9^th edition)

2.  When communicating with the patient the nurse must use a cyraphone or a trained interpreter if not fluent in the Spanish language, which is the dominant language of Mexican Americans. Nurse must use language that is understandable and appropriate for the patient.

3.  Greet the patient by name, greet all visitors in the room, introduce yourself. Shake hands, considered polite and is usually welcomed by Mexican Americans. Establish understanding and listen to the patient’s concerns. Negotiate a plan that includes treatment, education and further evaluation. Plan for follow up care and closing the interview. Give patient a chance to ask final questions.

4.  Use therapeutic communication such as simple vocabulary, active listening, therapeutic touch, open-ended questions and hand gestures. Mexicans Americans expect their health providers to be warm, friendly and actively interested in their patient’s lives. Sitting as close as possible, leaning forward when speaking and listening and giving comforting pat on the shoulder or other caring gestures can indicate interest and care.

5. The nurse should take into consideration the male dominance in the Mexican American family dynamics. The nurse should include the male in making health care decisions.

6.  The nurse must consider the cultural approach for clients before discussing sensitive topics such as sexual history, mental health history, alcohol and illicit drugs, death and dying. In the Mexican American culture, sensitive issues are kept within the family.

7.  The nurse must take into consideration the Mexican American food beliefs and rituals. Diabetes, hypertension, heart disease and obesity are prevalent among Mexican Americans. Mexican Americans eat foods that are very high in fats. The nurse should encourage exercise and dieting and may refer such clients to a dietician or nutritionist.

Summary

Demonstrating knowledge and understanding of the meaning of health and illness in a specific culture is crucial to developing culturally competent nursing care. The nurse who is entrusted with the care of the client and their family must recognize the values and importance of providing culturally appropriate care. The nurse should expect to support the presence of the extended family and their participation during a loved one’s hospitalization. Quality health care that is culturally sensitive to the needs of the Mexican American client is effective when knowledge of the culture and beliefs is used as a basis for intervention. Cultural practices are meaningful to the Mexican Americans and they should be treated in a nonjudgmental and respectful manner. It is imperative that the care provided by nurses demonstrates cultural consideration for the increasing Mexican American population.

Health Promotion Plan for Mexican American With Substance Abuse.

Substance abuse is considered a major public health problem that reduces the quality of life of the American population. Alcohol is the most common substance of abuse and is one of the biggest health problems in the Mexican American community. Other substances used are marijuana, stimulants, cocaine and opiates. Alcohol abuse contributes to various illnesses such as cirrhosis of the liver, hepatitis, stroke, heart disease and cancer of the mouth, larynx, tongue and lungs. Studies show that pregnant women who drink alcohol or abuse other substances have a higher risk of birth defects, prematurity, low birth weight babies and miscarriages.

Mexican Americans consume large quantities of alcohol at one time known as binge or “fiesta” drinking. Males as young as 12 years of age binge drink. Many Mexican American men drink as a result of unemployment which leads to depression and frustration because of the inability to meet financial commitments. Statistical records show the highest frequencies of alcohol abuse occur in families of low economic status and many of those afflicted are unaware of or not eligible for treatment programs.

Substance abuse, (alcohol abuse) has a major impact on individuals, families and communities and is the cause of physical and emotional problems for many people. The three leading causes of death among Mexican Americans who drink are motor vehicle accidents, homicides, suicide.

 Plan:

1. It is important that the nurse knows the substance that is been abused and assist with withdrawal symptoms. The nurse must understand that withdrawal from a substance could be painful and measures should be put in place to help clients during the withdrawal process. Teach clients and family alcohol withdrawal symptoms for example delirium tremors, seizures, hallucinations, confusion and disorientation. If client experiences these symptoms they should immediately call 911 or go to the emergency room.

2. Teach clients the effects of alcohol consumption as well as other substance use which can impair judgment and coordination. Inform clients that alcohol consumption can cause aggression resulting in domestic violence and child abuse. STD’s and HIV/AIDS can be the result of risky sexual behavior.

3. Provide information about self help programs and therapy. Alcoholics Anonymous (AA) is the most well known and widely available self help group for treatment and recovery. AA uses fellowship and a set of guided principles (the 12 steps) to help members achieve and maintain sobriety.

4. Educate clients on the importance of good nutrition for a healthy recovery. It is important to eat right, get plenty of sleep and practice deep breathing exercises and relaxation techniques. A healthy eating plan and exercise routine can replenish and strengthen the body. A nutritionist may be recommended.

5. Involve the family, counselors, other recovery alcoholics, your health provider and people from your faith community in the patient’s recovery process. Recovery from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort and guidance. Teach women the dangers and risk factors of substance abuse during pregnancy.

6. Encourage youth involvement in after school activities and religious programs. Encourage clients to find new hobbies, volunteer activities, work, exercise which will make them feel better about themselves. Peer support groups can be a good source of guidance, assistance and encouragement.

7. Provide educational materials for example pamphlets, brochures, magazines, videos or literature in client’s preferred language about the dangers of drinking alcohol and the use of other dangerous substances.

8.  Set up a community health clinic with different treatment programs, recruit volunteers example nurses, doctors, inspirational speakers, religious leaders, social worker and counselors to educate and provide information to help clients recover from their addiction. Encourage follow up visits with physician.

 Summary

Education is the most efficient way to lower the incidence of substance abuse among Mexicans Americans, through health promotion and prevention. Educational programs must target the whole family as well as friends and must involve active interaction. It is very important to educate the youths at an early age to reduce the incidence of substance abuse. To protect the health, safety and quality of life especially our children’s, we as a community should provide the resources needed to reduce or eliminate the use of alcohol or illicit drugs in our society.

 

References

Bickley C. Lynn and Szilagyi G. Peter (2007) “Bates Guide to Physical Examination and          History Taking” ( 9^th Edition, pages 23-55). Philadelphia, Lippincott Williams &Wilkins.

Galvan H. Frank, Ph D., L.C.S.W, and Caetano, MD. Ph D. (December, 2003) Alcohol use and related problems among ethnic minorities in the United States, Volume 27 No.  University of Medicine and Science, Los Angeles California.

Galarraga Jessica ( May 31^st, 2007) “Hispanic-American Culture and Health” Case   Westren Reserve University

Garcia M. Alma (2002) “The Mexican Americans” (pages 67-89, 81-86, 89-106) Connecticut: Greenwood press.

Leham Jeffery, Robert Von Dassanowsky, Rudolph J. Vecoli “Gale Encyclopedia of multiple Americans” (Second Edition), Volume 2. Georgian Americans-ojibwa. Copyright 2000- pages 1190-1218.

Potter A. Patricia and Perry Griffin Anne (2002), “ Fundamentals of Nursing” (Fifth Edition pages 126-129) St. Louis Missouri: Mosby inc.