¶ … Mex Am / Hispanic Am. Hlth Care Sub- cultural Scholarly Paper: Hispanic-American Health

Due to the rising cost of health care and lack of communication and cultural attitudes towards health many Hispanics are faced with poor health, obesity, and in most cases serious illness. This paper provides insight into health concerns, dilemmas of the subculture, and the specifics revealed in the interview process as relates to the individual, the family and ultimately, the community and the culture's collective society.

Subcultural Scholarly Paper: Hispanic-American Health

Criteria:

The theoretical framework used to evaluate this subculture is Purnell's Model. This is a subculture study of Hispanic-Americans in relation to their lack of knowledge concerning their personal healthcare.

Description of Subculture:

One way to address the challenges of providing health care to differing cultures is through advances in the development of competence among cultural providers in the healthcare field as per the minority which they focus in serving. The United States Department of Health and Human Services Office of Minority Health defines cultural competence as "having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors and needs presented by consumers and their communities."

Demographics:

Why then is it vital that the healthcare provider be possessed of cultural competency and to what effect does it serve in the competency or create a disservice in the failure to address issues among the community such as the problems that are associated with obesity among the Hispanic communities? Cultural competency is essential to help reduce health differences between ethnic groups. Continued racial health differences are evident and are readily associated with a cultural heredity factor and yet in the U.S. is so often ignored or "missed" in the provision of healthcare to the community in which weight and obesity demonstrates so definite a problem and with associated diseases being so prevalent among certain cultural groups. Specific areas in the Hispanic community that need particular attention in their healthcare are in the areas of cancer, heart and vascular disease, infant mortality, HIV and AIDS, diabetes, as well as child and adult immunizations for guarding against disease. Each of these problems is related either directly or indirectly to obesity of the individual.

Theoretical Framework:

Under the United States Civil Rights Act of 1964, cultural competency is also named as a "core competency for public health professionals, of whom the competencies include the provision of skills necessary to be proficient at the practice of public health." The Surgeon General and the Joint Commission on the Accreditation of Healthcare Organizations maintains that "cultural competency is essential to provide adequate care." While the Hispanic population makes up 29.4% of America's obese (AOA, 2003), a greater understanding and need for quality healthcare services in Hispanic communities is imperative.

According to the American Obesity Association (AOA), among Mexican-Americans in the years 2002-2003, Hispanic women are reported as having the "dominating obesity factors among all those interviewed in all cultural sets." The Hispanic female population makes up 67.6% of America's at-risk citizens. The male Hispanic population has the highest prevalence of overweight at 67.1% and obesity at 23.1% (ibid). These numbers bring us to question what causes such a high percentage of the Hispanic culture to be at-risk or to suffer from obesity. The following pages work to provide answers while offering insight into possible solutions.

Healthcare Utilization Patterns:

Of the 5 members of this subculture interviewed, all held the belief that family is very important and a strong family bond is evident. All the individuals in this study stated they think family is very important and for culture to be passed down so children and grandchildren do not lose the culture. This was inclusive of simple everyday elements in life such as the making of tamales and the grinding of hominy for "malto" meal. Stressed was the belief in communication among the family being extremely important. Only one participant, a great-grandfather, emigrated from Spain; the rest are from South Texas. Of members interviewed, the granddaughter of the emigrant from Spain has fair skin color and she says her father's skin was pale, as well. Her children's skin color resembles her husbands (darker), of which she tells when the children were young and she would pick them up from school, the teachers would always assume she was the mother of another child. One time her youngest child came home and asked, "Mom are we Mexicans?" She affirmed, but the young...

Only daddy is." The woman explains that she had a hard time convincing the child. Including this story, we show what "family" means in this community. There is an emission of pride in the words and on the faces of those interviewed. A clear concern for one another is evident. Therefore, we can now draw upon this factor in determining what factors play a large part concerning the obesity problems in the community. Many Hispanic-Americans do not have access to the medical care they desperately need. A common reason is simply lack of knowledge on how to obtain assistance, which this study finds is directly related to a number of factors of which the two prevalent reason include the community's education (lack of formal education) and cultural values (asking for or obtaining assistance is against family belief).
Healthcare Utilization Patterns:

Pride plays a major role in each of these areas. For example, the grandfather emigrant does not have the educational background of the average white American male. His youth was spent working to help provide for his family. The same is true of his middle aged years. The goal was to feed his family and provide the basic necessities and the jobs taken were essentially low-wage, no benefit positions. In cases such as these, the leading family provider spends all his time working to provide the basic needs of the family. Watching his weight or dealing with obesity issues within the family (especially, within the collective community) is not a priority.

As time passes and as we see with the grandfather in this study, age creeps upon these men and they find themselves in poor health without the knowledge of how to become healthy and they cannot afford healthcare. Many Hispanic settings in America are in lower-income areas of respective cities. These areas are not often frequented by those people who possess the knowledge of healthcare and healthy eating and lifestyle habits. Therefore, learned behavior is inherited. For example, the grandfather has always been a hard worker. His goal was to provide for his family. Family is important. Most all family gatherings include delicious meals and fellowship. The outcome is -- simply stated- allot of eating and little to no exercise.

From this setting we can clearly see the development of many diseases (e.g., diabetes, heart disease). Obesity alone can be detrimental to one's health, but when left untreated can lead to one or more additional health concerns.

However, the perception that obesity in Hispanics is prevalent among the adult community is a myth. In fact, a new CNRC study, Viva la Familia, takes a close look at the reasons why weight problems are more common among Hispanic children, which the study reports has increased significantly in the United States over the past 10 years [highest among Hispanic boys and girls] (Consumer News, 2001).

Interventions and Strategies:

Dr. Nancy Butte, a CNRC energy expert and Baylor College of Medicine associate professor of pediatrics, explains, "Obese children are more likely to suffer additional health problems like insulin-resistant diabetes, high blood pressure, and orthopedic disorders." As a result of undiagnosed health problems such as those above, the Hispanic community becomes dominated by unhealthy adults. Buttes (2001) attributes environmental factors such as diet and physical activity as affecting weight gain, but primarily places the risk factors on heredity.

The fact that obesity tends to run in families suggests that genetic factors are also involved (ibid). Again, looking at the educational background and income levels in the majority of Hispanic households, there is a clear relation between these factors and poor health. In families with a greater risk for obesity and related diseases, the need for health education and health care is imperative. The Baylor College of Medicine explains there are "social consequences" of obesity, of which studies show "extra pounds can lead to high blood pressure, diabetes, heart disease, and orthopedic and mobility problems, not to mention low self-esteem and social problems." (Children's Nutrition Research Center) In addition, the CNRC states:

Weight management programs for all but the most severely overweight children and adolescents should not focus on weight loss. Instead, the goal is to keep weight stable while the child gets taller and more muscular over time. As with adult programs, the cornerstones are physical activity and a healthy diet. However, a child has a much better chance for success when her family also adopts healthy behaviors.

(CNRC, 2004)

Clearly, healthy habits in childhood create healthy habits as adults. But what about the adult Hispanic community at present? There needs to be stern intervention to educate the community on the benefits of healthy eating…