Background The individual is a 26 year-old female living in Bethesda, Maryland. For the purposes of retaining anonymity and privacy, only the person’s initials (MA) will be used to describe her responses to interview questions related to cultural affiliations, values, kinship, religion, and all other elements relevant to the comprehensive cultural assessment. The Andrews & Boyle (2012) cultural assessment framework is used to guide interview questions and analyze responses. Furthermore, MA’s responses will be compared with results of an interview with someone from MA’s family’s country of origin, which is Mexico. MA was the first in her generation to be born in the United States; both her parents were born in Oaxaca, Mexico. Comparing the results of MA’s interview with the results of an interview with her aunt who still lives in Oaxaca enhances the ability of a healthcare worker to provide culturally competent care.

Cultural Affiliations

MA identifies as Mexican American, and uses terms like “Hispanic” and “Latina” to describe herself. She was born in Baltimore, but her parents moved to Bethesda when MA was eight years old. Both of her parents were born in Oaxaca, Mexico and both speak English fluently. MA claims that both her parents are “proud” of their heritage, and like her, they identify as Mexican American. However, living in an area with a “negligible” Mexican community has impacted their connections with their heritage and culture. Interestingly, their level of enculturation may serve as a protective variable, as “enculturation was associated with increasing life satisfaction,” (Ojeda, Edwards, Hardin, et al, 2013, p. 63). MA claims that she and her parents will visit family members in Oaxaca and Puebla at most once per year but that they are close with their relatives in Mexico.

The cultural affiliations of a Mexican American are bound to be different from the cultural affiliations of a Mexican individual who still resides in Mexico. Comparing MA’s responses with those of her aunt in Oaxaca do reveal that the dual identity issues are not present in the aunt as they are with MA. MA “goes between” her different identities and adapts herself to the situation—something she claims she learned since she was a baby and has no identity conflicts. For example, in Mexico, MA is in “full Mexico mode” as she puts it, speaking only in Spanish. At the same time, she has one foot in each culture, whereas her aunt has both feet planted firmly in the root cultures of Oaxaca and Puebla, where she was from originally. The results of the interviews show that possessing a double identity as an immigrant or daughter of immigrants can lead to a unique cultural affiliation, which is distinct from the cultural affiliations of those who only identify with their one culture and nationality. At the same time, an analysis of MA’s aunt’s responses do show that being from Oaxaca is itself a unique cultural affiliation because of the diversity of Mexico’s own cultural landscape. In other words, a Mexican person from Oaxaca is perceived of differently than if she were from, say, Sinaloa—and also has a self-perception different from persons from other states in the country.

Values Orientation

When asked about health values, beliefs, and attitudes, MA chuckles because her father is a doctor who has “strong attitudes” about health, and who inculcated into his family a sense of respect for the medical profession in general. MA claims that she is much more interested in holistic and complementary medicine than her father, who is disparaging about anything that is not solidly grounded in the scientific literature. MA jokes about her father’s attitudes, and when pressed about her own, ultimately admits that she trusts the medical model even though it cannot “fix...

MA is currently pursuing a degree in public policy and political science. Both her parents received their Bachelor’s degrees in the United States, after which they received work permits and eventually full United States citizenship. Their educational attainment was something they never took for granted, passing on their belief in education not just as a pathway to career achievement but as a means to fulfilling higher needs such as knowledge, independence, and self-fulfillment. MA claims that she is strongly oriented towards using her power and privilege to help others, which is why she became interested in public policy.
In terms of relating with people from other cultures, MA almost seems surprised by the question. She claims that while Bethesda might not have the “strongest Mexican community in the country,” that she nevertheless feels comfortable as a minority. MA’s perception of the demographics of Bethesda are reflected in United States Census (2016) data showing the area with less than 7% Latino/Hispanic. She says that she understands the implications of “passing as white,” and that most people do not realize that she is Mexican or Latina until they become close friends, hear her last name, or direct pose the question. MA is used to interacting with people from different backgrounds because she went to a school that had kids from “all over,” as she puts it.

Communication

At home, the family weaves between English and Spanish, using whatever language best describes the situation and their feelings. MA also acknowledges that they speak the language that makes their guests most comfortable, as when they have visiting relatives who do not speak English as well as they do. MA describes their family library as consisting of books in both languages, her mother having been a professor of literature for ten years followed by work at the Library of Congress. MA’s father is a surgeon who had worked for years at the main Johns Hopkins medical center and who was recently transferred to Suburban Hospital in Bethesda to lead the surgical team there. Given MA’s health-seeking behaviors and those of her parents, it is clear that there are “substantial differences between English-speaking versus Spanish-speaking Hispanics” in terms of acquiring health-related screenings—disparities that are only “partially explained by SES and access to care,” (Liss & Baker, 2014, p. 228).

In terms of non-verbal communications, MA jokingly refers to her heritage as a strong factor in their “massive hugging” and other signs of emotional expressiveness. MA claims that no one in their family, regardless of their gender or age, has a problem with emotionality and freely admits their feelings even if sometimes leads to miscommunications when interacting with people from more reserved cultures. Being around white people most of the time means that MA and her parents have adapted somewhat to what she calls “mainstream” cultural norms of communication. MA also points out that gender may play more of a role in determining communication styles in her family, with her father being much more reserved than her mother. On this note, MA’s responses provide an ideal counterpoint to the interview with the relative in Mexico who states almost the opposite in that men and women in Oaxaca are emotionally expressive verbally and nonverbally.

Health-Related Beliefs and Practices

MA’s health-related beliefs reflect her father’s position as a head surgeon at a Johns Hopkins institution. When asked specifically about body image, MA admits to having some struggles in the past. She was “borderline bulimic” in high…