Purnell's Model for Cultural Competence: Hispanic/Latino

Introduction to Purnell's Model for Cultural Competence

Sociologists and anthropologists have offered many definitions of culture. Purnell defines culture as the totality of behaviors, arts, customs, ways of life, beliefs, and values that are transmitted from one society to another. He views it as the product of human work that guides the way people see the world and make decisions. These patterns may be explicit or implicit, but they are learned and transmitted through the family and shared by members of a particular cultural group. Culture can also include emergent phenomena that change in response to global forces. People learn about their culture through family, community, school, and social organizations such as the church (Purnell, 2003, p. 3).

For the purposes of this assessment, the cultural group selected is the Hispanic/Latino population — people of Latin American or Iberian ancestry who are fluent in Spanish (Nevaer, 2016).

Purnell's Model for Cultural Competence comprises the following structural elements organized as concentric circles:

The 12 domains are interdependent and influence one another. They provide a comprehensive framework for assessing individuals and groups across cultural lines.

Overview of the Hispanic/Latino Population

The Hispanic or Latino population is the fastest-growing and largest minority group in the United States. The U.S. Census defines a Latino or Hispanic person as someone of Spanish culture with origins in South and Central America, Puerto Rico, Mexico, or Cuba, regardless of race.

In recent years, the term Latino has become widely used to refer to people whose primary ethnic heritage originates from Latin America. The terms Latino and Hispanic are used interchangeably — even by the U.S. Census Bureau — though Hispanic tends to appear more frequently in government, statistical, and research records. Latino has grown in common usage more broadly.

Communication, Family Roles, and Workforce Issues

One of the most widely shared characteristics among Latino/Hispanic groups is the retention and use of the Spanish language. However, factors such as geographic location, residence type, economic background, education level, generational cohort, and immigration history greatly influence proficiency in English. Individuals with limited English proficiency often encounter significant barriers when accessing social and medical services.

For Latino/Hispanic elders in particular, the use of Spanish serves as a marker of identity and is connected to quality of life. The U.S. Census uses the term linguistically isolated to describe people living in households where no one aged 14 or older speaks English fluently. Approximately two-fifths of elderly Hispanic/Latino individuals speak only Spanish and are therefore considered linguistically isolated (Talamantes, Lindeman, & Mouton, 2010).

Family is central to Mexican/Latino/Hispanic culture. Latino mothers play an important role in determining whether family members need medical care, even when the family ultimately decides to send a member to a medical facility. The oldest male in the family — who may be the grandfather rather than the father, depending on the household structure — is typically regarded as the primary decision maker. However, very important decisions may involve the entire family. The father or oldest male also serves as the family spokesperson, as it is generally believed that older adults make decisions that are in everyone's best interest, especially when they live with their children or grandchildren (Talamantes, Lindeman, & Mouton, 2010). Hispanic children also tend to marry at younger ages compared to non-Hispanic white women.

The U.S. Census reveals that more than half of Latino residents aged five and older speak English fluently; however, a significant number of Latino adults speak English poorly or not at all. Immigration status can be a compounding factor, as Hispanics living in the U.S. may be exploited if they are unable to provide the correct documentation. It is estimated that 30.7% of Hispanics lack health insurance, further limiting their access to care.