Culture is shared knowledge, beliefs, values, language, attitudes, and experiences among a population group. Learned and shared patterns of communication and information that have meaning for a group. (Mikel’s slides)
Hispanic population is a culture because this culture values the family and religious practices, they have their own holidays such as Cinco de Mayo, they have a Hispanic cuisine and style that only the Hispanic Culture is known for.
Defining Hispanic Culture:
Hispanic is a term that is used to describe people that are either natives or descendants of a Spanish speaking country. Spanish is one of the fastest growing second languages throughout the world. It is currently the national official language of 21 countries. The term Hispanic was coined by the US federal government in the 1970’s to refer to Americans born in a Spanish speaking nation or could trace their ancestry to Spanish territories or Spain. Today over 45 million Americans are either from or descendants from Spanish speaking nations. In comparison, in 1950 there were only 4 million Americans from Spanish speaking nations. About 50 percent of Americans of Hispanic culture have origins in Mexico. The other 50 percent of Americans of Hispanic culture have origins from a variety of countries including Columbia, Puerto Rico, El Salvador, and the Dominican Republic. There is much diversity among people and descendants from these 21 nations, so this means that there is varying cultural implications and traditions among people of Hispanic culture. It is always important to remember that how one defines culture and their cultural experience/background is unique to them.
Hispanic subgroups usually share more similarities by the region or area of the world where they are from or a descendent from. Over the years there is increasingly increased influence of Hispanic culture and presence throughout the United States whereas in earlier years Puerto Rican Americans commonly lived in New York, Mexican Americans in the southwest United States, and Cuban Americans in Miami, Florida. The states with the largest populations of Americans of Hispanic culture include California, Texas, New York, Illinois, and Florida. As people of Hispanic culture now live all throughout the United States more commonly, traditions and knowledge of Hispanic culture have also spread and become more known. However, stereotypes about Hispanic culture have also sadly developed by misconceptions, assumptions, and the media. It is essential to remember that Hispanic culture is a very broad term and it is important to ask and get to know the persons’ culture and ways of doing things specifically.
It is very important to know that most Americans who were born in or have ancestry of a Spanish speaking nation see themselves and refer to themselves by their ethnic identity. For example, they prefer usually to be referred to as Cuban, Mexican American, Columbian, or Puerto Rican, not as Hispanic or Latino.
“The U.S. Census Bureau defines Hispanic Origin as: Persons of Hispanic origin were identified by a question that asked for self-identification of the person’s origin or descent. Respondents were asked to select their origin (and the origin of other household members) from a “flash card” listing ethnic origins. Persons of Hispanic origin, in particular, were those who indicated that their origin was Mexican, Puerto Rican, Cuban, Central or South American, or some other Hispanic origin. It should be noted that persons of Hispanic origin may be of any race.”
A List of Spanish Speaking Countries and Capitals:
Cuba – Havana
Dominican Republic – Santo Domingo
Puerto Rico – San JuanSouth America
Venezuela – Caracas
Colombia – Bogotá
Ecuador – Quito
Peru – Lima
Bolivia – 2 Capitals
La Paz (Administrative)
Paraguay – Asunción
Chile – Santiago
Argentina – Buenos Aires
Uruguay – Montevideo
2. i. Values/Norms:
Family is viewed as the primary source of support. Family is broadly defined, close knit, and emotionally and financially supportive.
The eldest male is typically the authority figure.
Gender roles are traditional.
Important decisions are made by the whole family, not the individual.
Children are taught to avoid confrontations with their parents and older persons, and to be obedient, respectful and shy.
Persoanlismo, means the trust and rapport that is established with others by developing warm, friendly, and personal relationships.
Respecto and dignidad are other important values that play an important factor when dealing with medical problems
2. ii. Beliefs/Attitudes:
Hispanics are less likely to smoke; some attribute this to low incidence of smoking among Hispanic women.
Majority are Catholic.
Attending a woman during delivery is a woman’s job.
Traditionally, husbands are to not see their wife or child until the delivery is over and both have been cleaned and dressed.
Generally Hispanic women prefer that their mothers attend them in labor.
2. iii. Traditions:
Family is an essential part of Hispanic culture and traditions are based around celebrating and spending time with loved ones. The high value of family in Hispanic culture shows the importance placed upon relationships and extending a hand emotionally, spiritually, physically, and/or financially to one’s family in good times and in bad. As stated earlier, people of Hispanic culture are from or a descendent of a country where Spanish is spoken. Traditions and customs are passed down usually from by family members or society from generation to generation.
Hispanic countries celebrate the more popular international holidays in the United States such as Easter, Christmas, and New Year’s Day typically as well as each country celebrating its El Dia de Independencia (independence day). Las fiestas refer to festivals that may be local, regional, or national and may last for one day or may last several days.Hispanic cultural holidays include Cinco de Mayo, Mexican Independence Day, and Puerto Rican Emancipation Day that may be celebrated.
Cinco de Mayo is a celebration for Mexicans celebrating the Mexican victory over the French at the battle of Pueblo on May 5, 1862. Parades and music play a large role in this celebration.
Mexican Independence Day is celebrated on September 16, claiming the beginning of Mexico’s Revolution breaking away from Spanish rule in 1810 and then officially in 1821.
Puerto Rican Emancipation Day is celebrated on March 22 and celebrates when slaves were set free in the nation.
The most predominant religious affiliation in Hispanic culture is Roman Catholic, because Spain was a Roman Catholic nation, thus many Roman Catholic traditions are practiced depending on the person’s and family’s religious affiliation. More than 90% of the Spanish-speaking world is Roman Catholic thus faith and church life play a large role in traditions and family values. Family ties are usually very strong and families usually gather to celebrate holidays, birthdays, baptisms, first communions, graduations, and weddings.
Other Hispanic cultural traditions may include the celebration of a fifteen year old girl’s Quinceañera. This is a Spanish coming of age ceremony for a young women usually celebrated with many family and friends. Piñatas are used most typically at birthdays and Christmas to celebrate. Children are blindfolded and hit a decorated container filled with toys and/or candy until it breaks. Then the objects and/or goodies are gathered by the kids.
2. iv. Concept of self/space:
Hispanics view sense of space differently than American culture. Personal space for Americans is at least arms length while it is less than an arm’s length distance for Hispanics. While greetings for Americans are usually a firm handshake a greeting in Hispanic culture is often a less firm handshake, hug, or a kiss on the cheek.
2. v. Communication/Style/Language:
Personal space is close.
May communicate intense emotion and appear quite animated in conversations a behavior that is sometimes misinterpreted by non-Hispanics as being “out-of-control.”
If not raised in the U.S., they may avoid direct eye contact with authority figures or in awkward situations.
May nod affirmatively but does not always mean agreement. Silence may mean failure to understand and embarrassment about asking or disagreeing.
Modesty and privacy are important. Health issues should not be discussed with family members, but should be discussed with an interpreter.
For personal issues, use same gender interpreter.
2. vi. Dress/Appearance
What is worn and how it is worn says a lot about the person. Because first impressions are very important, even if expensive clothing isn’t afforded, their clothes will be ironed and their shoes will be polished. Jewelry and accessories are very important for girls and matching outfits are a must. Jewelry is very important from a very young age, basically birth. This explains why baby girls get their ears pierced.
There are many different styles of traditional Mexican clothes. The folklore dresses are used by folk dancers and are very elaborate in detail. An example can be seen in the Cinco de Mayo celebration picture. Other traditional attire includes the sombrero which shields from the sun. Peasant sombreros are usually made of straw whereas the more expensive ones are made of felt.
2. vii. Food/Feeding Habits:
Food plays a large role in Hispanic culture in everyday life and in celebrations. In some Hispanic cultures, the people refer to foods and herbs by their degree of hot or cold. Many Hispanic culture shoppers in the United States look for authentic cultural foods when buying groceries for their families. Food preparation techniques of the Hispanic regions vary from certain towns, regions, cities, nations, and families as well.
There are usually regional variations in heat, spiciness, pungency, and sweetness so this makes it difficult it difficult to define a specific Hispanic cultural style of cuisine.
Examples of cultural variance: Sofrito is a cooking sauce used to flavor beans, rice, fish, and stews. The Spanish sofrito is sweet and made with tomatoes and Puerto Rican sofrito is pungent and made with cilantro, and the Cuban sofrito is mild and made with parsley.Mexicans tend to favor corn and amaranth products. South Americans usually prefer wheat, quinoa, and potatoes. People from the Caribbean and coastal regions of Latin America favor rice more typically.
Breakfast is typically a light meal. Lunch is largest meal of the day. In some Spanish speaking countries, a siesta or nap follows the midday meal. Dinner is typically served in the later evening.
Popular Hispanic Culture Dishes:
Moles: Pronounced Mo-lay, the name of this dish comes from the Aztec word for “mixture.” Mole Poblano de Guajolote, is a mixture of dried chiles, nuts, seeds, vegetables, spices and chocolate.
Tortillas: This flat bread is made of wheat flour or masa and forms the base of tons of tasty Mexican dishes like enchiladas, burritos and fajitas.
Ceviche: A Mexican dish of raw fish marinated in lime juice, often in a chopped salad.
Poc Chuc: A Yucatecan specialty made with pork fillet cooked with tomatoes, onions and spices.
Links to many Spanish Recipes:
http://www.donquijote.org/culture/recipes/ http://www.eatingwell.com/recipes_menus/collections/healthy_hispanic_recipes http://www.masterstech-home.com/the_kitchen/recipes/recipe_indices/international_recipe_indices/HispanicRecipesIndex.html
2. viii. Concept of time:
Hispanic concept of time is very different from the typical Americans concept of time. There is less importance placed on the concept of time and more importance is placed on relationships between people. More importance is placed on the present than the future.
2. ix. Relationships/social organization:
Family is the main social group this includes the extended family. The extended family includes aunts, uncles, cousins, grandparents, and godparents. All parts of the extended family are important and heavily relied on in the family support system. Family needs always trump the needs of individuals. Family members are expected to stay loyal to other family members. Family and extended family are relied on not only in crisis situations but also in daily life and often the entire family live in close proximity to one another. The male role is often the authority of the family while the female role is holding the family together and keeping cultural tradition and passing wisdom to the next generation.
Eggenberger, S., Grassley, J., Restrepo, E. (2006). Culturally Competent Nursing for Families: Listening to the Voices of Mexican-American Women. The Online Journal of Issues in Nursing, 11 (3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume112006/No3Sept06/ArticlePreviousTopics/CulturallyCompetentNursingCare.aspx
2. x. Learning Styles/Teaching:
A child’s behavior is taught to respect and honor their family. The classroom competition among students may bring much discomfort to families of Hispanic culture. Hispanic culture focuses largely on working together whereas the United States educational system is primarily focused on the individual and achievement based on individual performance. It is important for teachers and counselors to be aware of a student or if the student has a family member who does not speak English. The student may need additional support or a Spanish-speaking teacher. It is important for educators to fully engage and include all students and assess their comprehension of the material individually.
2. xi. Work Habits:
Generally to the Hispanic culture work is considered a necessity. They put more value on relationships and family than work. The gratitude some Americans get from being successful in their job is similar to the gratitude that Hispanics feel with a successful relationship or seniority in the family.
The 2010 U.S. census is expected to find Hispanics number more than 50 million in U.S., and they command $1 trillion in buying power.
Hispanics compromise more than 15% of U.S. population, an increase of 42% since 2000 census.
Hispanic growth rate of 24.3% was more than three times growth rate of total U.S. population.
89% believe Hispanics will somewhat or significantly impact American taste in foods in next 5 years.
Spanish is the fourth most frequently spoken language in the world.
Twenty countries speak Spanish as their 1st language.
Hispanics are the largest minority in U.S.
One in 7 people in the United States is of Hispanic origin.
Hispanics are concentrated in the U.S. Southwest. 60% live in California, Arizona, New Mexico, Colorado, and Texas.
Only 56% of Hispanics 25 years-of-age and over have graduated from high school, compared to 83% of the total U.S population.
Economic status of Hispanic Americans parallels their educational status.
According to the Office of Minority Health “Hispanics have the highest uninsured rates of any racial or ethnic group within the United States.”
Mexican American women 73% are overweight or obese, Hispanic Americans 1.1 times more likely to be obese than non Hispanic whites
4. c : Differences between American and Hispanic culture
4. b and d: Discrimination and Mental Health
Research indicates perceived discrimination among Latinos and Hispanic has not only a negative impact on income levels, educational attainment, and ultimately life chances, but also on their mental health outcomes. (Noh, 2003) Latinos who report higher levels of discrimination had consistently higher levels of stress, depression and poor mental health. (Taylor, 2002) “In a recent survey, 83% of Latinos and Hispanics reported that discrimination among and between Latinos and Hispanics is a problem (National Survey of Latinos, 2002). The same survey found that, overall, 41% of all Latinos and Hispanics reported receiving poorer service in restaurants and stores, 30% have been called names or insulted, and 14% have not been hired or promoted because of racial and/or cultural discrimination.” (Araújo, 2006)
Latino discrimination appears be attributed to their racial and ethnic status, and are further attributed to two separate factors: experiences based on the language and accents spoken and discriminatory experiences based on physical appearance. There also seems to be discrimination amongst the Latino/Hispanic community based mostly on skin color. To begin with, the community shows discord on self-definition, as evidenced by the inability of the census to racially classify Latinos.
“In 2003, there were 42 million Latinos and Hispanics in the United States. Latinos and Hispanics make up 14% of the population, and the largest Latino subgroup among this population consists of Mexicans—66% of all Latinos and Hispanics. Puerto Ricans constitute 9%, and Dominicans make up 2% of all Latinos and Hispanics.” (U.S. Census Bureau, 2003)
“49.9% of Hispanics identified themselves as White Hispanic, only 2.7% identified as Black Hispanic, and 47.4% identified as Other.” (U.S. Census Bureau, 2003)
Research has indicated that darker skinned Latinos and Hispanics experience more racial discrimination in areas such as employment (Logan, 2004), while another study indicates that lighter skinned Hispanic immigrants, such as Cubans, have greater success educationally than darker skinned Cubans and other dark-skinned Latinos. (Araújo, 2006) While it is assumed the source of discrimination comes from Caucasian Americans, it has also been found within the Latino community itself, particularly evident in ethnic enclaves such as Little Havana in Miami, Florida. (Taylor, 2002) However, there are gender differences, as fewer Latino women report discriminatory experiences, and thus, less mental health issues than Latino men. The reason for this is unknown, but may be related to better coping strategies of females, improved social support between women, or their own perceived lower class of citizenship from Latino males, therefore making racial discrimination blend into their lifetime of female treatment within their own culture. (Taylor, 2002)
Araújo, B., & Borrell, L. (2006). Understanding the link between discrimination, mental health outcomes, and life chances among Latinos. Hispanic Journal of Behavioral Sciences, 28(2), 245-266.
Logan, J. R. (2004). How race counts for Hispanic Americans. Sage Race Relations Abstracts, 29(1), 7-19.
Noh, S.,& Kasper, V. (2003). Perceived discrimination and depression: Moderating effects of coping, acculturation, and ethnic support. American Journal of Public Health, 93(2), 232-239.
Taylor, J., & Turner, R. J. (2002). Perceived discrimination, social status, and depression in the transition to adulthood: Racial contrasts. Social Psychology Quarterly, 65(3), 213-226.
U.S. Census Bureau. (2003). The Hispanic population: Census 2000 brief.
Birth Control and Health Access
Researchers interviewed Hispanic women living in the United States for less than 10 years to learn more about their experiences with health care, and to identify some of the reasons healthcare is not utilized by so many women, particularly regarding reproductive issues. (Sable, 2009) It was learned that for many Hispanic women, their first visit in their lifetime to a doctor is to deliver their first baby. (Wilson, 2009) This is the first opportunity for so many to learn about prenatal care and receive information regarding birth control options. For those who have heard about birth control, much of the information is incorrect (such as once you use birth control you will never be able to conceive another child) or based on family “old wives tales.” Here are a couple of the interesting stories about this topic.
“My sister says after sexual relations, . . . you have to get up right away to drink a glass of water, clean yourself, and suck a lime. This suggests there are people who control [their fertility] like that. I met a woman who had been using this method for 10 years, and she never got pregnant. (Participant 9, Focus Group 2)” (Sable, 2009)
“In the university where I was studying, some of the students from medical school were taking herbs. I know those are good because my mother was using them, but I wonder if they were really that good because we had a big family of 13 children. . . . [The tea] was used as a birth control method. If you drank the tea regularly, and if you lost track of how many times you’ve had the tea and you became pregnant, the tea made you abort. . . . They mixed different kinds of herbs and drank them as a way to prevent pregnancy. When I was pregnant and I was ready to have my baby, I drank the tea to make the delivery of my baby quicker. (Participant 1, Focus Group 4)” (Sable, 2009)
For a majority of the group, it had never occurred to them to seek birth control at all following their marriage, citing either a desire to have children immediately, or a need to please their new husbands by producing heirs. (Riviera, 2007) Other factors that limited their access to healthcare and birth control option appear to be poverty and cultural modesty; however, the religious doctrine of Catholicism regarding abundant and unlimited procreation seems to have little influence on this decision. (Wilson, 2009) The greatest influence on the choice to use birth control seems to be the husband. Of the women interviewed, a majority of the spouses were opposed limiting the numbers of children, referring to the culturally based value of “machismo, men’s exaggerated sense of power or strength.” (Sable, 2009) Machismo also appears to be the cited source for a man’s “right” of promiscuity, which for many women, becomes the reason contraception is sought. (Sable, 2009) One participant related her apprehension to the possibility of her husband leaving permanently and leaving her to care for and financially support the children. She also was in fear of not only adding to those children with another pregnancy, but also of her husband bringing home a fatal sexually transmittable disease, and thereby leaving her children without both parents. (Sable, 2009)
Rivera, C., Méndez, C., Gueye, N., & Bachmann, G. (2007). Family Planning Attitudes of Medically Underserved Latinas. Journal of Women’s Health (15409996), 16(6), 879-882.
Sable, M., Havig, K., Schwartz, L., & Shaw, A. (2009). Hispanic immigrant women talk about family planning. Affilia: Journal of Women & Social Work, 24(2), 137-151.
Wilson, E. (2009). Differences in contraceptive use across generations of migration among women of Mexican origin. Maternal & Child Health Journal, 13(5), 641-651.
4. e: A Hispanic Cultural Taboo:
Expressing negative attitudes directly is considered a taboo. This may become apparent by the patient not telling the provider important information, not following treatment, or terminating their care.
4. f : 5 Important things for Nurses to know:
It is important to use a little bit of Spanish to gain respect with a Hispanic client. Greeting the patient with “Buenos dias” (good morning) or “Buenas tardes” (good afternoon) is important as well as
using the proper titles such as Senor (Mr.), Don (Sir), Senora (Mrs.) or Dona (Madam). Greeting the patient in this way also helps show your respect for the Spanish language and helps them feel more comfortable, just remember to address them formally unless the patient specifies otherwise. It is especially important to address these patients in this way if the provider is younger and will show respect to the patient. In return, the provider will be rewarded with the patient’s respect as an authority figure.
Physical space between the provider and the patient is important, Hispanics typically prefer being closer to the provider than non-Hispanic whites do. If the provider places themselves two feet or more away from their Hispanic patient, they may be perceived as distant and uninterested. The provider can fix these misconceptions by sitting closer, giving a comforting pat on the shoulder or leaning forward.
It is really important to encourage the patient to ask questions because they tend to avoid asking them or disagreeing or expressing doubts to their health care provider in regards to their treatment.A health care provider should not ask questions about alcoholism, domestic violence, mental health and sexual practices directly to the patient. Questions related to these topics should be asked in an indirect manner so that the patient isn’t embarrassed. A couple of examples of questions would be “How often does your husband go out?” or “Have you seen ads about the use of condoms?”
In general, Hispanics tend to be very in tune with non-verbal messages. This is very important for non-Spanish speaking providers in establishing a good relationship with the patient. In an emergency situation non-verbal communication may be and probably will be the only way to communicate, especially if the patient only speaks Spanish.
Helpful Videos for Nurses in Caring for Patients and Their Families of Hispanic Culture:
*Note: references are the websites listed throughout the text. Articles are also referenced appropriately with corresponding information.