Real Italians and Italy

Welcome to Italy!


Italy is located in Southern Europe and can easily be found because of its “boot shaped appearance.” Sicily and Sardinia are two large islands on the Mediterranean Sea that are a part of the country as well. With a very mild Mediterranean climate, Italy is a great place to visit and even greater place to live! Welcome to Italy and the Italian culture!

Italians are known for their beauty and wealth. Within the culture the nickname “Italian Stallion” has been derived.

The true “Italian Stallion”

Culture can be defined as “the integrated pattern of human knowledge, belief, and behavior that depends upon the capacity for learning and transmitting knowledge to succeeding generations.” It can also be defined as “the customary beliefs, social forms, and material traits of a racial, religious, or social group; the characteristic features of everyday existence (as diversions or a way of life} shared by people in a place or time.”

The word Italian-or pronounced Italia, is a word which conjures up a harmonious bond between body, spirit and soul. Known for their very religious catholic beliefs, the Italians focus much of their culture around their religion. Like every culture, Italians have integrated patterns of human knowledge, belief, and behavior into their environment; making them a unique culture. They share customary beliefs, social forms, material traits or racial and religious features that are incorporated into everyday existence. Things such as art, fashion, cuisine, wine, literature, religion, language, beliefs, and government are all things that the Italians do different from other cultures and this makes them a unique and proud culture. One thing that is unique about the Italian culture is the sense of timelessness. The entire country of Italy is filled with art, buildings, and beliefs that were started centuries ago. Looking at pictures and talking with people who have visited the country, the feeling or the essence of Italy is timeless. Visitors often think they are living in the now, but surrounded by the past.

Overview of the Italian Culture

  • Values/Norms
  • Beliefs/Attitudes
  • Traditions
  • Sense of Self/Space
  • Communication Style/Language
  • Dress/Appearance
  • Food/Feeding Habits
  • Time Consciousness
  • Relationships/Social Organization
  • Mental Process/Learning
  • Work Habits/Practices

Values and Norms-

  • “Family.” A word that stirs strong emotions, both good and bad. To Italians, it is much more than the sense of love and affection, warm memories and fun times. For Italians, “La famiglia è tutto” or, “family is everything.” The Italians value the treasure of family over their clothes, food, and even self. In some parts of the country, it is common for all the immediate family to live together. In other parts, it’s customary for extended family members to live under one roof.
  • Religion, style, and food are the other pillars of Italian culture, and they are among the world leaders at each.

Beliefs and Attitudes

  • The largest religion in the country of Italy is Catholicism, even though one-third of the 84% of Italians who identify themselves as Roman Catholic are active members of the Roman Catholic Church. The Catholic church also takes part in the nation’s political affairs.
  • There are other religious groups in Italy which include Eastern Orthodox Christians, Greek Orthodox, Pentecostals and Evangelicals, Jehovah’s Witnesses, Waldensians, Seventh-day Adventists, Mormons, Baptists, Lutherans and Methodists.
  • Some superstitious beliefs
    • Purple and black are the colors of morning and is thus considered bad luck to wear purple.
    • Friday the 17th is a bad luck day, comparable to Friday the 13th in American culture.
    • The colpo d’aria (“punch of air” otherwise known as a draft) is believed to cause anything from a cold to paralysis


  • For Italian’s traditions are deeply rooted into their culture and encompass not only the nuclear family but the townspeople, known as paesani. Traditions are heavily based around religion beliefs, and are often seasonal religious festivals. For centuries it was the responsibility of the family to uphold and instill traditions in younger generations but as time has progressed it has become the duty of the societies to preserve and interpret this essential heritage.
  • Baptism ceremonies: Customary to rent a large hall big enough to accommodate the vast number of guests attending have music, dancing, special pastries, and wines.
  • Wedding ceremonies: Considered very special, intimate events that are commonly shared with large numbers of extended family and friends in the form of a traditional Catholic wedding (usually about 3 hours long) and a reception to follow.
  • Funerals: Consist of wakes, where candles are kept lit to represent the life of the deceased, a traditional Catholic Mass attended by family and friends and then a procession to accompany the deceased to their final resting place. Prayers are said over the casket and condolences are offered to the family.
  • Kissing on the cheek is a traditional greeting for friends and family. To properly execute this traditional greeting it is appropriate to kiss the person you are greeting first on the left side cheek then on the right. It is also traditional for friends to bring gifts (such as flowers and chocolate) when invited over to a friend’s home. In regards to many stereotypes it is not considered appropriate in Italian culture to bring wine when visiting (mainly because the wine being provide during your stay would have already been selected and provide by the host)

Sense of Space within the Italian Culture-

When Americans walk into a doctor’s office and go to sit down, they will almost always find a seat that isn’t close to anyone. It is the worst thing walking in and noticing that the only seat that is available is directly in the middle of 7 occupied chairs. What to do? Do you stand or take the uncomfortable, no personal space chair?

  • In the Italian culture, there is no such thing as personal space. It is actually considered polite to sit close to someone and even to interact with personal touching of the hands and arms.
  • Italians are also not afraid to show affection or love when in public. Public embracing and kissing upon greeting people is a must and is not looked down upon in any way.
  • There is much respect within the Italian culture and eye contact is a must. In order to show respect, eye contact is used and if eye contact is broken, it is said that person is hiding something. The culture is also a confident culture. They do not back down and tend to hold to their values
See  full size image

Sense of Self –

Italians have a saying “Bella Figura” which  means good image and looking through Italian photos, it is apparent that the Italian culture thinks very highly of themselves and the majority of the culture will not go out in public unless they look their best.

  • Your appearance in the Italian culture indicates your social status, family background, and education. They are always trying to impress one other and the “sense of self” is ranked very high.
  • The culture tends to judge a person upon meeting them based on their clothes, even before any words are expressed. The women dress to impress and the men tend to look proper. This is evident in the previous centuries of the Italian culture, and is still evident in today’s culture as well.
  • Italy is one of the top leading fashion designer countries in the entire world. The overall appearance of the culture is elegant, strong, confident, and well put together

Communication Style and Language

  • Communication is very formal. It is proper to use surname until invited to use a first name. Handshakes and smiles are appropriate for strangers. Kisses and patting the back are common for close friends and family. Eye contact is a must!
  • Italian is the language of the land, and the speakers use it over phones, email, texting, however they much prefer face-to-face communication. They are expressive speakers and often use their hands, along with many words to get a single point across.

Talking like a true Italian!

Dress Appearance

Italians are people who cherish outward appearances and would give up comfort to achieve elegance.

  • They would expect you to have well-groomed hair, flawless sense of style and really neat shoes.
  • The outward appearance to the Italian culture means everything and someone is quickly judged on how they look and how they dress. What you wear says everything about you; including social status, family background, and education.
  • Some of the world’s best designers hail from Italy such as Gucci, Armani, and Prada. Quality, elegance, comfort, and fantasy are the four cornerstones of Italian fashion with an emphasis put on Quality and elegance.
  • However, Italian fashion is actually about attitude (custom-made, fluid, sophistication) and confidence rather than just being about the clothes.

Mental processing and learning

  • Italian education is organized in a similar fashion as in the US. There is a division between public school and private school. The levels of education include kindergarten (3-5 years), primary school (6-10 years), middle school (11-13 years), high school (14-18 years).
  • Currently, the Ministry of Education is promoting the reform of the national school system. The levels would then be separated into primary school (ages 6-11), lower secondary school (ages 11-14), and then students have options regarding their choice of upper secondary school (ages 14-19) such as classical, scientific, linguistic, sociological-psychological and pedagogical orientation, art, technical, and vocational school.
  • After higher secondary school and receiving their diploma after passing and exam, students can either receive higher education or begin their careers in the profession of their choice. Students that get a higher education have a choice of getting a University diploma, Bachelor of Arts/Science, Research doctorate, and/or a diploma of specialization.

FOOD!! What Italians are known for!

In Italy cooking is considered at art and Italians live by the motto ‘good food, good wine and good company!’. In fact it is this exact combination of things that makes cooking and eating such an intimate, enjoyable, and significant aspect of Italian culture. Cooking and dining is one of the finest expressions of Italian culture and is an essential part to each and every day.

  • Ingredients: Italians always utilize fresh, seasonal ingredients in their cuisine. This accounts for the difference in cuisine and dishes served throughout the 20 different regions in Italy. Each region utilizes its fresh ingredients and local products to make their own distinctive and exceptional dishes, cheeses and wines.
  • Olive oil: is the base of many Italian dishes and considered an essential in the kitchen and in any dish! Olive oil along with sauces, spices, herbs, cheese are all basic building ingredients in all dishes.
  • Breakfast: Is always very light. It consists of cappuccino or sometimes yogurt and never includes meat or eggs.
  • Lunch and Dinner: It is customary that these meals are severed in several courses. Typically at least 2 or more courses are ordered for each meal.
  • First course: Appetizers of cold cuts and specialties of the region
  • Second course: Pasta, soup or rice.
  • Third course (with side dish): Fish, meat or vegetable and side of salad or potato.
  • Dessert: Fruit, cheese, and gelato.
  • Interesting Facts:

o   Pasta and bread are NOT served together. Pasta is served with lunch but NOT with dinner.

o   Buttered bread is not common (use olive oil for bread) but bread is not served as an appetizer because ‘it will fill you up and ruin your appetite’.

o   Custom to have mineral water and wine with meals. Soda and milk are for children and/or teenagers or when eating pizza.

o   Coffee is only served after a meal and never with it. cappuccino (with whipped cream) are served during breakfast only and espresso are served with lunch and dinner.

o   Bar’s are not just for drinking. Many people go there to get breakfast, gelato, sandwiches.

Italian meals can last at least an hour or two and sometimes last even longer. The food is served on several different plates and in much smaller portions that in America. When dining at a restaurant you must ask you waiter for the check when you are done eating or they will not bring it to you. This is because meals usually last awhile and Italians do not want to feel rush (or rush others) to finish a meal by getting the check presented before they are ready. Meal time is taken very seriously in Italy! Meals are NOT rushed and if they are it is seen as an insult to the chef. Tips are not necessary but there is a small mandatory fee added to your check for the bread and table setting, this extra charge is known as copreto. Sundays are the traditional days in Italy to eat a long lunch with your family.

Time Consciousness

In Italy it is hard to find what time it is and when you do find a clock, it is expressing a different time than a clock 6 blocks away. The Italian culture is present based, fluid flowing culture. Time is of little essence.

  • The culture lives in the here and now and it is not rare for someone to come into an appointment 30 minutes late.
  • Coffee dates last for hours because people simply “lose track of time,” and appointments are put on the back burner. If there is an appointment at 3 and a coffee date at 2; the appointment will come after the coffee date, what ever time that is.
  • As previously stated, the Italian culture is all about “timelessness” and this is very evident when it comes to time consciousness!
  • The Italian culture is more about leisure and they are less punctional than other cultures. The culture is all about relaxation and living a stress free life.
  • Showing up late to social events is completely acceptable, and Italians always make time for social events. This is how they find out what is going on within the culture/city; even if they show up late, they will always make an appearance.

Relaxation anyone?

Relationships and Social Organization

  • Traditional relationships between man and woman are still the most commonplace, however, acceptance of same-sex marriages/unions is steadily growing. A recent poll showed a nationwide 41.0% acceptance of same-sex marriages.
  • The social classes are broken down into six categories ranking from richest to poorest, they are as follows: Bourgeoisie, White-collar middle class, Urban petit bourgeosie, Rural petit bourgeosie, Urban working class, Rural working class.
  • Friends are much like those in other cultures, Italian friends go to the bars, they hang out at the piazzas, hit up the clubs, eat out at the restaurants, and watching movies at the cinema.
  • Sporting events is a major focus of social activities within the Italian culture. During the Olympics, Italians tend to flock to bars and restaurants; share wine and drinks with friends and root on their country. They are very united as a country.

Work Habits and Practices

Respect, especially of age and power, is a fundamental and very important value in Italian culture. Therefore a handshake with direct eye contact is a must when greeting someone for the first time. First impressions and demeanor are critical in any Italian relationship; as Italians rely strongly on their intuition to guide them and tend to only do business with individuals that they know and trust. Any verbal agreement in Italy is seen as a contract and a set plan; and must be adhered to under any and all circumstances!

  • Hierarchy is considered the cornerstone for Italian business. Italians are very hard workers!
  • You must be ‘invited’ to be able to call someone by their first name.
  • Face-to-face contact is preferred. Internet, e-mail, and telephone are not highly liked. Punctuality is a huge virtue in Italy and is expected in business relationships!
  • Italians are eager to know something (personal) about you before conducting business with you. Therefore, networking is huge and personal contacts truly help you get ahead in life.
  • Appointments are mandatory! They should be made 2-3 weeks in advanced and be submitted in writing. A phone call is then required to confirm the meeting again. (Italians and business is VERY time conscious)
  • In Italy many companies are closed during the moth of August and most business are closed. This is a time that Italians designate for vacations and traveling.
  • Like food, Italians often tend to take a more leisurely approach to business. However, they still recognize the idea that ‘time is money’. Italians do not use meetings to make decisions and agendas are not often followed. Meetings are seen as a time to allow for  a “free flow” of ideas where everyone is allowed to talk loudly, express themselves, their ideas and be heard.

Demographics and Statistics

Based upon the 2000 census:

  • 15,723,000 Italian Americans in the US (49.5% male, 50.5% female, and 14% <17 years old).
    • Italian Americans have high population concentration in areas on the East Coast such as Rhode Island (20%), Connecticut (19.8%), and New Jersey (18.5%) with New York having the highest number of Italians at a little under 3 million people.
  • Average age: 33.8 years old (male 33.1 years old, female 34.6 years old)
  • Marital Status:
    • Never married: Male 32%, Female 27%
    • Married: Male: 57%, Female 54
    • Divorced: Male 8%, Female 10%
  • Family: Number of families in the US: 3,948,000
    • Average size is 3.0
    • Median income:  $61,297/year
  • Living environment:
    • urban areas, 12 rural areas
  • Birth place: 95% are US Natives
  • Education:
    • High School Graduates: 29%
    • Bachelors Degrees 18.5%
    • Masters Degrees 7%
    • Professional School Graduates 2%
    • Doctorate Degrees 0.85
    • Total Italians in workforce: 49%

Changes in at-risk behavior for HIV- infection among HIV positive  persons in Italy

A recent study conducted in 5 different major Italian metropolises, centered around the high risk behaviors before and after diagnosis, gave interesting insight into HIV positive Italians’ lives. Fresh data puts the number of Italians living with HIV/AIDS at 150,000, that is 0.4% of the population (0.2% lower than that of America.) The study was a professionally administered questionnaire administered to 497 participants who were all HIV positive. The questions ranged from drug use, number of sexual partners, and protection used during intercourse before and after learning of their diagnoses. The majority of the respondents noted decreased drug use, increased protection use, and a noticeable decrease in number of sexual partners. As a whole, the people of Italy seem to be well educated in the area of high risk behaviors. However, the country still needs encouragement when it comes to the use of condoms. The HIV positive Italians in this study used condoms an average of 29.8% of the time during sexual intercourse.

Differences Between Italian and American Culture

There are several differences between the Italian culture and the American culture. Some of these differences include:

  • Italians don’t have a ‘privacy bubble’ like Americans do
  • Italians walk to many of their destinations on a daily basis, on average around 2-3miles apart, while Americans prefer to drive to their destinations.
  • Most Italian women do not wear deodorant and many don’t shave their legs or underarms.
  • In Italy they separate public life and private life.

Although these are only some of several differences they have the ability to vastly affect the way that individuals interact with each other. As health care professionals it is important to recognize some of the major differences between the health care given in America and that given in Italy. According to Assumptions and blind spots in patient-centeredness: action research between American and Italian health care professionals one of the major differences between the care provided by Americans and the care provided by Italians is the focus of the care. Although they are both patient oriented the health care provided in America is often seen as more solution oriented, as opposed to emotionally oriented, in the eyes of Italians. Health care professionals see it is as their duty to their patient to inform them of what is going on with their health while Italians see it as their duty to protect their patients.

Preconceived Discrimination???

At the present time, Italians don’t seem to be discriminated against but rather adored. In the past, there was a time when they were treated worse than animals which had several causes. One of which was because the first Italians that immigrated were from southern Italy. Southern Italians had a darker complexion and were viewed as subhuman, so this racial prejudice set up a difficult situation for future Italian immigrants. Another reason was that they were viewed as menial and unintelligent laborers due to their willingness to work in the least ideal of conditions and little did people know that the reason they worked so hard was to support their families. However low this might have seemed, it served as a stepping for acceptance in America. Another reason that made the situation worse for Italians is that they came into a protestant country when they hold to Catholicism, and simply because newly immigrated Italians didn’t speak English very well. Over time, the hard work paid off and Italians started making themselves know to American society on different terms. They became politicians and business owners. One notable person that helped shape a more positive stereotype of Italians was and an Italian actor named Rudolph Valentino who gave to Hollywood an image of a charismatic Italian male who was irresistible to women. Towards the 20th century, Italians were adamantly established into American pop culture where they were not viewed as dirty Neanderthals living in tenements anymore.

Health Risks

  • Obesity, ranking 25th on the worldwide list of obese countries, only 8.5% of Italians are considered obese.
  • Suicide rates in Italy are a moderate 7.1 per 100,000 which is considerably lower than the rate of 42 and 38 in some of Italy’s neighbors to the north in Lithuania and Russia respectively.
  • Car smog is one of the fast rising public health risks as the number of cars goes up and the restrictions in the country are not great.
  • Marijuana use is fairly common, as law enforcement does not penalize unless you are caught buying or selling.
  • Alcohol use, very common in the country with dinner, can often be abused. The culturally acceptable age to begin drinking is in the teens and many are heavy drinkers by their early 20’s.
  • Random piece of information: According to one source, Italians view the Avatar 3D glasses a health risk to the public.
  • Random piece of information #2: Italian men are quite forward people. Rape allegations rarely hold up in court. There is an unspoken Italian rule that when a woman enters a man’s apartment, she relinquishes her right to say no to sex.
  • Smoking is very common in Italy, everyday there are over 195,000,000 cigarette butts thrown on the ground in the country.

Considering that smoking is very common in Italy, Federico, Costa, and Kunst conducted a study to see the prevalence of smoking among groups of people based on birthdate ranges; 1940-1949, 1950-1959, 1960-1969 (2007). This article also gave insight into whether or not there was an association between high and low socioeconomic groups, and between smoking variables and level of education and it used statistical analysis to study the data obtained for those associations. As health care professionals it is important to note that Italians who are lower-educated individuals and who are middle aged had lower smoking cessation rates. It would also be important to note that Italy has started to intervene and is trying to educate the people and push them to quit and prevent them from starting. The article put an emphasis on making policies that addressed initiation and cessation of smoking in younger birth cohorts (later birthdate ranges).

Tid Bits and Taboo’s

  • Extending the index and pinkie finger forming the shape of a pair of horns and gesturing with it with the horns pointed down is an insult to somebody which basically means that their husband or wife is unfaithful.
  • Having birds in the house is believed to bring bad luck.
  • Currently,  saying the “C” word (condom) is considered taboo in Italy because of the fact that it is a predominately Catholic country and part of what they teach is that HIV and AIDS can be prevented through abstinence.
  • Cheese and fish don’t mix
  • Pasta and bread don’t mix either, this purely is an American thing.
  • Don’t say Ciao to everyone because it is a greeting that is mostly used by people who know each other, you will get the impression that you are overly informal.
  • The word “sex” is inappropriate to use in a family conversation as it is a really big deal.
  • Conversation topics shouldn’t include religion, politics, and World War.
  • Asking someone you’ve just met about their profession is considered insulting.

5 (or so) things nurses need to be aware of…

  • Understand that Italians talk with their hands. This is how they express situations and everyday experiences. Nurses will need to prepare for a puppet show when dealing with this culture.
  • Italians are very dramatic people. Normal complications and situations will turn into a crazy story. Nurses need to just sit back and listen.
  • Only 8% of the Italian culture is obese so this is not a common thing that will be treated in Italy
  • The Italian culture does not believe in contraceptives. Nurses need to be aware, advocate, and educate patients
  • Italians cherish family. Nurses must be aware that patients will incorporate family into decision making and family will be at the bedside of patients
  • Awkward silence is frowned upon.
  • Remember that Italians think high of themselves and their social status.


Click to access IA_Profile.pdf

Article #1


Article 2

Lamiani, G., Meyer, E., Rider, E., Browning, D., Vegni, E., Mauri, E., et al. (2008). Assumptions and blind spots in patient-centredness: action research between American and Italian health care professionals. Medical Education, 42(7), 712-720. Retrieved from CINAHL with Full Text database.


Article 3

Federico, B., Costa, G., Kunst, A. E., (2007). Educational inequalities in initiation, cessation, and prevalence of smoking among 3 Italian birth cohorts. American Journal of Public Health. 97(5), 838-845. Retrieved from CINAHL with Full Text database.


Alla Fine (-means “the end”)

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