ANALYSIS OF THE EFFECTS OF CULTURE ON HEALTH PRACTICES

BARBARA PSAROUDIS R.N.

The Hispanic Community of Paterson N.J.

Objectives of Presentation

To understand the role that culture plays in health practices in the community

To examine beliefs that impede or enhance health and wellness

To analyze group patterns in order to facilitate positive change

To propose solutions that will promote healthier lifestyles

Health Care Workers

Target Audience

NursesSocial WorkersPoliticians and Policy makersCommunity Health WorkersHospital AdministratorsPhysiciansClergy

Outline of Presentation

Description of target populationAnalysis of health beliefsIllness needs of communityManagement of health and illness

needsSummary and Analysis

Paterson Population Demographics 2009

Hispanic - 83,086 (56.7%)Black alone - 42,327 (28.9%)White alone - 17,858 (12.2%)Asian alone - 3,190 (2.2%)Other race alone - 1,120 (0.8%)Two or more races - 534 (0.4%)

http://www.city-data.com/races/races-Paterson-New-Jersey.html

2000 U.S. Census**Pew Hispanic Center

2000 U.S. Census**Pew Hispanic Center

2000 U.S. Census2000 U.S. Census

Paterson149,222

Hispanic– 50.1%Median household

income $ 32,77829.1% of Hispanics in

Paterson live in poverty**

New Jersey 8,414,350

Hispanic– 13.3%Median household

income-$55,146

Population Demographics Comparison

Races in Paterson

Hispanics currently acHreHipresent over

50% of

HH

Education tEhe Paterson

EpElation8.2%

29.8%

EDUCATIONHigh school graduates, percent of persons age 25+, 2000 - 58.5%

EDUCATIONBachelor's degree or higher, percent of persons age 25+, 2000 –8.2%

Number %Passaic County Total Population 489,049 100 %Hispanic or Latino (of any race) 146,492 30 % - Mexican 20,859 4.3%

-Puerto Rican 41,324 8.4%

-Cuban 3,009 0.6 % Other Hispanic or Latino 81,300 16.6 %Not Hispanic or Latino 342,557 70 %

Religious Beliefs

Majority are Catholic with increasing presence of Pentecostals

Health is a gift from God and should not be taken for granted

Prevention of illness through prayer

http://culturediversity.org/hisp.htm

.

Social Customs

Elders have prestigious statusFamily often looks to elders for advicePaternalism– male- dominated familyFamily often turns to home remediesMore emotionally expressiveExpectation of being pampered when ill

http://culturediversity.org/hisp.htm

Language

40.3% of residents of Paterson speak English at home.

50.7% of residents speak Spanish at home (49% speak English very well,

51% speak English less than very well).

**Language can be a barrier is accessing Healthcare System

Nutrition

Latino families face disproportionately high rates of hunger, food insecurity, and obesity.

Access to nutritious food is key in addressing these conditions.

Need to improve nutrition in the Latino community by increasing access to federal food assistance programs, resources, and education.

OBESITY

One in four Hispanic adults living in the U. S. was obese (having a Body Mass Index of 30 or more). More than one in six (16.8%) Hispanic high school students is overweight.

Food insecurity affects 21.7% of Latino households compared to 8.6% of non-Hispanics Hispanics' rates of being overweight are significantly higher than white high schoolers (11.8%) Greater reliance on high-calorie and high-fat foods associated with poverty and food insecurity Hispania News no date http://www.hispanianews.com/archive/2006/07/21/07.htm

Obesity and Activity

Diminished physical activity: Nearly half ( 47.6%) of all Hispanics live in central city households which often lack opportunities to be physically active

Many poor urban families typically live in

neighborhoods where getting exercise and being able to play outside is less feasible and even dangerous.

Education

According to a 2007 U.S. Census Bureau report, 61 percent of Hispanics in comparison to 89 percent non-Hispanic Whites have a high school diploma. 12.5 percent of Hispanics in comparison to 30.5 percent of non-Hispanic whites have a bachelor’s degree.

Health Practices

“Present-oriented” society leading to neglect of preventative care

Birth control other than rhythm is unacceptable due to Catholicism

Most see thinness as a problem and plumpness as the ideal

Turn to family and friends to problem solve before Social WorkersCurandero—holistic healer http://culturediversity.org/hisp.htm

Health Concerns

Leading causes of illness and death among Hispanics, which include heart disease, cancer, unintentional injuries (accidents), stroke, and diabetes (CDC).

Other health conditions and risk factors that significantly affect Hispanics are: asthma, chronic obstructive pulmonary disease, HIV/AIDS, obesity, suicide, and liver disease.

http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=54

Sexually Transmitted Diseases (STD)

Gonorrhea prevalence rate among Hispanics/Latinos was 69.2.  This rate is 1.9 times higher than the 2007 rate among whites (34.7 cases per 100,000 population).

Chlamydia prevalence rate among Hispanics/Latinos (473.2) was also three times higher than that of whites (162.3) in 2007.

Syphilis prevalence rate increased 22.9% among Hispanics/Latinos (from 3.5 to 4.3 per 100,000 population). (from 2006-2007)

Diabetes

Mexican American adults were 2 times more likely than non-Hispanic white adults to have been diagnosed with diabetes by a physician. In 2005 Hispanics were 1.6 times as likely as non-Hispanic Whites to die from diabetes. End-stage renal disease (ESRD). Male Hispanics had substantially higher proportions of ESRD attributed to diabetes than did Blacks or Whites,

•http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=54

Tuberculosis (TB)

For the fourth consecutive year, Hispanics/Latinos exceeded all other racial or ethnic groups with the largest percentage (29%) of total cases in the United States.  

TB

HIV/AIDS

Hispanics/Latinos are disproportionately affected by HIV/AIDS. The overall prevalence rate for Hispanics/Latinos (585 cases per 100,000 population) was nearly three times the rate for whites (224 cases per 100,000 population).

In 2005, HIV/AIDS was the fourth leading cause of death among Hispanic/Latino men and women aged 35 to 44 years.

http://www.cdc.gov/nchhstp/healthdisparities/Hispanics.html

Health Promotion and Disease Prevention

. a. Cervical Cancer. Because of the very high incidence of

cervical cancer among Hispanic/Latino women, special attention to appropriate screening is recommended.

b. Diabetes. Periodic blood glucose monitoring for Puerto Rican and Mexican American elders is recommended because of the high incidence of diabetes,

c. Depression. Appropriate assessment of depression is important, especially among less acculturated older women.

(Espino et al, 2000)

Economic Roadblocks

Hispanics are

more likely to be uninsured than whites or African-Americans,

face elevated rates of obesity, diabetes, and asthma.

Community Resources

Hispanic Multi-Purpose Services Center911 East 23rd Street, Paterson, NJ 07504 (973) 684-3320Relocation assistance, shelter, housing, emergency food, education, and employment services.

Hogar Infantil560-566 Main Street, Paterson, NJ 07503(973) 279-4486A child development and day care center open to all residents of Paterson, with before- and after-school programs for income-eligible families.

Community Action for Social Affairs (CASA)84-86 Mill Street, Paterson, NJ 07505 (973) 523-5452

Provides employment services, emergency food, vouchers, translation services

Abstract

Hispanics are currently the largest ethnic minority group in the United States and are expected to comprise approximately 30% of the total U.S. population by 2050. More generally, barring significant policy changes, immigrants and their descendants across all ethnic groups will account for most population growth during the next several decades(Pew Hispanic Center, 2008). As these trends indicate, there is an urgent need for research focused on Hispanic health

Paterson N.J. is an urban city, located in northern N.J., just 25 miles from New York City. Its Hispanic residents face crime, poor education, and increasing health problems, for the most part brought on by poverty, language barriers and decreased access to primary care physicians

References

Demographic profile of Hispanics in New Jersey, 2008. Pew Hispanic Center. retreived from http://pewhispanic.org/states/?stateid=NJ on May 5, 2011

Espino, D.V., Palmer, R.F., Miles, T.P., Mouton, C.P., Wood, R.C., Bayne, NS, & Markides, K.P., (2000). Prevalence, incidence, and risk factors associated with hip

Health disparities in HIV/AIDS, viral hepatitis, stds, and tb: Hispanics/ Latinos. Jan 25, 2010. Center for Disease Control and Prevention. retreived from http://www.cdc.gov/nchhstp/healthdisparities/Hispanics.html. May 4, 2011.

Healthy foods, healthy families. NCLR National Council of La Raza. 2010 retrieved from http://www.nclr.org/index.php/issues_and_programs/health_and_nutrition/healthy_foods_families

Hispanic/Latino Profile 2009. The Office of Minority Health.. Department of Health and Human Services. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=54

Hispanic population health issues portend challenges for health care system KHN Kaiser Health News April 1, 2011.retreived from http://www.kaiserhealthnews.org/daily-reports/2011/april/01/hispanic-health.aspx on May 4, 2011

Key facts about childhood obesity in the Latino community. Hispania News. nd retrieved from http://www.hispanianews.com/archive/2006/07/21/07.htm on May 5, 2011.

Races in Paterson, New Jersey (NJ) detailed stats: ancestries, foreign born residents, place of birth. City Data.com retrieved from http://www.city-data.com/races/races-Paterson-New- Jersey.html on May 4, 2011

Resources for Spanish-speaking people. LSNJ Law. nd. retrieved from http://www.lsnjlaw.org/english/governmentaid/resources/spanishresources/

Talamantes, M., Lindeman, R. and Mouton, C. (2000). Ethnogeriatrics Curriculum Module: Health and Health Care of Hispanic/Latino American Elders.http://www.stanford.edu/group/ethnoger/ebooks/hispanic-latino_american.pdf

The Hispanic American community. Transcultural Nursing retrieved from http://culturediversity.org/hisp.htm on May 5, 2011