Understanding the Cultural Context of Cultural Responsiveness for Latinos By Isabel S. Perez-Yanez, MPH, CHES, CATC

Understanding the Cultural Context of Cultural Responsiveness for

Latinos

ByIsabel S. Perez-Yanez, MPH,

CHES, CATC

Focus of Presentation Overview of Latino Trends Cultural Context Perspective Cultural Responsiveness not a Trend Hope, Health and Healing

Myth of Cultural Competency Competent implies we have reached a

level of competency Diverse meanings; sensitivity, diversity,

human diversity, tolerance Diversity promotes separation What is culture?

Yvette G. Flores, Ph.D.

Responsive services What are they?

Meet needs of the client Consider ecological factors Do not compartmentalize Evaluates physical, psychological, emotional and

spiritual needs of clients Evaluates client social, relational and cultural strengths

and needs Respectful Culturally attuned


Understanding the Cultural Context for Responsive services What are they?

Meet needs of the client Consider ecological factors Do not compartmentalize Evaluates physical, psychological, emotional and

spiritual needs of clients Evaluates client social, relational and cultural strengths

and needs Respectful Culturally attuned

Factors Effecting the Lives of Latinos Individual Family Cultural Values Collectivism/

Interdependence Migration

Environment Systems &

Institutions Laws and Policies Stereotypes,

Racism, Oppression

Hispanics Account for More than Half of Nation's Growth in Past DecadeThe 2010 Census counted 50.5 million Hispanics

California at Glance Hispanic Population 13,682,000 Hispanics as Percent

of State Population 37% Median Age of Hispanics 27 Median Income, Hispanics

16+ $20,500 Poverty Rate,

Hispanics 17 and Younger 27%

Hispanics WithoutHealth Insurance

29% Hispanic Homeownership 45% Hispanics as Percent of

All K-12 Students 49%

Source: PEW Hispanic Center

www.latina.org

Diversity Amongst Latinas/Latinos We are Mexicans, Honduran, Puerto

Ricans, Argentineans, Cuban, Salvadorans, Dominicans, Panamanians, Guatemalans, Nicaraguans, Peruvians, Costa Ricans, Bolivians, Chileans, Colombians, Venezuelans and more………

Black, white, rainbow of colors and different racial preferences

Source: Latinas/os in the United States: Changing the Face of America

Diversity Amongst Latinas/Latinos What we call ourselves Mostly Catholics, Protestants, Jewish, Islamic,

atheists, Santeros/as Curanderos/as Born here prior to this land became United States Born here after, fairly recent arrivals Speak only English, bilingual, only Spanish, Mayan

Languages, and other languages

Source: Latinas/os in the United States: Changing the Face of America

Traditional Hispanic Values, Characteristics, Behavior Patterns

Family Values (familismo) very important, respect & loyalty

Cooperation rather than competition Interpersonal relationships very important Deep respect and affection among friends

and family Strictness of child rearing, religiosity,

respect for adults Extended family, non-blood relatives Father (responsible) children (obedient)

god- parents (resourcefulness Source: Counseling Culturally Diverse, Theory and Practice, 5th Edition,

Derald Wing Sue, David Sue

•Despite policy changes and the increased militarization of the U.S.-Mexico border, thousands of men and women continue to make the journey north •Generally the migration is motivated to improve the living conditions of their families left behind•Post migration alcohol and drug use is likely to increase•Migration is considered a significant risk factor for both those who leave and those who remain

Migration

Source: Yvette G. Flores, Ph.D.University of California, DavisChicana & Chicano Studies Program

Buying Power Latinas/Latinos’ buying power increased from

$211.9 billion in 1990 to $978.4 billion in 2009 Projected to climb to $1.3 trillion in 2014. The percentage change between 1990 and 2014

is 528%, the highest of all race/ethnic groups Share of the consumer market was 9.1% in 2009

Source: Changing workplaces. Changing Lives, Catalyst, March 2010

Language at Home: Persons 5 and OlderOnly English Spoken at Home

2,794,000 (23%)

Language Other than Only English Spoken at Home

9,420,000 (77%)

Higher Education Degrees From 2000 to 2004 number of college-

bound Hispanic women increased by 22%-6% increase or more over Latinos

Source: WomensColleges.org

In 2006-2007-For Latinos/Latinas7.5% getting bachelor’s5.8% getting master’s degrees3.4% getting PhD’s

Source: Changing workplaces. Changing Lives, Catalyst, March 2010

Remitance Senders and Recievers 6 million immigrants from Latin America

send families back home Flow from U.S. to Latin America and the

Caribbean close to $30 billion Continue to increase

Yvette G. Flores, Ph.D.Yvette G. Flores, Ph.D.19

Culture and class as determining variables

Latino diversity derives from differences in class, education, and value systems

Values can be traditional, transitional or contemporary values

Values are influenced by the person’s relationship to the means of production

At any given time, values and class interact to influence specific behaviors, attitudes or practices

Source: Bernal & Alvarez

Substance Abuse Patterns Binge Drinking –Latinos have a rise in numbers

now higher than the national average U.s. born Hispanic Americans higher rates of

substance abuse compared to those born in their native born

More acculturated to the American culture , higher substance abuse pattern

Research and News, August 3, 2010, SAMHSA

Latinos and Treatment Hispanics are among the highest percentages of

those needing but not receiving treatment compared with their respective percentage of the total in treatment.

Have the next highest percentage of needing but not receiving treatment for illicit drug or alcohol use

Hispanics showed a pattern of steady increase of admissions

Source: 2010 California Needs Assessment Report

Substance Abuse & Other Issues Substance abuse is the most common behavioral risk factor

reported by patients with TB in the U. S.

Hispanics and Asian/Pacific Islander account for 82% of TB Cases in California in 2008

Latinos were second highest arrested for misdemeanor drug offense for Marijuana, Other drugs, public intoxication, and liquor laws

45.6% adult and juvenile were arrested for felony and misdemeanor DUI age 12 and up

Latinos were second highest for at risk gambling, problem gamblers, pathological gambling

Source: 2010 California Needs Assessment Report

Latina Population Type of Service, 2005 Long-Term Residential 18. 5% Short-term Residential 1.1 % Day Treatment/ Intensive outpatient 8.4% Outpatient Treatment 62. 2% Detox-Residential 5.5% Detox-Hospital 0.0% Detox-outpatient 4.3%

Source: Resources for Latina Population, California Women Children and Families TA Project, A project of Children and Family Futures, Funded by the California Dept of Alcohol & Drug Programs, Marta Ortegon and Deborah Werner

Primary Drug of Choice, 2005 51% -Methamphetamine 15% Heroin 14% Alcohol 12% Marijuana/Hashish 8% Other


Incarceration Rates

Between 1991 and 2007- number of offenders sentenced in federal courts doubles (118%)

During the same period, Hispanic offenders nearly quadrupled 270% from 7, 924 in 1991 t0 29, 281 in 2007.

Hispanics accounted for more than half (54%) of

the growth in the number of sentenced federal offenders over this period.

PEW Hispanic Center, February 18, 2009

Public Policy Institute of California, July 2011

Sources: California Department of Corrections and Rehabilitation data, 2010: Census Bureau data. 2010. From: Just the Facts: California’s Changing Prison Population, PPIC. 2011.

Latina and Substance Abuse Treatment In 2005, 15, 287 Latinas entered treatment for

alcohol and other drug problems 74% -Mexican, 22 % Other Hispanic/Latino, 2%

Puerto Rican 7% identified were pregnant at time of admission 53% of Latina admissions were under 30 years


Dropout rates for White youth have remained below the rates for other racial/ethnic groups

Juvenile Offenders and Victims: 2006 National Report NCJJ/OJPP

Stereotyping Latina Adolescents Despite this popular perception, most

Latina girls do not fit the negative images typically portrayed in the media.Latina Girls, Voices of Adolescent Strength in the United States, Jill Denner , Bianca L. Guzman

Most research focuses on negative issues.

Stereotyping Latina Adolescents The common perception of a Latina

adolescent is a girl who makes poor choices and who will likely drop out of school, become a teenage mother, or be the girlfriend of a gang member.

Latina Girls, Voices of Adolescent Strength in the United States, Jill Denner , Bianca L. Guzman

Punitive instead of positive While Hispanic-Latino youth are less likely

to receive mental health services, they are more likely to become involved with the juvenile justice and/or child welfare systems (Vega & Alegria, 2001).

Types of Trauma Stress

Community and School Violence

Complex Trauma Domestic Violence Medical Trauma Natural Disasters Neglect

Physical Abuse Refugee and War

Zone Trauma Sexual Abuse Terrorism Traumatic Grief

National ChildTraumatic Stress

Network


Provider characteristics Cultural incompetence

Lack of information about Latinas Stereotyping & over generalizing

Racial/ethnic/class differences Perception of Latinas as “the other”, foreigners,

trespassers, overly reproductive Differences in world views Linguistic differences

Perceived Discrimination In US

Growing scientific evidence that the subjective experience of discrimination is detrimental to the mental health and physical health of women, ethnic/racial minorities, and the poor.

Perceived discrimination (PD) is the subjective experience of being treated unfairly relative to others in everyday experience.

Journal of Health and Social Behavior, Kessler, Williams,1999

Types of Racism-Related Stress Racism-related life event - significant

life experiences across various domains.

Vicarious racism experiences - through observation and report from family, friends, and even strangers.

Types of Racism-Related Stress

Daily racism microstressors - microaggressions-degradations, put downs, slights, exclusions-being ignored, disrespected, observed, stereotyped.

Chronic-contextual stress - impact of social structure, political dynamics, institutional racism.

Stress and Discrimination Growing evidence that exposure to discriminatory

experiences is an ongoing aspect of life for Latinos in and the Mexican-Origin population within the U.S.

Gender differences in Discrimination and Health In addition to general stress discrimination stress

as an ethnic minority places them at increased risk for health and mental health problems

Source: Perceived Discrimination, Perceived Stress, and Mental and Phsycial Health Among Mexican-Origin Adults, Floret, Tschann, Dimas, Bachen, Pasch, de Groatl August 2008

Stress and Discrimination Cumulative exposure compromises

psychological well-being and physical health

Need to include assessments for the effects of discrimination stress with other chronic stress relevant to this population

Source: Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults, Floret, Tschann, Dimas, Bachen, Pasch, de Groatl August 2008

Education Schools frequently punished students with

the greatest academic , social, and emotional needs.

Most likely to be suspended, expelled, or removed from the classroom for punishment, reveals that minorities, (Blacks and Latinos) males, and low achievers are vastly overrepresented.

Source: Pedro Noguera PH.D, NYU. Schools, Prisons, and Social Implications of Punishment

Cannot forget the “ divide and conquer” fall into the trap of racism within our own culture “ as long as people of color fight among themselves, they can’t form alliances confront the establishment.” Counseling the Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue

Traditional Counseling Counseling and Therapy have oppressed,

harmed, damaged marginalized people (often unintentionally)

Counseling Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue

Professional Education and Training Focus tends to be on pathological lifestyles

and/or maintenance of false stereotypes Ethnocentric bias been highly destructive

to natural help giving networks of minority communities

( Duran, 2006) Counseling Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue

5% Rule5% Rule

Source: UCD-Civil Rights Training

Guiding Principles for Gender-Responsive

Services• Gender

• Environment

• Relationships

• Women’s Services

• Economic & Social Status

• Community

Copyright © 2009, Stephanie S. Covington, Ph.D.Copyright © 2009, Stephanie S. Covington, Ph.D.

Cultural Context & Social Justice

Juvenile justice system must be purged of the class and race discrimination that sends disproportionate numbers of poor kids and kids of color to Juvenile Hall---and eventually prison. Dirty - Meredith Maran

Five Characteristics of Effective Helping Professionals

Worldview Respect Hope Humility Trust Empathy

Adapted from Fundamentals of Substance Abuse Practice, Jerry L. Johnson

Clinical Acculturation Express own feelings about heritage and self-perception Encourage exploration of strengths of cultural backgrounds,

histories, heritages, old & new ways to incorporate spirituality into their lives

Adopt acculturation assessment tools that include information on migration patterns, experiences, stress, country of origen, and specific endorsement of Latina values

Develop and provide psychoeducational family programs

Source: Alvarez and Ruiz 2001: Caetano et al. 2007:CSAT 2003 b; Medina 2001- TIP 51

Advice to Clinicians and Administrators in Substance Abuse Treatment

Resources 2010 California Needs Assessment Report Counseling the Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue,

National Trauma Stress Network

Resources for Latina Population, California Women Children and Families TA Project, A project of Children and Family Futures, Funded by the California Dept of Alcohol & Drug Programs, Marta Ortegon and Deborah Werner

Latina Girls, Voices of Adolescent Strength in the United States, Edited by Jull Denner and Bianca L. Guzman

Pedro Noguera PH.D, NYU. Schools, Prisons, and Social Implications of Punishment

Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults, Floret, Tschann, Dimas, Bachen, Pasch, de Groatl August 2008

Pew Hispanic Center

Substance Abuse Treatment Addressing the Specific Needs of Women, TIP 51, www.samhsa.gov Women’s Health.gov.

XOCHIQUETZAL:She is a nature Goddess of beauty and is called the flower goddess. Goddess of birds, butterflies, song, dance and love. Also a protector of artisans, prostitutes, pregnant women and birth. Like Persephone, was kidnapped and taken from her husband, Tlaloc, to the underworld by Tezcatlipoca a lord of the underworld.

Contact Information

Isabel S. Perez-Yanez, MPH, CHES, CATC4472 Edwards LaneCastro Valley, CA 94546(510)733-2390E-mail: [email protected]

Documents

Understanding the Cultural Context of Cultural Responsiveness for Latinos By Isabel S. Perez-Yanez, MPH, CHES, CATC