Cultural Nursing Ch211 Discussion

Mexican Americans
Larry Purnell, PhD, RN, FAAN

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage

• Mexican, Mexican American, Latino(a), Chicano(a), la gente de la raza, Hispanic, etc. are commonly used terms.
• Second largest Spanish speaking group in the world
• 500+ different dialects and ethnic groups in Mexico
• Mexico City is one of the largest cities in the world

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage Continued

• 60% of the population is mestizo—a blend of Spanish white and Indigenous Indian
• The majority of the Hispanic population in the United States
• Hispanic is the largest “minority” group in the United States surpassing African Americans in 1999

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage Continued

• Original inhabitants, along with Native American Indians, of southwest United States
• Majority of newer immigrants come to the United States for economic opportunities and are poorer than previous immigrants
• Low educational rates in the United States
• Ninth-grade educational level required in Mexico —mean is 5 years

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

• Dialect varies by region of Mexico, including Mayan
• Rapid speech pattern with apocopation (e.g., como esta usted = com-esta-sted)
• Idiomatic and slang expressions are common—like English

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

• Concepts of personalismo is important.
• Touch between the men and between women is acceptable.
• Men and women greet with a hug and kiss to the cheek.
• Eye contact with staring is expected for peers.
• Many avoid direct eye contact with superiors as a sign of respect.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

• Intense eye contact can cause the “evil eye,” a folk illness common in all Hispanic and Mediterranean cultures.
• Children are more susceptible to the evil eye than are women who are more susceptible than men.
• Healthcare provider should greet men with a firm handshake.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

• Temporality varies via socioeconomic level
• Clock time is not categorically imperative; events begin when they begin and not until then
• Name format: First name, middle name, father’s surname followed by mother’s maiden name.
• A woman takes her husband’s last name which is place before her maiden name..

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles

• Traditional families are patriarchal but vary greatly.
• Current research is dispelling the myth of machismo and patriarchal decision-making.
• Children are closely protected and are not expected to work or do many chores in middle-class families—children are supposed to be allowed to be children.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

• Children are taught to respect parents, elders, and teachers, etc.
• Multigenerational families in Mexico, less so in the United States.
• Children have comadres, compadres (godparents).
• Single parenting somewhat stigmatized, severely so in some groups.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

• Significant number of Unido until at which time the family has the money for a religious wedding ceremony.
• Academic and professional degrees are highly respected.
• A good education also means having good manners.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

• If family and close friends are aware of gay/lesbian relationships, they are not talked about.
• Stigma continues to be a significant problem with many.
• Dignity, Hola, and Ellas are support groups and they all have 800 numbers and are located in Washington, DC.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

• Intestinal parasites and diarrhea are major health problem among immigrants; also tuberculosis, STIs, and HIV/AIDS.
• Hypertension, cardiovascular disease, diabetes, malaria, cholera, typhoid, dengue fever, and high suicide rates. Incidence varies from point of migration and living conditions.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology Continued

• Alcohol metabolism is slowed, especially among those with an Indigenous Indian ancestry.
• Require lower doses of antidepressants and are poor metabolizers of debrisoquinine.
• Greater toxicity from tuberculosis drugs.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

• Large percentage of women are overweight—seen as positive and is a sign of health, fertility, wealth, and beauty.
• Anytime is a time to celebrate with food.
• Food choices vary by area of immigration—mountains, metropolitan areas, seaports, etc.
• Staples include tacos and rice and plantains.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

• Lactose intolerance, especially from adults so calcium obtained from soups with bones and bone marrow, leafy greens, and corn tortillas treated with calcium carbonate.
• Many ascribe to the hot/cold theory of foods, although they may not speak to it directly.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

• Not all foods are spicy! And Nachos are American—not Mexican
• Meal times vary, but many continue with the afternoon siesta if job permits
• Many foods are deep fried or fried in some manner—high-fat diet mostly
• Iron and Vitamin A deficiency—especially among lower socioeconomic groups

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Childbearing Family

• Birth rate in Mexico and United States is higher among Mexican Americans than among other United States groups.
• Wide range of contraceptives when used, but not always admitted.
• Condom use: used mostly with prostitutes for infection prevention.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

Many Hispanic Americans have lactose intolerance. A good source of calcium if the diet is

Flour tortillas.

Corn tortillas.

Chicken

Pork.