8. Hispanic Culture

Hispanic  (Spanish: hispano, hispánico; Portuguese: hispânico; Latin:Hispnus, adjective from Hispnia, the Roman name for the Iberian Peninsula) is a term that historically denoted relation to the ancient Hispania (geographically coinciding with the Iberian peninsula; modern day Spain, Portugal, Andorra and Gibraltar) and/or to its pre-Roman peoples.

The term is now confined to refer to the culture and people of Spain plus the Spanish-speaking countries of Hispanic America. Additionally, countries or regions with a historical legacy from Spain, including the Southwestern United States and Florida; the African nations of Equatorial Guinea, Western Sahara and the Northern coastal region of Morocco; the Asia-Pacific nations of the Philippines, Guam, Northern Mariana Islands may be considered to be a part of the Hispanosphere.

During the 1970s, the United States Government defined the term “Hispanic” to identify Latin American individuals, and their descendants, living in the U.S. regardless of race.

The ethnic label Hispanic was the result of efforts by a New Mexican U.S. Senator, Joseph Montoya, who wanted a label that could be used to quantify the Spanish-speaking population for the U.S. Census. The label Hispanic was chosen in part because in New Mexico, people of Spanish descent such as Montoya referred to themselves as Hispanos which was anglicized as “Hispanic.”

The U.S. Office of Management and Budget currently defines “Hispanic or Latino” as “a person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race”.

The terms Hispanic and Latino tend to be used interchangeably in the United States due largely to a syntax inconsistency between the English language and the Spanish language. Some define the term “Latino” as a shortened version of the noun ‘“Latin American.” Others define the word “Latin” as the name of the language used by the ancient Romans, while “Latino” is the name given to the people who spoke the language.

Hispanization

Hispanization is the process by which a place or a person absorbs characteristics of Hispanic society and culture. Modern hispanization of a place, namely in the United States, is illustrated by Spanish language newspapers, radio stations, churches, as well as Latin restaurants, tortilla factories, panaderias (bakeries), taquerias (taco restaurants) and specialty music stores, clothing stores, and nightclubs. Hispanization of a person is illustrated by speaking Spanish, making and eating Latin food, listening to Spanish language music, dressing in Santa Fe style or other Hispanic styles, and participating in Hispanic festivals and holidays.

Hispanization is the opposite of assimilation. Assimilation is the process by which a minority culture absorbs characteristics of the dominant society and culture. In the United States Anglo culture has long been the dominant culture and, historically, U.S. immigrants have assimilated by the third generation. For example, by the third generation most Ukrainian-Americans have lost the ability to speak Ukrainian, make Ukrainian easter eggs, cook Ukrainian food, play Ukrainian music, or dance like a Cossack. A few immigrant groups to the U.S. have been slow to assimilate—Greeks, Chinese, and especially Hispanics.

One of the reasons why the assimilation of Hispanics in the U.S. is not comparable to that of other cultural groups, is that Hispanic peoples have been living in some parts of North America for centuries, in many cases well before the Anglo culture became dominant. For example, California, Texas, Colorado, New Mexico, Arizona, Nevada and Florida have been home to Hispanic peoples since the 18th century, even before the U.S. gained independence from Great Britain. These and other Spanish-speaking territories were part of the Viceroyalty of New Spain, and later Mexico, before these regions joined the United States in 1848. Some cities in the U.S. were founded by Spanish settlers in the 17th century, prior to the creation of the Thirteen Colonies. For example, Pensacola and St. Augustine, Florida were founded in 1559 and 1565 respectively, and Alburquerque, New Mexico was established in 1660. Therefore, in some parts of the U.S. the Hispanic cultural legacy is older than the Anglo-Saxon origin. For this reason many generations of U.S. Hispanics have largely maintained their cultural traditions and Spanish language.

Language retention is a common index to assimilation, and according to the 2000 census, about 75 percent of all Hispanics spoke Spanish in the home — even many Hispanics who can trace their ancestry to the original Spanish settlement of the U.S. Southwest between 1598 and 1769. Spanish language retention rates vary geo-graphically; parts of Texas and New Mexico have language retention rates over 90 percent, whereas parts of Colorado and California have retention rates lower than 30 percent.

Hispanic retention rates are so high in parts of Texas and New Mexico and along the border because the percentage of Hispanics living there is also very high. Laredo, Texas; Chimayo, New Mexico; Nogales, Arizona and Coachella, California, for example, all have Hispanic populations greater than 90 percent. In these pockets, Hispanics have always been the majority population. These communities are known within the Hispanic community as “continuous communities” because Hispanics have continuously been the majority population since they were settled in the 16th or 17th centuries. Interestingly, Anglo Americans moving into these communities often Hispanicize, creating a situation where assimilation and Hispanization are one and the same.

Religious Diversity

With regard to religious affiliation among Hispanics, Christianity — specifically Roman Catholicism — is usually the first religious tradition that comes to mind. Indeed, the Spaniards took the Roman Catholic faith to Latin America, and Roman Catholicism continues to be the overwhelmingly predominant, but not the only, religious denomination amongst most Hispanics. A small but growing number of Hispanics belong to a Protestant denomination.

There are also Hispanic Jews, of which most are the descendants of Ashkenazi Jews who migrated from Europe (German Jews, Russian Jews, Polish Jews, etc.) to Latin America, particularly Argentina, Peru and Cuba (Argentina is host to the third largest Jewish population in the Western Hemisphere, after the United States and Canada) in the 19th century and during and following World War II. Some Hispanic Jews may also originate from the small communities of reconverted descendants of anusim — those whose Spanish and Portuguese Sephardi Jewish ancestors long ago hid their Jewish ancestry and beliefs in fear of persecution by the Spanish Inquisition and Portuguese Inquisition in the Iberian peninsula and Latin America. There are also the now Catholic-professing descendants of marranos and the Hispano crypto-Jews believed to exist in the once Spanish-held Southwestern United States and scattered through Latin America. Additionally, there are Sephardic Jews who are descendants of those Jews who fled Spain to Turkey, Syria, and North Africa, some of who have now migrated to Latin America, holding on to some Spanish/Sephardic customs, such as the Ladino language.

Among the Hispanic Catholics, most communities celebrate their homeland’s patron saint, dedicating a day for this purpose with festivals and religious services. Some Hispanics syncretize Roman Catholicism and African or Native American rituals and beliefs. Such is the case of Santería, popular with Cuban Americans and which combines old African beliefs in the form of Roman Catholic saints and rituals. Other syncretistic beliefs include Spiritism and Curanderismo.

While a tiny minority, there are some Hispanic Muslims in Latin America and the US. In the United States some 70% of U.S. Hispanics report themselves Catholic, and 23% Protestant, with 6% having no affiliation. A minority among the Roman Catholics, about one in five, are charismatics. Among the Protestant, 85% are “Born-again Christians” and belong to Evangelical or Pentecostal churches. Among the smallest groups, less than 4%, are U.S. Hispanic Jews and U.S. Hispanic Muslims. Most U.S. Hispanic Muslims are recent converts.

Retrieved from http://en.wikipedia.org/wiki/Hispanic

Population Information

• It is estimated that Hispanics are the largest minority group in the U.S.
• 98% of Hispanics live in urban areas.
• Hispanics have Indian, European, and African roots; they are very racially diverse.
• Puerto Ricans are US citizens. “Operation Bootstrap” established yearly migration of thousands of Puerto Ricans to agricultural farmlands in the Northeast. From 1970-1990 many Hispanics returned to PR due to a declining US economy; reliance on federal social programs increased. Many in lower socioeconomic strata migrate back and forth to PR, which can be stressful to families and disruptive of healthcare services. This travel back and forth has also resulted in reinforcement of PR culture and development of bicultural identity.
• Colombians have been coming to the U.S. since 1950’s fairly steadily, mainly for economic reasons.
• Dominicans have been migrating to the U.S. since the 1960’s, when the U.S. supported a military coup in their country.
• Many Guatemalans and other Central Americans came to U.S. fleeing political persecution.
• The general U.S. population is aging, but the Hispanic population is increasingly youthful.
• While 29% of the Hispanic population lives below the poverty level, compared to 6.8% of the overall population, this also means that over 70% of Hispanics do not live in poverty. Hispanics have the lowest median family income ($20,516 vs. $39,172). The unemployment rate for Hispanics is almost twice as high as the general population’s rate (13.5% vs. 7.5%).
• Less than half of adults age 25 or older have graduated high school, compared to 72% of the general population.
• About 78% of Hispanics over age 5 speak Spanish at home. About 37% say they speak English poorly or not at all.
• Nationally, Hispanics are four to six times more likely than the general U.S. population to read English below the fourth grade level; many have low literacy in Spanish as well. An individual’s literacy level depends on the person’s socioeconomic background and education.

Names

• Children are often named after relatives or religious figures. The middle name is followed by the father’s last name, which is followed by the mother’s last name. Traditionally, wives keep their maiden names and add on their husband’s names in the following form: maiden name, followed by “of” (de), followed by husband’s last name.
• Some Hispanic surnames are not Spanish. The founding father of Chile was named O’Higgins, and the presidents of Peru, Argentina and Chile have been Fujimori (Japanese), Menem (Syrian) and Aylwin (Welsh).

Family Structures

• Familismo – Hispanics/Latinos tend to view the family as a primary source of support. Families are broadly defined, close knit, and emotionally and financially supportive. Family often includes non-blood-related persons, including compadrazgos (when a couple baptizes the child of another). Some non-Hispanics interpret these family characteristics negatively as over-involvement or dependence.
• The eldest male is typically the authority figure, and gender roles are traditional.
• Important decisions are made by the whole family, not the individual.
• Elders often provide childcare so that children and spouses can work.
• In traditional Hispanic families, children are highly protected and very dependent on their parents. They are expected to live with their parents until they marry. Punishment is often emphasized over positive rewards. Children are taught to avoid confrontations with their parents and older persons, and to be obedient, respectful, and shy.

Communication and Social Interaction

• Personalismo – This refers to the tendency of Hispanics to place utmost value on individuals as opposed to institutions. They tend to trust and cooperate with individuals they know personally, and many dislike impersonal and formal structures. Hispanic customers may identify a health worker by name rather than by job title or institution. In a professional situation, many expect formality in address (Mrs. X), but alsopersonalismo (how are your kids doing in school?). The quality of a social interaction is often seen as more important than length.
• Respeto - The special consideration and respect that should be shown to elders and authority figures within the community. When speaking Spanish, elders should be addressed as usted, not tu.
• Simpatía - This describes many Hispanics’ preference for smooth social relations based on politeness and respect, as well as avoidance of confrontation and criticism. Overt disagreement is not considered appropriate behavior. Some expect offers of gifts or food to follow a pattern of offer, refusal, insistence, and final acceptance, so receivers do not appear greedy or givers insincere.
• Many Hispanics are characterized by warm, friendly, and affectionate relationships. Personal space is close and frequently shared with family members or close friends.
• Some Hispanics may get agitated or emotional when nervous or frightened. They may communicate intense emotion and appear quite animated in conversations – a behavior that is sometimes misperceived by non-Hispanics as being “out of control”. Latinos’ voice pitch and inflections are sometimes misinterpreted as confrontational. Many are very loud and outspoken in expressing pain.
• Many Hispanics, particularly if they were not raised in the U.S., may avoid direct eye contact with authority figures or in awkward situations.
• Many will nod affirmatively but not necessarily mean agreement. Silence may mean failure to understand and embarrassment about asking or disagreeing.
• Many may understand English better than they can speak it, especially under stress.
• Modesty and privacy are important. Stigmatized health issues should be discussed through an interpreter and not family members. When a family member is used as interpreter, if the issue is personal, try to use a family member of the same gender. Sexuality issues are hard to discuss. Often the word for sex (sexo) is not even used - tener relaciones (to have relations) is used instead.

Time Orientation

• Time and punctuality may be flexible. Social gatherings are often expected to start later than the announced time.
• Many Hispanics are averse to a hurried pace, especially given the expectation of personalismo.

Health Beliefs and Practices

• Health is generally viewed as: being and looking clean; being able to rest and sleep well; feeling good and happy; having the ability to perform in one’s expected role as mother/father, worker, etc. In Puerto Rico, the phrase llenitos y limpios (clean and not too thin) is used.
• A person’s sense of bienestar (well-being) is thought to depend upon a balance in emotional, physical, and social arenas. Imbalance may produce disease or illness. Some attribute physical illness to “los nervios”, believing
• illness results from having experienced a strong emotional state. Thus, they try to prevent illness by avoiding intense rage, sadness, and other emotions.Depression is not talked about openly; a person may say, “I am sad” (triste).
• Eating well and drinking fruit juices are common health promotion practices. Exercise is often not perceived as a health promotion practice and is discouraged during illness. As with other issues, this will vary by educational level.
• Individuals may not seek help until they are very sick.
• Hispanic cultures view illnesses, treatments, and foods as having “hot” or “cold” properties, although how these are ascribed may vary by country.Some consider health as the product of balance among four body humors (blood and yellow bile are “hot”, phlegm and black bile are “cold”). One would balance a hot illness with cold medications and foods, etc. This might result in not following a doctor’s advice to drink lots of fluids for a common cold, if one believes such drinks add more coldness to body. Instead, hot liquids (teas, soups, broth) could be recommended. Colombians often use meat broth instead of chicken soup when sick; also drink agua de panela (unprocessed sugar and water) for respiratory/flu symptoms.
• Prevention strategies could build on this concern for balance – e.g., adopt a balanced diet to prevent diabetes and other diseases associated with overweight.
• Some common illnesses and their accepted causes:

Ataque – severe expression of shock, anxiety, sadness

Bilis – vomiting , diarrhea, headaches, dizziness, migraine, nightmares, loss of appetite, inability to urinate, brought on by livid rage and revenge fantasies.Believed to stem from bile pouring into bloodstream in response to strong emotion.

Empacho – lack of appetite, stomachache, diarrhea, vomiting, caused by poorly digested or uncooked food. Treated by massaging the stomach and drinking purgative tea, or by azarcon or greta, medicine that has been implicated in some cases of lead poisoning.

Mal de ojo (evil eye) – Vomiting, fever, crying, restlessness, brought on by an admiring or covetous look from a person with an evil eye. Children susceptible. Preventable by wearing particular jewelry.

Pasmo – tonic spasm of voluntary muscle; chronic cough or stomach pain; arrest of child’s growth and development, all brought by exposure to cold air when body is overheated.

Susto (fright) – anorexia, insomnia, hallucinations, weakness, painful sensations, brought on by traumatic experiences. Treatment may include a barrida (spiritualistic cleansing by sweeping body with eggs, lemons, bay leaves), herb tea, prayer.

Asthma may be called fatiga by Puerto Ricans.

Health Promotion, Prevention, and Treatment

• Preventative medicine is not a norm for most Hispanics. This behavior may be related to the Hispanic “here and now” orientation, as opposed to a future-planning orientation.
• Some commonly known Hispanic sayings suggest that events in one’s life result from luck, fate, or other powers beyond an individual’s control.
  do not appear greedy or givers insincere.
  Que será, será (What will be will be);
  Que sea lo que Dios quiera (It’s in God’s hands);
  Esta enfermedad es una prueba de Dios (This illness is a test of God);
  De algo se tiene que morir uno (You have to die of something).
• Persons with acute or chronic illness may regard themselves as innocent victims of malevolent forces. Severe illness may be attributed to God’s design or bad behavior or punishment. Genetic defects in child may be attributed to parents’ actions.
• Family and friends may indulge patients, allowing them to be passive – a stance that may conflict with the view that active participation is required to prevent or heal much disease.
• Other Hispanic sayings support health promotion, and illustrate the considerable status given to health and prevention:
  La salud es todo o casi todo (Health is everything, or almost everything);
  Es mejor prevenir que curar (An ounce of prevention is worth a pound of cure);
  Ayúdate que Dios te ayudará (Help yourself and God will help you).
• “Helping yourself” may lead to placing responsibility for cure with the entire family. The challenge for health professionals is to assess the amount of control patients believe they have over their health and to design interventions that build on traditional support systems.
• Vaccination is very important and adhered to for children.
• Western medicine is expected and preferred in case of severe illness, but some Hispanics may also use native healers. Curanderos utilize prayers,massage, and herbs to treat physical, spiritual, and emotional ailments.Espiritistas are believed to have spiritual or psychic powers to cure illness by communicating with dead souls.
• A “botanica” is a resource store for herbs and other traditional remedies. Some Hispanics may go there before going to a physician or clinic. In many Latin American countries, pharmacists prescribe medications, and a wider range of medications is available over the counter. People may share medicines, or write home for relatives to send them medications. Individuals may discontinue medication if it doesn’t immediately alleviate symptoms, or after their symptoms abate. Many believe taking too much medicine is harmful.
• Due to history, some Hispanics may distrust the health system (many Puerto Rican women experienced involuntary sterilization, or were adversely affected by birth control pill trials), or view it as an extension of a repressive government (Central Americans), or fear it as a point of contact with immigration authorities. Some may confuse public health programs with welfare and avoid them due to stigma.

Health Status

• The five leading causes of death for Hispanics are: cancer, heart disease,homicide, AIDS, and unintentional injuries. For the general population they are: heart disease, cancer, stroke, chronic lung diseases, pneumonia and influenza.
• Nationally, Hispanics are about twice as likely to have non-insulin dependent diabetes than are non-Hispanic whites, and are more likely to have undiagnosed diabetes.
• Hispanic men are more likely to have undiagnosed, untreated, or uncontrolled hypertension than the national average.
• Incidence of AIDS among Hispanics is 4 times more likely than among the general population. Cases of gonorrhea are 2 times more prevalent.
• The incidence of tuberculosis for Hispanics is 5 times greater than for the general population (17.5% vs. 3.5). Some patients may mistake the tuberculin test for a vaccine, and not realize the importance of medical follow-up. Some authorities recommend arranging for the reading of results of the test at work or school, for the client’s convenience. Also, the use of the Bacillus Calmette-Guerin (BCG) vaccine in many Latin American countries may complicate the clinical detection of tuberculosis infection among Hispanics.

Behavioral Health Risk Factors

• Hispanics are less likely than the general population to smoke (20.3% vs. 22.4%). Some authorities attribute this to the low incidence of smoking among Hispanic women. One researcher states that Hispanics are more likely to smoke in social settings rather than in response to “need” or nicotine addiction.
• Hispanics are less likely than the general population to be overweight, but more likely to be obese.
• Hispanics are a third less likely than the general population to exercise regularly (30.4% vs. 45%), and engage in less leisure-time physical activity.One researcher notes that a high percentage of Hispanics work in manual labor that does not contribute to aerobic fitness.
• Hispanics are more likely than the general population to eat 5 servings of fruits and vegetables per day (29% vs. 24%).
• Hispanics are nearly 50% less likely to drink alcohol than the general population.
• Hispanics are more likely than the general population to use safety belts or child safety restraint (81% vs. 76%).

Health Screening

• Women participate in more screening activities than men. Women’s breast and pelvic cancer screening procedures may be seen as intrusive and embarrassing, thus may be delayed or not done.
• Many Hispanic men are resistant to the concept of health screening. Wives may be very influential in men’s screening decisions. Elderly might be influenced by children. Health screening recommendations for children are generally followed.

Maternal and Child Health

• The birth rate of Hispanics is about twice as high as for the general population (116.4 vs. 57.5 per 1000 women ages 15-44).
• A greater percentage of Hispanic mothers than all mothers deliver babies without prenatal care in the first trimester. (14.8% vs. 10.3%). Yet the rate of low birth weight babies is only slightly higher in the Hispanic population (6.8% vs. 6.3%)
• Hispanic teenagers ages 14-18 are over 3 times as likely to give birth than all teenagers in the general population.
• Hispanic babies are over 3 times as likely to be born into poverty (78.1% vs.25.5% for general population).
• Breastfeeding is less common among Hispanic women than among non-Hispanic whites. Many Latin American women believe colostrum is harmful for babies.

Diet and Food Practices

• The typical diet is high in fiber, relying heavily on beans and grains (rice)rather than on meats for protein.
• Leafy green vegetables are not a usual part of the diet.
• Relatively little intake of dairy products. Milk is consumed in coffee.
• Generally eat a lot of tropical fruits, fruit juices, and starchy root vegetables(e.g., potatoes, cassava, plantains). Sofrito (blend of spices) is used to season stews.
• Puerto Ricans do not typically eat tortillas. More than 100 varieties of herbal teas are used to treat illness and promote health. For colds, flu and viruses, many use a mixture of honey, lemon and rum as an expectorant and antitussive. Egg yolk, sugar, and milk, malta, or fruit juices may be used as nutritional support for illness.

Retrieved from http://www.health.state.ri.us/chic/minority/lat_cul.php

The Hispanic Family

The family is a complex and important social structure in any population, but it is especially complex and increasingly important in the Hispanic population. Latinos account for all of the growth in the number of young adults, those of prime marrying and childbearing years. Indeed absent the Hispanics, the U.S. population would be shrinking in the 20- to 35-year-old age bracket. The prime sources of Hispanic population growth are immigration and high fertility among immigrants. As a result, marriages, childbearing, and household formation often take place in the cauldron of change that is migration. For most Latinos, families are made and broken amid transformations in culture, economic footing, civic status, and identity. Any consideration of policy consequences has to take account of this very powerful, very particular context.

Hispanics are a diverse people, and rapid demographic growth is making them only more diverse. Immigrants come with a range of talents and abilities. They come from a variety of places, and they come under a variety of circumstances. Once in the United States some live in densely Latino communities where civic society and public institutions geared towards the immigrant experience are well-established while others venture into new settlement areas where Latinos are a sparse presence. Meanwhile, the social, political, and legal backdrop is shifting as the host society comes to terms with the influx of newcomers. And finally, aside from immigrants and their offspring, there are also many millions of Latinos who trace their roots in this country back multiple generations and who have their own varied expressions of American culture and mores.

Summary

By virtue of its size, growth, and relative youth, the Hispanic population will have a growing impact on all policy matters related to the family. This impact will be large and distinctive. The growth of the Hispanic population has already slowed the decline of the two-parent family in the United States as immigration produces a steady flow of young adults with a higher propensity to marry than their native-born peers, both Latino and non-Latino. But, immigration, particularly under current policies, is also producing a disproportionate number of Hispanics who are geographically separated from their spouses. The dynamics shaping the Hispanic family are both complex and fluid. Within the Hispanic population there are notable differences in the prevalence of some key behaviors. Of greatest concern is the finding that births to women who are unmarried are more common among native-born Latinos than foreign-born Latinos. Such differences are especially significant for the long term because a large and growing share of the youth population is made up of the native-born children of immigrants. Survey data show that a powerful process of acculturation is taking place among immi-grants and their offspring which produces an erosion of the strong sense of family evident among recent immigrants in favor of attitudes similar to those of non-Latinos in the U.S. population.

Retrieved from http://www.brookings.edu/papers/2007/11_hispanicfamily_suro.aspx

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Health Institute, Boston, MA (617) 350-6900.