Prevention Outreach to Hispanic Community Ligia Gómez Maritza Maldonado Dyer
Prevention Outreach to Hispanic Community 1. Overall and cultural issues in the Hispanic Community 2. Addictions, prevention, services 3. Cases
Hispanic and Latino The Census Bureau's 2010 census does provide a definition of the terms Latino or Hispanic and is as follows: Hispanic or Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
The U.S. and Immigrants Immigrants and their descendants constitute the majority of the population of the U.S.
Why We Immigrate?
Why we immigrate? Pushing Factors: Poverty War and violence Political instability Natural disasters Lack of basic services
Immigrants to the U.S. PULL FACTORS Better future for their kids Higher standard of living Employment Education Access to Health Care Peace and freedom Promise of a better life
Demographics 55 MM Hispanic/Latinos in the U.S. (Pew Hispanic Center; 2014) Largest U.S. Minority Fastest growing minority; at current rate: By 2020, 1 in 5 people in U.S. will be Hispanic or Hispanic descendant By 2050, 25% of U.S. will be Hispanic. (U.S. Census, 2000)
Distribution of Hispanics in USA
Demographics Ohio's Hispanic/Latino population has grown by 63.4% since 2000 - Accounting for 350,000. -3.4%, of Ohio's total population. (U.S. Census Bureau)
Hispanics in the Cincinnati Area >65,000 Hispanic/Latinos in Cincinnati region (8 counties). Almost half of Cincinnati area Hispanics (20,000) are under age of 18 Source: Center for Family and Demographic Research, BGSU
Hispanics in the Cincinnati Area Most are from Mexico and Guatemala Areas of concentration: Springdale, Hamilton, Sharonville, Norwood, Fairfield, Lower Price Hill, Forest Park, Covington, Florence.
Hispanic/Latino immigrant population Immigrant population is not homogenous: wide range of historical, cultural experiences and socioeconomic status Share language and some cultural characteristics Each nationality has its own historical perspective that affects how they view themselves.
Hispanic Culture Culture is the sum of beliefs, practices, habits, customs, rituals and so forth that are passed to us by our families and society
Core Values of Hispanic/Latino Cultures La Familia (Family) Respeto (Respect) Personalismo (Personal relationships) Confianza (Trust) Spirituality (Fatalismo)
La familia (family): the most important social unit Include parents, grandparents, siblings, aunts, cousins, compadres (close friends), godparents (padrinos) Emphasize interdependence over independence, cooperation over competition
Medical Decisions Mother is consulted for medical decisions Other family members are consulted Medical decisions based on faith & other s opinions
Respeto Dictates appropriate behavior towards others based on age, sex, social position, economic status and authority. Health providers are given a high level of respect. Elders are highly respected.
Respeto Yes to everything No questions asked No eye contact Wife may look at partner for answer Fail to report home remedies
Personalismo Personal rather than institutional relationships Closer physical space Attuned to non verbal messages When the provider shows respect for the culture and shows personal interest wins their confianza (trust)
Acculturation Process by which immigrants adopt the attitudes, values, customs, beliefs and behaviors of a new culture Acculturation is complex and multidirectional How do immigrants respond to acculturation pressure: Retain culture of origin without attempting to integrate: segregation Abandon culture of origin: assimilation Retain heritage while integrating into the mainstream culture: biculturation
The Impact of Acculturation level: Low Acculturation Cultural marginality Environment is frightening, confusing, overwhelming Depression Familial isolation Social withdrawal Despair Anxiety
The Impact of Acculturation level: High Acculturation Negative health behavior and mental problems Assumption of host country behaviors: poor diet, teen pregnancy, and school dropout Higher rates of depression and suicide
The Impact of Acculturation level: Biculturalism Maintenance of culture of origin while acquiring the second culture. Bicultural individuals report the most adaptive behaviors with higher levels of: Quality of life Psychological Adjustment Family commitment and Support Socialization
Barriers to Services Language Lack of health insurance Education Poor understanding of U.S. systems Poverty Transportation Immigration status Limited knowledge of resources Work schedule
Barriers to Services: Language Barrier Over 24 million individuals speak English less than very well and are thus said to be limited English proficient (LEP).
Barriers to Services: Poor Understanding of US Systems Complex systems in our society become barriers to obtain services Differences in the health care system and its structure makes it it very difficult to navigate Lack of personal contact
Barriers to Services: Transportation No reliable public transportation in the city to reach services Undocumented immigrants cannot have driver s licenses Reliance on neighbors or family for rides Those that do drive limit the distance Risks associated with walking
Barriers to Services: Immigration status Undocumented immigrants are not eligible for most government benefits Fear of applying for benefits (cash assistance or food stamps) for their American children because of the misconception of: Having to pay back to the government Their children can be taken away by the government They never will be able to obtain a legal status Mixed status families Status impacts access to high education Unaccompanied minors
Barriers to Services: Limited knowledge of resources Because of language barriers and lack of network and cultural isolation, new immigrants are not aware of services they could be eligible for. Knowledge of charitable resources or those government funded, are reachable by word of mouth.
What can we to support the Hispanic Community Be aware of our own biases Respect cultural concepts as long as they don t jeopardize their health or well being. Be patient, observant and compassionate, go the extra mile. Advocate for professional interpretation in community service settings.
What can we to support the Hispanic Community Allow extra time for teaching Use different teaching techniques; visual, written, verbal Ask questions to evaluate understanding Ask questions to clarify customs/wishes Be aware of your body language Explain Plan of Care
PREVENTION OUTREACH IN THE HISPANIC COMMUNITY Maritza Maldonado-Dyer, CDCA Clinical Specialist Addiction Services Council 2828 Vernon Place Cincinnati, OH 45219 maritzad@addictionservicescouncil.org 513-281-7880 (w) 513-313-7616 (c)
Prevention Outreach to Hispanic Communities What Factors Predict Drinking Behavior in the Hispanic Community? Acculturation is the process of adapting to the beliefs, values, and behaviors of a new culture. A critical factor in predicting drinking patterns in the Hispanic community is level of acculturation. Living and working in the United States, raising families here, speaking English, and above all, getting an American education all contribute to adapting to American culture. But as acculturation levels increase, so can alcohol consumption. The evidence is clear that as women become acculturated to American life, they tend to drink more alcohol. There is mixed evidence of the same effect for men.
PREVENTION OUTREACH TO THE HISPANIC COMMUNITY What are the reasons for use according to my experience: Acculturation Lost of Identity Isolation/Separation/ Loneliness Depression Mental Health Family History Lack of Work or to much work Anxiety Fears of Deportation Lack of Support Stressors Language/lost of language Family issues and change of life-style Leaving country of origin Family separation
PREVENTION OUTREACH TO THE HISPANIC COMMUNITY What could we do differently. Tailor Programs that are specifically designed for this population Creating programs that addressed, acculturation, society in this new system of living. A program that addresses and fits there needs. Teach on Alcohol and other Drugs Think out of the Box Be creative Attend Coalitions that will support you your clients Support groups Ask for longer time/assessments Learn the culture
WHEN I WAS PUERTO RICAN LOST IDENTITY A few days after we arrived in Brooklyn I learned that, by virtue of being in the United States I was Hispanic, a word I d never heard in Puerto Rico, and had certainly never applied to myself or to anyone I Knew. Later I learned that people from Spanish speaking countries (though not Spaniards) were also called Latinos. It was hard to convey the terror that those two words made me feel when I was first told that I was a Hispanic, or a Latina. It was as if a label were pasted on my forehead, placed there for the benefit of others, to make it easier for them to identify me, saving them the energy to get to know me. I am from Puerto Rico, a real place with its own culture and historical perspective. The words Hispanic and Latina take away from my place of birth. Esmeralda Santiago
Scenario A Guatemalan mother of 3 children who does not speak English called the office to indicate that the school had referred her to your agency to see how you could help her with her 14-year-old son (who is bilingual both in English and Spanish and was born in USA) who she caught drinking in his room. Her son s school directed her to your facility to see how she could be helped. You take this triage call. She reports the following: She reports that she caught her 14-year-old hiding alcohol in his room. She indicates that as she was washing the dishes, she heard her son vomiting in the bathroom, when she went to check on him, she could smell alcohol. She asked him if he had been drinking, which he replied yes that he had been drinking in his room. She reports, that she was very concerned and wants to get him help as soon as possible before this continues and gets worse. What are the main components that need to be in place in order to provide the appropriate support? How would your strategy look like to support the family and to provide an accurate Diagnosis and level of care?
WE ALL PLAY A PART IN SOCIETY, WHAT PART ARE YOU COMMITTED IN PLAYING? This Photo by Unknown Author is licensed under CC BY-SA
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