Imagine you are planning a health intervention for a certain group. The first step is to know your intended audience.
Skim through Spector (2017) chapters 9-13, and select ONE racial/ethnic group, which is DIFFERENT from your own or that of your partner or spouse. This should be a group with which you are not very familiar; so, after reading the chapter, you will have more insight into the population than you do so now.
Carefully review the chapter in Spector (2017) that matches the racial/ethnic group that you have chosen; in other words, you only review ONE chapter out of the five possible options.
If you choose to review chapter 9, 11, or 13, then please pay close attention to disparities in income (poverty), age, and gender.
If you choose to review chapters 10 or 12, then please pay close attention to issues of immigration, age, gender, and poverty.
Write a 2-4 page paper using APA 7th edition format (double space, cite sources in paper and as references, paragraph format, free from spelling/grammatical errors) addressing the following:
State which population you chose and summarize (put in your own words while citing the textbook) just five of the eleven sectionslisted below. Make these very clear so I can easily identify your answers.
(1) brief background and history of the population; (2) traditional definitions of health and illness; (3) traditional methods of health maintenance, protection, and restoration; (4) folk medicine and/or religion, alternative health practices, and rituals; (5) other notable health practices; (6) current health problems; (7) racial disparities in care; (8) views on mental health and/or views on mental health by gender; (9) access to the health care system and/or access to the health care system based on immigration status; (10) special considerations for health care providers; and (11) any additional notable issues you would like to mention. NOTE: Be sure to include info on age, gender, poverty, and immigration (See Above).
Provide your feedback and analysis as a health care practitioner based on what you have learned in the chapter that you reviewed. Here’s how:
If you were to plan a health intervention to address one issue mentioned in the chapter, what additional tools and resources do you think you would need in order to be successful?
What makes planning interventions for a different race/ethnicity/culture both rewarding and challenging at the same time? Feel free to be honest here and use your critical thinking skills.
What is the one greatest insight you had after reviewing this chapter based on another racial, ethnic, or cultural group other than your own.
List the textbook and any other sources you used as references at the end of the paper using APA 7th edition format.
Cultural Diversity in Health and Illness
Ninth Edition
Chapter 9
Health and Illness in the
American Indian and
Alaska Native Population
Copyright © 2017, 2013, 2009 Pearson Education, Inc. All Rights Reserved
Figure 9-1 Beadwork – The Circle Is Divided into
Four Quadrants That Represent the Directions
North, South, East, and West
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Figure 9-2 Sage – A Sacred Plant Commonly Used in
Ceremonies to Purify a Setting (Such as Room,
Entire Home, or Store) or a Person
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Figure 9-3 “Burial Moon,” by Philip Young,
Illustrates a Traditional Way of Burying People
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Learning Objectives (1 of 2)
9.1 Discuss the historical and demographic backgrounds of
the American Indianand Alaska Native population.
9.2 Describe the traditional definitions of health and illness
of the American Indian and Alaska Native population.
9.3 Explain the traditional methods of healing of the
American Indian and Alaska Native population.
9.4 Discuss the practice of a traditional healer.
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Learning Objectives (2 of 2)
9.5 Describe current healthcare problems of the American
Indian and Alaska Native populations.
9.6 Summarize the services rendered by the Indian Health
Service
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Demographic Overview: Census 2014
Estimates (1 of 2)
• 5.4 million people
• 1.2% U.S. Population
• 566 Federally recognized tribes (1/2015)
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Demographic Overview: Census 2014
Estimates (2 of 2)
• American Indian or Alaska Native
– Refers to a person having origins in any of the original
peoples of North and South America (including
Central America) and
– Who maintains tribal affiliation or community
attachment.
▪ This category includes people who indicated their
race(s) as “American Indian or Alaska Native” or
reported their enrolled or principal tribe, such as
Navajo, Blackfeet, Inupiat, Yup’ik, or Central
American Indian groups or South American Indian
groups.
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Background
• Must be known as Nations within the United States
• Land issues
• Broken treaties
• Citizenship
• American Indian Movement
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Largest American Indian Nations
• Cherokee
• Navajo
• Latin American Indian
• Choctaw
• Sioux
• Chippewa
• Largest Alaska Native group – Eskimo
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Health
• Living in total harmony with nature
• The ability to survive difficult situations
• Relationship with the earth
– Earth may be healthy or less healthy.
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Illness
• Reason for every Illness
• Associated with evil spirits
• Disharmony with nature
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Selected Causes of Illness
• Displeasing holy people
• Annoying the elements
• Disturbing animal and plant life
• Neglecting celestial bodies
• Misuse of ceremony
• Tampering with witches
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Types of Illness
• Contagious diseases
– Measles
– Smallpox
– Diphtheria
– Syphilis, and gonorrhea
– Generalized illnesses
• Body fever
– Body ache
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Diagnosis
• Motion in the hand
• Sand paintings
• Chanting
• Stargazing
• Listening
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Traditional Remedies
• Purification
– Cleanse body and spirit
– Total immersion
– Controls consciousness
– Prepare for meditation
• Sweat lodges
• Herbal remedies
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Selected Traditional Remedies
Illness
Remedy
Colds
Witch Hazel
Sore Throat
Comfrey
Diarrhea
Elderberry flowers
Headache
Tansy and sage
Ear Infection
Skunk oil
Mouth sores
Dried raspberry leaves
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Healers
• Medicine man or woman
– Power developed from solitary vision quests and
fasts.
– Acquisition of full shamantic powers takes many
years.
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Current Healthcare Problems
• American Indian and Alaska Native people have long
experienced lower health status when compared with
other Americans.
– Lower life expectancy
– Disproportionate disease burden
• Related to:
– Inadequate education.
– Disproportionate poverty.
– Discrimination in the delivery of health services.
– Cultural differences.
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Morbidity
• Life expectancy is 2.4 years less than the U.S. all races
population.
• Infant mortality rate of nearly 10 per every 1,000 live
births
• Higher incidence of diabetes, tuberculosis, homicide, and
suicide
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Comparison of Selected Health Status Indicators:
2013 All Races and American Indians /Alaska
Natives
All Races
American Indians
and Alaska Natives
Crude birth rate per 1,000 population
12.4
10.3
Infant mortality per 1,000 live births,
2012
6.0
8.4
Respondent-reported prevalence
percent of adults: Cancer—all sites,
2012–2013, 18 years and over
5.9
4.3
Male death rates from suicide, all
ages, age adjusted per 100,000
resident population, 2013
20.3
18.1
Male death rates from homicide, all
ages, age adjusted per 100,000
resident population, 1999-2003
8.2
8.2
blank
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Mental Illness
• Ghost sickness
• Preoccupation with death and a diseased person
• Associated with witchcraft
• Symptoms
– Bad dreams
– Weakness
– Feelings of danger
– Loss of appetite
– Confusion
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Alcoholism
• Consequences
– Unintentional injuries
– Chronic liver disease
– Cirrhosis
– Suicide
– Homicide
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Fetal Alcohol Syndrome (1 of 2)
• Abnormal browth
• Central nervous system problems
– Learning disabilities
– Behavioral and/or mental problems
– Abnormal sleeping and eating patterns
• Specific facial deformities
– Smooth philtrum
– Thin vermillion border
– Small palpebral fissures
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Fetal Alcohol Syndrome (2 of 2)
• 70,000 babies born per year.
• Many are American Indians.
• Problem is increasing.
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Domestic Violence
• Physical assault by a husband, boyfriend, or some
significant other
• Subsequent episodes of abuse tend to get worse.
• Traditionally, violence toward women was not practiced.
• Presently, sanctions and protections against domestic
violence have decreased.
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Urban Problems
• More than 70% of American Indians live in urban areas
• High rates of:
– Diphtheria
– Tuberculosis
– Otitis media with subsequent hearing defects
– Alcohol abuse
– Inadequate immunization
– Mental health problems
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Indian Health Service (1 of 2)
• Provides a comprehensive health service delivery service
delivery system for American Indians and Alaska Natives
– Members of the 566 federally recognized tribes
• Divided into 12 physical areas of the United States
• Eligibility Limitations
• Interfaces with the Affordable Care Act
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Indian Health Service (2 of 2)
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Available Services
• Tribal health
– Direct services for physical and mental health
• Law enforcement
– Police protection may be necessary.
• Legal assistance
– Assistance for immediate shelter and emergency food
and transportation
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The 10 Leading Causes of Death for American
Indians and Alaska Natives and for All Persons,
2013
American Indians and Alaska
Natives
All Persons
1. Diseases of heart
2. Malignant neoplasms
3. Unintentional injuries
4. Diabetes mellitus
5. Chronic liver disease and cirrhosis
6. Chronic lower respiratory disease
7. Cerebrovascular diseases
8. Suicide
9. Influenza and pneumonia
10. Nephritis, nephrotic syndrome, and
nephrosis
1. Diseases of heart
2. Malignant neoplasms
3. Chronic lower respiratory diseases
4. Unintentional injuries
5. Cerebrovascular diseases
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephrotic syndrome, and
nephrosis
10. Suicide
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Cultural Problems
• Indians
– Suffer disease when they come into contact with the
White health care provider.
– Are victims of haphazard care and disrespectful
treatment.
– Have conflict between person’s perception of illness
and what physician diagnoses.
– Dislike long appointment waits.
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Communication Problems
• Provider Must be aware of:
– Importance of non-verbal communication.
– Expectation to deduce the problem.
– Avoiding extensive questioning.
▪ Seen as invasive
– Need for quiet conversation.
– Notetaking taboo.
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Copyright
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Cultural Diversity in Health and Illness
Ninth Edition
Chapter 10
Health and Illness in the
Asian Population
Copyright © 2017, 2013, 2009 Pearson Education, Inc. All Rights Reserved
Figure 10-1 Amulet – Hung in the Home or
Workplace to Maintain Balance in the Space and
Bring Good Luck and Health to the People Living or
Working There
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Figure 10-2 Dragon – Appears on January 1, the
Chinese New Year, and Other Festive Occasions;
Brings Physical as Well as Spiritual Health and
Strength, Luck, and Prosperity, and Happiness
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Figure 10-3 Smiling Buddha – a Powerful
Spiritual Symbol for a Shrine
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Learning Objectives (1 of 2)
10.1 Discuss the historical and demographic background of
the Asian American population.
10.2 Describe the traditional definitions of health and illness
of the Asian American population.
10.3 Explain the traditional methods of healing of the Asian
American population.
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Learning Objectives (2 of 2)
10.4 Describe the practice of a traditional healer.
10.5 Summarize current healthcare problems of the Asian
American population.
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Demographic Overview: Census 2014
Estimates
• 18.9 million people
• 5.3% U. S. Population
• Asian
– A person having origins in any of the original peoples
of the Far East, Southeast Asia, or the Indian
subcontinent
– Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and
Vietnam
– Hawaii, 60.9% Asian
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Background
• Chinese immigration began over 150 years ago
– Laborers
▪ Met the needs of the dominant society
– Mainly men
• Discrimination
– Did not have the same culture, language, habits of
whites
• Close knit communities
– Chinatown
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Asian Religions’ Teachings (1 of 2)
• Buddhism
– Harmony/nonconfrontation (silence as a virtue)
– Respect for life
– Individualism is devalued.
• Confucianism
– Achievement of harmony through observing the five
basic hierarchical roles and relationships of society,
and importance of family.
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Asian Religions’ Teachings (2 of 2)
• Taoism
– Harmony between humans and nature
– Charity
– Happiness
– Long life
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Health
• A state of spiritual and physical harmony with nature
– In ancient China, the task of the physician was to
prevent illness.
• Foundation rests in the religion and philosophy of
Taoism.
• Harmonious balance
– Balance of Yin and Yang
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Holistic Concepts
1. A human body is regarded as an integral organism, with
special emphasis on the harmonic and integral
interrelationship between the viscera and the superficial
structures.
2. Special attention is paid to the integration of the human
body with the external environment.
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Yin and Yang (1 of 2)
• Female
– Negative energy
– Forces of darkness, cold, and emptiness
• Male
– Positive energy
– Produces light, warmth, and fullness
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Yin and Yang (2 of 2)
• Inside of body
• Front of body
• Gallbladder, stomach, large and small intestines, bladder
• Diseases of winter and spring
• Surface of body
• Back of body
• Liver, heart, spleen, lungs and kidney
• Diseases of summer and fall
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Illness
• Disharmony of yin and yang
• Disturbances of vital energy and blood
• Malfunctioning of the visera
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Selected Causes of Illness
• Upset in the balance of yin and yang
• Weather
– Heat – injures heart
– Cold – injures lungs
• Overexertion
• Prolonged sitting
• Prolonged lying in bed
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Types of Diagnosis (1 of 2)
• Inspection
– Glossoscopy
▪ Examine tounge
– Osphretics
▪ Listen and smell
– Anamnesis
▪ Ask questions
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Types of Diagnosis (2 of 2)
• Palpitation
– Sphygmopalpitation
▪ Feel the pulses
– Pulse
▪ “Storehouse of the blood”
▪ Six different pulses in each hand
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Chinese Medicine (1 of 2)
• Emperor Shen Nung
– Died 2697 BC
– “Red Emperor”
– Studied herbs – poisons and antidotes
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Chinese Medicine (2 of 2)
• Huang-ti
– Ruled 2697 to 2595 BC
– “Yellow Emperor”
– Studied medicine
– Wrote the Nei Ching
▪ Characteristics and realm of Chinese medicine
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Health Maintenance and Restoration
• Diet
• Amulets
• Folk Diseases
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Traditional Health Restoration
• Acupuncture
– Puncture body’s meridians with small needles to treat
symptoms
• Moxibustion
– Heat pulverized wood and pass above the skin
• Cupping
– Remove cold and damp “evils” from the body
• Herbals
– Many remedies available
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Accupuncture
• Ancient practice of puncturing the body to cure disease or
relieve pain
• Earliest use
– 106 BC to 200 AD
• Needles inserted in specific meridians
• Generally considered safe
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Other Modalities
• Moxibustion
– Heat is applied to the meridians using mugwart and
holding over the skin.
• Bleeding
– Use of leeches to remove heat from the body
• Massage, Tui Na
– “Pushing and pulling” complex system of massage
used in orthopedics
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Cupping (1 of 2)
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Cupping (2 of 2)
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Traditional Herbal Remedies
Remedy
Illness
Deer Antlers
Weak bones
Lime calcium
Clear excessive mucus
Quicksilver
Venereal diseases
Rhinoceros horns
Antitoxin for snake bites
Turtle shells
Remove gallstones
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Ginseng (1 of 2)
• Derived from the root of a plant that resembles a man
• Uses:
– To stimulate digestion
▪ Rub ginseng to a powder, mix with the white of an
egg, and take three times per day.
– As a sedative
▪ Prepare a light broth of ginseng and bamboo
leaves.
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Ginseng (2 of 2)
• Uses:
– For faintness after childbirth
▪ Administer a strong brew of ginseng several times
a day.
– As a restorative for frail children
▪ Give a dash of raw, minced ginseng several times
per day.
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Chinese Pharmacy (1 of 2)
Figure 10-5A Interior of a Chinese pharmacy; herbal
prescription on counter.
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Chinese Pharmacy (2 of 2)
Figure 10-5B Weighing herbs for a prescription.
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Healers
• Chinese Doctor
– Highly educated in traditional diagnosis and therapy
• Herbalist
– Asian pharmacy
▪ Over the counter medications
▪ Prescription
▪ Preparation
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Ayurvedic Medicine
• The science of life
• Originated in India 3,000+ years ago
• Holistic
– Integrates body, mind, and spirit
• People, health, and the universe are related
• Food and diet important components
• Main system of health care in India
• Variations in Pakistan, Nepal, Sri Lanka, and Tibet
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Comparison of Selected Health Status Indicators:
2013 All Races and Asian or Pacific Island
Blank
All Races
Asian or
Pacific Island
Crude birth rate per 1,000 population
12.4
14.3
Infant mortality per 1,000 live births, 2012
6.0
4.1
Respondent-reported prevalence percent of
adults: Cancer—all sites, 2012–2013, 18
years and over
5.9
3.4
Male death rates from suicide, all ages, age
adjusted per 100,000 resident population,
2013
20.3
9.1
Male death rates from homicide, all ages,
age adjusted per 100,000 resident
population, 1999-2003
8.2
2.3
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Cultural Problems
• Language difficulties
• Adherence to traditional practices
• Upset by blood drawing
– Believe blood is not replaced
• Institutional food
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Communication Problems
• Provider Must be aware of:
– Importance of non-verbal communication
– Use of interpreters who speak the native language
and dialect of patient
– Meaning of non-commital silence
– Infrequent revelation of pain
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Mortality: 2013 (1 of 4)
Asian or Pacific Islander
1. Malignant neoplasms
2. Diseases of the heart
3. Cerebrovascular disease
4. Unintentional injuries
5. Diabetes mellitus
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Mortality: 2013 (2 of 4)
6. Influenza and pneumonia
7. Chronic lower respiratory diseases
8. Alzheimer’s disease
9. Nephritis, nephroitic syndrome, and nephrosis
10. Suicide
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Mortality: 2013 (3 of 4)
All persons
1. Diseases of the Heart
2. Malignant neoplasms
3. Chronic lower respiratory diseases
4. Unintentional injuries
5. Cerebrovascular disease
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Mortality: 2013 (4 of 4)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephroitic syndrome and nephrosis
10.Suicide
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Copyright
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Cultural Diversity in Health and Illness
Ninth Edition
Chapter 11
Health and Illness in the
Black Population
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Figure 11-1 African Amulet – May Be
Worn for Health Protection
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Figure 11-2 Islamic Amulet – May Be Worn in a
Satchel as a Necklace or Carried in a Pocket or
Purse for Health Protection
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Figure 11-3 St. George Beth El Church in Flint,
Michigan. The Sign over the Door Proclaims, “The
Church Where Everybody Is Somebody.”
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Learning Objectives (1 of 2)
11.1 Discuss the historical and demographic backgrounds
of the Black or African American population.
11.2 Describe the traditional definitions of Health and
Illness of the Black or African American population.
11.3 Explain the traditional methods of Healing of the
Black or African American population.
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Learning Objectives (2 of 2)
11.4 Describe the practice of a traditional Healer.
11.5 Analyze current healthcare problems of the Black or
African American population.
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Demographic Overview: Census 2014
Estimates (1 of 2)
• 44.5 million people
• 13.2% U.S. population
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Demographic Overview: Census 2014
Estimates (2 of 2)
• Black or African American
– Refers to a person having origins in any of the Black
racial groups of Africa
– Includes people who indicated their race(s) as “Black,
African American, or Negro” or reported entries such
as African American, Kenyan, Nigerian, or Haitian
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Historical Overview
• Black or African American people entered this country a
year earlier than the Pilgrims, in 1619.
• Majority descend from people who were brought here as
slaves from the west coast of Africa during the 17th
century.
• Black or African American people have been living in the
United States for many generations.
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Highlights: Civil Rights Movement
• 1954 – Brown v. Board of Education
• 1957 – Little Rock, Arkansas integrated
– Central High School
• 1962 – Civil Rights movement organized
• 1964 – Civil Rights Act passed
• 1968 – Dr. M.L. King assassinated
• 2007 – Efforts to strike down Brown v. Board of Education
• 2013 – Voting Rights Act (1965) under fire
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Figure 11–4 Central High School, Little
Rock, Arkansas
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Health and Illness
• Health
– All things influence one another
– Harmony with nature
– Do not separate body, mind, and spirit
• Illness
– State of disharmony
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Maintain Health
• Proper diet
• Hot breakfast
• Rest
• Clean environment
• Laxatives
– Keep bowels open
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Protect Health (1 of 2)
• Asafetida
– Worn around neck
– Prevents contagious disease
• Cod liver oil
– Prevent colds
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Protect Health (2 of 2)
• Sulfur and molasses
– Prevent illness in the spring
• Bangles
– Bracelets (copper or silver) worn to protect from harm
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Restore Health (1 of 2)
• Sugar and turpentine
– Get rid of worms
• Poultices
– Fight infection
• Herbs and Herbal Teas
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Restore Health (2 of 2)
• Hot water and honey
– Colds
• Raw onions on feet
– Treat a fever
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Traditional Herbal Remedies
Remedy
Illness
Hot camphor oil
Congestion
Lemon water with honey
Treat colds
Poultices
Fight inflammation
Salt Pork
Treat cuts and wounds
Sugar and turpentine
Get rid of worms
Sour milk
Cuts
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Traditional Methods of Health (1 of 2)
• Voodoo
– Arrived in North America in 1724
– 1850 – Height in New Orleans
– Practiced by some people today
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Traditional Methods of Health (2 of 2)
• Gris-gris
– Good gris-gris
▪ Pleasantly scented powders and oils
▪ Many colors and positive uses
– Bad gris-gris
▪ Vile odors
▪ Used for negative reasons
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Candles (1 of 3)
• White
– Symbolizes peace
• Red
– Victory
• Pink
– Love
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Candles (2 of 3)
• Yellow
– Driving off enemies
• Brown
– Attracting money
• Black
– Bring bad luck
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Candles (3 of 3)
Figure 11-5 Voodoo candles
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Saints with Powers
Saint Michael
Conquest of enemies
Saint Anthony de Padua
Brings luck
Saint Mary Magdalene
Popular with women in love
Virgin Mary
Presence in the home
prevents illness
Sacred Heart of Jesus
Cures organic illness
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Healers
• Many believe in the power of some people to heal
• Religious practices
– Pentecostal Movement
• Voodoo
– Root Worker
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Black Muslims
• About 5.5 million adherents
– Person is “what he or she eats”.
▪ Follow Islamic dietary restrictions.
– No pork products
– Pray 5 times per day.
– Fast of Ramadan
– Modesty
– Self-help and assist in uplifting each other
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Mental Health (1 of 2)
• Boufée delirante
– The sudden outburst of agitated and aggressive
behavior, confusion, or occasional hallucinations
– Africa and Haiti
• Falling-Out
– Sudden collapse without warning
– Southern U.S. and Caribbean
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Mental Health (2 of 2)
• Zar
– Person is possessed by a spirit and may shout, weep,
laugh, hit his or her head against the wall, or sing.
– North African countries
• Brain Fog
– Physical and mental exhaustion, difficulty
concentrating, memory loss, irritability, and sleeping
and appetite problems
– West Africa
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Physiological Assessment
Pallor
Absence of underlying red tones
Erythema
Assess skin with fingertips
Cyanosis
Inspect lips, tongue, palms of hands
Ecchymosis
Swelling of skin surface
Jaundice
Sclera – yellow discoloration
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Comparison of Selected Health Status Indicators:
2013 All Races and Black or African American
Blank
All Races
Black or
African
American
Crude birth rate per 1,000 population by race of
mother, 2013
12.4
14.5
Infant mortality per 1,000 live births, 2012
6.0
10.9
Respondent –reported prevalence of cancer—
all sites, 2010-2013, 18 years and over
5.9
4.8
Male death rates from suicide, all ages, age
adjusted per 100,000 resident population, 2013
20.3
9.3
Male death rates from homicide, all ages, age
8.2
adjusted per 100,000 resident population, 19992003
31.6
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Sickle-Cell Anemia (1 of 3)
• Red blood cells sickle
– Genetically inherited trait
– Hypothesis of African adaptation to fight malaria
• Results
– Hemolysis and thrombosis of red blood cells
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Sickle-Cell Anemia (2 of 3)
• Comprises the following blood characteristics:
1. Presence of two hemoglobin-S genes (Hb SS)
2. Presence of the hemoglobin-S gene with another
abnormal hemoglobin gene (Hb SC, Hb SD, etc.)
3. Presence of the hemoglobin-S gene with a
differentabnormality in hemoglobin synthesis
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Sickle-Cell Anemia (3 of 3)
• Manifestations
– Hemolysis
– Anemia
– States of sickle-cell crises
– Severe pain in the areas of body where the
thrombosed red cells are located
– The cells also tend to clump in abdominal organs,
such as the liver and the spleen.
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Culture-Bound Mental Illness
• Rootwork
– Generalized anxiety related to hexing
• Falling-out
– Sudden collapse
• Boufée delirante
– Sudden agitated and aggressive behavior
• Spell
– Trance state
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Mortality: 2014 (1 of 4)
Black or African American
1. Diseases of the heart
2. Malignant neoplasms
3. Cerebrovascular disease
4. Unintentional injuries
5. Diabetes mellitus
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Mortality: 2014 (2 of 4)
6. Chronic lower respiratory diseases
7. Nephritis, nephroitic syndrome, and nephrosis
8. Homicide
9. Septicemia
10.Alzheimer’s disease
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Mortality: 2014 (3 of 4)
All persons
1. Diseases of the Heart
2. Malignant neoplasms
3. Cerebrovascular disease
4. Chronic lower respiratory diseases
5. Unintentional injuries
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Mortality: 2014 (4 of 4)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephroitic syndrome and nephrosis
10.Septicemia
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Copyright
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Cultural Diversity in Health and Illness
Ninth Edition
Chapter 12
Health and Illness in the
Hispanic Populations
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Figure 12-1 Jet Stones – Worn as a Necklace for
Protection from the Evil Eye or Envy
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Figure 12-2 Small Packet of Seeds, Amulets, and a
Mano Milagroso – Carried in a Purse or Pocket for
Protection
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Figure 12-3 Santo Nino – the Holy Child, Dressed in
a Healthcare Provider’s White Uniform and
Wearing a Stethoscope Placed in Home or Work
Place for Protection
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Learning Objectives (1 of 2)
12.1 Discuss the historical and demographic backgrounds
of the Hispanic American population.
12.2 Describe the traditional definitions of health and illness
of the Hispanic American population.
12.3 Explain the traditional methods of healing of the
Hispanic American population.
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Learning Objectives (2 of 2)
12.4 Describe the practice of a traditional healer.
12.5 Summarize current healthcare problems of the
Hispanic American population.
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Demographic Overview: Census 2014
Estimates (1 of 2)
• Largest emerging majority population
• 17.3% of U. S. Population
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Demographic Overview: Census 2014
Estimates (2 of 2)
• 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
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Demographic Profile 2013
• More than 50% growth in U.S. population between 20002013 was due to Hispanic population
• Largest populations
– California
– New Mexico
– Texas along the Mexican border
• Mexican origin
– 63% of the Hispanic population
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The “Fence” along the US/Mexico Border
• The “fence” built to “protect” the United States from
people who cross the border seeking work.
• Structure 16 feet high and topped with barbed wire.
• People are able to “jump” the fence.
• It abuts yards of homes in Mexico.
• Planned to cover the 2,000 miles of the U.S./Mexico
border.
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U.S./Mexico Border
Figure 12.4 The fence along the U.S.-Mexico border;
Mexico is on the right side.
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Health (1 of 2)
• Result of good luck
• Reward for good behavior
• Gift from God
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Health (2 of 2)
• Balance of the four humors
– Blood
▪ Hot and wet
– Yellow bile
▪ Hot and dry
– Phlegm
▪ Cold and wet
– Black bile
▪ Cold and dry
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Illness
• Imbalance in a person’s body
– Imbalance between “hot” and “cold” or “wet” and “dry”
• Punishment meted out for wrongdoing.
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Illness Causes
• Body’s imbalance in the four humors
• Dislocation of parts of the body
• Magic or supernatural causes outside the body
• Strong emotional states
• Envidia
– Envy
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Imbalance in the Four Humors (1 of 2)
1. Blood, hot and wet
2. Yellow bile, hot and dry
3. Phlegm, cold and wet
4. Black bile, cold and dry
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Imbalance in the Four Humors (2 of 2)
• Hot illness treated with a “cold” substance.
• Cold illness with a “hot” substance.
– Not physical measurable temperature
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Dislocation of Body Parts
• Empacho
– Believed to be caused by a ball of food clinging to the
wall of the stomach.
• Caida de la mollera (fallen fontanel)
– A more serious illness
– Occurs in dehydrated infants and young children
younger than 1 year old
– Anterior fontanel is depressed below the contour of
the skull.
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Magic or Supernatural Causes
• Outside the body
• Witchcraft or possession
– Brujas (witches)
▪ Use malevolent forces
▪ Cast spells
– Mal Ojo
▪ “Bad eye”
▪ May result from excessive admiration by another
person
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Strong Emotional States
• Susto
– Illness arising from fright
– Involves soul loss
– Soul is able to leave the body and wander.
▪ While dreaming
▪ After a traumatic event
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Envidia
• “To succeed is to fail”
• Envy of friends or neighbors leads to misfortune.
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Religious Rituals
• Making promises
– A promesa may be made to God or to a saint for
recovery from an illness.
• Visiting shrines
– Pilgrimages to shrines
• Offering medals and lighting candles
– Pinning small medals on saints
• Offering prayers
– At home, in churches, in shrines
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An Yerberia (1 of 3)
Figure 12-5 A traditional community resource Yerberia in
Mission, Texas.
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An Yerberia (2 of 3)
Figure 12-6 Samples of amulets sold in Sr. Garcia’s
Yerberia.
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An Yerberia (3 of 3)
Figure 12-7 Samples of candles sold in Sr. Garcia’s
Yerberia.
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Protect Health
• Eat proper foods.
• Work the proper amount of time.
• Prayer
• Wear religious medals and amulets.
• Keep relics in the home.
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Restore Health
• Herbal remedies
• Limpias
• Religious rituals
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Retalbo
Figure 12-8 A retalbo that depicts a person praying to the
Virgin of San Juan de la Valle for the healing of a loved
one.
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Alter in El Santuario de Chimayo
Figure 12-9 An altar in El Santuario de Chinmayo, in
Chinmayo, New Mexico.
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Traditional Healers
• Curandero/a
• Materia
• Partera
• Herbalista
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Milagros (1 of 2)
Figure 12-10 Milagros. This photograph is
an example of the assortment of various
miniature articles that may be purchased
for the nominal cost of $1.00 in botanicas
or in a marketplace from traditional people.
In this image are crutches, a head, a
woman, children and a baby, an arm, a leg,
eyes, breasts, a torso, a heart, a car, a
horse, a key, a whisky bottle, and others.
When a person is experiencing a problem
with one of these anatomical areas or
objects, he or she may pray for recovery;
make a promesa to a saint; and when the
person’s prayer is answered, take the
milagro to a church and place it near the
saint the person prayed to.
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Milagros (2 of 2)
Figure 12-11 Milagros placed at the Shrine of Saint
Anthony in the Church of the Sacred Heart of Mary in San
Antonio, Texas.
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Curandero/a
1. “Born” to heal
• Known from the moment of cuandero’s birth that something is
unique about this person and destined to be a healer.
2. Learn by apprenticeship
• Person is taught the ways of healing, especially the use of herbs.
3. “Calling” through a dream, trance, or vision
• Contact is made with the supernatural.
4. The “call” comes either during adolescence or during the midlife
crises.
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Partera (1 of 2)
• Lay midwife
– Giving advice to the pregnant woman
– Giving physical aid, such as treating any illness the
woman may experience during pregnancy
– Guiding the woman through her pregnancy in terms of
nutrition or activities she can and cannot do
– Being in attendance during labor and delivery
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Partera (2 of 2)
Figure 12-12 Sign for a partera
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Comparison: Traditional–Modern
Caregiver (1 of 2)
• Traditional
– Informal
– Home visits
– Consults family
– Less expensive
– Attentive to spiritual needs
– Shares patients world-view
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Comparison: Traditional–Modern
Caregiver (2 of 2)
• Modern
– Businesslike
– Patient visits setting
– May ignore family
– Costly
– Secular care
▪ Little regard for patient’s religion
– Does not share patient’s world
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Mental Health
• Mental Illness
– Epilepsy
– Mal Ojo (evil eye)
• Moral Illness
– Vice
– Emotions
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Traditional Herbal Remedies
Remedy
Illness
Manzanilla – Chamomile
Fright – Susto
Yerba Buena spearmint
Nervousness
Te de narranjo – Orange
leaves
Albacor – Sweet basil
Nervousness
Fright – Susto
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Santeria (1 of 2)
• Afro-Caribbean magic and Health practices
• Traditional Healer is a santero.
• Catholic saints, who have African names and are known
as protectors, protecciones
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Santeria (2 of 2)
• Several folk ailments
– Mal ojo
▪ Prevent with amulets
– Empacho
▪ Treated by massage
– Fatigue
▪ Asthma-like symptoms
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Orishas, Saints and Health
Orisha
Saint
Health Problem
Chango
Saint Barbara
Violent death
Ifa
Saint Anthony
Fertility
Obatala
Crucified Christ
Heals bronchitis
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Comparison Of Selected Health Status Indicators:
2013 All Races And Hispanic Americans (1 of 2)
blank
All Races
Hispanic
Americans
Crude birth rate per 1,000 population
by race of mother, 2013
12.4
16.7
Infant mortality per 1,000 live births,
2012
6.0
5.1
Respondent –reported prevalence of
cancer—all sites, 2010-2013, 18 years
and over
5.9
3.6
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Comparison Of Selected Health Status Indicators:
2013 All Races And Hispanic Americans (2 of 2)
blank
All Races
Hispanic
Americans
Male death rates from suicide, all
ages, age adjusted per 100,000
resident population, 2013
20.3
9.3
Male death rates from homicide, all
ages, age adjusted per 100,000
resident population, 1999-2003
8.2
7.3
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Mortality: 2014 (1 of 4)
Hispanic or Latino
1. Malignant neoplasms
2. Diseases of the heart
3. Unintentional injuries
4. Cerebrovascular disease
5. Diabetes mellitus
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Mortality: 2014 (2 of 4)
6. Chronic liver disease and cirrhosis
7. Chronic lower respiratory diseases
8. Alzheimer’s disease
9. Influenza and pneumonia
10.Nephritis, nephrotic syndrome, and nephrosis
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Mortality: 2014 (3 of 4)
All persons
1. Diseases of the Heart
2. Malignant neoplasms
3. Chronic lower respiratory diseases
4. Unintentional injuries
5. Cerebrovascular disease
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Mortality: 2014 (4 of 4)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephrotic syndrome, and nephrosis
10.Suicide
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Barriers to Health Care
• Language
• Poverty
– High incidences
▪ Tuberculosis, malnutrition, cancer, lead poisoning
– Migrant farmworkers
▪ Occupational hazards
• Time orientation
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Cultural Diversity in Health and Illness
Ninth Edition
Chapter 13
Health and Illness in the
White Population
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Labour to keep alive in your Breast that
Little Spark of Celestial Fire Called
Conscience.
—George Washington, in J. Needleman (2003)
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Figure 13-1 Magentropfen – a Common
German Herbal Preparation to Treat Nausea
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Figure 13-2 Mosaic Icon – The Virgin of
Czestochowa, Poland, Believed to Bring Healing and
Other Miracles
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Figure 13-3 Saint Anthony of Padua – The
Patron Saint of Finding Lost Things or People
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Learning Objectives
13.1 Discuss the historical and demographic backgrounds
of selected populations within the White non-Hispanic
population.
13.2 Compare and contrast the traditional definitions of
Health and Illness of selected populations within the White
non-Hispanic population.
13.3 Discuss the traditional methods of Healing of selected
populations within the White non-Hispanic population.
13.4 Describe current health status and problems of the
White non-Hispanic population.
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Demographic Overview: Census 2013
Estimates (1 of 2)
• 318.9 million people
• 77.4% White
– 62.1% White alone
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Demographic Overview: Census 2013
Estimates (2 of 2)
• White
– Refers to a person having origins in any of the original
peoples of Europe, the Middle East, or North Africa. It
includes people who indicated their race(s) as “White”
or reported entries such as Irish, German, Italian,
Lebanese, Arab, Moroccan, or Caucasian.
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European Ancestry: 2013
Ancestry
German
Irish
English
Italian
Polish
French (except Basque)
Scottish
Number in millions
47.7
34.6
25.8
17.4
9.6
8.7
5.5
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German Americans
• Since 1830, more than 7 million Germans have
immigrated to the United States.
• Largest ancestry population in the United States.
• California, Texas, and Pennsylvania have the largest
German populations.
• Introduced first kindergartens
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Health: German Americans
• A state of well being physically and emotionally
• Ability to do your duty
• Positive energy to do things
• Ability to do, think, and act the way you would like
• Enjoy life
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Illness: German Americans
• The absence of well-being
• Pain
• Malfunction of body organs
• Not being able to do what you want
• Disorder of body
• Imbalance
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Selected Causes of Illness: German
American
• Most people – “Germ Theory”
• Stress
• Drafts
• Environmental changes
• Belief in the “evil eye”
• God’s punishment
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Symptoms and Traditional Remedies:
German American
Constipation
Castor oil, Black draught
Cold
Olbas oil from Germany
Congestion
Goose fat rub on chest
Earache
Warm oil in ear
Sore throat
Chicken soup
Puncture wound
Soak in kerosene
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Polish Americans
• First arrived in 1608 in Jamestown, Virginia.
• Over 9.5 million people claim Polish ancestry.
• Polish people shared problems as a community.
• Major influx 1870 to 1913
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Health: Polish Americans
• Feeling ok as a whole
– Body, spirit
• Happy
• Active
• Able to work
• Good to everybody
• Never cross
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Illness: Polish Americans
• Nothing wrong with body, mind, or spirit
• Not able to work
• Not active
• Feeling bad
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Maintain Health: Polish American
• Maintain a happy home
• Being kind
• Walking
• Exercise
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Symptoms and Traditional Remedies:
Polish American
Cold
Flaxseed poultice
Colic and cramps
Peppermint tea
Constipation
Senna-leaf tea
Cough
“Gugel Mugel” concoction with whisky, milk, and
butter
Indigestion
Spearmint tea
Kidney problems
Swamp Root
Puncture wounds
Salt pork
Scratches
Spider webs
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Swamp Root
Figure 13-4 Swamp root.
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Italian Americans
• Over 17.4% of the population claims Italian ancestry.
• Country named for an Italian – Amerigo Vespucci.
• Between 1820-1990, over 5 million people immigrated
from Italy.
• The family is the main tie.
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Health: Italian Americans
• Old Beliefs
• Congenital abnormalities can be attributed to the
unsatisfied desire for food during pregnancy.
• If a woman is not given food that she smells, the fetus will
move inside, and a miscarriage will result.
• If a pregnant woman bends or turns or moves in a certain
way, the fetus may not develop normally.
• A woman must not reach during pregnancy because
reaching can harm the fetus.
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Illness: Italian Americans
• Traditional Causes
1. Winds and currents that bear diseases
2. Contagion or contamination
3. Heredity
4. Supernatural or human causes
5. Psychosomatic interactions
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Health-Related Problems: Italian
Americans
• Two genetic diseases commonly seen among Italians
– Favism
▪ A severe hemolytic anemia caused by deficiency
of the X-linked enzyme glucose-6-phosphate
dehydrogenase and triggered by the eating of fava
beans
– Thalassemia syndromes
▪ Hemolytic anemias
– Alpha-thalassemia
– Beta-thalassemia (Cooley’s Anemia)
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Comparison of Selected Health Status
Indicators: 2013 All Races and White
Health Indicator
All Races
White only
Crude birth rate per 1,000 population by race
of mother, 2013
12.4
12.0
Infant mortality per 1,000 live births, 2012
6.0
5.1
Respondent–reported prevalence of cancer—
all sites, 2010-2013, 18 years and over
5.9
6.2
Male death rates from suicide, all ages, age
adjusted per 100,000 resident population,
2013
20.3
22.6
Male death rates from homicide, all ages, age
adjusted per 100,000 resident population,
1999-2003
8.2
4.4
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Mortality: 2014 (1 of 4)
White alone
1. Diseases of the heart
2. Malignant neoplasms
3. Chronic lower respiratory diseases
4. Unintentional injuries
5. Cerebrovascular disease
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Mortality: 2014 (2 of 4)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephroitic syndrome and nephrosis
10. Suicide
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Mortality: 2014 (3 of 4)
All persons
1. Diseases of the heart
2. Malignant neoplasms
3. Chronic lower respiratory diseases
4. Unintentional injuries
5. Cerebrovascular disease
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Mortality: 2014 (4 of 4)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephroitic syndrome and nephrosis
10. Suicide
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