Research Paper
Develop a 5-page (not including title, abstract, and reference pages), APA-style research paper on health indicators of a specific cultural group. Analyze and describe how health disparities seen in the selected group impacts morbidity and mortality at the individual, group, community, and societal levels.
Be sure to include:
- Title Page
- Abstract
- Introduction to the problem and its significance
- Description of health indicators & disparities
- Description of health beliefs, health behaviors and contributing factors
- Recommendations for improving health care and reducing disparities in the selected group
- Conclusion
- Reference page (not part of page count). Use at least 5 scholarly sources; websites may be included but do not count towards your scholarly sources. Do not use .com or wikipedia, rather, Use .gov, .org, and . edu websites.
Sample Research Papers Attached for reference.
Runninghead: NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 1
Native Americans and the Human Immunodeficiency Viru
s
Student’s Name
National University
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 2
Paper TitleNative Americans and Human Immunodeficiency Virus
Native Americans are the indigenous people of North, South, and Central America
.
Native Americans have been abused by governments for centuries by oppression and conqueri
ng
of tribal land. This abuse has left them vulnerable to unique health disparities. One majo
r
disparity is the ongoing problem of the human immunodeficiency virus or HIV. The Native
American population has seen an increase in HIV cases from 1990 to 2001 of over 900%, th
is
makes them the most rapidly growing group for infection (Dennis, 2009). HIV was the ninth
cause of death for Native Americans aged 25-34 in 2010; they have been shown to have poorer
survival rates compared to all other races after diagnosis with HIV (Centers for disease control
and prevention (CDC), 2013). While ethnicity is not a risk factor for any disease there are man
y
other factors that lead to higher infection rates. This paper will review what makes the Native
American population so vulnerable to the HIV pandemic.
Firstly when considering the Native American population, demographics and histo
ry
have to be addressed because of the impact it has made on their culture. The term Native
American is used to describe a varying population of approximately 5.2 million people that are a
part of over 500 individual tribes (CDC, 2013). Each tribe behaves uniquely and has its ow
n
culture, and with that their own views on healthcare. Even with many different tribes there is a
common feeling of oppression that most Native Americans feel from the years of maltreatment.
Native Americans fell victim to many diseases that were brought over from Europe, this
weakened their numbers to the point where they could not defend themselves against the theft of
their land (Weaver, 1999). This loss of land has had a negative impact on Native Americans
and
has lead to the loss of culture. According to the United States Census Bureau(2011)., only 2
2%
of Native Americans live on reservations as of 2010 (2011). Loss of land was not the only way
Comment [AI1]:
Citat
ion needed
Comment [AI2]: Prove!
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 3
that Native Americans were abused. Native Americans have been subjected to unethical research
practices and substandard medical care since the early 1900s, this have left them hesitant about
using western healthcare (Dennis, 2009). Loss of land and years of racism and abuse has caused
serious trauma that negatively impacts Native American culture toda
y.
The forced loss of land and genocide has led to an effect called “soul wound” on the
Native American people (Dennis, 2009). The “soul wound” felt by the Native American people
is one factor that culturally influences the increased HIV infection rate. As Mary Kate Dennis
notes, “historical trauma and trauma from interpersonal violence contribute to risk factors f
or
HIV infection” (Author?, 2013, page number?).
Another cultural factor is the belief that HIV does not affect Native Americans and
that
they are not at risk for contracting the virus (Weaver, 1999). This belief leads to unsafe sex
practices and needle sharing during traditional ceremonies, which in turn can lead to HIV
infection. Native Americans also are not accepting of same sex relationships and refer to gay or
lesbian people as “two spirit” (Dennis, 2009). This leads to people not getting medical care when
ill over fear of reprisal about their sexual orientation. Because they keep their sexual p
references
a secret, gay Native Americans are more likely to use the gay bar scene to meet partners which
leads to exposure to alcohol and drug use which can lead to unsafe sex (Dennis, 2009). Seventy
five percent of all new HIV infections in 2011 were attributed to men having sex with men
(CDC, 2013). Native American culture is only a part of the reason why the HIV infection rate is
increasing among this population.
The socioeconomic status of Native Americans is also a concern. The average household
income in 2010 was $35,062 for Native Americans compared to $50,046 for the nation as a
whole (United States Census Bureau, 2011). This leads to a less proportion of Native Americans
Formatted: Indent: First line: 0.5″
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 4
having health insurance. Approximately 29% of Native Americans did not have health insura
nce
compared to 15.5% of the nation in 2010 (United States Census Bureau, 2011). Native
Americans do have government funded healthcare available to them but as mentioned earlier
only 22% of Native Americans live on reservations so access may be limited to those facilitie
s.
Even if they have access to the federally funded Indian Health Service there is a general mistrust
of western medicine due to years of abuse suffered in the hands of western doctors. For example
in the 1920s over 20,000 unnecessary eye procedures were preformed that lead to eye disease
such as blindness and in the 1970s, up to 40 percent of Native American women were sterilized
without informed consent (Dennis, 2009). This leads to many Native Americans not receiv
ing
any healthcare or waiting until an ailment is life threatenin
g.
Other health disparities also correlate and make Native Americans overall more
susceptible to HIV. Having sexually transmitted diseases increase the susceptibility of
contracting HIV and Native Americans have the second highest rates of all races for gonorrhea,
chlamydia, and syphilis (CDC, 2013). HIV and sexually transmitted diseases can both be
contracted through unsafe sex so it makes sense that they are positively correlated.
Alcoholism and substance abuse is also a huge risk factor for contracting HIV.
According to Dennis (2013) “Native American women are more likely to be injection drug users
than any other ethnic group” (page number?2013). Alcoholism is also prevalent in Native
Americans which leads to riskier sexual behaviors. Mental health also needs to be noted.
The
“soul wound” mentioned earlier has been correlated with poor mental health and Native
Americans suffer from ailments such as historical trauma response, post traumatic stress
disorder, alienation, and depression at higher rates than other groups which leads to increased
risk for HIV (Dennis, 2009).
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 5
There are many factors that leave the Native Americans more vulnerable to HIV such as
historical trauma, socioeconomic status, mistrust of western healthcare and other health
disparities. Hopefully future education about safe sex practices and needle exchanges can help
bring down the number of new infections of HIV. To be successful though, a pro
gram
would
have to look at Native American culture as a whole and take into consideration the historical
trauma that this group has suffered before members can begin to gain confidence in western
healthcare once again. Some Native Americans say HIV was predicted long ago and will be the
downfall of all Native Americans and others say they have the power to stop the death. For the
sake of all future generations, now is the time to act and stop HIV in its tracks (Weaver, 1999).
Comment [AI3]: Comparison to majority or
other groups is limited/
miss
ing
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 6
References
Centers for Disease Control and Prevention (2013, Mar 27). HIV/AIDS among American Indians
and Alaska Natives. Retrieved from
http://www.cdc.gov/hiv/resources/factsheets/aian.htm. Date accessed ?
Dennis, M. K. (2009). Risk and Protective Factors for HIV/AIDS in Native Americans:
Implications for Preventive Intervention. Social Work, 54(2), 145-154.
United States Census Bureau (2011, Nov 1). American Indian and Alaska Native Heritage
Month: November 2011. Retrieved from
http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/c
b11-ff22.html. Date accessed?
Weaver, H. N. (1999). Through Indigenous Eyes: Native Americans and the HIV Epidemic.
Health & Social Work, 24(1), 27-34.
http://www.cdc.gov/hiv/resources/factsheets/aian.htm
http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff22.html
http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff22.html
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 7
Outstanding
Achieveme
nt
Commendable
Achievement
Marginal
Achievement
Unsatisfacto
ry
Achieveme
nt
Faili
ng
Identified a
cultural
group
Description of the
target
group
historical
perspective
Demographics
5%
Clearly defines
cultural group
in
terms of history,
geography and
population
characteristics
4%
Clearly defines a
cultural group
without
adequately
describing some
characteristics
3%
Defines a cultural
group
without
adequately
describing many
important
characteristics
2%
Lists a
cultural
group
without
further
definition
0%
miss
ing
Identified health
disparities
Health issues and
disparities
Morbidity and
mortality rates
Patterns of C
are
Access to care
Mental health
issues
2
0%
Clearly identifies
disparities by
comparing
descriptive
epidemiology of
group to majority
group or other group
15%
Clearly identifies
disparities using
descriptive
epidemiology
however without
adequate
comparisons
10%
Correctly lists
health
disparities
without adequate
descriptive
epidemiology
5%
Lists health
disparities
incorrectly
0%
miss
ing
Identified health
behaviors
Preventive and
protective health
behaviors
Sick-role behaviors
Illness behaviors
Societal health
behaviors
20%
Clearly describes all
common health
behaviors with
supporting
evidence
15%
Clearly describes
most common
health behaviors
missing some
categories
10%
Correctly lists
health behaviors
without adequate
references to
commonality
5%
Lists health
behaviors
incorrectly
0%
miss
ing
Identified health beliefs 15%
Clearly describes
commonly held
attitudes, beliefs and
values
12.75%
Clearly describes
some
health
beliefs
7.5%
Correctly lists
health beliefs
without adequate
reference to
cultural group
4.25%
Lists health
beliefs
incorrectly
0%
miss
ing
Identified
contributing
factors
Barriers to health
and healthcare
10%
Clearly discusses
socio-economic,
language, political,
religious and other
factors that
contribute to the
health disparity
7.5%
Clearly discusses
some contributing
factors
5%
Correctly lists
some contributing
factors
3.75%
Lists
contributing
factors
incorrectly
0%
miss
ing
Recommendations &
Conclusion
5%
Provides strong,
3.75%
Provides cl
ear
2.5%
Provides weak
1.25%
No
0%
miss
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 8
clear, convincing
conclusions.
Strong supporting
evidence is present.
Consistently relevant
detail
support the
conclusions made.
Offers
recommend
ation(s)
conclus
ions
Supporting
evidence is present
with detail.
Uses generalized
(not specific)
examples to
support the
conclusions made.
Offers
recommendation(s)
conclusions
Some supporting
evidence and
minimal detail is
present.
Offers
recommendation(s)
conclusions
articulated.
Supporting
evidence
and detail is
lack
ing.
Offers
recommend
ation(s)
ing
Writing Style 10%
All sentence
s are
well-constructed
with varied
structure.
All
sentences sound
natural and are easy-
on-the-ear when read
aloud. Each sentence
is clear and has an
obvious emphasis.
Writer makes no
errors in grammar or
spelling that distracts
the reader
from the
content.
Writer makes no
erro
rs in
capitalization or
punctuation, so the
paper is
exceptionally easy to
read.
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader’s mind, and
the choice and
placement of the
words seems
accurate, natural and
not forced.
Communica
tion
tone
and word choice
follo
w a
7.5%
Most sentences are
well-constructed
with varied
structure.
Almost all
sentences sound
natural and are
easy-on-the-ear
when read aloud,
but 1 or 2 are stiff
and awkward or
difficult to
understand.
Writer makes few
errors
in gram
mar
or spelling that
distracts
the reader
from
the content.
Writer makes 1 or
2 errors in
capitalization or
punctuation, but
the paper is still
easy to read.
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader’s mind, but
occasionally the
words are used
inaccurately or
seem overdone.
Communication
5%
Most sentences are
well-constructed
but have a similar
structure.
Most
sentences
sound natural and
are easy-on-the-ear
when read aloud,
but several are stiff
and awkward or
are difficult to
understand.
Writer makes some
errors in grammar
or spelling that
distracts the reader
from the content.
Writer makes a
few errors in
capitalization
and/or
punctuation
that catch the
reader’s
attention
and interrupts the
flow.
Writer uses words
that communicate
clearly, but the
writing
lacks
variety, punch or
flair.
Communication
tone
and word
choice is
3.75%
Sentences
lack
structure
and appear
incomplete
or rambling.
The
sentences
are difficult
to read
aloud
because
they sound
awkward,
are
distractingly
repetitive,
or are
difficult to
understand.
Writer
makes
many errors
in grammar
or spelling
that
distracts the
reader from
the content.
Writer
makes
several
errors in
capitalizatio
0%
Pape
r
lacks
clarit
y.
Lang
uage
or
sente
nce
is so
mud
dled
that
it’s
mea
ning
is
uncl
ear
in
num
erou
s
spots
.
Erro
rs in
punc
tuati
on,
spell
ing,
gram
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 9
scholarly/report-
writing style (passive
voice/third
person).
tone and word
choice follow a
scholarly style
(passive voice/third
person).
occasionally
informal
(active
voice/first
person)….
n and/or
punctuation
that catches
the reader’s
attention
and greatly
interrupts
the flow.
Writer uses
a limited
vocabulary
that
does
not
communicat
e strongly
or capture
the reader’s
interest.
Jargon or
clichés may
be present
and detract
from the
meaning.
Communica
tion tone
and word
choice is
infor
mal
(active
voice/first
person).
mar
and
usag
e are
highl
y
distr
actin
g.
Com
muni
catio
n
tone
is
highl
y
infor
mal
and
does
not
follo
w a
scho
larly
style
.
Pape
r
relie
s on
gene
raliz
ation
s.
APA format &
Referencing
15%
No errors
in APA
style. Title
page and
numbering is
complete and
accurate.
Citations and
references are in
proper APA format.
Numerous sources
12.75%
Rare errors in APA
style. Title
page
and numbering is
complete and
accurate.
Citations and
references are in
proper APA
format.
Many
7.5%
Errors in APA
style are
noticeable.
Title
page and
numbering
contains minimal
errors.
Citations and
references are in
4.25%
Many errors
in APA
style. Title
page and
numbering
is
incomplete
or
inaccurate.
0%
Title
page
and
num
berin
g are
miss
ing.
Citat
NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 10
are cited. All claims
are supported with a
professional
reference.
sources are cited.
Some
claims leave
the reader looking
for
a reference.
proper APA
format. Many
sources are cited.
Many claims leave
the reader looking
for a reference.
Citations
and
references
are limited,
missing or
incor
rect.
Many
claims leave
the reader
looking for
a reference.
ions
and
refer
ence
s are
miss
ing
or
incor
rect.
Total maximum points for Research Paper = 79.75/100
Runni
nghead: MEXICAN-AMERICAN CULTURE AND HEALTH
1
Title Mexican-American Culture and Health
Student’s Name
National Universit
y
COH 310 Culture and Health
XXXXXXXXXXX
September 2013
MEXICAN-AMERICAN CULTURE AND HEALTH 2
Paper titleMexican-American Culture and Health
Mexican-Americans who live in the United States have a rich history of traditions,
including strong religious, family and community beliefs. They have endured several conflicts
over history, as well as strife in their country of origin. Their resiliency and resourcefulness help
them maintain an attitude of looking to the future. Even today, they strive to maintain their
culture, strengthen their families and create a better future
.
Persons of Hispanic ethnicity are generally thought of as speaking and/or understandi
ng
the Spanish language. They come from a melting pot of backgrounds and countries such as
Spain (“Spanish”); Latin America (“Latino”); and, Mexico (“Mexican”). Persons born in the
United States (U.S.), whose ancestors came from Mexico, are called “Chicano,” and those who
have assimilated in American culture from Mexico, are called “Mexican-Americans” (Jandt,
2010).
Mexico is approximately three times the size of Texas and is bordered by the U.S. states
of California, Arizona, New Mexico, and Texas. The country’s geography is ideal for agriculture
and farming since there are abundant water sources with several mountain ranges where they
have adapted to living in the rugged terrain.
Historically, since the 1500’s, Mexico was under Spain’s control. In 1823, this control
was overturned and a republic was formed. From 1846-1848, during the U.S.-Mexican War, l
and
north of the Rio Grande was lost by Mexico to the United States (Giger, 2008, pg. 240).
Government corruption has resulted in Mexico’s economy becoming vastly divided between the
wealthy and the poor; increasing poverty, hardship and lack of security for its people. Since the
Mexican Revolution in 1910 to early 1920’s, migration to the United States increased as better
opportunities were sought for their families. In 2000, it was estimated there were over 33 millio
n
Comment [S1]: Citation needed
http://en.wikipedia.org/wiki/Arizona
MEXICAN-AMERICAN CULTURE AND HEALTH 3
Mexican-Americans living in the U.S., primarily in California, Florida and Texas; this number
increasing 58% between 1990 and 2000, making them the largest minority group in the United
States. It is estimated that by the year 2050 their numbers will grow to approximately 102.6
million (KlineKline & Huff, 2007, pg. 188).
Mexican-Americans come to the U.S. both legally and illegally, even with the threat of
deportation. According to Giger (2008), about one-third, of the approximate 7 milli
on
undocumented workers in the U.S., come from Mexico. Issues faced by migrant workers are
not
understood by those who haven’t had to live under conditions they face each day. These include
living within poverty levels of income, moving seasonally, separation from families; health
problems from long, hard days of physical labor, result in back pain and arthritis, and illnesses
that include poor dental health and possibly malnourishment (Giger, 2008, pg. 266). Political
efforts are being made to reform immigration laws allowing more people to gain legal status and
eventual citizenship (Giger, 2008, pg. 241).
Mexican-American culture is very family oriented, with many living in neighborhoods
where they keep their traditions and language intact. Familiaismo, or family/group values
are
emphasized over individualism (KlineKline & Huff, 2007). Compared with other Latino groups
(Puerto Ricans, Central Americans, Dominicans, South Americans and Spaniards), their median
age is 27.2 years compared to 36.2 years (KlineKline & Huff, 2007, pg. 188). They comprise
83% of the U.S. farm/agriculture workers (KlineKline & Huff, 2007, pg. 189) and also work
industrial jobs (Giger, 2008, pg. 241), primarily in the border states of California and Texas
(KlineKline & Huff, 2007, pg. 188). Often they work long hours, with low pay. As younger
generations attend school and learn English, approximately 60% receive a high school diploma
with 12% receiving bachelor’s degrees (KlineKline & Huff, 2007, pg. 189). Those who do not
MEXICAN-AMERICAN CULTURE AND HEALTH 4
graduate from high school tend to be unemployed and as they get older, have poorer health than
those who graduate (Kline & Huff, 2007, pg. 189).
According to KlineKline & Huff (2007), disparities in health include lack of health
insurance and not receiving preventive immunizations. Increased morbidity and mortality rates
from diabetes and lung disease have resulted from not having health insurance, making it more
difficult to receive consistent, timely medical care. They are also less likely to receive smoking/
alcohol/obesity/ nutrition counseling and twice as likely to have chronic type-two diabetes over
non-Latinos. The longer people assimilate into American way of life, the less healthier their
eating habits tend to be. Diet, activity, environmental factors and genetic predisposition are all
contributing factors of type-two diabetes (KlineKline & Huff, 2007, pg. 195). These same risk
factors, along with lack of physical exercise and hypertension, lead to increased risk f
or
cardiovascular disease and myocardial infarction among Mexican-American males (KlineKline
& Huff, 2007, pg. 198).
First generation Mexican-Americans attempt to keep their culture intact by speaking
Spanish as their primary language and English selectively and persistently. The many different
dialects make it difficult to effectively communicate. Many youth speak “Spanglish,” which is a
combination of English and Spanish words in the same sentence. This adds to the complexity of
learning Spanish, and affects how different age groups interact (Jandt, 2010, pg. 340). Many
Americans are ethnocentric and may not see the importance of trying to learn the language, and
only about 5% of U.S. physicians are of Latino origin, which leads to additional disparities
in
health care (Giger, 2008, pg. 246).
Mexican-Americans tend to live in multi-level families, depending on each other for
economic and social support. The concept of respecto, which is a strong sense of respect for
MEXICAN-AMERICAN CULTURE AND HEALTH 5
elders or those in authority, is prominent. As members may leave family neighborhoods for
more independence and assimilation into American culture, they can experience increased stress
and depression. Students who do not graduate from high school also tend to exhibit signs of
stress as they have a more difficult time getting employment. Men tend to have a strong sense of
machismo, which
does
not allow for someone to identify with loss of self-esteem or authority, so
they may not acknowledge mental health issues or seek help from outside the family. Instead
they attribute their problems to physical symptoms (KlineKline & Huff, 2007). Women may
suffer stress due to changing societal roles where they may be expected to work outside the
home, while still maintaining household duties and raising their children (Giger, 2008, pg. 249).
Mexican-Americans are often diagnosed with advanced stages of breast cancer due
to
fewer cancer screenings; however, there has been increased awareness of mammograms in recent
years. Age, income, education, health insurance coverage, language proficiency, physician
referrals and system barriers contribute to the lack of preventive health measures (KlineKline &
Huff, 2007, pg. 209).
Mexican-Americans, similar to the Asian culture, believe in the theory of hot and cold
imbalances, that is to cure an illness, you apply the opposite principle. They also include prayer
and herbs in their healing practices. Illness is thought of as misfortune or bad luck, or a
punishment from God, or just an imbalance in the body; rather than diet, environment and other
factors that Western medicine implies. They may believe that old age is the reason for the illness,
thus there is no reason for making changes because illness is inevitable (Giger, 2008, pg. 254).
Folk medicine using “healers,” is primary in the culture, which includes the concept of
curanderismo, the belief that health is a matter of chance and controlled by forces in nature
(Giger, 2007, pg. 256). Persons called yerbero, those specializing in herbs and spices and
MEXICAN-AMERICAN CULTURE AND HEALTH 6
curandero and curanderas, who focus on the sins of the patient as being the reason for illness.
At a higher level of healers are witches who practice black, red and green magic. These types of
folk medicine attempts are generally made before Western medicine, especially those pers
ons
who have limited English language skills and dissatisfaction with medical practice (Giger, 2007,
pg. 257). Since Mexican-Americans believe they have their own folk medicine health options,
they may not choose to participate in Western health care unless a trust relationship can be
formed by health care workers.
It is important to understand the overall belief systems of the culture. The medical team
should understand the concept of espiritu, (which emphasizes the mind/body/spirit each working
together), when considering health and wellness. Understanding personalismo, (developing
personal over impersonal – institutional physician/patient – relationships); as well as confianza (a
trust/confidence relationship developed over time); will go a long way to develop relationships
that encourage better health outcomes.
Cultural sensitivity and avoiding the practice of stereotyping is important. Recognizing
cultural differences of health values and ethnic practices, family life, diet, and the availability of
insurance as well as helping to navigate health care and education systems, encouraging the
entire family to participate in education programs, will help us to effectively interact with others
outside our own culture (Giger, 2008, pg. 264).
The rich heritage and family values inherent in the Mexican-American culture is a
valuable asset to the preservation of the same values the Unites States was founded on. By
embracing this group and working toward a better understanding of both Mexican and American
cultures, we will be able to move toward a healthier population in the future of the United States.
MEXICAN-AMERICAN CULTURE AND HEALTH 7
MEXICAN-AMERICAN CULTURE AND HEALTH 8
Refer
ences
Giger, J. & Davidhizer, R. (2008). Transcultural nursing: Assessment and intervention (5
th
ed.).
St. Louis, MO: Mosby Elsevier.
Kline, M., & Huff, R. (2007). Health promotion in multicultural populations (2
nd
ed.).
Thousand Oaks, CA: Sage Publicat
ions.
Russell, A. , et. al. (1993). Patterns of contraceptive use and pregnancy among young Hispanic
women on the Texas-Mexico border. Journal of Adolescent Health,.14(5):373-9.
Formatted: Font: Bold
Comment [AI2]: Limited, Some citations not
listed on reference
page
Formatted: Font: Bold
Formatted: Font: Italic
MEXICAN-AMERICAN CULTURE AND HEALTH 9
Outstanding
Achievement
Commendable
Achievement
Marginal
Achievement
Unsatisfactor
y
Achievement
Faili
ng
Identified a cultural group
Description of the
target
group
historical perspective
Demographics
5%
Clearly defines
cultural group in terms
of history, geography
and population
characteristics
4%
Clearly defines a
cultural group
without
adequately
describing some
characteristics
3%
Defines a
cultural
group
without
adequately
describing many
important
characteristics
2%
Lists a
cultural
group
without
further
definition
0%
missi
ng
Identified health
disparities
Health issues and
disparities
Morbidity and
mortality rates
Patterns of Care
Access to care
Mental health issues
2
0%
Clearly identifies
disparities by
comparing
descriptive
epidemiology of group
to majority group or
other group
15%
Clearly identifies
disparities using
descriptive
epidemiology
however without
adequate
comparisons
10%
Correctly lists health
disparities without
adequate descriptive
epidemiology
5%
Lists health
disparities
incorrectly
0%
missi
ng
Identified health behaviors
Preventive and
protective health
behaviors
Sick-role behaviors
Illness behaviors
Societal health
behaviors
20%
Clearly describes all
common health
behaviors with
supporting evide
nce
15%
Clearly describes
most common health
behaviors missing
some categories
10%
Correctly lists health
behaviors without
adequate
references
to commonality
5%
Lists health
behaviors
incorrectly
0%
missi
ng
Identified health beliefs 15%
Clearly describes
commonly held
attitudes, beliefs and
values
12.75%
Clearly describes
some health
beliefs
7.5%
Correctly lists health
beliefs without
adequate reference
to cultural group
4.25%
Lists health
beliefs
incorrectly
0%
missi
ng
Identified
contributing
factors
Barriers to health and
healthcare
10%
Clearly discusses
socio-economic,
language, political,
religious and other
factors that contribute
to the health disparity
7.5%
Clearly discusses
some contributing
factors
5%
Correctly lists some
contributing factors
3.75%
Lists
contributing
factors
incorrectly
0%
missi
ng
Recommendations &
Conclusion
5%
Provides stro
ng,
clear, convincing
conclusions.
Strong supporting
evidence is present.
Consistently relevant
detail support the
conclusions made.
Offers
recommendat
ion(s)
3.75%
Provides clear
conclusions
Supporting evidence
is present with detail.
Uses generalized
(not specific)
examples to support
the conclusions
made. Offers
recommendation(s)
2.5%
Provides weak
conclusions
Some supporting
evidence and
minimal
detail
is
present.
Offers
recommendation(s)
1.25%
No
conclusions
articulated.
Supporting
evidence and
detail is
lacki
ng.
Offers
recommendat
ion(s)
0%
missi
ng
MEXICAN-AMERICAN CULTURE AND HEALTH 10
Writing Style 10%
All sentences are well-
constructed with
varied
structure.
All sentences
sound
natural and are easy-
on-the-ear when read
aloud. Each sentence is
clear and has an
obvious emphasis.
Writer makes no errors
in grammar
or spelling
that distracts
the
reader
from the
content.
Writer makes no errors
in
capitalization or
punctuation, so the
paper is exceptionally
easy to
read.
Writer uses vivid
words and phrases
that
linger or draw pictures
in the reader’s mind,
and the choice and
placement of the words
seems accurate, natural
and not forced.
Communication
tone
and
word choice
follo
w a
scholarly/report-
writing
style (passive
voice/third person).
7.5%
Most
sentences are
well-constructed
with varied structure.
Almost all sentences
sound natural and are
easy-on-the-ear when
read aloud, but 1 or 2
are stiff and
awkward or difficult
to
understand.
Writer makes few
errors in grammar or
spelling
that distracts
the reader
from the
content.
Writer makes 1 or 2
error
s in
capitalization or
punctuation, but the
paper is still easy to
read.
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader’s mind, but
occasionally the
words are used
inaccurately or seem
overdone.
Communication tone
and word choice
follow a schol
arly
style (passive
voice/third person).
5%
Most sentences are
well-constructed but
have a similar
structure.
Most sentences
sound natural and
are easy-on-the-ear
when read aloud, but
several are stiff and
awkward or are
difficult to
understand.
Writer makes some
errors in grammar or
spelling that distracts
the reader from the
content.
Writer makes a few
errors in
capitalization
and/or
punctuation that
catch
the
reader’s
attention and
interrupts the
flow.
Writer uses words
that
communicate
clearly, but the
writing lacks variety,
punch or flair.
Communication tone
and word choice is
occasionally
informal
(active
voice/first person)….
3.75%
Sentences
lack structure
and appear
incomplete
or rambling.
The
sentences are
difficult to
read aloud
because they
sound
awkward, are
distractingly
repetitive, or
are difficult
to
understand.
Writer makes
many errors
in gram
mar
or spelling
that distracts
the reader
from the
content.
Writer makes
several errors
in
capitalization
and/or
punctuation
that catches
the reader’s
attention and
greatly
interrupts the
flow.
Writer uses a
limited
vocabulary
that does not
communicate
strongly or
capture the
reader’s
interest.
Jargon or
clichés may
be present
and detract
0%
Paper
lacks
clarit
y.
Lang
uage
or
sente
nce
is so
mudd
led
that
it’s
mean
ing is
uncle
ar in
nume
rous
spots
.
Error
s in
punct
uatio
n,
spelli
ng,
gram
mar
and
usage
are
highl
y
distra
cting.
Com
muni
catio
n
tone
is
highl
y
infor
mal
and
does
MEXICAN-AMERICAN CULTURE AND HEALTH 11
from the
meaning.
Communicati
on tone and
word choice
is informal
(active
voice/first
person).
not
follo
w a
schol
arly
style.
Paper
relies
on
gener
alizat
ions.
APA format & Referencing 15%
No errors in APA
style. Title page and
numbering is complete
and
accurate.
Citations and
references are in
proper APA format.
Numerous sources are
cited. All claims are
supported with a
professional
reference.
12.75%
Rare errors in APA
style. Title page and
numbering is
complete and
accurate.
Citations and
references are in
proper APA format.
Many sources are
cited. Some claims
leave the reader
looking for a
reference.
7.5%
Errors in APA style
are noticeable.
Title
page and numb
ering
contains minimal
errors.
Citations and
references are in
proper APA format.
Many sources are
cited.
Many claims
leave the reader
looking for a
reference.
4.25%
Many errors
in APA style.
Title page
and
numbering is
incomplete
or inaccurate.
Citations and
references
are limited,
missi
ng or
incor
rect.
Many claims
leave the
reader
looking for a
reference.
0%
Title
page
and
numb
ering
are
missi
ng.
Citati
ons
and
refer
ences
are
missi
ng or
incor
rect.
Total maximum points for Research Paper = 92/100
HISPANIC/LATINO AMERICANS AND HIV 1
HISPANIC/LATINO AMERICANS AND HIV
Student’s Name
COH 310- Culture and Health
XXXXXXXXXXXXX
November 22, 2013
HISPANIC/LATINO AMERICANS AND HIV 2
Abstract
The purpose of this paper will be to discuss the prevalence of HIV among the
Hispanic/Latino community and how some of the disparities such as poverty, lack of educatio
n
and access play a role in the overall poor health that the Hispanic/Latino community is fac
ing.
In
addition, we will also discuss these cultures values, health beliefs, health issues as well as thei
r
morbidity and mortality rates. Finally, we will provide recommendations to promote awarenes
s
within the community.
HISPANIC/LATINO AMERICANS AND HIV 3
Hispanic/Latino Americans and HIV
Introduction
HIV is among one of the top causes of death for Hispanics/Latinos. This disease affects
both men and women of this community. HIV is more prevalent among young Latino males
(MSM) men having sex with men. Women are also impacted because they may not be aware of
their male partner’s sexual activities. HIV can be transmitted by male to male sexual contact,
heterosexual contact, injected drug use, or injected drug use/ MSM. In 2009 Hispanic/Latinos
accounted for a substantial percentage of new HIV cases and many have died as a result from
AIDS. There are many disparities that plague the Hispanic/Latino community. Poverty,
Education and Access to care are only naming a few. This paper will discuss the impact of these
disparities on the community and the recommendations to educate, prevention and engagi
ng
community stakeholders to assist. In addition, we will discuss the need for physicians
and
medical trained personnel to be culturally competent and sensitive to the needs of th
is
community.
Human Immune Deficiency Virus is one of the leading causes of death amongst
Hispanics/Latinos. Of the 197,090 diagnoses of the HIV infection from 2008, Hispanic/Latinos
account for 21% of the total, 16% are women, 18% of the infection attributed to heterosexual
contact according to the Center for Disease Control. Hispanic/ Latinos represent 16% of the total
United States population making them the largest ethnic group in the Nation (CDC, 2012).
Hispanic/Latino Americans are persons of Cuban, Mexican, Puerto Rican, South or Central
American or other Spanish Origin. Hispanics/Latinos have been present in the United States
since 1565 and primarily resided in what is now known as the most populous states, California,
Texas and Florida (Kline and Huff, 2008)
.
Comment [AI1]: Citation needed
Comment [AI2]: Sentence
structure
Comment [AI3]: Write out in full first
HISPANIC/LATINO AMERICANS AND HIV 4
According to the United States Census Bureau population rates as of July 1, 2011, there
are roughly 52.0 million Hispanics living in the United States, representing approximately 16.7%
of the U.S. total population, making people of Hispanic origin the nation’s largest ethnic or race
minority. The U.S. Hispanic population for July 1, 2050 is estimated to reach 132.8 milli
on,
constituting approximately 30% of the U.S. population by that date (US Census, 2011).
Among Hispanic subgroups, in 2010, Mexicans ranked as the largest at 63%. Follow
ing
Mexicans were Puerto Ricans 9.2%, Cubans 3.5%, Salvadorans 3.3%, Dominicans 2.8%, and the
remaining 18.2% were people of other Hispanic or Latino origins. Latinos view ill health as an
imbalance between the individual and his or her environment, with variables such as emot
ions
and social, physical and spiritual factors accounting for sickness, individuals will often seek
assistance from folk healers which can be either female or male, the use of rituals, prayers,
pledges, and herbal baths into effect healing. In addition, the yerbalista will employ herbal
prescriptions which can be brewed into a broth or tea. Or they will seek treatment from a
sobadora, typically female who uses massage and manipulation of the bone and joints to treat.
Overall Hispanic/Latino culture emphasizes wellness rather than illness. Illnesses are thought to
have either natural or supernatural origins. They also believe that health is a gift from god.
When it comes to a Western medical approach, trust and cost are major factors (Kline & Huff,
2008).
Some of the disparities that Latinos face are poverty, lack of education and access to care.
Many Americans are faced with the issue of poverty but it is more prevalent in minority groups.
A 2009 Census estimates show that of the nearly 50 million Latinos in the country, 28.2%
are
living below the poverty threshold of $23,500.00 (family of four) annually compared with 23.
4%
African Americans. That is 742,000 more than the official poverty count of 13,346,000
Comment [AI4]: Citation needed
Comment [AI5]: Citation needed
HISPANIC/LATINO AMERICANS AND HIV 5
Hispanics (US Census, 2009). The second disparity is the lack of education. Because of
poverty, many Hispanics/Latinos live in low income urban areas. There are few schools and the
student population is exceptionally high with minorities. Because of the segregation in these
educational institutions, schools who are predominantly minority tend to get less funding.
Without proper fund
ing,
schools have a lack of educational resources such as teaching material
s.
There is also little funding to make structural improvements and they cannot purchase the latest
technology. In addition, teachers’ salaries are not competitive enough to draw the necessary and
vital personnel to teach the regular curriculum so that students can learn comprehension and
critical thinking skills which will help them further in their education. In 2005,
Hispanics/Latinos represented 11.8% who had a high school diploma compared to 29.4% of
whites followed by 16.1% African Americans and 54% Asian (Census.gov). Hispanics accou
nt
for 9% drop outs with a GED credential and African Americans accounted for 20% and whites
29% according to Pew Hispanic Center tabulations of the 2008 American Community survey.
Finally, Access to care is also an issue for Latinos. There is a lack of minority medical students
within the United States. According to the AAMC, the U.S. Physicians by Race and Ethnicity,
2007, there are 2.8% Hispanic/Latino physicians across the nation. Because Hispanics/Latinos
represent such a high percentage of the population there are not enough Hispanic/Latino
physicians to treat this growing population (AAMC, 2013). Poverty levels, poor education and
the inability to obtain jobs that pay descent wages or offer medical health insurance, most
Hispanics/Latinos cannot afford the out of pocket costs for medical health insurance and rely on
public assistance such as Medicaid or they may not be covered by insurance at all. Because of
the inflated cost of healthcare and the drastic cuts to Medicaid, many are faced with having to cut
back on the care that they receive. In addition, for those who are not covered by insurance, other
Comment [AI6]: Citation??
Comment [AI7]: Citations missing
Comment [AI8]: Full name
Comment [AI9]: Write out in full first
Comment [AI10]: Citation missing
HISPANIC/LATINO AMERICANS AND HIV 6
life necessities come before medical care is rendered. For Latina women, their health is put
second to feeding their children and providing shelter for their families. In addition, most
impoverished Hispanics live in rural areas, in section 8 housing. These areas may not have the
funds to provide medical facilities for those in need. There could be an issue with the number of
HIV specialists that are available in rural areas or the HIV specialists are located in urban areas
and transportation can be an issue. In addition, language could be a barrier as well. Since there
are not enough Hispanic/Latino physicians the individual may not be inclined to seek treatment
from a white physician because they do not believe that the physician will listen. In regards to
mental health 1 of 10 Latinos report a major depressive episode. Mental ailments such as
depression are often related to physical health like being tired or having difficulty sleeping,
nervousness or irritabilityle and may not respond to individual and group therapies in the same
way as non-Latinos do (Kline & Huff, 2008). Latinos may not seek care for mental health
services due to access, lack of health insurance cost, or for lack of transportation.
In the Hispanic/Latino community most are not aware of their HIV+ status, they practice
don’t ask, don’t tell and/or they do not share their HIV status with their partners even if they do
know that they are HIV+. They will also decline treatment for lack of ability to pay for the
services, or will not follow treatment instructions given to them by physicians and take
further
risk by dropping out of their antiviral treatment and ignore the disease. When this happens,
many find themselves seeking care in the emergency rooms. By that time, most individuals who
were not aware of their HIV status would have transitioned into AIDS. This creates an
opportunity for opportunistic diseases such as Pneumocystis pneumonia, viral or fungal
infections to invade the body because an individual loses their ability for their natural disease
defense system or immunity to fight the disease. Many AIDS patients have prolonged stays
in
Comment [AI11]: Citations missing
HISPANIC/LATINO AMERICANS AND HIV 7
hospitals due to the lack of preventive care. Some AIDS patients are transferred to hospice care
for Palliative services when the patient is not responding to the treatment that is being given. At
this stage, palliative services are provided to support the patient, their family and to control the
patients pain until the patient expires (death occurs).
Young Latino males tend to be more at risk. Because they tend to have multiple partners
and may not be inclined to use a condom, many become infected with HIV or other sexuall
y
transmitted diseases. According to the CDC there are 50,000 new HIV infections annually.
Every 9.5 minutes someone in the United States is infected with the HIV virus. One in five
people infected, are not even aware that they contracted this disease (AIDS.GOV, year?). In
2009, Hispanic/Latinos accounted for 79% of new HIV infections in the United States (CDC,
2012). Hispanic/Latino men were two and half times as high as that of white men. In addition,
men having sex with men (MSM) accounted for 81% of the HIV infections among all Latino
men and 20% among all MSM. Among Latino MSM, 45% of the new infections occurred in
those under 30 years of age. Hispanic/Latina women accounted for 21%. They were more than
four times that of white women. During their lifetime 1 in 36 Hispanic/Latino men and 1 in 106
Hispanic/Latina women will be infected with HIV. In addition, there have been 636,000 deaths
since this epidemic began. More than 96,200 Hispanics/Latinos with an AIDS diagnosis have
died since 1981(AIDS.GOV).
The barriers that impact the Hispanic/Latino population can be grouped into personal,
systemic and community based. Personal barriers can include mental health status, cultural and
linguistic background, education level and family structure. Individuals may not possess the
education capacity to follow along with the program. There is also the language barrier.
Many
are limited in speaking the English language and they may not understand the verbal directions
Comment [AI12]: Citation missing
Comment [AI13]: Citation needed
HISPANIC/LATINO AMERICANS AND HIV 8
they are given. Systemic issues could result from location of the clinic, transportation barriers,
hours of clinic operations and the appearance of the care facility. Community barriers may be
political in nature or simply a matter of tradition. Engaging community leaders and
collaborating with community needs may constitute the difference between the failure or success
of the program (Kline &Huff, 2008)
The recommendations given to ensure the success of raising awareness of the
implications of HIV to the Hispanic/Latino community would be to raise awareness to those
that
have not been infected in the community or do not have an understanding about the severity of
contracting this disease by providing them with brochures and pamphlets explaining their disease
in their primary language. Engaging those who do not know about HIV or who do
not
understand HIV would be the primary target. Giving these individuals the opportunity to learn
more about the disease and how to prevent the spread of this disease would be extremely
valuable. The second recommendation would be to empower those who have already been
exposed to HIV. One way of doing this would be to target the population and educate them of
the importance of decreasing the risk of transmitting the disease to others and working with
physicians to educate this population with treatment options and resources such as free
medication programs and referrals to mental health specialists Mental health providers can then
offer emotional support to the patient and give them tools on ways to help them cope with their
disease and provide the patient with the necessary information so that he/she can make informed
decisions about their care. The third recommendation would be to focus on the framework to
ensure a reduction in the number of new HIV cases. Develop new programs that will help better
evaluate any approach to strengthening the preventative strategies to reduce health disparities as
HISPANIC/LATINO AMERICANS AND HIV 9
well as creating partnerships with stake holders for expansion of health education and promotion
of sexual health in the community. By developing partnerships with the stakeholders and
healthcare providers of the community, focus can be put on promoting awareness about HIV. It
will also set the stage to coordinate health fairs and raise awareness of HIV through World Aids
Day.
In conclusion, many Hispanic/Latinos male and female have been infected with HIV and
thousands of lives have been lost because of this devastating disease. Educating about the risks
associated with risky sexual behaviors and injection drug use can provide Hispanic/Latinos with
the necessary tools to better educate themselves about what they can potentially be exposed to
and if exposed, it would provide them with information on the treatment options so that he/she
can make an informed decisions about their care. In addition, increasing the number of culturally
competent physicians and medical personnel and setting protocols in place to meet the needs of
the community can impact the success of any program in a positive way.
HISPANIC/LATINO AMERICANS AND HIV 10
References
America Needs a More Diverse Physician Workforce. (2004). Retrieved November 21, 2013,
from AAMC: https://www.aamc.org/download/87306/data/
CDC(2011, August). Retrieved November 17, 2013, from Strategic Plan Division of HIV
Prevention: http://www.cdc.gov/hiv/pdf/policies_DHAP-strategic-plan
Department of Health. (n.d.)Retrieved November 17, 2013, from
http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/plan/stds/focus_area_1.htm
Health disparities Experienced by Latinos- United States. (2004, October 15). Retrieved
November 20, 2013, from CDC: http://www.cdc.gov.mmwr/preview/mmwrhtml/mm5340al.htm
HIV among Latinos. (2011, November). Retrieved November 20, 2013, from CDC:
http://www.cdc.gov/hiv/pdf/risk_latino
HIV/AIDS & Socioeconomic Status. (n.d.) Retrieved November 17, 2013, from American
Psychological Association: http://www.apa.org/pi/ses/resources/publications/factsheet-hiv-
aids.aspx
HIV/AIDS Patient Education. (n.d.)Retrieved November 17, 2013, from Vitals: HYPERLINK
“http://www.vitals.com/patient-education/hiv-aids” http://www.vitals.com/patient-education/hiv-
aids
Huff, M. V. (2008). Health Promotion in Multicultural Populations. Northridge: SAGE
Publications.
U.S. Statistics. (n.d.). Retrieved from AIDS.GOV: aids.gov/hiv-aids-basics/hiv-aids-
101/statistics/
(n.d.)Retrieved November 17, 2013, from http://aids.gov/hiv-aids-basics/hiv-aids-
101/statistics/index.html
Comment [AI14]: Not in proper APA format
Many references are missing in-text
http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/plan/stds/focus_area_1.htm
http://www.cdc.gov/hiv/pdf/risk_latino
http://www.apa.org/pi/ses/resources/publications/factsheet-hiv-aids.aspx
http://www.apa.org/pi/ses/resources/publications/factsheet-hiv-aids.aspx
http://www.vitals.com/patient-education/hiv-aids
http://www.vitals.com/patient-education/hiv-aids
HISPANIC/LATINO AMERICANS AND HIV 11
Outstanding
Achievement
Commendable
Achievement
Marginal
Achievement
Unsatisfacto
ry
Achieveme
nt
Faili
ng
Identified a
cultural
group
Description of the
target
group
historical
perspective
Demographics
5%
Clearly defines
cultural group in
terms of history,
geography and
population
characteristics
4%
Clearly defines a
cultural group
without
adequately
describing some
characteristics
3%
Defines a cultural
group
without
adequately
describing many
important
characteristics
2%
Lists a
cultural
group
without
further
definition
0%
miss
ing
Identified health
disparities
Health issues and
disparities
Morbidity and
mortality rates
Patterns of Care
Access to care
Mental health
issues
2
0%
Clearly identifies
disparities by
comparing
descriptive
epidemiology of
group to majority
group or other group
15%
Clearly identifies
disparities using
descriptive
epidemiology
however without
adequate
comparisons
10%
Correctly lists
health
disparities
without adequate
descriptive
epidemiology
5%
Lists health
disparities
incorrectly
0%
miss
ing
Identified health
behaviors
Preventive and
protective health
behaviors
Sick-role behaviors
Illness behaviors
Societal health
behaviors
20%
Clearly describes all
common health
behaviors with
supporting
evide
nce
15%
Clearly describes
most common
health behaviors
missing some
categories
10%
Correctly lists
health behaviors
without adequate
references to
commonality
5%
Lists health
behaviors
incorrectly
0%
miss
ing
Identified health beliefs 15%
Clearly describes
commonly held
attitudes, beliefs and
values
12.75%
Clearly describes
some
health
beliefs
7.5%
Correctly lists
health beliefs
without adequate
reference to
cultural group
4.25%
Lists health
beliefs
incorrectly
0%
miss
ing
Identified
contributing
factors
Barriers to health
and healthcare
10%
Clearly discusses
socio-economic,
language, political,
religious and other
factors that
contribute to the
health disparity
7.5%
Clearly discusses
some contributing
factors
5%
Correctly lists
some contributing
factors
3.75%
Lists
contributing
factors
incorrectly
0%
miss
ing
Recommendations & 5% 3.75% 2.5% 1.25% 0%
HISPANIC/LATINO AMERICANS AND HIV 12
Conclusion Provides strong,
clear, convincing
conclusions.
Strong supporting
evidence is present.
Consistently relevant
detail
support the
conclusions made.
Offers
recommend
ation(s)
Provides cl
ear
conclusions
Supporting
evidence is present
with detail.
Uses generalized
(not specific)
examples to
support the
conclusions made.
Offers
recommendation(s)
Provides weak
conclusions
Some supporting
evidence and
minimal detail is
present.
Offers
recommendation(s)
No
conclusions
articulated.
Supporting
evidence
and detail is
lackin
g.
Offers
recommend
ation(s)
miss
ing
Writing Style 10%
All sentence
s are
well-constructed
with varied
structure.
All
sentences sound
natural and are easy-
on-the-ear when read
aloud. Each sentence
is clear and has an
obvious emphasis.
Writer makes no
errors in grammar
or
spelling that distracts
the reader
from the
content.
Writer makes no
erro
rs in
capitalization or
punctuation, so the
paper is
exceptionally easy to
read.
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader’s mind, and
the choice and
placement of the
words seems
accurate, natural and
not forced.
Communica
tion
tone
and word choice
7.5%
Most sentences are
well-constructed
with varied
structure.
Almost all
sentences sound
natural and are
easy-on-the-ear
when read aloud,
but 1 or 2 are stiff
and awkward or
difficult to
understand.
Writer makes few
errors
in gram
mar
or spelling that
distracts
the reader
from
the content.
Writer makes 1 or
2 errors in
capitalization or
punctuation, but
the paper is still
easy to read.
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader’s mind, but
occasionally the
words are used
inaccurately or
seem overdone.
5%
Most sentences are
well-constructed
but have a similar
structure.
Most
sentences
sound natural and
are easy-on-the-ear
when read aloud,
but several are stiff
and awkward or
are difficult to
understand.
Writer makes some
errors in grammar
or spelling that
distracts the reader
from the content.
Writer makes a
few errors in
capitalization
and/or
punctuation
that catch the
reader’s
attention
and interrupts the
flow.
Writer uses words
that communicate
clearly, but the
writing
lacks
variety, punch or
flair.
Communication
tone
and word
3.75%
Sentences
lack
structure
and appear
incomplete
or rambling.
The
sentences
are difficult
to read
aloud
because
they sound
awkward,
are
distractingly
repetitive,
or are
difficult to
understand.
Writer
makes
many errors
in grammar
or spelling
that
distracts the
reader from
the content.
Writer
makes
several
errors in
0%
Pape
r
lacks
clarit
y.
Lang
uage
or
sente
nce
is so
mud
dled
that
it’s
mea
ning
is
uncl
ear
in
num
erou
s
spots
.
Erro
rs in
punc
tuati
on,
spell
ing,
HISPANIC/LATINO AMERICANS AND HIV 13
follo
w a
scholarly/report-
writing style (passive
voice/third
person).
Communication
tone and word
choice follow a
scholarly style
(passive voice/third
person).
choice is
occasionally
informal
(active
voice/first
person)….
capitalizatio
n and/or
punctuation
that catches
the reader’s
attention
and greatly
interrupts
the flow.
Writer uses
a limited
vocabulary
that
does
not
communicat
e strongly
or capture
the reader’s
interest.
Jargon or
clichés may
be present
and detract
from the
meaning.
Communica
tion tone
and word
choice is
infor
mal
(active
voice/first
person).
gram
mar
and
usag
e are
highl
y
distr
actin
g.
Com
muni
catio
n
tone
is
highl
y
infor
mal
and
does
not
follo
w a
scho
larly
style
.
Pape
r
relie
s on
gene
raliz
ation
s.
APA format &
Referencing
15%
No errors
in APA
style. Title
page and
numbering is
complete and
accurate.
Citations and
references are in
proper APA format.
12.75%
Rare errors in APA
style. Title
page
and numbering is
complete and
accurate.
Citations and
references are in
proper APA
7.5%
Errors in APA
style are
noticeable.
Title
page and
numbering
contains minimal
errors.
Citations and
4.25%
Many errors
in APA
style. Title
page and
numbering
is
incomplete
or
0%
Title
page
and
num
berin
g are
miss
ing.
HISPANIC/LATINO AMERICANS AND HIV 14
Numerous sources
are cited. All claims
are supported with a
professional
reference.
format. Many
sources are cited.
Some
claims leave
the reader looking
for
a reference.
references are in
proper APA
format. Many
sources are cited.
Many claims leave
the reader looking
for a reference.
inaccurate.
Citations
and
references
are limited,
missing or
incor
rect.
Many
claims leave
the reader
looking for
a reference.
Citat
ions
and
refer
ence
s are
miss
ing
or
incor
rect.
Total maximum points for Research Paper = 90.25/100