Discussion 1:Students will pay close attention to the section of acculturation and Middle Eastern American Families starting on page 273. For this discussion you will make a comparison of your culture based on how you were raised and the Middle Eastern culture focusing on any four (4) topics below. (If you want to do them all that is encouraged for a better understanding). Family roles (father, mother, children, extended family)Gender RolesMarriageFamily StructureParental DisciplineReligion and Social SupportCommunication StylesBe sure to use additional references to support or provide you with more information. Also include how their culture is portrayed in the media and whether any of the topics play a role in this portrayal.2:Read Esteban and Maria Luz’s stories in the Culture and Identity textbook.If you are a counselor with a Latino family (Dad, Mom, Son, Daughter, and Grandmother), discuss what cultural issues that may need to be considered working with the family and how you would counsel them. Be sure to review the article in the link, video, and the text as a basis of at least one issue to consider.
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Building Our Understanding: Culture Insights
Communicating with Hispanic/Latinos
Culture is a learned system of knowledge, behaviors, attitudes, beliefs, values, and norms that
is shared by a group of people (Smith, 1966). In the broadest sense, culture includes how people
think, what they do, and how they use things to sustain their lives. Cultural diversity results from
the unique nature of each culture. The elements, values, and context of each culture distinguish it
from all others (Beebe, Beebe, & Redmond, 2005).
Hispanics in the United States includes any person of Cuban, Mexican, Puerto Rican, South or
Central American, or other Spanish culture or origin, regardless of race. Latinos are people of
“Latin-American” descent (Webster’s 3rd International Dictionary, 2002). Widespread usage of
the term “Hispanic” dates back to the 1970s, when the Census asked individuals to self-identify
as Mexican, Puerto Rican, Cuban, Central/South American or “other Hispanic.” While the terms
Hispanic and Latino are used interchangeably, they do have different connotations. The Latino
National Survey (2006) found that 35% of respondents preferred the term “Hispanic,” whereas
13.4% preferred the term “Latino.” More than 32% of respondents said either term was
acceptable, and 18.1% indicated they did not care (Fraga et al., 2006).
Origin can be viewed as the heritage, nationality group, lineage, or country of birth of the
person or the person’s parents or ancestors before their arrival in the United States (U. S. Census
Bureau, 2000). People who identify their origin as Spanish, Hispanic, or Latino may be of any
race (Black/African-American, White/Caucasian, Asian, and Native American) or mixed race. In
the 2000 Census, seven million respondents designated themselves as multicultural: 48% of
Hispanics identified as “White only,” 2% of Hispanics identified as “Black only,” 42% of
Hispanics identified as “Some other race,” and 17% of Hispanics also reported belonging to two
or more races.
According to the 2008 U. S. Census Bureau population estimate, there are roughly 46.9
million Hispanics living in the United States (representing 15% of the total U. S. population).
Among Hispanic subgroups, Mexicans rank as the largest (66%) followed by Central and South
Americans (13%), Puerto Ricans (9.4%), Cubans (3.9%), and people of other Hispanic origins
(7.5%). Hispanics/Latinos are a fast-growing, diverse population in the United States. With their
growth surging nearly 58% from 1990 to 2000 that is more than four times the growth rate of the
U. S. population (U.S. Census, 2008a). These Culture Insights help you communicate with
them more effectively.
Insights into the Hispanic/Latino Culture
1. By 2011, nearly one person out of every six living in the United States will be of
Hispanic/Latino origin (Selig Center Multicultural Economy Report, 2006).
2. The traditional patriarchal structure grants the father or oldest male relative the greatest
power, whereas women are expected to show submission (Kemp & Rasbridge, 2004).
3. Hispanics come from a collectivistic culture where group activities are dominant,
responsibility is shared, and accountability is collective. Because of the emphasis on
collectivity, harmony and cooperation among the group tends to be emphasized more
than individual function and responsibility (Gudykunst, 1998).
4. Demographically, Hispanics/Latinos are younger than the non-Hispanic population. The
median age of the Hispanic/Latino population in 2006 was 27.5 years compared to that of
the U. S. population at 36.9 years. In fact, 62.7% of Hispanics/Latinos are 34 years of age
and younger (American Community Survey, 2008).
5. Income levels are rising. While the Hispanic/Latino median income is lower than the U. S.
average, data suggest that more Hispanics/Latinos are moving into the middle class
(earning at least $40,000). In addition, Hispanics/Latinos are an increasing proportion of
the total affluent market (defined as adults with household incomes of $100,000 or more).
From 1991 to 2000, the growth of affluent Hispanics/Latinos rose 126% (U.S. Census,
6. Hispanic/Latino teens are a growing segment. In 2006, Hispanic/Latino teens constituted
20% (estimated 6.3 million) of the U. S. teen population and accounted for more than
38% of the total Hispanic population in the United States (Cheskin Research, 2006).
7. Hispanics live longer. Despite having a lower income than white Americans, Hispanics
live longer than whites. Hispanics have an average life-expectancy of 75.1 years for men
and 82.6 years for women compared to white Americans of 74.8 years for men and 80.1
years for women (U. S Census Bureau, 2008a).
8. Getting diseases is a bigger concern than dying. For the Hispanic community, issues of
morbidity rather than mortality are of greatest concern, which include lifestyle and
behaviors affecting health; environmental factors such as exposure to pesticides, unclean
air and polluted water; and the ongoing need for more effective use of existing health
services (National Alliance for Hispanic Health, 2004).
9. Household size is larger. The average size of Hispanic/Latino households is 3.47 people
compared to 2.62 for the total population. In addition, the average family size of
Hispanics (3.92 people) is greater than that of the total U. S. population (3.22 people)
(American Community Survey, 2008).
10. Children are a big part of family households. In 2008, there were 10.4 million Hispanic
family households: 62% included children younger than 18; 66% consisted of a married
couple; 43% included a married couple with children younger than 18; and 70% of
Hispanic children lived with two married parents (U. S. Census, 2008a).
Culture Insights can help you to communicate more effectively with specific cultures in order
to influence their behavior. To develop Culture Insights, secondary data is collected and
analyzed from CDC-licensed consumer databases, books, articles, and the Internet. For more
information and resources, contact Dr. Stephanie Sargent Weaver with the CDC’s Healthy
Communities Program at SWeaver@cdc.gov.
Targeting Health Communication
Knowing the habits and preferences of Hispanics can help you plan effective health
communication efforts for this audience.
• Consider custom publications since they have proven to be an important way to communicate
with the Hispanic/Latino market. Companies such as Procter & Gamble and Sears have
invested millions to reach (and enhance their relationships with) Hispanic/Latino consumers
via custom publications in Spanish that address their lifestyle interests and needs (Doublebase
Mediamark Research & Intelligence, 2007).
• Hispanic/Latino teens respond best to bilingual ad messages—especially from Englishlanguage celebrities “who happen to slip in some Spanish”—because it mirrors their own
usage patterns (Cheskin Research, 2006).
• Research shows that while Hispanics consume every type of media, they do seem to have a
special attraction to television and radio. These are proven, effective channels in targeting
Hispanics (Sonderup, 2010).
• Language is an important aspect that one should be sensitive because it has less to do with
competency and more to do with the cultural meanings people attach to language. For
Hispanics/Latinos in the U. S., Spanish is a key marker of personal, social and political
identity. As a result, Spanish-language TV remains important for even those who are fluent
English speakers and who regularly watch English-language TV. In communicating with
Hispanics, it is not an either/or question but a matter of carefully integrating both languages to
best communicate with the Hispanic/Latino consumer in the U. S. (Tracy, 2004).
• Consider starting with the differentiation of U. S. born and non-U. S. born. By doing that, you
will know certain facts about them that will help you reach and communicate with them
• Understand that it is important to target health messages to men as well as women. Hispanics
typically subscribe to values of “machismo” and “marianismo” which culturally define the
desirable male and female qualities. True to these values, men are often reluctant to consult
physicians for health problems until someone is so ill that they must visit an emergency room.
Fathers/husbands may make other family members, especially their wives and daughters, to
wait until the last minute for care or take an uncooperative stance on the health care needs of
family members. (Parangimalil, 2001).
• Coordinate community outreach activities through established and trusted organizations and
people. For example, promotoras are trusted community health advisors and can be accessed
through Community Health Centers. They visit homes and individually work with families
(Maurana & Rodney, 2000).
• Understand that Hispanics/Latinos are assimilating to prevalent U. S. culture, but they are not,
and probably never will be, fully assimilated. Instead, theirs is a path of acculturation. It is a
process of integration of native and traditional immigrant cultural values with dominant
cultural ones (Sonderup, 2010).
• Culture is central in their health habits. These four characteristics have been consistently
identified as influencing health habits and should be reflected in communication:
(1) A reliance on traditional healing systems is common not only because it is culturally
approved but also because of the lower costs involved. Expensive modern medical care is
unaffordable for many.
(2) Collectivist values or group orientation permeates Hispanic life and individuals often look
to one another for opinions. A collectivist orientation may serve as a valuable asset in terms of
health promotion. For instance, dissemination of information about good health habits can be
easily achieved in a cost-efficient manner.
(3) An emphasis on the cultural diversity within the Hispanic population when conducting
health assessment and promotion. The subgroups of the Hispanic population such as Mexicans,
Puerto Ricans, and Cubans differ in their lifestyles, health beliefs, and health practices.
(4) Many recent immigrants are less educated that their U. S. counterparts. They may live a
marginal life here, on minimal incomes from low-paying jobs, without health insurance or
other fringe benefits. The acculturation struggle has become a source of stress, leading to
interpersonal conflicts, family breakdowns, and health problems. Hispanics often accord
health-related concerns a secondary relevance only, and traditional health- and illness-related
habits and behaviors linger (Parangimalil, 2001).
• Because of their collectivistic values and tendency to look to others to help guide decisions
and opinions, consider reaching them through social networks such as Facebook and MySpace
which facilitates such collective sharing of information and communication. A recent survey
found 44% of English-preferring Hispanics and 35% of Spanish-preferring Hispanics visit
MySpace regularly greater than any other ethnic group. Facebook was regularly visited by
18% of English-preferring Hispanics and 13% of Spanish-preferring Hispanics compared to
7% of non-Hispanic Whites (korzenny & Vann, 2009).
• When deciding where to focus health marketing and communication efforts, consider where
most Hispanics live. For example, the three primary country groups demonstrate affinities for
different regions, creating their own areas of concentration nationwide. The majority of
Mexicans live in the West (55%), 77% of Cubans live in the South and 59% of Puerto Ricans
live in the Northeast (U.S. Census Bureau, 2008a).
U.S. Hispanic Population, 2008
Top 10 States
Source: Pew Hispanic Center, 2008
Total U. S.
Magazines: # of issues read
in a month
Newspapers: # read in a 28
Radio: # of half-hours
listened to in a week
Television: # of half-hours
viewed in a week
Internet: # of times used in a
Source: Doublebase Mediamark Research & Intelligence, 2009.
• Overall, Hispanics said that the main reason they read magazines is to keep up to date on
the latest styles and trends (61%) (Doublebase Mediamark Research & Intelligence, 2009).
Top 5 Magazines Looked at by Hispanics (Last 6
People en espanol
Source: Doublebase Mediamark Research & Intelligence, 2009.
• The top reason that Hispanics reported for reading newspapers is because it keeps them
informed and up to date (55%) (Doublebase Mediamark Research & Intelligence, 2009).
• Minority newspapers are an inseparable part of the local minority community. They deliver
what no other mass medium can—news that is specifically geared to the needs and
concerns of individual minority communities (Sonderup, 2010).
• Newspaper readership skews to adult 34-54 age group with an average household income
of $40K+ (Sonderup, 2010).
• Hispanics reported that the top reason they watch television is because it is pure
entertainment (77%) (Doublebase Mediamark Research & Intelligence, 2009).
• 49% of U. S. Hispanics who watch television during prime-time hours, watch Spanish
language programming (Sonderup, 2010).
• 40% of Spanish-dominant Hispanics regularly watch English-language programming
• 30% of English-dominant Hispanics regularly watch Spanish programming (Sonderup,
Top TV Shows watched by Hispanics (2-4 times in last month)
American Idol (Fox)
Manana para Siempre
Dancing with the Stars
Gran Estreno (Univision)
Grey’s Anatomy (ABC)
Cuidado con el Angel
CSI: Miami (CBS)
Mujeres Asesinas (Univision)
Aqui y Ahora (Univision)
Source: Nielsen, 2009.
NOTE: These ratings are based on Hispanic viewership who watched the program while it aired
and those who viewed the shows via digital video recorder within 24 hours of their airing. The
rating is the percentage of households watching a TV program out of the potential audience of
11.63 million Hispanic households.
• Overall, the main reason Hispanics reported that they used the Internet because it is a
good source of learning (64%) (Doublebase Mediamark Research & Intelligence, 2009).
• The total number of Hispanics using the Internet in January 2010 was 23,625,000, an
increase of 3.3 million users from the previous year (comScore Media Metrix, 2010).
• 45% of online Hispanics (10.55 million) now use Facebook (comScore Media Metrix,
• 36% of English-preferring Hispanics visit social networking sites at least two or three
times a month (Korzenny & Vann, 2009).
• When segmenting by age, younger Spanish-preferring Hispanics (35 and younger) are the
least likely to use social media (33%) compared to 58% for English-preferring Hispanics
and 57% for non-Hispanic Whites. For those older than 36, both English-preferring
Hispanics (24%) and Spanish-preferring Hispanics (23%) are the most likely to visit
social networking sites more than two or three times a month (Korzenny & Vann, 2009).
• Online Hispanics are young, affluent, have large households, are “more enthusiastic
about the benefits of the Internet than the general market,” and are more sophisticated
technology users (AOL Advertising & Cheskin Research, 2010).
Top 5 Websites Visited by Hispanics (last 30
Source: comScore Media Metrix, 2010.
• The top reason that Hispanics reported for listening to the radio is because it puts them in
a good mood (56%) (Doublebase Mediamark Research & Intelligence, 2009).
• The most unique aspect of Spanish-language radio stations is the time spent listening.
The Hispanic population often listens to the radio all day. The entire family may listen to
one station and tune in, on average, 26-30 hours per week. This ranks more than 13%
above the general population (Sonderup, 2010).
Top 5 Radio Formats Preferred by Hispanics
Contemporary Hit Radio
Mexican/Tejano/Ranchera (subset of Hispanic)
Source: Doublebase Mediamark Research & Intelligence, 2009.
Top 5 Radio Networks Preferred by Hispanics
Dial Global Contemporary Network
Dial Global Complete FM Network
Premiere Mediabase Female
Dial Global Female Perspective
Source: Doublebase Mediamark Research & Intelligence, 2009.
Priority Health Concerns
Hispanics have lower mortality rates than the overall population but are at greater risk for a
number of chronic illnesses and diseases. Hispanic populations exhibit a number of positive
health indicators in terms of diet; low levels of smoking and illicit drug use; and a strong family
structure. However, the longer each generation has been in this country these positive indicators
tend to deteriorate (National Alliance for Hispanic Health, 2004).
Hispanics share a range of sociocultural characteristics, as well as national, experiential, and
in some instances genetic make-up, that can impact their health status within the United States.
For example, certain cultural factors such as a more traditional diet and lower rates of smoking
among women impact favorably on their health status. Other factors like low-immunization rates
linked to low-economic status and fear of authority among new immigrants have negative
consequences. Acculturation among new immigrants and their children seems to weaken the
positive health factors and lead to the adoption of negative ones from U. S. culture (such as
smoking, alcohol use, and early sexual activity).
The top ten leading causes of death for Hispanics of all age groups are:
1. Heart disease
2. Malignant neoplasms
3. Accidents and adverse effects
4. Human immunodeficiency virus infection (HIV),
5. Homicide and legal intervention
6. Cerebrovascular diseases
7. Diabetes mellitus
8. Chronic liver disease and cirrhosis
9. Pneumonia and influenza
10. Certain conditions originating in the prenatal period. (National Alliance for Hispanic
The top two leading causes of death are the same for the Hispanic and the non-Hispanic white
population: heart disease and cancer (National Alliance for Hispanic Health, 2004). The 2009
edition of Cancer Facts & Figures for Hispanics/Latinos reports that Hispanic/Latino Americans
have a unique cancer profile that requires a targeted approach to cancer prevention.
Hispanic/Latino Americans are less likely than non-Hispanic whites to develop and die from all
cancers combined as well as the four most common cancers (female breast, prostate, colorectum,
and lung). However, Hispanics have higher rates of several cancers related to infections
(stomach, liver, and cervix) and are more likely to have cancer detected at a later stage
(American Cancer Society, 2009).
The proportion of recent Mexican immigrant adults who characterize their health as fair to
poor is lower than that of long-term Mexican immigrants, U. S. born Mexican Americans and U.
S. born non-Latino whites. Even after age differences are factored, Mexican immigrants report
fewer chronic conditions overall, spend fewer days in bed because of illness, and have lower
mortality rates than U. S. born non-Latino whites (Dey & Lucas, 2006; Turra & Goldman, 2007).
Health Care-Seeking Behaviors
• Many Hispanics combine traditional health care practices with …
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