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    Length: A minimum of 150 words per post, not including references
    Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
    Citations need to be within 5 (Five)  years
    Context: Nursing in the USA

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Cultural, Spiritual, and Pracitces Among Latinos in South Central California

I live and work at a medical center in south central California in Tulare County. According to public records we have a population of 465, 861 and the ethnic make-up is 65.2% Hispanic, 28% white 3.2% Asians and 1.6% African Americans, according to Tulare County demographics as of 2019. Clearly Hispanic/Latinos make up the predominate cultural and ethnic group. If I am to be a successful practitioner to this population, I must become familiar with Hispanic customs, beliefs, and culture.

The Hispanic population is quite fluid. Many are here to work in agriculture as and such as seasonal and return to Mexico on the off season. This worker exists at the lower end of the economic earning scale and many do not have health insurance. In Mexico they are accustomed to pay for healthcare services when they need them, the concept of preventative health care does not resonate with this population. It is a strong patriarchal culture where men have the dominant role. The exception is in preganacy and childbirth, where the care and expertise are strictly matriarchal, with deference given to the opinion of elders (Shaak et al., 2018).

The Hispanic cultural is very strongly tied to Catholicism. The individuals are brought up in the Catholic traditions of the sacraments and prevailing church mores. The parish priest is looked to as the moral compass of the community. Health and illness are coming from God. The power of faith and prayer holds much significance to the Hispanic/Latino culture (Brintz et al., 2017). Historically, this population can not afford to access care. Even with health insurance they obtain care in busy rural clinics and sometimes must take a day off work to travel to that clinic (Poma, 1987). The local folk healers such as curanderos (healers), hueseros (bone setters) and sobadores (massage therapists) prove easy access and affordable care for this population. Some have postulated that the sole reason this population accesses care with folk healers are questions of economics, however studies have shown that the reason that they continue to seek care form folk medicine practitioners is an outgrowth of beliefs in the source of healing the meaning of illness. they seek care form these practitioners due to shared beliefs and cultures (Quandt et al., 2017).

To be an effective practitioner with this group it is imperative that the practitioner speak Spanish, the language that we grew up using is the language that is used in times of illness and stress. The practitioner must understand that even if the patient speaks English, they may still not understand medical concepts which are foreign to their belief system. Health literacy is a big issue both when discussing treatment and preventative services. As we see transculturally many individuals only seek medical care when they are ill and want a quick fix for health issue that have been deteriorating for years (Poma, 1987).

Hispanic women are quite shy when it comes to womens health issues Hispanic women have one of the lowest rates of PAP Smear screening for any ethnic group and consequently a higher rate of cervical cancer. Preganacy and birth are a gift to the community from God. The developing pregnancy is guided by the female elders of the family and they are the ultimate authority. Any discussion regarding the pregnancy must include the elder women in the discussion (Poma, 1987).

Providing healthcare to this cultural group contains some major challenges. It is through awareness and understanding that the practitioner can gain some level of respect form the patient and the family. It is prudent for the practitioner to understand health/illness beliefs and to seek a way to meld these beliefs with western biomedicine.

References
Brintz, C. E., Birnbaum-Weitzman, O., Llabre, M. M., Castaneda, S. F., Daviglus, M. L., Gallo, L. C., & Penedo, F. J. (2017). Spiritual well-being, religous activity, and metabolic syndrome: Results from the hispanic community health study/study of latinos sociocultural ancillary study. Journal of Behavioral Medicine, 40(6), 902-912. http://dx.doi.org/10.1007/s10865-017-9858-7
Poma, P. A. (1987). Preganancy in hispanic women. Retrieved from http://www.ncbi.nih.gov/pmc/articles/PMC2625605/pdf/jnma00924-0043.pdf
Quandt, S. A., Sanberg, J. C., Graham, A., Mora, D. C., Stub, T., & Arcury, T. A. (2017). Mexican sobadores in north carolina: Manual therapy in a new settlement context. Journal of Immigrant and Minority Health, 19(5), 1186-1195. http://dx.doi.org/10.1007/s10903-016-0466-3
Shaak, K., Johnson, M. B., Marsh, J. K., Hansen, S. E., Elaine, S. B., Stello, B., & Careyva, B. A. (2018). Exploring health beliefs among hispanic adults with prediabetes. Journal of Community Health, 43(5), 962-968. http://dx.doi.org/10.1007/s10900-018-0512-2

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