Transcript Understanding the Cultural Context of Cultural Responsiveness

Understanding the Cultural Context of Cultural
Responsiveness for Latinos
By
Isabel S. Perez-Yanez, MPH,
CHES, CATC
Focus of Presentation
Overview of Latino Trends
 Cultural Context Perspective
 Cultural Responsiveness not a Trend
 Hope, Health and Healing
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Myth of Cultural Competency
Competent implies we have reached a
level of competency
 Diverse meanings; sensitivity, diversity,
human diversity, tolerance
 Diversity promotes separation
 What is culture?
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Responsive services
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What are they?
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Meet needs of the client
Consider ecological factors
Do not compartmentalize
Evaluates physical, psychological, emotional and
spiritual needs of clients
Evaluates client social, relational and cultural strengths
and needs
Respectful
Culturally attuned
Yvette G. Flores, Ph.D.
Understanding the Cultural Context for
Responsive services
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What are they?
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Meet needs of the client
Consider ecological factors
Do not compartmentalize
Evaluates physical, psychological, emotional and
spiritual needs of clients
Evaluates client social, relational and cultural strengths
and needs
Respectful
Culturally attuned
Yvette G. Flores, Ph.D.
Factors Effecting the Lives of Latinos
Individual
 Family
 Cultural Values
 Collectivism/
Interdependence
 Migration
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Environment
 Systems &
Institutions
 Laws and Policies
 Stereotypes,
Racism,
Oppression
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Hispanics Account for More than Half of
Nation's Growth in Past Decade
The 2010 Census counted 50.5 million Hispanics
California at Glance
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Hispanic Population
13,682,000
Hispanics as Percent
of State Population
37%
Median Age of Hispanics
27
Median Income, Hispanics
16+
$20,500
Poverty Rate,
Hispanics 17 and Younger
27%
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Hispanics Without
Health Insurance
29%
Hispanic Homeownership
45%
Hispanics as Percent of
All K-12 Students
49%
Source: PEW Hispanic
Center
www.latina.org
Diversity Amongst Latinas/Latinos
We are Mexicans, Honduran, Puerto
Ricans, Argentineans, Cuban,
Salvadorans, Dominicans, Panamanians,
Guatemalans, Nicaraguans, Peruvians,
Costa Ricans, Bolivians, Chileans,
Colombians, Venezuelans and more………
 Black, white, rainbow of colors and
different racial preferences
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Source: Latinas/os in the United States: Changing the Face
of America
Diversity Amongst Latinas/Latinos
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What we call ourselves
Mostly Catholics, Protestants, Jewish, Islamic,
atheists, Santeros/as Curanderos/as
Born here prior to this land became United States
Born here after, fairly recent arrivals
Speak only English, bilingual, only Spanish,
Mayan Languages, and other languages
Source: Latinas/os in the United States: Changing the Face of
America
Traditional Hispanic Values, Characteristics, Behavior
Patterns
Family Values (familismo) very important,
respect & loyalty
 Cooperation rather than competition
 Interpersonal relationships very important
 Deep respect and affection among friends
and family
 Strictness of child rearing, religiosity,
respect for adults
 Extended family, non-blood relatives
 Father (responsible) children (obedient)
god- parents (resourcefulness
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Source: Counseling Culturally Diverse, Theory and Practice, 5th Edition,
Derald Wing Sue, David Sue
Migration
•Despite policy changes and the increased
militarization of the U.S.-Mexico border,
thousands of men and women continue to
make the journey north
•Generally the migration is motivated to
improve the living conditions of their families
left behind
•Post migration alcohol and drug use is
likely to increase
•Migration is considered a significant risk
Yvette G. Flores, Ph.D.
factor for both those who leave and those Source:
University of California, Davis
Chicana & Chicano Studies
who remain
Program
Buying Power
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Latinas/Latinos’ buying power increased from
$211.9 billion in 1990 to $978.4 billion in 2009
Projected to climb to $1.3 trillion in 2014.
The percentage change between 1990 and 2014
is 528%, the highest of all race/ethnic groups
Share of the consumer market was 9.1% in 2009
Source: Changing workplaces. Changing Lives, Catalyst, March 2010
Language at
Home: Persons 5
and Older
Only English
Spoken at Home
Language Other
than Only English
Spoken at Home
2,794,000
(23%)
9,420,000
(77%)
Higher Education Degrees
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From 2000 to 2004 number of collegebound Hispanic women increased by
22%-6% increase or more over Latinos
Source: WomensColleges.org
In 2006-2007-For Latinos/Latinas
7.5% getting bachelor’s
5.8% getting master’s degrees
3.4% getting PhD’s
Source: Changing workplaces. Changing Lives, Catalyst, March 2010
Remitance Senders and Recievers
6 million immigrants from Latin America
send families back home
 Flow from U.S. to Latin America and the
Caribbean close to $30 billion
 Continue to increase
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Culture and class as
determining variables
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Latino diversity derives from differences in class,
education, and value systems
Values can be traditional, transitional or
contemporary values
Values are influenced by the person’s
relationship to the means of production
At any given time, values and class interact to
influence specific behaviors, attitudes or
practices
Source: Bernal & Alvarez
19
Yvette G. Flores, Ph.D.
Substance Abuse Patterns
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Binge Drinking –Latinos have a rise in numbers
now higher than the national average
U.s. born Hispanic Americans higher rates of
substance abuse compared to those born in their
native born
More acculturated to the American culture ,
higher substance abuse pattern
Research and News, August 3, 2010, SAMHSA
Latinos and Treatment
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Hispanics are among the highest percentages of
those needing but not receiving treatment
compared with their respective percentage of the
total in treatment.
Have the next highest percentage of needing but
not receiving treatment for illicit drug or alcohol
use
Hispanics showed a pattern of steady increase of
admissions
Source: 2010 California Needs Assessment Report
Substance Abuse & Other Issues
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Substance abuse is the most common behavioral risk factor
reported by patients with TB in the U. S.
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Hispanics and Asian/Pacific Islander account for 82% of
TB Cases in California in 2008
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Latinos were second highest arrested for misdemeanor drug
offense for Marijuana, Other drugs, public intoxication, and
liquor laws
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45.6% adult and juvenile were arrested for felony and
misdemeanor DUI age 12 and up
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Latinos were second highest for at risk gambling, problem
gamblers, pathological gambling
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Source: 2010 California Needs Assessment Report
Latina Population Type of Service, 2005
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Long-Term Residential 18. 5%
Short-term Residential 1.1 %
Day Treatment/ Intensive outpatient 8.4%
Outpatient Treatment 62. 2%
Detox-Residential 5.5%
Detox-Hospital 0.0%
Detox-outpatient 4.3%
Source: Resources for Latina Population, California Women Children and
Families TA Project, A project of Children and Family Futures, Funded by
the California Dept of Alcohol & Drug Programs, Marta Ortegon and
Deborah Werner
Primary Drug of Choice, 2005
51% -Methamphetamine
 15% Heroin
 14% Alcohol
 12% Marijuana/Hashish
 8% Other
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Source: Resources for Latina Population, California Women Children and
Families TA Project, A project of Children and Family Futures, Funded by
the California Dept of Alcohol & Drug Programs, Marta Ortegon and
Deborah Werner
Incarceration Rates
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Between 1991 and 2007- number of offenders
sentenced in federal courts doubles (118%)
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During the same period, Hispanic offenders
nearly quadrupled 270% from 7, 924 in 1991 t0
29, 281 in 2007.
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Hispanics accounted for more than half (54%) of
the growth in the number of sentenced federal
offenders over this period.
PEW Hispanic Center, February 18, 2009
Public Policy Institute of California, July 2011
Sources: California Department of Corrections and Rehabilitation data, 2010:
Census Bureau data. 2010. From: Just the Facts: California’s Changing Prison
Population, PPIC. 2011.
Latina and Substance Abuse Treatment
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In 2005, 15, 287 Latinas entered treatment for
alcohol and other drug problems
74% -Mexican, 22 % Other Hispanic/Latino, 2%
Puerto Rican
7% identified were pregnant at time of admission
53% of Latina admissions were under 30 years
Source: Resources for Latina Population, California Women Children and
Families TA Project, A project of Children and Family Futures, Funded by
the California Dept of Alcohol & Drug Programs, Marta Ortegon and
Deborah Werner
Dropout rates for White youth have remained below the
rates for other racial/ethnic groups
Juvenile Offenders and Victims: 2006 National
Report NCJJ/OJPP
Stereotyping Latina Adolescents
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Despite this popular perception, most
Latina girls do not fit the negative images
typically portrayed in the media.
Latina Girls, Voices of Adolescent Strength in the United States, Jill Denner , Bianca L. Guzman
Most research focuses on negative issues.
Stereotyping Latina Adolescents
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The common perception of a Latina
adolescent is a girl who makes poor
choices and who will likely drop out of
school, become a teenage mother, or be
the girlfriend of a gang member.
Latina Girls, Voices of Adolescent Strength in the United States, Jill Denner , Bianca L. Guzman
Punitive instead of positive
While Hispanic-Latino youth are less likely
to receive mental health services, they are
more likely to become involved with the
juvenile justice and/or child welfare
systems (Vega & Alegria, 2001).
Types of Trauma Stress
Community and
School Violence
 Complex Trauma
 Domestic Violence
 Medical Trauma
 Natural Disasters
 Neglect
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Physical Abuse
 Refugee and War
Zone Trauma
 Sexual Abuse
 Terrorism
 Traumatic Grief
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National Child
Traumatic Stress
Network
Provider characteristics
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Cultural incompetence
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Lack of information about Latinas
Stereotyping & over generalizing
Racial/ethnic/class differences
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Perception of Latinas as “the other”, foreigners,
trespassers, overly reproductive
Differences in world views
Linguistic differences
Yvette G. Flores, Ph.D.
Perceived Discrimination In US
Growing scientific evidence that the
subjective experience of discrimination
is detrimental to the mental health and
physical health of women, ethnic/racial
minorities, and the poor.
 Perceived discrimination (PD) is the
subjective experience of being treated
unfairly relative to others in everyday
experience.
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Journal of Health and Social Behavior,
Kessler, Williams,1999
Types of Racism-Related Stress
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Racism-related life event - significant
life experiences across various
domains.
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Vicarious racism experiences - through
observation and report from family,
friends, and even strangers.
Types of Racism-Related Stress
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Daily racism microstressors microaggressions-degradations, put
downs, slights, exclusions-being ignored,
disrespected, observed, stereotyped.
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Chronic-contextual stress - impact of
social structure, political dynamics,
institutional racism.
Stress and Discrimination
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Growing evidence that exposure to discriminatory
experiences is an ongoing aspect of life for
Latinos in and the Mexican-Origin population
within the U.S.
Gender differences in Discrimination and Health
In addition to general stress discrimination stress
as an ethnic minority places them at increased
risk for health and mental health problems
Source: Perceived Discrimination, Perceived Stress, and Mental and
Phsycial Health Among Mexican-Origin Adults, Floret, Tschann, Dimas,
Bachen, Pasch, de Groatl August 2008
Stress and Discrimination
Cumulative exposure compromises
psychological well-being and physical
health
 Need to include assessments for the
effects of discrimination stress with other
chronic stress relevant to this population
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Source: Perceived Discrimination, Perceived Stress, and Mental
and Physical Health Among Mexican-Origin Adults, Floret,
Tschann, Dimas, Bachen, Pasch, de Groatl August 2008
Education
Schools frequently punished students with
the greatest academic , social, and
emotional needs.
 Most likely to be suspended, expelled, or
removed from the classroom for
punishment, reveals that minorities,
(Blacks and Latinos) males, and low
achievers are vastly overrepresented.
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Source: Pedro Noguera PH.D, NYU. Schools, Prisons, and Social
Implications of Punishment
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forget the “ divide and
conquer” fall into the trap of
racism within our own culture “ as
long as people of color fight among
themselves, they can’t form
alliances confront the
establishment.” Counseling the Culturally Diverse, Theory
and Practice, 5th Edition, Derald Wing Sue, David Sue
Traditional Counseling
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Counseling and Therapy have oppressed,
harmed, damaged marginalized people
(often unintentionally)
Counseling Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue
Professional Education and Training
Focus tends to be on pathological lifestyles
and/or maintenance of false stereotypes
 Ethnocentric bias been highly destructive
to natural help giving networks of minority
communities
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( Duran, 2006) Counseling Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue, David Sue
5% Rule
Source: UCD-Civil Rights Training
Guiding Principles for
Gender-Responsive Services
•
Gender
•
Environment
•
Relationships
•
Women’s Services
•
Economic & Social Status
•
Community
Copyright © 2009, Stephanie S. Covington, Ph.D.
Cultural Context
& Social Justice
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Juvenile justice system must be purged
of the class and race discrimination that
sends disproportionate numbers of poor
kids and kids of color to Juvenile Hall--and eventually prison. Dirty - Meredith
Maran
Five Characteristics of Effective Helping
Professionals
Worldview Respect
 Hope
 Humility
 Trust
 Empathy
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Adapted from Fundamentals of Substance Abuse Practice, Jerry L. Johnson
Advice to Clinicians and Administrators in Substance
Abuse Treatment
Clinical
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Acculturation
 Express own feelings about heritage and self-perception
 Encourage exploration of strengths of cultural backgrounds,
histories, heritages, old & new ways to incorporate
spirituality into their lives
 Adopt acculturation assessment tools that include
information on migration patterns, experiences, stress,
country of origen, and specific endorsement of Latina
values
 Develop and provide psychoeducational family programs
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Source: Alvarez and Ruiz 2001: Caetano et al. 2007:CSAT 2003 b; Medina 2001- TIP 51
Resources
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,
2010 California Needs Assessment Report
Counseling the Culturally Diverse, Theory and Practice, 5th Edition, Derald Wing Sue,
David Sue
National Trauma Stress Network
Resources for Latina Population, California Women Children and Families TA Project,
A project of Children and Family Futures, Funded by the California Dept of Alcohol &
Drug Programs, Marta Ortegon and Deborah Werner

Latina Girls, Voices of Adolescent Strength in the United States, Edited by Jull Denner
and Bianca L. Guzman
Pedro Noguera PH.D, NYU. Schools, Prisons, and Social Implications of Punishment

Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among
Mexican-Origin Adults, Floret, Tschann, Dimas, Bachen, Pasch, de Groatl August 2008
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Pew Hispanic Center

Substance Abuse Treatment Addressing the Specific Needs of Women, TIP 51,
www.samhsa.gov
Women’s Health.gov.
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XOCHIQUETZAL:
She is a nature Goddess of beauty and is called the flower goddess. Goddess of birds,
butterflies, song, dance and love. Also a protector of artisans, prostitutes, pregnant
women and birth. Like Persephone, was kidnapped and taken from her husband,
Tlaloc, to the underworld by Tezcatlipoca a lord of the underworld.
Contact Information
Isabel S. Perez-Yanez, MPH, CHES,
CATC
4472 Edwards Lane
Castro Valley, CA 94546
(510)733-2390
E-mail: [email protected]