Entry into Mainland Health Systems
Puerto Ricans living in New York City and other parts of the northern United States experience a high rate of illness and hospitalization during their first year on the mainland, as do other people of Hispanic origin. It is worthwhile consider- ing the vast differences between living in New York and living in Puerto Rico. In Puerto Rico, there is no winter weather. The winters in the North can be bitterly cold, and adjustment to climate change in itself is extremely difficult. Migrant people may be forced to live in crowded living quarters with poor sanitation.
Puerto Ricans seeking health care may go to a physician, a folk practitio- ner, or both. The general progression of seeking care is as follows:
1. The person seeks advice from a daughter, mother, grandmother, or neighbor woman. These sources are consulted because the women of this culture are the primary healers and dispensers of medicine at the family level.
Table 12–7 Examples of Cultural Phenomena Affecting Health and Health Care among Hispanic Americans
Nations of Origin Hispanic countries: Spain, Cuba, Mexico, Central and South America, Puerto Rico
Environmental Control Traditional health and illness beliefs may continue to be observed by “traditional” people Folk medicine tradition Use of herbs, teas, lotions, and candles Traditional healers: curandera, espiritista, partera, senoria
Biological Variations Diabetes mellitus Parasites Coccidiodomycosis Lactose intolerance
Social Organization Nuclear families Large, extended family networks Compadrazzo (godparents) Strong church affiliations within community Community social organizations
Communication Primary language: Spanish or Portuguese
Space Tactile relationships: touch, handshakes, embrace Value physical presence