How Acculturation Impacts Health and Education

1
How Acculturation Impacts Health and Education

• CLASE Conference
• Leslie Rodriguez, RD, LD
• October 6, 2004

2
Presentation Overview

• The multicultural United States
• Define acculturation terminology
• Link between acculturation and health
• Link between acculturation and student
  achievement
• Possible problems with research conducted in this
  area
• Recommendations/Implications
• Resources
• Summary
• Questions

3
What is Culture?

• Many meanings
• Everything that makes a person who he/she is
• Attitude, behavior patterns, traditions, values,
  experiences, knowledge, language, and lifestyle
• Relationship to education/achievement and
  health/health-related behaviors

4
Multiculturalism of the U.S.

• U.S. has very diverse population
• in 1990, 1 in 4 adults was categorized as
  African, Asian, Hispanic, or American Indian
• by 2020, could be 1 in 3
• by 2050, could be 1 in 2

• Different backgrounds and cultures
• everyone doesnt fit neatly into a broad ethnic
  groups
• all have different cultures

5
Acculturation

• Complicated and multifaceted process
• One culture living among another culture
• Process of one group assuming the characteristics
  of another groups culture
• occurs consciously or unconsciously
• some new characteristics essential for
  survival-language
• some characteristics may have effect on health
  and/or achievement levels

6
History of Acculturation

• Early part of 20th century
• based on European immigrants
• Adolescents
• early studies showed that complete assimilation
  was best
• African-Americans and Latinos not believed to be
  distinct cultural group and thought to be
  inferior
• made them uninteresting to study

7
Assimilation versus Acculturation

• Assimilation is complete integration into
  dominant culture
• Occurs at 2 levels behavioral/cultural and
  structural
• Behavioral/cultural values and lifestyles
• Structural social groups, institutions, and
  organizations
• In U.S., minorities have not been fully
  integrated into mainstream culture at
  educational, political, or economic level
• This is why we study acculturation, instead of
  assimilation

8
Hispanics/Latinos in the U.S.

• Hispanic vs. Latino
• 1 in 8 people in U.S. of Hispanic origin
• 25 of total U.S. population in next 50 years
• Heterogeneous population
• Varying levels of acculturation

(U.S. Census Bureau, 2001)
9
Varying Acculturation Levels

• 12.8 million Latinos in U.S. (39) are foreign
  born
• 43 entered U.S. in 1990s
• 29.7 in 1980s
• 27.3 before 1980
• Still coming!
• Spanish-speaking population (proxy measure)
• In U.S., more than 28 million people speak
  Spanish at home, and about half of these people
  speak English less than very well.
• (U.S. Census Bureau, 2001)

10
How Acculturation Happens
Socioecological Influences
Social Behavior
Family Influences
Individual
Multicultural Influences
(Clark Hofsess, 1998)
11
The three phases of acculturation

• Contact
• When two or more cultural groups interact
• In educational setting-when children from
  non-European backgrounds enter school
• Conflict
• When two opposing belief systems clash results
  in power struggle
• In educational setting-Spanish names being
  translated
• Result acculturative stress
• Adaptation

12
Adaptation

• May take three forms and are all influenced by
  environmental and school demands
• Adjustment cultural behaviors of minority group
  become similar to those of dominant group to
  reduce conflict
• Language, values, customs, self-identification,
  taking the translated name, etc.
• Reaction minority group may experience
  aggression and disagreement regarding dominant
  cultures views
• Forming political groups or organizations to
  promote their culture or not responding when
  called on with translated name
• Withdrawal minority group withdraws from
  dominant group
• Segregation, building isolated communities,
  refusal to go to school

13
Measuring Acculturation

• Societal and individual level
• Behavioral and value dimensions
• Instruments measure several factors
• psychosocial
• sociodemographic
• how much culture lost, maintained, and adoption
  of new traits of dominant culture
• Language-based scales

14
Continuum of Acculturation
Unacculturated
Bicultural
Acculturated
(Clark Hofsess, 1998)
15
Cultural Matrix Model of Acculturation (Clark
Hofsess, 1998)
high
Unacculturated
Bicultural
Native Culture
Marginal
Acculturated
low
high
New Culture
16
Youth in school and acculturation

• In academic settings, Latino students are
  expected to absorb values, cultural traits, or
  characteristics not only of dominant culture, but
  also of school culture
• Expected to perform academically like the other
  kids
• Learning English is first major cultural trait
  that needs to be acquired to have a better chance
  at academic success
• Literacy demands multi-faceted, multi-layered
  process of acculturation trouble developing
  literacy skills
• Latino students continue to achieve below
  national norms in literacy
• Students who know English perform better on
  problem solving portion of standardized
  tests-will do better academically
• BUT-enhancement of problem solving skills does
  not have to come at the expense of students
  native culture/language

17
Latino youth and maintenance of culture/language

• Academic success has been attributed to high
  levels of acculturation or behavioral/cultural
  assimilation
• Keep in mind, though, that students culture or
  proficiency in Spanish has not been shown to
  negatively impact achievement or impede success
• In fact, skills in reading and writing in Spanish
  contribute to English proficiency
• Other factors contributing to lower achievement
  levels students learning styles, self-esteem,
  instructional methods, acculturative stress,
  discrimination (real and perceived)

18
Acculturation and Health

• Core beliefs and practices in relation to
  specific health or medical conditions not
  measured
• Hispanic immigrants have protective factors
• Health deteriorates as they live in American
  culture

(Molina et al., 1994 Bond et al., 2002)
19
Acculturation and SES

• Most acculturated have higher incomes and
  educational levels
• more likely to use prenatal, preventive, and
  primary health care services than less
  acculturated
• More low SES Latinos
• Is it acculturation or SES? What is the role of
  the level of education?

(Molina et al., 1994 Vega Alegria, 2001
Sorlie et al., 1993)
20
Acculturation and Drug Use

• Marijuana use 8x higher in English-speaking
  Mexican Americans
• English dominant Mexican Americans 25x more
  likely to use cocaine than Spanish speakers

(Amaro et al., 1990)
21
Acculturation and Pregnancy

• Teenage pregnancy
• more prevalent among U.S. born Hispanic mothers
• U.S. born also more likely to be unmarried at
  time of birth
• More low birth weight babies in U.S. born
  Hispanics
• less likely to smoke and better nutrition in
  Mexico

22
Acculturation and Pregnancy (continued)

• U.S. born Hispanic women more likely to begin
  prenatal care in first trimester
• Low acculturation linked to more breastfeeding

(Ventura Taffel, 1985)
23
Acculturation and Adolescents

• High levels of acculturative stress in Latino
  adolescents linked to depression and suicidal
  tendencies
• trapped between cultures
• acculturation gaps
• Acculturated pregnant Latinas more likely to do
  drugs, smoke, and consume alcohol

(Hovey King, 1996 Franco Zea, 1999 Amaro et
al., 1990)
24
Acculturation and Gender

• Smoking
• Higher smoking rates among less acculturated men
  and more acculturated women
• Sexual behaviors
• Machismo and marianismo
• More acculturated women engage in risky sexual
  practices
• Less acculturated men have more sexual partners

(Marin Marin, 1991 Wood Price, 1997)
25
Acculturation and Access to Care

• English preference associated with utilizing more
  health services
• Insurance coverage
• Breast cancer screening
• greater acculturation higher screening rates
• Withstands SES adjustments
• Is it acculturation or language barriers?
• Language as indication of functional integration

(Solis et al., 1990 OMalley et al., 1999)
26
Access to Care and Interpreters

• Not necessarily more likely to access health
  services if translator/bilingual individual is
  present
• Prefer person who can relate to them
• With Latino culture or background
• Culturally competent
• Promotoras have been shown to be very successful

(Solis et al., 1990 OMalley et al., 1999
Taylor et al., 2000)
27
Acculturation and Obesity

• Changes in dietary patterns
• Eat less healthy foods and more junk foods
• Less cooking from scratch
• Less physical activity
• Urbanization

(Gwynn Gwynn, 1997 Crespo et al., 2001
Luchsinger, 2001)
28
The Impact of Increased Acculturation on Health
Status of Latinos
Health Status
Acculturation
29
Problems with studies available on acculturation

• How is acculturation measured?
• Scales used-can they measure acculturation for
  all subgroups? How precise and appropriate are
  the scales? Are the instruments appropriate for
  children/youth?
• What subgroups have been studied?
• Bulk of research is with Mexican-Americans
• Deciphering between English proficiency, SES,
  education, etc. and acculturation
• What are the social norms, attitudes, and
  knowledge of Latinos in countries of origin?

(Deyo et al., 1985 Solis et al., 1990
Luschinger, 2001 Molina et al., 1994 Amaro et
al., 1990)
30
How to use this information

• Can be useful in predicting health-related
  behaviors and student achievement levels
• Can help when planning family interventions
• Interventions must take into account where along
  acculturation continuum target population lies
• Use of culturally appropriate programs
• Hispanic Paradox

31
Hispanic Paradox

• Lower mortality despite higher obesity rates,
  lack of insurance, and low education levels
• Want to increase acculturation at some levels
• Knowledge and education
• But, still emphasize traditional Latino customs
  for maintenance of protective behaviors
• (Vega Amaro, 1994)

32
So, what does all of this mean for you?
33
Research Community

• Observe
• Ask questions
• Involve parents and children to find out what is
  really going on at home and its influence on
  school or vice versa
• Find out about community resources
• Try to get a sense of where target population
  falls along the acculturation continuum
• This will help you determine what
  issues/challenges families may be facing

34
More things to consider

• Why are Latino students not performing well
  academically? Think about English proficiency,
  acculturative stress, how acculturation is
  impacting their health, etc.
• Support parents decision to maintain their
  native culture
• Encourage speaking Spanish at home and other
  cultural practices-assure them that becoming
  English literate will not mean they have to
  sacrifice their own identity

35
Acculturations Impact

• Some Latinos (less acculturated) many prefer
  Spanish programs and others (more acculturated)
  may prefer English
• Some may not be able to read either language
• May require picture-oriented tools and/or
  hands-on lessons
• Stress overall family health-important to Latinos
• Develop culturally competent programs/materials
  tailored to level of acculturation and understand
  the importance of maintenance of culture to
  Latinos

36
Resources

• Soy Única Soy Latina
• Promoting cultural pride among Latina youth
• www.soylatina.gov
• National Association for Bilingual Education
• Proud to be Bilingual essay contest
• www.nabe.org
• National Alliance for Hispanic Health
• www.hispanichealth.org
• American Diabetes Association
• www.diabetes.org

37
Summary

• Acculturations impact on education and family
  health
• Use of ideas related to acculturation in school
  setting
• Minority populations growing-need for more
  research on this subject

38
Thank You!Questions?????