Academic journal article Health and Social Work

Use and Implications of Ethnomedical Health Care Approaches among Central American Immigrants

Academic journal article Health and Social Work

Use and Implications of Ethnomedical Health Care Approaches among Central American Immigrants

Article excerpt

Many segments of the Latino population hold a worldview that includes beliefs that illness and health are strongly influenced by spiritual and religious factors that may ultimately affect health outcomes (Congress & Lyons, 1992; Fishman, Bobo, Kosub, & Womeodu, 1993; Landrine & Kionoff, 1994; Pachter, 1994).Many of these beliefs are part of complex medicine systems that originated in pre-Columbian times and remain to this day present among some segments of the Latino population. For instance, the Mayans had developed a complex medicine system that Garcia, Sierra, and Balam (1999) compared to the Chinese medicine system. They concluded that the Mayan system sees human beings "in an integral and interactive relation with the cosmos, which includes both nature and society" (Garcia et al., 1999, p. xxxiv). Thus, health is attributed to the equilibrium between forces of nature and illness is attributed to the disequilibrium of these forces. Breaking the equilibrium between the forces of nature, or breaking the bal ance in the community institutions, could bring negative effects on the individual, the family, or the community.

Spiritual and cosmogonic worldviews frequently found among Latinos influence ethnomedical approaches, such as the use of spiritual folk healers and folk remedies, which ultimately influence health outcomes. When health care providers are not familiar with a worldview other than their own, they may encounter difficulties in understanding, treating, and communicating with Latinos. Health care providers also may fail to recognize or accept the many ethnomedical approaches available to treat general physical illnesses and illnesses specific to Latino groups (Guarnaccia, De La Cancela, & Carilo, 1989; KossChioino, 1995; Marsh & Hentges, 1988; Pachter, 1993; Zea, Quezada, & Beigrave, 1997).

The use of ethnomedical approaches among the different Latino communities is prevalent where there are large concentrations of Latinos (Koss-Chioino, 1995). Large-scale descriptive investigations documenting the extent of ethnomedical use by Latinos in the United States have been conducted with Mexican Americans (Higginbotham, Trevino, & Ray, 1990; Marsh & Hentges, 1988; Rivera, 1988; Skaer, Robison, Sclar, & Harding, 1986). Few studies have examined the frequency of ethnomedical use with Caribbean Latinos (Brandon, 1991; Pachter, Cloutier, & Bernstein, 1995; Zalvidar & Smolowitz, 1994). There is a dearth of descriptive information regarding the use of ethnomedical approaches among Central and South Americans.

CENTRAL AMERICAN IMMIGRANTS

Central and South Americans make up 23 percent of the Latino population in the United States and are the most recent Latino immigrants arriving in this country (Zea, Diehl, & Porterfield, 1997). Central America comprises Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, and Belize, although Belize is not part of Hispano-America. In the 1970s and 1980s, a large influx of Central Americans arrived in the United States as a result of political persecution, repression, and civil wars.

It has been difficult for Central American immigrants to attain high educational levels, health benefits, documented immigrant status, and adequate employment on immigrating to the United States (Zea, Diehl, & Porterfield, 1997). Many Central American immigrants face mental health concerns as a result of their violent political history (Garcia & Rodriguez, 1989; Montes & Garcia, 1988). In addition, they have had to deal with the stress of adapting to a new culture. All these factors have been implicated in negative health outcomes (Aday & Anderson, 1984; Chesney, Chavira, Hall, & Gary, 1982; Higginbotham et al., 1990). Moreover, attitudes of health care providers toward ethnomedical approaches often serve as barriers to keep Central American patients from disclosing their healing practices and adhering to prescribed care, which in turn may increase negative health outcomes. …

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