Comparison of Cultural Values

Anglo Culture: The concept of self relies on a sense of personal identity that is in part job-defined and is characteristically gender balanced.

Latino culture: For Latino immigrants, their sense of identity is derived in large part by family membership in combination with nationality and gender specialization.

Identity is a multi-layered concept involving age, gender, name, sexual orientation, nationality, personal preferences, ethnicity, and culture. However among these different dimensions, some are more important than others within different cultures.

Personal Identity vs. Family Membership

When identifying ourselves in the States we focus on personal traits, e.g. "I am outgoing" or "I like kayaking", or our professions. We do not gravitate towards using group-related identifiers like roles (e.g. "I am a father"). Despite our great demographic diversity, we favor binary categories: man or woman, gay or straight, American or non-American, religious or atheist, able or disabled. So, specially in less cosmopolitan communities, we are puzzled by mixed races, bi-culturalism, non conforming genders, and alternative life styles. Often we do not feel comfortable until we have "figured somebody out" and by that I mean placed them into one of our mental boxes/categories. We enjoy certainty and are not too sure how to handle ambiguity in communication, expectations, values, and identity.

Job-defined vs. Nationality-defined Identity

In the States, shortly after being asked our name, the very next question tends to be "...and what do you do?". That is not the case for Latino immigrants. After exchanging greetings and names, it is customary to ask "¿Y de que país es Usted?" / "So, what country are you from?". That is because among immigrants, their country of origin, for example Mexico or El Salvador, is more defying of their identity than their profession.

Gender-balanced vs. Gender-specialized Identity

In the States men and women are essentially the same when it comes to basic legal rights, equal pay for equal work, and engaging in similar levels of responsibility, opportunity, and recognition. The male and female roles are interchangeable and it is socially acceptable to be a career woman as it is to be a stay-home dad.
In Latin Amercia each gender is specialized into roles that are only moderately flexible. Men are expected to be the heads of household, bread-winners, discipline enforcers, and ultimate decision makers on important decisions. Though many Latin women are receiving more education and are active in the workforce they are still expected to have a supportive, nurturing, domestic, child-rearing role.

Examples of Cultural Misunderstandings

Scenario A

Situation: A dietitian trains a diabetic man on how to fix nutritious and balanced meals but he is never around the kitchen and does not buy the food for the household. Because the wife was not present for the training, eating habits do not change. During the following month the patient's glucose spike several times a week.

Mitigation: The dietitian invites both husband and wife to the training. In recognition that the wife runs the household, she is educated regarding food purchases, preparation, portion size, and insulin storage.

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Scenario B

Situation: In an effort to be politically correct, a pediatrician asks the father (instead of the mother) what the baby's eating and sleeping habits are but he just looks confused and returns a blank stare back.

Mitigation: For a more fluid communication, the provider uses their understanding of established gender roles and directs questions relating to young children first to the mother.

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Scenario C

Situation: A pediatric surgeon asks a mother if she wants to proceed with her child's heart valve replacement. She asks for more time because she needs to consult with her husband first. Because the husband was not present nor was he part of the conversation, a new appointment needs to be set up and precious time is lost.

Mitigation: To reach a consensus faster on important decisions involving surgery, financial expenses, end-of-life matters, risky or experimental procedures, the provider will consult and involve the main male family authority figure, be it the father, husband, or eldest son.

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This article is part of a series on Latino Culture and Healthcare.
View the main article here.