309 People of Mexican Heritage Chapter 18 RICK ZOUCHA and CECILIA A. ZAMARRIPA Overview, Inhabited Localities, and Topography OVERVIEW People of Mexican heritage are a very diverse group geo- graphically, historically, and culturally and are not easy to describe. Although no specific set of characteristics can fully describe people of Mexican heritage, some common- alities distinguish them as an ethnic group, with many regional variations that reflect subcultures in Mexico and in the United States. A common term used to describe Spanish-speaking populations in the United States, including people of Mexican heritage, is Hispanic. However, the term can be misleading and can encompass many different people clustered together owing to a com- mon heritage and lineage from Spain. Many Hispanic people prefer to be identified by descriptors more specific to their cultural heritage, such as Mexican, Mexican American, Latin American, Spanish American, Chicano, Latino, or Ladino. Therefore, when referring to Mexican Americans, use that phrase instead of Hispanic or Latino (Vázquez, 2001). As a broad ethnic group, people of Mexican heritage often refer to themselves as la raza, which means “the race.” The Spanish word for race has a different meaning than the American interpretation of race. The concept of la raza has brought people together from separate worlds to make families and is about inclu- sion (Vázquez, 2000). HERITAGE AND RESIDENCE Mexico, with a population of 107,449,525 (CIA, 2007), is a blend of Spanish white and Indian, Native American, Middle Eastern, and African. Mexican Americans are descendants of Spanish and other European whites; Aztec, Mayan, and other Central American Indians; and Inca and other South American Indians as well as people from Africa (Schmal & Madrer, 2007). Some individuals can trace their heritage to North American Indian tribes in the southwestern part of the United States. Mexico City, one of the largest cities in the world, has a population of over 20 million. Mexico is undergoing rapid changes in business and health-care practices. Undoubtedly, these changes have accelerated and will continue to accelerate with the passage of the North American Free Trade Agreement as people are more able to move across the border to seek employment and edu- cational opportunities. Historically, people of Mexican heritage lived on the land that is now known as the southwestern United States for generations, long before the first white settlers came to the territory. By 1853, approximately 80,000 Spanish-speaking settlers lived in the area lost by Mexico during the Texas Rebellion, the Mexican War, and the Gadsden Purchase. After the northern part of Mexico was annexed to the United States, the settlers were not offi- cially considered immigrants but were often viewed as foreigners by incoming white Americans. By 1900, Mexican Americans numbered approximately 200,000. However, during the “Great Migration” between 1900 .

1. 309
People of Mexican
Heritage
Chapter 18
RICK ZOUCHA and CECILIA A. ZAMARRIPA
Overview, Inhabited Localities,
and Topography
OVERVIEW
People of Mexican heritage are a very diverse group geo-
graphically, historically, and culturally and are not easy to
describe. Although no specific set of characteristics can
fully describe people of Mexican heritage, some common-
alities distinguish them as an ethnic group, with many
regional variations that reflect subcultures in Mexico and
in the United States. A common term used to describe
Spanish-speaking populations in the United States,
including people of Mexican heritage, is Hispanic.
However, the term can be misleading and can encompass
many different people clustered together owing to a com-
mon heritage and lineage from Spain. Many Hispanic
people prefer to be identified by descriptors more specific
to their cultural heritage, such as Mexican, Mexican
American, Latin American, Spanish American, Chicano,
Latino, or Ladino. Therefore, when referring to Mexican
Americans, use that phrase instead of Hispanic or Latino
(Vázquez, 2001). As a broad ethnic group, people of
Mexican heritage often refer to themselves as la raza,

2. which means “the race.” The Spanish word for race has a
different meaning than the American interpretation of
race. The concept of la raza has brought people together
from separate worlds to make families and is about inclu-
sion (Vázquez, 2000).
HERITAGE AND RESIDENCE
Mexico, with a population of 107,449,525 (CIA, 2007), is
a blend of Spanish white and Indian, Native American,
Middle Eastern, and African. Mexican Americans are
descendants of Spanish and other European whites;
Aztec, Mayan, and other Central American Indians; and
Inca and other South American Indians as well as people
from Africa (Schmal & Madrer, 2007). Some individuals
can trace their heritage to North American Indian tribes
in the southwestern part of the United States.
Mexico City, one of the largest cities in the world, has
a population of over 20 million. Mexico is undergoing
rapid changes in business and health-care practices.
Undoubtedly, these changes have accelerated and will
continue to accelerate with the passage of the North
American Free Trade Agreement as people are more able
to move across the border to seek employment and edu-
cational opportunities.
Historically, people of Mexican heritage lived on the
land that is now known as the southwestern United
States for generations, long before the first white settlers
came to the territory. By 1853, approximately 80,000
Spanish-speaking settlers lived in the area lost by Mexico
during the Texas Rebellion, the Mexican War, and the
Gadsden Purchase. After the northern part of Mexico was
annexed to the United States, the settlers were not offi-

3. cially considered immigrants but were often viewed as
foreigners by incoming white Americans. By 1900,
Mexican Americans numbered approximately 200,000.
However, during the “Great Migration” between 1900
and 1930, an additional 1 million Mexicans entered the
United States. This may have been the greatest immigra-
tion of people in the history of humanity (Library of
Congress, 2005).
Hispanics, the fastest growing ethnic population in the
United States, include over 35.3 million people, or 13.2
percent of the population. Fifty-eight percent are of
Mexican heritage, with an increase from 13.5 million in
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1990 to 20.6 million in 2000 (U.S. Bureau of the Census,
2001). Mexican Americans reside predominantly in
California, Texas, Illinois, Arizona, Florida, New Mexico,
and Colorado. However, the major concentration of
Mexican Americans, totaling over 18 million, are found
in the southern and western portions of the United States
(U.S. Bureau of the Census, 2001). Ninety percent of
Mexican Americans live in urban areas such as San Diego,
Los Angeles, New York City, Chicago, and Houston,
whereas less than 10 percent reside in rural areas.
REASONS FOR MIGRATION AND ASSOCIATED
ECONOMIC FACTORS
Historically, many Mexicans left Mexico during the

4. Mexican Revolution to seek political, religious, and eco-
nomic freedoms (Congress, 2005). Following the
Mexican Revolution, strict limits were placed on the
Catholic Church, and until recently, clerics were not
allowed to wear their church garb in public. For many,
this restricted the expression of faith and was a minor
factor in their immigration north to the United States
(Meyer & Beezley, 2000). Since the “Great Migration,”
limited employment opportunities in Mexico, especially
in rural areas, has encouraged Mexicans to migrate to the
United States as sojourners or immigrants or with undoc-
umented status; the latter are often derogatorily referred
to as wetbacks (majodos) by the white and Mexican
American populations.
Of undocumented immigrants in the United States, an
estimated 6 million are from Mexico (Van Hook, Bean, &
Passel, 2005). Before the Immigration Reform and
Control Act of 1986, hundreds of thousands of Mexicans
crossed the border, found jobs, and settled in the United
States. Although the numbers have decreased since 1986,
border towns in Texas and California still experience large
influxes of Mexicans seeking improved employment and
educational opportunities. The tide of illegal immigration
to the United States has increased, as evidenced by the
apprehension of Mexicans attempting to enter the United
States annually, with estimates of 250,000 to 300,000 peo-
ple entering illegally (Passel, 2004).
Even though the economy of Mexico has grown, the
buying power of the peso has decreased and inflation
rates have increased faster than wages; thus, 43 percent of
the population continues to live in poverty (CIA, 2007).
Recent Mexican immigrants are more likely to live in
poverty, more pessimistic about their future, and less edu-
cated than previous immigrants. Many Mexicans are

5. among the very poor, with little hope of improving their
economic status. Between the years 1999 and 2000 in the
United States, the poverty rate for Hispanics was 22.6 per-
cent (U.S. Bureau of the Census, 2001).
EDUCATIONAL STATUS AND OCCUPATIONS
Many second- and third-generation Mexican Americans
have significant job skills and education. By contrast,
many, especially newer immigrants from rural areas,
have poor educational backgrounds and may place lit-
tle value on education because it is not needed to
obtain jobs in Mexico. Once in the United States, they
initially find work similar to that which they did in
their native land, including farming, ranching, mining,
oil production, construction, landscaping, and domes-
tic jobs in homes, restaurants, and hotels and motels.
Economic and educational opportunities in the United
States are attainable, which allows immigrants to pur-
sue the great American dream of a perceived better life
(Kemp, 2001). Many Mexicans and Mexican Americans
work as seasonal migrant workers, who may relocate
several times each year as they “follow the sun.”
Sometimes, their unwillingness or inability to learn
English is related to their intent to return to Mexico;
however, this may hinder their ability to obtain better
paying jobs (Fig. 18–1).
The mean educational level in Mexico is 5 years. Until
1992, Mexican children were required to attend school
through the sixth grade, but since the Mexican School
Reform Act of 1992, a ninth-grade education is required.
However, great strides have been made in educational
standards in Mexico, which now reports a 92 percent lit-
eracy rate among its population (CIA, 2007). A common

6. practice among parents in poor rural villages is to educate
their children in what they need to know. This group
often finds immigration to the United States to be their
most attractive option. For many Mexicans, high school
and a university education is unavailable and, in many
cases, unattainable.
Hispanics are the most undereducated ethnic group in
the United States, with only 57 percent aged 25 years or
older having a high school education, compared with
88.4 percent for non-Hispanic whites. However, that
number increased from 43 percent to 57 percent complet-
ing high school from 1993 to 2000 (U.S. Bureau of the
Census, 2001). Some migrant worker camps have free or
low-cost bilingual educational programs to assist Mexican
Americans in learning to read and write in both lan-
guages. Only 10.6 percent of Mexican Americans aged 25
years or older have a college degree. However, the number
of Hispanics who completed 4 years of college doubled
between 1990 and 2000 (U.S. Bureau of the Census,
2001).
310 • CHAPTER 18
FIGURE 18–1 A migrant worker camp on Maryland’s eastern
shore.
The Sanchez family (discussed in the Case Study on line) lives
in such
a camp, as do many Mexican American farm workers in the
United
States.
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7. Communication
DOMINANT LANGUAGE AND DIALECTS
Mexico is one of the largest Spanish-speaking countries in
the world, with over 80 million speaking the language.
The dominant language of Mexicans and Mexican
Americans is Spanish. However, Mexico has 54 indige-
nous languages and more than 500 different dialects
(Spanish Language, 2007). Knowing the region from
which a Mexican American originates may help to iden-
tify the language or dialect the individual speaks. For
example, major indigenous languages besides Spanish
include Nahuatl and Otami, spoken in central Mexico;
Mayan, in the Yucatan peninsula; Maya-Quiche, in the
state of Chiapas; Zapotec and Mixtec, in the valley of
Oaxaca; Tarascan, in the state of Michoacan; and
Totonaco, in the state of Veracruz. Many of the Spanish
dialects spoken by Mexican Americans have similar word
meanings. However, the dialects of Spanish spoken by
other groups may not have the same meanings. Because
of the rural isolationist nature of many ethnic groups and
the influence of native Indian languages, the dialects are
so diverse in selected regions that it may be difficult to
understand the language, regardless of the degree of flu-
ency in Spanish.
Radio and television programs broadcasting in Spanish
in both the United States and Mexico have helped to
standardize Spanish. For the most part, public broadcast
communication is primarily derived from Castilian
Spanish. This standardization reduces the difficulties
experienced by subcultures with multiple dialects. When
speaking in a nonnative language, health-care providers

8. must select words that have relatively pure meanings in
the language and avoid the use of regional slang.
Contextual speech patterns among Mexican Americans
may include a high-pitched, loud voice and a rate that
seems extremely fast to the untrained ear. The language
uses apocopation, which accounts for this rapid
speech pattern. An apocopation occurs when one word
ends with a vowel and the next word begins with a
vowel. This creates a tendency to drop the vowel ending
of the first word and results in an abbreviated, rapid-
sounding form. For example, in the Spanish phrase for
How are you?, ¿Cómo está usted? may become
¿Comestusted?. The last word, usted, is frequently
dropped. Some may find this fast speech difficult to
understand. However, if one asks the individual to enun-
ciate slowly, the effect of the apocopation or truncation
is less pronounced.
To help bridge potential communication gaps, health-
care providers need to watch the client for cues, para-
phrase words with multiple meanings, use simple sen-
tences, repeat phrases for clarity, avoid the use of regional
idiomatic phrases and expressions, and ask the client to
repeat instructions to ensure accuracy. Approaching the
Mexican American client with respect and personalismo
(being friendlike) and directing questions to the domi-
nant member of a group (usually the man) may help to
facilitate more open communication. Zoucha and Husted
(2002) found that becoming personal with the client or
family is essential to building confidence and promoting
health. The concept of personalismo may be difficult for
some health-care professionals because they are socialized
to form rigid boundaries between the caregiver and the
client and family.

9. CULTURAL COMMUNICATION PATTERNS
Whereas some topics such as income, salary, or invest-
ments are taboo, Mexican Americans generally like to
express their inner beliefs, feelings, and emotions once
they get to know and trust a person. Meaningful conver-
sations are important, often become loud, and seem dis-
organized. To the outsider, the situation may seem stress-
ful or hostile, but this intense emotion means the
conversants are having a good time and enjoying each
other’s company. Within the context of personalismo and
respeto, respect, health-care providers can encourage
open communication and sharing and develop the
client’s sense of trust by inquiring about family members
before proceeding with the usual business. It is important
for health-care providers to engage in “small talk” before
addressing the actual health-care concern with the client
and family (Zoucha & Reeves, 1999).
Mexican Americans place great value on closeness and
togetherness, including when they are in an in-patient
facility. They frequently touch and embrace and like to
see relatives and significant others. Touch between men
and women, between men, and between women is accept-
able. To demonstrate respect, compassion, and under-
standing, health-care providers should greet the Mexican
American client with a handshake. Once rapport is estab-
lished, providers may further demonstrate approval and
respect through backslapping, smiling, and affirmatively
nodding the head. Given the diversity of dialects and the
nuances of language, culturally congruent use of humor
is difficult to accomplish and, therefore, should be
avoided unless health-care providers are absolutely sure
there is no chance of misinterpretation. Otherwise, inap-
propriate humor may jeopardize the therapeutic relation-

10. ship and opportunities for health teaching and health
promotion.
Mexican Americans consider sustained eye contact
when speaking directly to an older person to be rude.
Direct eye contact with teachers or superiors may be inter-
preted as insolence. Avoiding direct eye contact with
superiors is a sign of respect. This practice may or may not
be seen with second- or third-generation Mexican
Americans. Health-care providers must take cues from the
client and family.
TEMPORAL RELATIONSHIPS
Many Mexican Americans, especially those from lower
socioeconomic groups, are necessarily present oriented.
Many individuals do not consider it important or have
the income to plan ahead financially. The trend is to live
in the “more important” here and now, because mañana
(tomorrow) cannot be predicted. With this emphasis on
living in the present, preventive health care and immu-
nizations may not be a priority. Mañana may or may not
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really mean tomorrow; it often means “not today” or
“later.”
Some Mexicans and Mexican Americans perceive time

11. as relative rather than categorically imperative. Deadlines
and commitments are flexible, not firm. Punctuality is
generally relaxed, especially in social situations. This con-
cept of time is innate in the Spanish language. For exam-
ple, one cannot be late for an appointment; one can only
arrive late! In addition, a few immigrants from rural envi-
ronments in which adhering to a strict time clock is
unimportant may not own a clock or even be able to tell
time.
Because of their more relaxed concept of time,
Mexican Americans may arrive late for appointments,
although the current trend is toward greater punctuality.
Health-care facilities that use an appointment system for
clients may need to make special provisions to see clients
whenever they arrive. Health-care providers must care-
fully listen for clues when discussing appointments.
Disagreeing with health-care providers who set the
appointment may be viewed as rude or impolite.
Therefore, some Mexican Americans will not tell you
directly that they cannot make the appointment. In the
context of the discussion, they may say something like
“my husband goes to work at 8:00 a.m. and the children
are off to school, then I have to do the dishes . . . .” The
health-care professional should ask: “Is 8:30 a.m. on
Thursday okay for you?” The person might say yes but the
health-care professional must still intently listen to the
conversation and then possibly negotiate a new time for
the appointment. In the conversation, the client may give
clues that they will not arrive at the intended time,
because it is important to save face and avoid being rude
by saying they will not arrive on time.
FORMAT FOR NAMES
Names in most Spanish-speaking populations seem com-

12. plex to those unfamiliar with the culture. A typical name
is La Señorita Olga Gaborra de Rodriguez. Gaborra is the
name of her father, and Rodriguez is her mother’s sur-
name. When she marries a man with the surname
Guiterrez, she becomes La Señora (denotes a married
woman) Olga Guiterrez de Gaborra y Rodriguez. The word
de is used to express possession, and the father’s name,
which is considered more important than the mother’s,
comes first. However, this full name is rarely used except
on formal documents and for recording the name in the
family Bible. Out of respect, most Mexican Americans are
more formal when addressing nonfamily members. Thus,
the best way to address Olga is not by her first name but
rather as Señora Guiterrez. Titles such as Don and Doña for
older respected members of the community and family
are also common. If using English while communicating
with people older than the nurse or health-care provider,
use titles such as Mr., Ms., Miss, or Mrs., as a sign of
respect.
Health-care providers must understand the role of
older people when providing care to people of Mexican
heritage. To develop confidence and personalismo, an ele-
ment of formality must exist between health-care
providers and older people. Becoming overly familiar by
using physical touch or addressing them by first names
may not be appreciated early in a relationship (Kemp,
2001). As the health-care professional develops confi-
dence in the relationship, becoming familiar may be less
of a concern. However, using the first name of an older
client may never be appropriate (Zoucha & Husted, 2000).
Family Roles and Organization
HEAD OF HOUSEHOLD AND GENDER ROLES

13. The typical family dominance pattern in traditional
Mexican American families is patriarchal, with evidence
of slow change toward a more egalitarian pattern in
recent years (Grothaus, 1996). Change to a more egalitar-
ian decision-making pattern is primarily identified with
more educated and higher socioeconomic families.
Machismo in the Mexican culture sees men as having
strength, valor, and self-confidence, which is a valued
trait among many. Men are seen as wiser, braver, stronger,
and more knowledgeable regarding sexual matters. The
female takes responsibility for decisions within the home
and for maintaining the family’s health. Machismo assists
in sustaining and maintaining health not only for the
man but also with implications for the health and well-
being of the family (Sobralske, 2006).
PRESCRIPTIVE, RESTRICTIVE, AND TABOO
BEHAVIORS FOR CHILDREN AND ADOLESCENTS
Children are highly valued because they ensure the con-
tinuation of the family and cultural values (Locke, 1999).
They are closely protected and not encouraged to leave
home. Even compadres (godparents) are included in the
care of the young. Each child must have godparents in
case something interferes with the parents’ ability to ful-
fill their child-rearing responsibilities. Children are taught
at an early age to respect parents and older family mem-
bers, especially grandparents. Physical punishment is
often used as a way of maintaining discipline and is some-
times considered child abuse in the United States. Using
children as interpreters in the health-care setting is dis-
couraged owing to the restrictive nature of discussing
gender-specific health assessments.
FAMILY GOALS AND PRIORITIES
V I G N E T T E 1 8 . 1

14. Mr. Perez is a 76-year-old Mexican American who was
recently diagnosed with a slow heartbeat requiring an
implanted pacemaker. Mr. Perez has been married for
51 years and has 6 adult children (three daughters aged 50,
48, and 42; three sons aged 47, 45, and 36), 11 grandchil-
dren; and 2 great grandchildren. The youngest boy lives three
houses down from Mr. and Mrs. Perez. The other children,
except the second-oldest daughter, live within 3 to 10 miles
from their parents. The second-oldest daughter is a registered
nurse and lives out of state. All members of the family except
for Mr. Perez were born in the United States. He was born in
Monterrey, Mexico, and immigrated to the United States at
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the age of 18 in order to work and send money back to the
family in Mexico. Mr. Perez has returned to Mexico through-
out the years to visit and has lived in Texas ever since. Mr.
Perez is retired from work in a machine shop. Mr. Perez has
one living older brother who lives within 5 miles. All mem-
bers of the family speak Spanish and English fluently.
The Perez family is Catholic, as evidenced by the religious
items hanging on the wall and prayer books and rosary on the
coffee table. Statues of St. Jude and Our Lady of Guadalupe
are on the living room table. Mr. and Mrs. Perez have made
many mandas (bequests) to pray for the health of the family,
including one to thank God for the healthy birth of all the

15. children, especially after the doctor had discouraged them
from having any children after the complicated birth of their
first child. The family attends Mass together every Sunday
morning and then meets for breakfast chorizo at a local
restaurant frequented by many of their church’s other parish-
ioner families. Mr. Perez believes his health and the health of
his family are in the hands of God.
The Perez family lives in a modest four-bedroom ranch
home that they bought 22 years ago. The home is located in a
predominantly Mexican American neighborhood located in
La Loma section of town. Mr. and Mrs. Perez are active in the
church and neighborhood community. The Perez home is
usually occupied by many people and has always been the
gathering place for the family.
During his years of employment, Mr. Perez was the sole
provider for the family and now receives social security
checks and a pension. Mrs. Perez is also retired and receives
a small pension for a short work period as a teacher’s aide. Mr.
and Mrs. Perez count on their nurse daughter to guide them
and advise on their health care. Mr. Perez visits a curandero
for medicinal folk remedies. Mrs. Perez is the provider of spir-
itual, physical, and emotional care for the family. In addition,
their nurse daughter is always present during any major surg-
eries or procedures. Mrs. Perez and her daughter the nurse
will be caring for Mr. Perez during his procedure for a pace-
maker.
1. Explain the significance of family and kinship for the
Perez family.
2. Describe the importance of religion and God for the
Perez family.
3. Identify two stereotypes about Mexican Americans that

16. were dispelled in this case with the Perez family.
4. What is the role of Mrs. Perez in this family?
The concept of familism is an all-encompassing value
among Mexicans, for whom the traditional family is still
the foundation of society. Family takes precedence over
work and all other aspects of life. In many Mexican fami-
lies, it is often said “God first, then family.” The dominant
Western health-care culture stresses including the client
and family in the plan of care. Mexicans are strong propo-
nents of this family care concept, which includes the
extended family. By including all family members, health-
care providers can build greater trust and confidence and,
in turn, increase compliance with health-care regimens
and prescriptions (Wells, Cagle, & Bradley, 2006).
Blended communal families are almost the norm in
lower socioeconomic groups and in migrant-worker
camps. Single, divorced, and never-married male and
female children usually live with their parents or extended
families, regardless of economics. Extended kinship is
common through padrinos, godparents who may be close
friends are usually considered family members (Zoucha &
Zamarripa, 1997). Thus, the words brother, sister, aunt,
and uncle do not necessarily mean that they are related
by blood. For many men, having children is evidence of
their virility and a sign of machismo.
When grandparents and older parents are unable to live
on their own, they generally move in with their children.
The extended family structure and the Mexicans’ obliga-
tion to visit sick friends and relatives encourage large num-
bers to visit hospitalized family members and friends. This
practice may necessitate that health-care providers relax

17. strict visiting policies in health-care facilities.
Social status is highly valued among Mexican
Americans, and a person who holds an academic degree
or position with an impressive title commands great
respect and admiration from family, friends, and the com-
munity. Good manners, a family, and family lineage, as
indicated by extensive family names, also confer high sta-
tus for Mexicans.
ALTERNATIVE LIFESTYLES
Twenty-six percent of Mexican families in the United
States live in poverty, and many are headed by a single
female parent. This percentage is lower than that for
other minority groups in the United States (U.S. Bureau of
the Census, 2001). Because the Hispanic cultural norm is
for a pregnant woman to marry, Mexicans are more likely
to marry at a young age. Yet, common law marriages
(unidos) are frequently practiced and readily accepted,
with many couples living together their entire lives.
Although homosexual behavior occurs in every soci-
ety, The Williams Project reported that five states
(California, Texas, New York, Florida, and Illinios) have
the highest number of same-sex Latino couples, totaling
100,796, living together in the United States (Gates, Lau,
& Sears, 2006). Newspapers from Houston, Texas;
Washington, D.C.; and Chicago, Illinois, report on the
efforts of Hispanic lesbian and gay organizations in the
areas of HIV and AIDS (La SIDA in Spanish) and life part-
ner benefits. In Mexico, antihate groups raised serious
concerns about killings of homosexual men, causing
many to remain closeted (Redding, 1999). In Mexico,
machismo plays a large part in the phobic attitudes toward
gay behavior. Larger cities in the United States may have

18. Ellas, a support group for Latina Lesbians; El Hotline of
Hola Gay, which provides referrals and information in
Spanish; or Dignity, for gay Catholics. Health-care
providers who wish to refer gay and lesbian clients to a
support group may use such agencies.
Workforce Issues
CULTURE IN THE WORKPLACE
In the United States, Hispanics are the most underrepre-
sented minority group in the health-care workforce.
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Although over 13 percent of the American population is
of Hispanic origin, only 1.8 percent of registered nurses
are from Hispanic heritage (National Sample Survey of
Registered Nurses, 2004). Cultural differences that influ-
ence workforce issues include values regarding family,
pedagogical approach to education, emotional sensitiv-
ity, views toward status, aesthetics, ethics, balance of
work and leisure, attitudes toward direction and delega-
tion, sense of control, views about competition, and
time.
People educated in Mexico are likely to have been
exposed to pedagogical approaches that include rote
memorization and an emphasis on theory with little prac-
tical application taught within a rigid, broad curriculum.

19. American educational systems usually emphasize an ana-
lytical approach, practical applications, and a narrow, in-
depth specialization. Thus, additional training may be
needed for some Mexicans when they come to the United
States.
Because family is a first priority for most Mexicans,
activities that involve family members usually take prior-
ity over work issues. Putting up a tough business front
may be seen as a weakness in the Mexican culture.
Because of this separation of work from emotions in
American culture, most Mexican Americans tend to shun
confrontation for fear of losing face. Many are very sensi-
tive to differences of opinion, which are perceived as dis-
rupting harmony in the workplace. People of Mexican
heritage find it important to keep peace in relationships
in the workplace.
For many Mexicans, truth is tempered by diplomacy
and tact. When a service is promised for tomorrow, even
when they know the service will not be completed tomor-
row, it is promised to please, not to deceive. Thus, for
many Mexicans, truth is seen as a relative concept,
whereas for most European Americans, truth is an
absolute value and people are expected to give direct yes
and no answers. These conflicting perspectives about
truth can complicate treatment regimens and commit-
ment to the completion of work assignments. Intentions
must be clarified and, at …