This document presents a seminar series on Hispanic health issues, focusing particularly on the health behaviors and illness perceptions of Caribbean Hispanics. It discusses cultural concepts of health, including the hot-cold theory of disease treatment and traditional practices associated with illnesses. The seminar aims to foster understanding and evaluation of diverse health beliefs, including their implications for health behavior models and community health strategies.

1. Diversity and Health Behaviors Ms. Ana Linares University of North Florida PEACE Center Dr. Otilia Salmon, University of North Florida COEHS Dr. Judith C. Rodriguez, University of North Florida COH March 25, 2005 This is part 2 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department. For more information or register for the seminars, please call 620-1289.

2. Caribbean Hispanics World views Illness etiologies and categories Behaviors Illnesses Application of Health Behavior Models

3. Comparison of world views Community vs. individual Emotional vs. rational Dependence/interdependence vs. self reliance/autonomy Focus on relationships vs. focus on time and money

4. Symptoms experience Assumption of sick role Care contact Patient role Recovery or rehabilitation Illness Behavior

5. Traditional Etiologies The result of “good luck” A reward for good behavior A gift from God An imbalance (body) Punishment for wrongdoing

6. Major Categories Body imbalance – hot or cold Dislocation of parts of the body Magic or supernatural causes Strong emotional state Envy (envidia)

7. Spiritualism, Santeria and Fatalism Problems spiritual in nature are treated with prayer and ritual Practiced in: Caribbean Mexico Central/South America

8. Identity and Implications for Health The Hispanic Paradox U.S. Census Categories and Hispanic Demographic Complexity Black and White categories Nativity status US Born vs. Foreign Born

9. Based on humoral medicine Based on concept of balance Foods, climate, situations can make the body fall out of balance, hence, ill (effect on body) Illness and disease are treated by manipulations that get the body back in balance Hot – cold theory of disease

10. Hot – cold theory of disease Treatment is based on “oppositions” Thermal quality is not the factor Perceived intrinsic quality or affect on the body may be basis of descriptor Some medicines may be considered hot

11. Health Behaviors Examples of curative or therapeutic behaviors Cold conditions = menstrual cramps, coryza , pneumonia, empacho , and colic are treated with hot medications and remedies to bring the individual back into balance. Some groups believe arthritis to be a “cold” disease

12. Health Behaviors Examples of curative or therapeutic behaviors Hot conditions - pregnancy, diabetes, hypertension, acid indigestion, susto , and bilis

13. Hot – Cold Foods Hot Chocolate Brown sugar Onion Garlic Rue Black pepper Ginger Honey Coffee Peanuts Some chiles Wheat Cold Vinegar Fava beans Cucumber Cauliflower Chayote squash Tomato Jicama Turnip Fresh cheese Beer Watermelon Cow’s milk

14. Discussion What questions could you ask to determine if there are hot – cold practices? How might you evaluate/respond to the practice?

15. Other Common Cultural Illnesses Aire Antojos Ataque de nervios Barrenillos

16. Other Common Cultural Illnesses Derrame de bilis Caida de la mollera Decaimiento Decenso

17. Other Common Cultural Illnesses Empacho Espasmo Mal de ojo Nerviosismo Susto

18. Discussion Examples of health prevention or treatment behaviors: “hot” medications. What questions could you ask to determine extent of traditional health beliefs or practices? How might you evaluate and respond to the practice?

19. Application of Theoretical Frameworks Health Belief Systems Family Systems Social Marketing

20. Health Beliefs Value? Possible behavior? Recommendation? Elements Perceived susceptibility Impact Advantages of change Barriers Self-efficacy

21. Family Systems Value? Possible behavior? Recommendation? Element Explores family and other significant relationships as a means of developing a support system

22. Social Marketing Element Uses marketing techniques to promote health Community based, multi-strategy Value? Possible behavior? Recommendation?

23. Cultural Diversity in Health and Illness. By Rachel Spector 2003 Cultural Care Guide to Heritage Assessment and Health Traditions. By Rachel Spector 2003 Ethnicity and Medical Care. By Alan Harwood, 1981 Health Issues in the Latino Community. By M. Aguirre-Molina, C. Molina, R. E. Zambrana. 2001. Latina Health in the United States . By M. Aguirre-Molina, C. Molina. 2003. Medical Anthropology. By Sargent & Johnson 1994 Resources

24. Questions? Thank you! University of North Florida, College of Health Ms. Ana Linares UNF PEACE Center Dr. Judith C. Rodriguez, UNF COH March, 2005