From Discussions VOL. 9 NO. 2
The Mexican American Health Paradox: The Collective Influence of Sociocultural Factors on Hispanic Health Outcomes
Neighborhood-Level Social Support: The Unifying Link of the Paradox
Each of the key factors discussed thus far, namely familism, curanderismo, and sleep efficiency, focus on specific Mexican American behaviors, ideals, or characteristics. To further a holistic analysis of the health paradox, the general social context of the neighborhoods in which Mexican Americans typically congregate is related to overall health. Kathleen Cagney (2007) suggests in “The Latino Paradox in Neighborhood Context: The Case of Asthma and Other Respiratory Conditions” that “high levels of social capital may affect the community's potential to encourage positive health habits or sanction negative ones” (p. 919). Particularly, social capital can include knowledge of access to health services and knowledge of salutary behaviors (such as nutrition) (p. 919). Higher levels of social support can also lend itself towards healthy interaction with other individuals, greater involvement in social activities, as well as instrumental supports such as the reassurance of being able to rely on others in time of need (p. 919). Dr. Brian Karl Finch and William Armando Vega (2003) supplement this idea in “Acculturation Stress, Social Support, and Self-Rated Health among Latinos in California” by noting that “social support may act more strongly on health as a buffer to deleterious health behaviors and social stressors” (p. 109). Thus, those who hold a sense of belonging to a sociocultural group and its practices hold less of a chance to engage in deviant behaviors such as substance use. Relatedly, Cagney and her team denote three main concepts that govern the effect of social organization on the health outcomes of any immigrant group concentrated in a single area, including Mexican Americans. The first, collective efficacy, focuses on the level of trust and attachment in the neighborhood that can be drawn on for mutually beneficial action (p. 919). Social interaction and social exchange deal with the extent of potentially health-protective social support within a community (p. 919). “For example, sharing health information or driving a neighbor to the doctor are the types of instrumental activities that result from dense network connections” (p. 919).
The components of social capital in a Mexican American community consist of familism and curanderismo. In effect, these cultural resources serve as the link that joins members of the ethnic community together. In terms of the knowledge of health care services and medical advice, members of Mexican American communities are well aware of the resources made available by curanderos, and can easily disseminate information pertaining to herbal treatments or other prescribed therapies. Using Cagney’s theoretic principles, collective efficacy develops as a byproduct of shared belief systems and curanderismo practices, in addition to other family values. Social interaction and exchange is also related to the spread of curanderismo treatments. Further research into specific physical health advantages that can be derived from the cultural self-sufficiency of these neighborhoods is vital to understanding how exactly they reiterate the positive health effects of curanderismo. For example, research conducted by the aforementioned Cagney and her colleagues in “The Latino Paradox in Neighborhood Context: The Case of Asthma and Other Respiratory Conditions” has shown that there exists a distinctly graded effect for asthma and other breathing problems among foreign-born Latinos, which depends on community composition. More specifically, Latinos embedded in a neighborhood that had a high percentage of foreign-born residents experienced a significantly lower prevalence of asthma and other breathing problems than those in communities that had a low percentage of foreign-born residents (p. 919).
Nevertheless, a counterargument can be made regarding the beneficial impacts of population concentrations of Mexican Americans in certain neighborhoods. According to A. Morales (1984) in the article “Substance Abuse and Mexican-American Youth: An Overview,” the trends of alcohol and drug use are paradoxical in communities especially stricken by extreme poverty. Mexican-American youth do not have greater rates of alcohol use, except for those from the lowest SES (p. 296). Also, “it is contended that Mexican-American youth drug use patterns may be less related to cultural factors and more related to poverty factors” (p. 297). Hence among some sections of society, poor health habits, such as increased drug and alcohol use, may be supported through the same mechanisms of social organization that instill sound health behaviors. Still, one must recognize that the virtues of family and curanderismo are still maintained as the core essence of Mexican American culture, exposing even these societies to similar protective effects in the other communities.
Although familism and curanderismo, the two central concepts that guide a holistic overview of the Mexican American health paradox, are grounded in the specific culture of the ethnic group, it is possible to examine parts of both cultural systems and to apply those principles to other ethnic groups. Based on the marked power of the Mexican American family to shape the particular behaviors and attitudes of its constituents for the better, it is likely that families from different backgrounds also have the potential to do so. A close study of the family dynamics in a familism-centered Mexican American family could be used to create family-based intervention programs for adolescents or young adults suffering from depression or substance and drug abuse. Furthermore, a holistic analysis of the health paradox reveals new insight into possible transformations of medical practice. If more herbs that are part of original curandero treatments are found to be physiologically effective, these natural cares can be implemented into modern physician treatment plans, so as to bring about possible changes in life expectancy for these other ethnic communities. Based on the psychological advantages that can be derived from curandero-patient interactions, modern physicians should work to foster the same level of relief and understanding that folk practitioners bestow unto their clients. Not only would this promote compliance with clinical recommendations, but it would also encourage the regular use of effective western-based health resources among additional ethnic groups. Essentially, the physician must work to recognize and respect the cultural proclivities of any given ethnic group they serve before discussing a variety of treatment options. Such consideration forms the basis for a successful doctor-patient relationship that preserves a perfect blend of professional authority and sensitivity.
As it stands, the Mexican American health paradox cannot be explained by a single theory. Rather, one must consider the multidimensional culture of this particular ethnic group, so as to encompass the variety of factors that might influence longevity. Of particular interest is the folk medicine system of curanderismo, which is intricately tied to other prominent aspects of Mexican culture, including the importance of family. In turn, the physical and mental health effects of such a psychologically and biologically sound health-care system can lead to additional, desired health outcomes, resulting in a significant disparity in life expectancy that continues to defy an exhaustive explanation.
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