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Written by Dr. Jane L. Delgado, the nation's leading expert on Hispanic health, The Latina Guide to Health features cutting-edge medical information and advice for all Hispanic women. With a deep understanding of what it means to be a Latina in the U.S. today, Dr. Delgado offers practical advice on the health issues women face, separates myths from facts, and answers questions about what to do. She thoroughly discusses concerns for Latinas, including higher rates of arthritis, cervical cancer, depression, and ...
Written by Dr. Jane L. Delgado, the nation's leading expert on Hispanic health, The Latina Guide to Health features cutting-edge medical information and advice for all Hispanic women. With a deep understanding of what it means to be a Latina in the U.S. today, Dr. Delgado offers practical advice on the health issues women face, separates myths from facts, and answers questions about what to do. She thoroughly discusses concerns for Latinas, including higher rates of arthritis, cervical cancer, depression, and diabetes, and the greater likelihood of being overweight. She also points to the good news: Latinas have lower rates of heart disease, stroke, and breast cancer, and live longer.
The Latina Guide to Health provides advice on:
Authoritative and accessible, this invaluable guide includes an extensive quick-reference health section, five essential tools to help Latinas keep track of their health, and sidebars, charts, and website resources throughout.
"Jane Delgado knows that culture and family are critical to the way our community sees medicine and receives treatment. Everything she does is informed by and imbued with Latino cultura."—Aliza Lifshitz, M.D., Internist, Cedars-Sinai Medical Center; Editor-in-Chief, VidaySalud.com; Medical Commentator, Univision Networks
It was the weekend, and once again I was going to call to catch up with Yolanda. As soon as I got on the phone, I could hear her breathless tone. She was speaking in that voice that meant that she couldn't talk to me now. It wasn't that she didn't want to, but she had too much to do. She had to take her father to the doctor, then take her mother to the pharmacy, take a conference call from her home, and decide what she was going to make for dinner that night. A hardworking woman with several part-time jobs, she was constantly juggling to balance caring for her parents, being there for her daughter, and dealing with the extra demands of a husband who attended only to his work. I asked her if in all her scheduling she had scheduled anything for herself She laughed as she said, "Of course not-I do not have the time!"
How does someone run out of time? as Latinas, we are often stretched to the limit by our obligations to our family, our work, and whatever else is on our plate. Most of these commitments are ones we gladly make, but sometimes our enthusiasm and sense of what has to be done overtake what is reasonable for us to do. We want to be good and helpful, and we believe our families and family time come first. But the speed with which we say yes to others-often before they even ask-distracts us from looking at our own health and well-being.
When we Latinas talk among ourselves, it's obvious that we share feelings of being burdened, stressed, and overwhelmed. The most negative outcome is that our own health and well-being become the easiest items to push off our to-do lists.
But are Latinas really different? Aren't all women overextended? The answer is clear: yes, on both counts.
Multitasking is not new to women. As mothers, we know that the "m" ) in mother stands for "more than one thing."-Eliana
In many ways we Latinas share much with other women-issues of balancing family and work, the joy of finally getting equal pay for equal work, the need to go for regular breast exams and Pap tests, and so on. Yet even though we share these similarities, Latinas are different in subtle ways that have a huge impact on our lives. We live longer than non-Hispanic women, but we suffer more from diseases that compromise the quality of our longer lives. The stress we experience in our close families, along with our dependence on family, turns one of our greatest strengths into our weakness. As a result, we are good at taking our children for their vaccines and wellness visits, but we do not make appointments to see our own health care providers.
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While most cultures cherish the idea of "family," for us familia means so much more. Decades of research support our personal experiences with familia. Compared with non-Hispanic women, we are more group oriented, more community oriented, and more "other" oriented in general. The concept of "me first" is not only unappealing but also a sign of being rude and malcriada (badly raised).
Does this mean that we are one big happy family? Of course not. Latinas, like other women, struggle with their family members. Some want more autonomy, while others want less. There is no one-size-fits-all lifestyle. Yet we try to come to terms with what our family means to us and the impact they have had on our lives.
The Hispanic culture imposes an enormous sense of the need to have family connectedness, even when relatives are physically far away, relationships have been far from ideal, or there is emotional distance. And when we do not have the family we want, we create new relationships to give us that sense of belonging. Our concept of familia is all-encompassing, as it reaches beyond blood relatives to include people who are part of our emotional community. It is a unique way of connecting with others and of nurturing that strong sense of family in our culture.
When we get together, we ask each other about our families, friends, and relationships as we try to see the linkages that may exist. For Latinas, this sense of belonging to a group is important. Our role models are not those Latinas who are solitary and independent but rather women who are connected to others. We like to be-and, for many of us, need to be-part of a family. This is a good thing in many ways. People who are connected to others tend to live longer and healthier lives; they are also less likely to suffer from depression. These are the good consequences of the Latina concept of familia-but there are also drawbacks.
What does not help us is the idea that our families are the only people we can trust and depend on. There is a common belief that we should neither discuss our problems outside our close circle nor seek help beyond it. This kind of focus on family goes beyond caring to becoming controlling. It can even entrap us in situations that are unbearable. It is at this point that familia generates an emotional chokehold on any action we would take to meet our own needs as individuals.
Doing things for ourselves becomes difficult because of how we set up our priorities. There is much that we convince ourselves we have to do for others. We live as if each day had more than twenty-four hours. First, we take care of our family members and friends, then we meet our job commitments, then we keep our house in order, and finally, we keep our clothes and cosas (things) in order. By the end of the day there is only enough time to put on our pajamas, go to bed, and-if we're lucky-have enough time to get a good night's sleep. Then, we start the same cycle all over again the next day. Familias may be wonderful, but they can also be exhausting. The question is, How can we balance the love of familia with what we can reasonably do? Understanding the need for that balance is an important first step toward our own health. To take care of ourselves, we need time which we often need to claim from others in our lives.
Since those around you benefit from all you do it is also in their best interest that you stay healthy, refreshed, and happy.
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Jane, I just don't know how to tell you that we are different. We don't all eat beans.-Carmen
My family has been here for 300 years; my values are different.- Leticia
I have lived in this country for 40 years and I have always felt like a foreigner.- Lucy
Every time people gather on a regular basis, they create a way of being and interacting. Culture is what we eat, say, do, wear, pray, love, and hate. Culture happens at school, work, church, and communities, and in each of our families. Groups of people create ways of doing things that bind them together. Culture has to do with how we see ourselves and how we relate to others. It includes everything from the language we use to the "right" way to do things.
I cannot tell you how often people confront me about my use of the terms Hispanic and Latina. Typically they say, "How can you use those words when Hispanic or Latina is made up of many groups of people that are all so different?" My response is always the same: "The same way we use non-Hispanic white or Anglo." That we are the mingling of several cultures only enriches who we are.
Whether or not we Latinas admit it, our own mix of cultures affects everything we do. Too often we are made to feel as if we do not belong to the culture that surrounds us. How often are Latinas asked, "Where are you from?" (Reply: "Los Angeles.") Followed by a more emphatically asked, "No, really-where are you from?" (Reply: "My parents are from Arizona.") Everything from such comments to certain glances to the subtleties of the politics of exclusion and bias steals from us the energy derived from our sí se puede (yes, we can) conviction. Too often people look at us, hear our names, or hear us speaking and consider us not to be Americans. Yet Americans we are.
On a recent trip outside the United States, some of the people I met commented that I was a "nice American." That combination of words struck me as unusual because when I am home, my fellow Americans do not see me as an American but as someone who is from somewhere else. And then there was the "nice" part. "Nice," I learned from further discussions, meant that I behaved like someone who valued other cultures, attempted to speak the language, and was polite. Sadly, the typical American is still seen as someone who dresses too casually for the place or setting, speaks loudly, and assumes that everyone knows English.
When I was younger I thought of myself as an English speaker with the ability to speak Spanish. My view of who I was changed when my mother and I went to one of those amusement areas where you play a game and end up winning a little plastic toy. Not being very coordinated, I avoided the games that required shooting or throwing balls. I preferred the game where you would try to toss rings around a wooden block.
As I randomly threw the rings, I was surprised when my last ring toss ended perfectly over the block. I knew instantly that I had won the largest stuffed animal. In my joy I shouted, "Gané! Gané!" (I won! I won!) I don't know what surprised me more- that I won or that I announced my joy in Spanish.
At that moment it became clear to me that culture was very complex. I knew that I spoke English 98 percent of the time, but when the moment came to express deep emotions, I did so in Spanish. -Jane Delgado
We are also affected by changing views of culture and what it means to belong. In the 1980s there was much discussion about the need for persons not born in the United States to adopt and fit into the predominant culture. For Latinas to be successful, we had to go through a process of acculturation. It did not seem like a good thing to me because it meant that in order to be part of the U.S. mainstream, I had to give up my own culture. I was not thrilled at the prospect of having to give up what I wanted to celebrate.
Today, we as a society have evolved to a point where acculturation refers not to a giving up of culture but to an exchange that occurs when different groups work and live together. It refers to communities being able to learn from one another. Consider what defines American cuisine. Although many people still think first of ketchup, that's now outsold by salsa.
But salsa aside, the question for each Latina to answer is, what does it mean to be a Latina in the United States? The answer is simple: it means different things to different people. But that is not the answer people want to hear. Most non-Latinas are looking for an easy way to capture who we are. The mainstream media that are so integral to how we are perceived and how we see ourselves do not capture all our other roles and identities.
The media images of Latinas in television (whether English or Spanish) are both distorted and overly dramatic. The advantage for Latinas with Spanish-language television is that we are cast in all the roles. In the English language media we are usually portrayed either as maids or as hot Latin lovers. Some of us are both; most are neither. We need to look at what is healthy for us and to have role models in all media that look like us.
We are also a large and significant group of women. As of 2009, Latinas account for one in every six women in the United States. This means that there are as many Latinas in the United States as there are people in all of Australia.
Given our diversity and numbers, we should be a highly valued part of society. Instead, too often we are submerged within the catchall term minority, which by its use and implication diminishes our impact and devalues our contributions. Society's devaluing of us dampens the ganas (determination and will) with which we need to approach our everyday life and especially our health.
But dampening of our passion is the past, and nurturing our ganas is the future.
Bringing It All Together
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The challenge we face is to relish the joys of familia and cultura while releasing the chokeholds on our lives. To take care of our health means that we have to have ganas with booster rockets, since health requires our active participation. It is our unique combination of American assertiveness and Latina respeto (respect) that will make us successful as we take the actions we need to improve our health.
Since your health and well-being are vitally important, you have to take care of yourself. Remember, it all begins with you.
while some Latinas do not want to focus on their own health because they are too busy taking care of their families, other Latinas hope their health problems will go away if they do not talk about them, and still others feel constrained by taboos about discussing one's own health.
At a basic level, we sometimes cannot talk about our own health because we cannot find the words to express what we are feeling. This is especially true when we speak in English. In English health refers only to physical health; mental health and spiritual health are left for other fields of study. For Latinas, this makes us not trust the health care system. As one amiga (friend) said to me, "How can a health care provider know what is wrong with me if they don't know my feelings and my struggles?"
For many years there was a myth that Latinas preferred folk medicine. In reality, the practitioners of folk medicine were some of the few providers of medicine and health care who were located in the community, and who knew the language and customs. Not only was mainstream health care something physically outside the community, it was also fragmented in its approach. It looked at the health of the body, separate from mind and spirit. As a result, Latinas looked for practitioners who were in the community, spoke the language, and understood the culture. That is how folk medicine found its greatest support.
When we were little and we had muscular injuries we would go to the sobandera. I don't know how to say that in English. Everyone knew who she was; she was like an ... elder. What she did was physical and spiritual ... it was in between a masseuse and a curandera. Perhaps something like a lay physical therapist? I don't know how to explain it. All I know is that it worked for us.-Concha
An example of this was the traditional role of the sobandera. Latinas from south Texas to Colombia to Venezuela knew where to find the sobandera-the woman who fixed dislocated bones through therapeutic massage. It was a combination of healing the body and mind, plus a bit for the spirit. For some of us, we go for massage therapy to get similar results, and in some cases we are pleased to find that it is covered by our health insurance plan. But, on the whole, much of what is similar to "folk medicine" has been devalued by the mainstream medical community. As a result, some Latinas have been discouraged from seeking traditional medical care, at least until an illness has become very serious.
The good news for everyone is that mainstream medicine is beginning to accept and understand what Latinas have long known: there is a complex interrelationship between body, mind, and spirit.
Medical Approaches Become Latina Friendly
Alternative and integrative approaches, which incorporate many aspects of folk medicine, have grown in use. According to the ongoing National Institutes of Health Study of Women's Health Across the Nation (SWAN), 43 percent of women used complementary and alternative medicine continuously, while 33 percent were sporadic users. The popularity of these methods clearly demonstrates the important role they play in our lives. While we may feel empowered when we use home-based and self-care approaches to our body, mind, and spirit, we also have to recognize the importance of contemporary diagnostics, medicines, and treatments.
Excerpted from The Latina Guide to Health by Jane L. Delgado Copyright © 2010 by Jane Delgado. Excerpted by permission.
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