Medical Services for Hispanics in the USA - Coursework Example

History of Puerto Rican migration into the United States

In the decade which followed the World War II, the migration of the Puerto Ricans into the United States exploded resulting in hundreds of thousands of women, men, children’s and families arriving into different towns of US. In the few decades which followed, the number of Puerto Rican in the US increased drastically, with some of the places experiencing the highest growth including Chicago, Philadelphia, New Jersey, New York City, Springfield, Boston, and Massachusetts. According to the report released by the United States Migration Department, about 85% of the Puerto Rican who migrated during this period settled in New York City before spreading to other cities. Due to this migration in the 1910s, New York has experienced a rise in the number of people from this region.

In the beginning of the twentieth century, Puerto Rico was a nation affected with a large population of unemployed citizens and high rates of poverty and crime. However, during this time, the region was experiencing growth in their aviation industry and the United States was experiencing a boom in their industrial growth following the Second World War forcing Puerto Ricans to move to the United States in search of economic opportunities. A significant number of Puerto Rican moved during this period in a process commonly known as Boat strap where a series of the state-sponsored program by both the Puerto Rican government and United States government taking place between the 1940s and 1950s. The process was meant to urbanize, industrialize, and modernize Puerto Rico economy by creating job and investments conducted by the United States government. The move had a major impact on the Puerto Rican migration to the US where the people took advantage of the good relationship between the two economies.

Even though Puerto Rican was allowed to travel to the United States, they were faced by major challenges where they were immigrants from another country. Some of the challenges included different in the cultural, economic, social, and political surrounding. In the New York and other cities where the Puerto Rican immigrants settled, they were offered jobs in industries but the greatest challenge was communication and language barriers with some claiming discrimination due to race and ethnicity. Since the migration of Puerto Rican into the United States, the community had affected the New York and other places significantly in terms of culture by introducing different art and music styles. Also, Puerto Rican cuisines have been adopted by a majority of United States population. Today, Puerto Rican communities continue to grow in the United States with some states such as Florida experiencing significant growth of new Puerto Rican due to economic and severe debts facing the island.

Cultural Communication Patterns of Puerto Ricans

English and Spanish are the official languages in Puerto Rico. The community has distinct cultural communication patterns compared to other communities in the United States. For example, when greeting each other, it is appropriate to kiss their cheek. This culture of greeting has spread to other ethnic groups in the United States including the White Americans. However, when Puerto Ricans are greeting the elders, they are supposed to say “Bendicion” which is meant to which each other the best. Additionally, when speaking, they find it very acceptable and normal to stand close to each other. Puerto Ricans also use a lot of hand gestures when speaking which make them unique. Use of gestures is also experienced when Puerto Ricans are talking about other people or showing a direction where they keep pointing using their lips. Puerto Ricans have different sports and activities which are not common or legal to other communities including cockfighting. Today, almost every Puerto Ricans has a coliseum which is constructed specifically for Rooster fighting which is a common sport in the community. However, cockfighting is considered a gentlemen sport and men with winning cocks are respected by the community members where they are considered capable of training and taking care of their roasters.

Among the Puerto Ricans, physical surrounding, and physical appearance are essential where they believe it providing visual cues as to the tone of conversation and status. For example, wearing black when going to public places is not recommended where the color is associated with mourning. Other patterns common among the Puerto Ricans includes having a relaxed attitude towards time. In this community, the last minute rush is common where they believe things will be done eventually. Unlike the Americans who value punctuality and believe the time is money, Puerto Ricans will always start doing their things at the last minute. Additionally, avoiding eye contact is a common communication pattern where they believe it’s a sign of respect especially when communicating with the elders. Lastly, the rule of taking turns when speaking is not common where people will interrupt a conversation and speak simultaneously without making the other speaker uncomfortable.

Biological Variations and Risk Factors for Diseases among Puerto Ricans

In the last few years, the number of Puerto Ricans in the United States has experienced significant growth with a study indicating that in 2050, 25% of the US population will be made of Hispanics who are of Puerto Ricans origin. The Hispanic population especially youths are representing an important and dramatic demographic trend in the United States, while the contemporary working population of the Hispanic adults is aging hence making the first wave of the Hispanic seniors. Due to these factors, biological variation and risk factors to diseases among Puerto Ricans is an important element to consider due to impact it has in shaping the United States long-term health and healthcare needs.

Compared to non-Hispanic whites and non-Hispanic blacks in the United States, Hispanics have lower age-adjusted rates of mortality. For example, the age-adjusted death rate of the Hispanic men according to the 2015 report is 544.5 per 100, 000 compared to 1393 and 1012 in black men and white men respectively. Among the different Hispanic groups living the United States today, Puerto Ricans women have the lowest death rates. Additionally, all Hispanic groups apart from Puerto Ricans have lower adjusted death rates. Heart attack and cancer are the most prevalent diseases among the Puerto Ricans population. Among the Hispanic Americans, Puerto Ricans men have the highest deaths because of heart attack and cancer. Other risk factors for disease among the Puerto Ricans include cirrhosis, chronic liver diseases, homicide, and other conditions originating from the perinatal period.

In the last few years, the number of homicides among Puerto Rican men between 15 to 24 years old has escalated due to socio-economic and other issues. Also, among the Puerto Ricans, alcohol and drug use are common causes of deaths and a major risk factor for diseases, especially among the youths. Due to alcohol, a significant number of Puerto Ricans is suffering from chronic hepatitis which is a major risk factor and a major contributor to high death rates among adult men. Lastly, because of their lifestyle and eating patterns, Puerto Ricans have a high prevalence of diabetes especially Type 2 diabetes and other diseases resulting from the manifestation of abnormal glucose metabolism. For example, about 26.7% of men aged between 20 to 44 years are suffering from diabetes. Some of the major risk factors diseases because of diabetes among the Puerto Ricans include kidney diseases, heart disease, blindness, and peripheral nervous system damage. Due to the prevalence of diabetes among Puerto Ricans, the burden of complications is highest compared to other groups.

Health Care Practices

Puerto Ricans are among the races in the United States experiencing health disparities due to lack of insurance, language barriers, illegal immigration status, cultural beliefs, illiteracy, and mistrust. To address these barriers, the healthcare sector uses culturally and linguistically appropriate methods which recommend language services, organizational support, and culturally competent care. Health care practices among the Puerto Ricans and other Hispanic populations are a major challenge due to lack of trained interpreters and rely on interpretation trough ad hoc by the children of the patients or bilingual staffs. In the last few years, Puerto Ricans have experienced a rise in the rate of chronic diseases including cancer, tuberculosis, diabetes, high blood pressure obesity, and other hence changing the health care patterns significantly. However, among this population, a folk medicine which is provided by folk healers and lay Practioner are some of the most common health care practices.

Folk medicine is a traditional health care practice among the Puerto Ricans, where herbs and other remedies that are based on traditional belief are used. Folk medicine is believed to conflict with a biomedical paradigm where it incorporates other traditional beliefs which may affect the use of modern medical facilities. For example, Puerto Ricans population prefer going to see folk healers instead of physicians because of the belief that diseases have a connection with evil spirits and medicine alone cannot cure them with the practice being common among the Puerto Ricans adults suffering from diabetes. On the other hand, Puerto Ricans have relied on lay practitioners for over half century in prevention and treatment of related diseases. The increased numbers of lay practitioners within Puerto Ricans community is based on the need to address the health disparities. Additionally, the lay Practioner is believed by the community members because they incorporate ethical, social, and experimental aspects which are close to the people.

Research Studies Involving This Group

A study was conducted by Jalil et al (2017) to systematically review what is known about the health care disparities among the Puerto Ricans adults living with diabetes and the effect this issue on the population living in the United States. The study used data from PubMed and CINAHL where keywords such as type 3 diabetes and Puerto Ricans were used. The researchers reviewed about 124 articles and other sources. According to the study results, Puerto Ricans which is one of the largest members of the Hispanics living in the United States is inappropriately affected by diabetes disparity. The study indicated that even though the Puerto Ricans adults are less affected by English proficiency, citizenship status and have adapted to the modern health care compared to other Hispanic groups, they have contextually different fatalistic perspective when it comes to diabetes.

On the other hand, an article by Glavelee et al (2015) titled Skin Color, Social Classification, and Blood Pressure in Southeastern Puerto Rico was meant to test the relationship between skin color and high blood pressure among Puerto Ricans. According to the article, sociocultural processes mediate the relationship which exists between blood pressure and skin color because the two elements racialize the worldview toward certain groups. The study also highlighted that skin color is an independent predictor of blood pressure with other factors including gender, age, and SES.

Compare and Contrast the Research Studies

When comparing the two articles, it is important to consider some of the factors that are common. Firstly, authors of the articles have emphasized on the issue of health disparity among the Puerto Ricans. According to the Jalil et al (2017) article, health disparities among the Puerto Ricans living with diabetes are a major factor contributing to rising in death due to this condition. On the other hand, the Glavelee et al (2015) article identified a relationship between the skin color and diabetes among the people of this community. However, the study identified the issue of health care disparities based on race as a major issue among the Puerto Ricans. From the two articles, it is clear that the diabetes is a major health concern among the Puerto Ricans population, and reducing health disparities would play an important role in addressing this issue.

Strengths and Limitations of Each Study

Major strengths and weaknesses were identified in the two studies. Some of the strengths identified in Glavelee et al (2005) study included the use of a small sample which made it easier to observe statistical significant of the relationship which may exist between high blood pressure and skin among the Puerto Ricans. However, the greatest weakness of the study is the measures of ascribed skin color was highly linked to ethnographic data hence making it unclear how every day social classifications are estimated. On the other hand, Jalil et al (2017) greatest strength is the focus on Type 2 diabetes among the adults. Type 2 diabetes is posing major challenges to this population hence the information from the article would be essential in planning for health care programs. However, the study did not collect primary data and it relied on a review of articles. This raises questions of accuracy on the findings where the articles may offer inaccurate information hence misleading results on the study.

Importance of the Studies in the Development of Culturally Competent Care Plan

When developing a culturally competent plan, the two article act as an important source of data. For example, Jalil et al (2017) article concluded that the use of the term Hispanic when describing the Hispanic groups need to be avoided because there are different races in this group with each group facing varying health care issue due to their culture. Additionally, when developing a competent care plan for diabetes among the Puerto Ricans, the study would help understand the unique cultural forces that influence poor individual behaviors and poor diabetes outcomes that contribute to suboptimal self-care among Puerto Ricans suffering from Type 2 diabetes. On the other hand, when developing a culturally competent care plan for Puerto Ricans population, Glavelee et al (2015) will help understand some of the sociocultural aspects of Puerto Ricans which determine prevalence to certain diseases including diabetes. Using the study results, it will clarify some beliefs which classify skin pigment with diastolic and systolic blood pressure.