Correctional Nursing: The Impact of Prison Culture on Health and Wellness - Article Example

Correctional Nursing: The Impact of "Prison Culture” on Health and Wellness “Health is wealth.” This is such a common cliché that most people hear every day but had seemed to be lost to its meaning. According to the World Health Organization, health is a “state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (World Health Organization, 1946). Zooming in on this significant definition, health does not only encompass the physical and biologic aspect, most importantly, it deals with the societal features of health. By social aspect, it includes one basic element in society—culture. Beliefs in various things keep a society going. It is an implicit entity that governs the actions of most individuals. Although culture can influence the priorities in delivering health care, its features may curtail utilization of health care services and distribution. United States, as some would say, is a melting pot of diverse ethnic groups. Many view this country as a place of “greener” pasture. Hence, immigration was quite rampant in the past decades. Similarly, one unique district in United States is home to a number of ethnic races. The place is located on “northwest of Washington, DC and west of Baltimore”—an hour’s drive to both places mentioned. According to a report by Cooper (n.d.), the City of Frederick is the second largest district in Maryland. The statistical census revealed that the city’s population reached to about 52,676 residents. Majority of the citizens is non-Hispanic whites (77%), and is duly followed by African-American (14.7%). The percentage rate of the Hispanic race is only about 4.8 percent (2,533 residents). They are the third largest ethnic group, while the rest are mixed races from the Pacific regions (“Frederick, MD,” n.d.). The city possesses a steadily growing population of 9.7 percent and boasts expanding economic industries. The place was once a rural locale, but its strategic location to Washington, DC led to the boom of its business ventures. It has a number of schools, from primary to secondary and college institutions. In terms of medical facilities, the Frederick City has numerous specialized private clinics, ranging from Family Planning Facilities, to Medical and Diagnostic Establishments and Substance Abuse Institutions. Hospitals and research laboratories are also present in the city, with control centers for specific disease conditions (“Frederick, MD,” n.d.). The private clinics represent the preventive and early curative measures in health, while some hospitals were more on the tertiary level—with advanced medical equipments and diagnostic procedures. Recognition on the growing number of minority groups, especially Hispanic race, had led the national government in United States to create some measures to ensure that these groups are protected by Federal laws. Hence, several programs were implemented to assist minority citizens in exercising their rights. The Presidential Initiative on Race, a decree passed in 1998, had been the foundation for Department of Health and Human Services (DHHS) in implementing policies to “reduce and eliminate racial and health disparities by initiating the following activities: promote health disparity research, training activities, baseline data collection, the design and evaluation of socio-cultural based interventions, and comprehensive outreach to minority communities” (“Hispanics/Latinos,” n.d.). This course of action mainly focuses on the cultural needs of minority groups in United States, thus, prioritizing programs that will cater to their ethnically different cultural orientation. Among the sub-groups enumerated above, one distinct ethnic inhabitant had managed to stay together and maintain the values of their origins. As of 2003, “Hispanic groups (people from Mexico, Central America, South America, and Caribbean) had been recognized as the largest minority group in the United States” (Galarraga, 2007). Yet, a statistical survey showed that 23 percent of Hispanic-Americans were living within poverty line, while a quarter “speaks little or no English words” (Young, 2001). The significance of the statistical figure lies on the culture and background of this race. Four main aspects were identified by Young (2001) which seemed to be embedded in the core values of Hispanic people: “personalismo (genuine relationship), respeto (respect), confianza (trust/confidence), and familiaismo (familial emphasis).” All of these are essential in dealing with Hispanics in a health care setting. Hispanics people place such high importance in maintaining the values of their race. They are quite particular with personal relationships, preferring nearby clinics and familiar community groups when submitting for care. They expect health care staffs to be “warm, friendly and initiate active interest” when dealing with clients (“Hispanics/Latinos,” n.d.). Furthermore, this race puts emphasis on the significance of family ties, and tends to consult their families and relatives before arriving at a definite conclusion, especially with matters on major health care decisions. What is good with their culture is that it underlines the worth of “wellness rather than illness.” In this aspect, Hispanic people strive to preserve a fit and healthy lifestyle—in a holistic and dynamic view of health (Young, 2001). Despite modern advancements in medicine, Hispanic citizens still rely on folk medicine in managing common ailments. This particular belief serves as proof that culture can be a barrier in medical health progression. According to Galarraga (2007), they have “curaderos (naturalist healer) and santeros (saint healer) that help ailing individuals. They were well-known as effective healers without any media advertisements, only through informal communication. Their usual forms of healing were more on traditional ones, and include: massages, counseling based on spiritual capacities, and cleanings through baths mixed with herbal plants.” All of these interventions are utilized in their homes; hence, this saves time and extra effort. Aside from evident descriptions on how Hispanic people handle health-deviating situations, other important issues to be taken into consideration are “imbalances in hot and cold, supernatural triggers, and envy.” These were said to be the sources of most disorders. Moreover, unbeknownst to most health care practitioners in United States, Hispanic people have particular disorders that even medicinal science cannot explain properly. Some of these conditions include “pasmo (tonic spasm of voluntary muscles due to cold exposure), susto (soul loss due to traumatic experience), nervios (restlessness due to negative life circumstance), empacho (lack of appetite with poorly digested or uncooked food), etc” (“Hispanics/Latinos,” n.d.). These beliefs have the tendency to create certain gaps between health care staffs and Hispanic clients, especially when the former do not have enough experience in dealing with such difference in views with the latter about health and disorders. Currently, modern-day Hispanic-Americans tend to mix folk healings with medical treatments. As stated by Young (2001), decisions to seek medical assistance are often dictated by monetary costs. Due to financial constraints, “utilization of licensed physicians” seems to be the last option. The Hispanic people manage their medical condition in their homes, employing herbal interventions and community healers in place of expensive medical treatment. In this case, expenses can be kept to minimum amounts. The cultural orientation of the discussed race is not the sole contributing factor that prevents Hispanic citizens from seeking medical attention. These people speak another language, mainly Spanish. In a report by Erving (n.d.), he clarified that “70 percent of Hispanic adults consider Spanish as their primary language.” In a health-care setting, good communication between physicians and patients is important. Various areas are discussed during such interaction. History of a patient’s medical condition and health practices are considered prior to any interventions. In addition, different instructions are commonly given, with specific directives on medication regimen, food and tasks to be avoided, and interventions specific to a patient’s disorder. Misunderstanding could occur if communication is neglected. Unconfirmed reports also revealed that cultural discrimination, even in health care setting, is still present. In an article on Hispanics/Latinos: Health Disparity Overview (n.d.), it stated that “minorities are less likely than whites to receive health services…cultural biases can affect clinical decision-makings.” Hence, they tend to depend more on familiar traditional healings that they were used to—to avoid derogatory treatment and complications on communication. The result of culturally different language extends from mere patient-physician relationship; it encompasses on the lack of information regarding available programs offered by government agencies. Most of the states in United States rely on various insurance programs to cover some expenses during emergency cases—including medical insurance. However, common misconception on the implication of these programs led some to ignore such details. This holds true for Hispanic citizens in the city of Frederick. Most do not have medical insurance, although, cultural differences and language barrier were not the only factors that emerged in uninsured Hispanic citizens. Socioeconomic difficulties had been recognized as one of the major reasons for increasing number of uninsured people. Galarraga (2007) confirmed that “Hispanics make up the largest group in the US without any health coverage.” Immigrants in United States apparently do not include education as part of the priority in their stay—educational level usually dictates the type of job occupied. A good number labored on low-paying occupations with an even lower chance of health benefits offered. Thus, medical insurance is least in their worries. Young succinctly described the situation that Hispanic citizens are experiencing: Financial burden clearly accounts for a large part of the health disparities among Hispanic American subpopulations. A lack of insurance and income results in the use of emergency rooms for urgent and non-urgent health care needs. A cultural response to these barriers includes heavy reliance on self-treatment and traditional healers…Not only are they accessible and affordable…they possess an ability to provide an explanation of illness and prescribe treatment in a cultural context. (Young, 2001) There is an increasing evidence of cultural beliefs as an escape route for most Hispanic families. Other races, such as Americans and British nationals, heavily rely on medical science to explain their conditions, but the Hispanic race has another option, and they turn to it whenever they cannot avail on the expensive treatment that medical science offers. The identified dilemmas that most Hispanic groups face had piled up through their years of stay in United States. Their race admittedly has a strong familial bond, yet this contributed little help in ensuring a safe provision in health care. One important cause for this is lack of health care insurance. The medical insurance could alleviate some burden in payment of bills during health check-ups and hospitalization. Without this medical aid, hesitation occurs. This issue regarding health insurance is not the supposed main root of such setbacks. Cultural orientations and traditions may seem to be the major reason for neglect in health maintenance, but they are more of an escape route for most Hispanics against expensive medical care. Two elements, language barrier and socioeconomic struggle, are disclosed as possible origins of inconsistency in health issues. Most Hispanic-Americans hurdle the daily task of bringing food on their table and sending their offspring to public school, thus, Hispanic adults can no longer afford have annual check-ups, let alone, pay for a medical insurance. This is heightened by encounters in language differences—which frequently results in discriminatory attitudes in health care settings. These are standing concerns not only in the local government but on the national level, as well. Something has to be done to remedy on the current predicament that most Hispanics experience—not only in Frederick, Maryland but also in other states. Correcting the problems presented in previous pages can be complicated. Language differences foster discrimination. This had been going on for several decades, especially in first-world and second world countries. Smedley et al. (2003) affirmed that “stereotyping, biases, and uncertainty on the part of health care providers can contribute to unequal treatment” (as cited in “Hispanics/Latinos,” n.d.). A definite step towards a practical solution is to get acquainted with cultural details of the Hispanic race. This can be achieved in the community setting. The locale health authorities, especially in Frederick, Maryland, can initiate a specified system that deals on specific cultural policies. This can include orientation and training on how to deal with Hispanic citizens. It entails broad instructions on the values and beliefs of Hispanic citizens, and proper management during occurrence of conflicts in views. The said program should also possess provisions for Spanish language education, since language is vital in carrying out an effective care. Discrimination can never be avoided for it is an inherent negative attitude on some individuals. However, with this type of system, better perception and understanding can somehow undermine narrow-mindedness in some health care professionals. The system is preventive in the sense that health education can be effectively provided if both sides understand each other, and it is curative when applied during discussions and instructions on how to manage the client’s medical condition. It is recommended that every community health establishments such as special clinics and hospitals implement the suggested system. This is a good policy not only on the part of health care providers, but Hispanic clients can also benefit on this arrangement. Better communication aids them in gaining sufficient information on how to live with healthier conditions. Good physician-client relationship also helps in breaking the chain of heavy reliance on traditional healing, thus, hesitations in seeking medical help can be eliminated. On the other hand, patching up the problem regarding economic difficulties requires extensive measures. This entails involvement on the national level. A better choice for employment opportunities is a possible economic backing that the national government can offer. A financial assistance program can be established wherein the priority group, Hispanic individuals, are given financial support and industrial training in setting up small-scale enterprises. For those who cannot afford higher education (college level), government programs such as scholarship grants for Hispanic students can be provided. The priority of this program should be Hispanic students with good scholastic performance but whose family is financially struggling. A good educational background frequently helps in landing on better-paying works. All these may be far-fetching policies, but they can give equal chance for the citizens to improve their economic status. A sound socioeconomic standing potentiates better chance on investments in reliable medical insurances, thus, difficulties in health care may be minimized. The overall view of health care is universal; however, cultural diversity dictates distinctions of care across the continents. In summary, dealing with culture in a foreign territory is different. It is a two-way transaction. At one end, the ethnic race who struggles to fit in, and at the other end, the foreigners who reserve the right to manage strange cultural views. Difference in culture alone cannot bring such extensive limitations, but with involvement of both sides, they contribute widespread restrictions in delivering holistic health care in all levels. Language barrier and traditional values bring forth discrimination that may alter medical interventions. In defense, the minority groups opt for traditional healing to avoid negative feedbacks. Socioeconomic improvements for Hispanic groups may be disregarded by the government due to understatement of their cultural needs. In this case, culture may have an impact in distribution on health care measures, but the reaction on cultural differences firms the bond against the dynamic delivery of health care. References Cooper, R. (n.d.). Frederick, Maryland. Retrieved from: http://dc.about.com/od/marylandneighborhoods/a/Frederick.htm Erving, C. (n.d.). The health of the Hispanic elderly: Mortality, morbidity, and barriers to health access. Retrieved from: http://www.nhcoa.org/pdf/ NHCOA_HEALTH_STATUS_Hispanic_older_adults.pdf Frederick, MD. (n.d.). Retrieved from: http://www.citytowninfo.com/places/maryland/frederick Galarraga, J. (2007). Hispanic-American culture and health. Retrieved from: http://www.cwru.edu/med/epidbio/mphp439/Hispanic_Healthcare.pdf Hispanics/Latinos: Health disparity overview. (n.d). Retrieved from: http://erc.msh.org/provider/informatic/HL_Disparities_Traditional.pdf World Health Organization. (1946). WHO definition of Health. Retrieved from: http://www.who.int/about/definition/en/print.html Young, M.M. (2001). Hispanic health information outreach: Recommendations for NLM strategy and tactics. Retrieved from: http://nnlm.gov/evaluation/tools/hispanicoutreach.pdf Read More