Solving Latino Psychosocial and Health Problems: Theory, Practice, and Populations

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page iii

Solving

Latino Psychosocial and Health Problems Theory, Practice, and Populations Kurt C. Organista

John Wiley & Sons, Inc.

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page ii

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page i

Solving

Latino Psychosocial and Health Problems Theory, Practice, and Populations

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page ii

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page iii

Solving

Latino Psychosocial and Health Problems Theory, Practice, and Populations Kurt C. Organista

John Wiley & Sons, Inc.

2/5/07

10:49 AM

Page iv

This book is printed on acid-free paper.

➇

orga_a01ffirs.qxd

Copyright © 2007 by John Wiley & Sons, Inc. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada. Wiley Bicentennial Logo: Richard J. Pacifico No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Depart ment, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permissions. Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological or any other expert assistance is required, the services of a competent professional person should be sought. Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration. For general information on our other products and services please contact our Customer Care Depart ment within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our web site at www.wiley.com. Library of Congress Cataloging-in-Publication Data: Organista, Kurt C. Solving Latino psychosocial and health problems: theory, practice, and populations / Kurt C. Organista. p. cm. Includes bibliographical references. ISBN-13: 978-0-470-12657-8 (pbk.) 1. Hispanic Americans—Social conditions. 2. Hispanic Americans—Psychology. Americans—Health and hygiene. 4. Hispanic Americans—Services for. I. Title. E184.S75O74 2007 305.868′073—dc22

3. Hispanic

2006034370 Printed in the United States of America. 10

9

8

7

6

5

4

3

2

1

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page v

To my wife Pamela Balls Organista who inspires the best in me by being the person she is, daughters Zena Laura and Zara Luz who fill my heart with joy, and to Ricardo Rico Organista, a good man and great father.

orga_a01ffirs.qxd

2/5/07

10:49 AM

Page vi

orga_a02ftoc.qxd

2/5/07

10:49 AM

Page vii

Contents

Foreword by Doman Lum

ix

Preface

xi

Acknowledgments About the Author

xxi xxiii

Part I Essential Social Science Theories, Frameworks, and Research to Enhance Culturally Competent Practice 1 The Americanization of Latinos: Patterns of Acculturation and Adaptation in the United States

3

2 The Social Stratification of Latino Ethnicity, Power, and Social Welfare in the United States

39

3 Latino Ethnic Identity: Psychological Impacts of Structured Inequality

65

4 Diversity within Latinos: Subgroups, Identities, and Social Welfare

93

5 A New Practice Model for Working with Latinos

119

Part II Selective Reviews of Major Problem Areas, Latino Groups, and Best and Promising Practices 6 The Latino Family

141

7 Latino Youth

181

8 Latino Mental Health

215

9 Latino Health

245 vii

orga_a02ftoc.qxd

viii

2/5/07

10:49 AM

Page viii

CONTENTS

10 Latino Power: Political Participation, Policy Benefit, and the Role of Service Providers

283

Epilogue: Adelante—Proceeding Forward

321

Author Index

323

Subject Index

333

orga_a03fbetw.qxd

2/5/07

10:50 AM

Page ix

Foreword I AM DELIGHTED that Dr. Organista has finished his book on Latino Americans. Having borne the test of teaching, research, and writing, Dr. Organista now shares his thoughts and findings with us in print. Understanding and Solving Latino Psychosocial and Health Problems: Theory, Practice, and Diverse Populations is a landmark book that brings together important current research on Latino Americans in 10 major areas: acculturation, social stratification, ethnic identity, diversity, competent practice, family, youth, mental health, health care, and politics. Its contributions to theory, practice, and populations make this a very important book with research-oriented studies and a focus on innovative practice principles. Dr. Organista points out in his introduction that Latinos are the largest minority group in the United States (35 million in 2006) and that by the year 2050 they will compose 25% of the American population. His book is “must” reading for those who will likely help and work with this important cohort. He takes an integrative approach that compares and contrasts different U.S. Latino groups as distinct but related entities. Dr. Organista distinguishes the various nuances between Mexican Americans, Puerto Ricans, and Cuban Americans. He divides his book into two parts: theories, frameworks, and research and best and promising practices in dealing with problem areas. Each chapter contains themes and their related parts, theory models, relevant research studies, and possible directions. Kurt Organista has built this book on comprehensive research studies of Latino Americans and relevant theories that shed light on issues related to this population. He achieves a sense of practice-oriented research and research-oriented practice consistently throughout the entire text. He takes an inductive approach to finding out what the research on Latino Americans says and groups the research data under the main themes of the text. At the beginning of this book, he pursues some important systemic issues, such as the Americanization of Latinos, social stratification, and Latino ethnic identity, that are important foundational topics for this text. Then he shifts to two important practice-oriented themes, Latino diversity and a creative and interesting new practice model for working with Latinos. Here he introduces the theories of social constructionism and essentialism, brings together cultural ix

orga_a03fbetw.qxd

x

2/5/07

10:50 AM

Page x

FOREWORD

competence and social diversity, and makes the case for the inclusion of both cultural and social components into competent practice. He offers a working model that intersects two practice levels (generalist and specialized practice) and four major dimensions of service (increasing access, problem assessment in social and cultural context, selection of culturally and socially congruent interventions, and accountability). Then Dr. Organista focuses on the Latino family and skillfully interweaves the themes of the family, culturally and socially competent practice, interpersonal violence, and family therapy. He also deals with the issues and concerns of the Latino elderly and the caregiver burden in Latino families. He is concerned about Latino youth and their problems that are “the results of unmet developmental needs due to the breakdown of conventional social and cultural supports and resources within the family, ethnic community and greater society.” He advocates school-based interventions and family-focused interventions. He examines two major problem areas: mental health and physical health. Under mental health, he offers a Latino demographic profile, examines social barriers (e.g., underutilization of mental health services and cultural obstacles), and makes recommendations (culturally and socially congruent mental health inventions for Latinos). Dr. Organista reports on the demographics of and obstacles to Latino disease prevention and health promotion and concentrates on culturally and socially competent assessment and intervention regarding diabetes and heart disease, cancer, and HIV/AIDS. Finally, he offers a relevant and realistic analysis of Latino politics and power, focusing on the dynamics of Latino political power and a political agenda that includes economic development and reform, immigration and welfare policy reform, language and education policy reform, health care policy reform, grassroots politics, church-based activism, formal Latino political organizations, and pan-Latino political power. When I started my teaching and writing career over 30 years ago, there was sociological theory, a few practice principles, and anecdotal case studies on ethnic minorities. Those of us who taught ethnic minority content (which eventually became cultural and ethnic diversity and later human diversity) were forced to be creative pioneers. Kurt C. Organista represents this present generation of scholars/educators who reflect maturity and insight into the present discussion on diversity, culturally and socially competent practice, and population groups such as Latino Americans. DOMAN LUM, PHD, THD Professor Emeritus of Social Work California State University, Sacramento

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xi

Preface

IMAGINE THE DILEMMA of trying to write a social science, practiceoriented book about the social welfare and psychosocial and health problems of Latinos in the United States—complete with solutions—in view of their imposing and rapidly growing population size, a complex set of challenging problems and issues, and the tremendous heterogeneity between, as well as within, each major U.S. Latino group (e.g., Mexican Americans, Puerto Ricans, Cuban Americans, Central and South Americans, Caribbeans). Although the term “solving” in the book’s title may understandably strike some as presumptuous, it is meant to convey optimism and seems so much better than other terms considered, such as “addressing” (too tentative) and “confronting” (too combative) Latino psychosocial and health problems. The historical and current diversity across Latino groups also seriously challenges blanket terms such as Hispanics and especially the overly popular largest minority group in America. Indeed, the 2000 U.S. census estimated that the Latino population is now 31 million, or about 13% of the U.S. population, and that they are projected to grow to be 25% of the U.S. population by 2050, which has long been the case in states like California, Texas, Illinois, New Mexico, Florida, and Arizona. The U.S. census further confirms that Latinos now reside in every state throughout the United States, rapidly forming enclave communities and supplying essential labor to vital American industries and markets, ranging from agricultural farmwork to poultry preparation and meat packing, construction, gardening and landscaping, restaurant services, hotel housekeeping and private domestic work, and other jobs too numerous to name in the vast service sector. At the other end of the socioeconomic spectrum, Latino representation continues to grow in America’s traditional centers of power and influence (i.e., professional, business and corporate sectors, political representation), although parity continues to be a long way off. Even in popular media and culture, we are finally beginning to witness the overdue integration of Latinos into the arts and entertainment industry, professional sports, and other areas. xi

orga_a04fpref.qxd

xii

2/5/07

10:50 AM

Page xii

PREFACE

Although it is popular to say that Latinos have now surpassed African Americans as the largest ethnic group in America, such assertions exaggerate the cultural and social similarities between major and minor Latinos groups. Thus the saying amounts to a half-truth. Latino group variations in their relations with dominant Anglo-American society (e.g., degrees of conflict and cooperation) are described in this book using an integrative approach that compares and contrasts many of the different U.S. Latino group scenarios. Such an approach, which is followed throughout the book, departs from the tendency in the cultural diversity literature to confine each racial/ethnic group to its own separate chapter. This integrative approach to diverse Latino populations is also applied to a variety of social science theories (e.g., from sociology, psychology, public health, education, political science) to more thoroughly analyze and provide a more comprehensive understanding of the Latino experience in America. The book’s integrative approach emphasizes the oldest and largest of U.S. Latino groups (i.e., Mexican Americans, Puerto Ricans, Cubans, Central Americans), comparing and contrasting their acculturation histories, related socioeconomic status, and general levels of social welfare. Numerically small (i.e., South Americans) and more recent (e.g., Dominicans) U.S. Latinos certainly deserve more attention, yet literature on these groups is just beginning to accrue. For these reasons, as well as space limitations, the latter Latino groups are less emphasized in this book. B O O K S T RU C T U R E , ORG A N I Z AT I O N, A N D PR AC T I C E MO DE L This book is composed of 10 chapters divided into two parts. Part I contains the first five chapters and is designed to enhance cultural awareness and sensitivity by applying a series of highly relevant social science theories or frameworks that deepen the reader’s understanding of the historical and current cultural and social experiences of diverse Latino populations in the United States. Part I culminates, in the fifth chapter, with a new practice model for working with Latinos that synthesizes many of the best elements of past and current multicultural and Latino-focused practice models in social work, counseling and clinical psychology, and other allied disciplines and fields. Part II, spanning Chapters 6 through 10, is designed to provide detailed illustrations of culturally competent best and promising practices with various Latino groups, problem areas, and intervention approaches (i.e., family- and youth-related psychosocial and health problems, health and mental health problems in general, and Latino politics-related socioeconomic vulnerability and social policy issues).

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xiii

Preface

xiii

Part I, “Essential Social Science Theories, Frameworks, and Research to Enhance Culturally Competent Practice,” is designed to enhance cultural sensitivity by grounding the study of U.S. Latinos in some of the most relevant social science theories and frameworks that show how minoritystatus factors have resulted in nonrandom patterns of major psychosocial and health problems that have compromised the social welfare of U.S. Latinos. Thus, Chapter 1, “The Americanization of Latinos: Patterns of Acculturation and Adaptation in the United States,” describes historical forms of adaptation to American society for each of the major Latino groups under study. This is accomplished by applying the sociological framework of acculturation to explicate major forms of contact and conf lict between Latinos and the host society, varying degrees of acculturative stress, and predominant forms of adaptation (e.g., segregation, integration, assimilation, marginality) for each major Latino group under study. Chapter 2, “The Social Stratification of Latino Ethnicity, Power, and Social Welfare in the United States,” picks up where Chapter 1 leaves off by analyzing and describing where different Latino groups are located in the American social stratification system and the implication of such locations for general patterns of well-being or social welfare. Issues of economic and educational vulnerability are covered in detail to render visible social structural and institutional issues central to Latino social problems and solutions. How Latino communities have responded to oppressive dynamics is also highlighted. The psychological, individual-level impacts of group-level phenomena are addressed in Chapter 3, “Latino Ethnic Identity: Psychological Impacts of Structured Inequality,” which provides a psychological analysis of the development of Latino racial and ethnic identity in the United States, including analysis of the relation between subordinate minority status and race/ethnicity-related selfconcept and self-esteem. This level of analysis speaks to the considerable heterogeneity of attitudes and behaviors of Latinos both within and across different Latino groups, and necessarily addresses White racial identity as discussed in the new area of critical White studies. Chapter 4, “Diversity within Latinos: Subgroups, Identities, and Social Welfare,” speaks to today’s pressing need to go beyond race and ethnicity to better understand how human variation within any single group of Latinos interacts with social problems and solutions. Chapter 4 challenges the tendency in the multicultural literature of providing monolithic discussions on race/ethnicity, and thus begins to address diversity within groups, including gender and sexual orientation, social class, skin color, and legal status, and shows how such dimensions interact with psychosocial and physical health problems. Addressing diversity within Latinos is imperative considering the preponderance of Latinas as consumers of social and

orga_a04fpref.qxd

xiv

2/5/07

10:50 AM

Page xiv

PREFACE

human services, as well as the continued marginalization of gay, lesbian, bisexual, and transgendered Latinos both in the larger society and in the Latino community. Chapter 5, “A New Practice Model for Working with Latinos,” the final chapter in Part I, presents the book’s new practice model for working with Latinos that integrates many of the best elements of multicultural and Latino-focused practice models in social work and psychology. Elements of Doman Lum’s (1999) Culturally Competent Practice: A Framework for Growth and Action were selectively integrated into the book’s practice model because of its comprehensiveness and deep-rootedness in the social work literature on cultural competence. Lum’s model addresses two levels of social work practice (generalist and advanced) across four domains of culturally competent practice (cultural awareness, knowledge acquisition, skill development, and inductive learning). However, because some of Lum’s dimensions overlap more than others (i.e., cultural awareness and knowledge acquisition; generalist and advanced levels), they are streamlined in the current practice model to highlight the knowledge, skills, and professional growth commitment necessary in multicultural learning and practice. Lum’s work is also complemented by that of Rogler, Malgady, Costantino, and Blumenthal (1987) based on their classic American Psychologist article, “What Do Culturally Sensitive Mental Health Services Mean? The Case of Hispanics.” Although this model is excellent in its special attention to issues of access and culturally congruent interventions, it is weak where Lum’s model is strong: problem definition and assessment issues. Thus, here is where synthesizing models become highly advantageous. Another tremendous advantage is that the Rogler model dares to advocate intervention strategies that explicitly deviate from Latino culture in the best interests of Latino clients. For example, although teaching Latinos to communicate assertively may run contrary to traditional Latino communication protocol, it helps to expand their bicultural repertoire and adaptation to the United States and is even a therapeutic tool for combating problems such as depression, as described in Chapter 8. Too often multicultural practice models appear to play it safe by advocating practice only within ethnic culture. Such a cautious bias is understandable in view of the historical treatment of ethnic minority groups, which has generally devalued ethnic culture and indeed deviated from culture in an imperialistic manner (e.g., forced assimilation boarding schools for Native Americans, antibilingual measures for Latinos). Yet, advanced cultural competence not only involves knowing how to biculturate Latinos in a nonoppressive manner, but it must also occasionally critique cultural elements that can be maladaptive to some group members in certain situations.

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xv

Preface

xv

Perspectives that inform the new practice model for Latinos are also described in Chapter 5 and include ecological-systems theory, the major contemporary social work perspective for understanding human behavior in the social environment, and a social constructivist perspective. Advantages of an ecosystems model include thinking about client problems and solutions at multiple levels (i.e., micro [individual] through macro [social]). Critics of this perspective (e.g., Wakefield, 1996), however, rightly point out that it is descriptive and not prescriptive and hence must be brought to life by combining several domain-specific theories and methods to address particular problem areas at the local level—precisely the overriding objective of this book. A postmodern social constructivist perspective is also provided to assist readers in considering the politics and power dynamics inherent in all human systems and relations and how “truths” can often be more relative than monolithic and hence open to being questioned and challenged, especially by those experiencing social injustice. The result is a user-friendly practice model that is fairly easy for practitioners, as well as administrators, to keep in mind as they actively provide, design, and critique the broad array of interventions needed to comprehensively address Latino psychosocial and health problems. The pragmatic approach to model development in this book is also meant to build on the current state of practice and to counter the frequent rhetorical tendency in the literature to overwhelm readers with long wish lists of all the things practitioners should but often can’t do, lists that can be exhaustive to a fault and thus exhausting to readers. Part II, “Selective Reviews of Major Problem Areas, Latino Groups, and Best and Promising Practices,” provides detailed descriptions and illustrations of best (i.e., empirically tested) and promising practices (i.e., conceptually well conceived and executed despite lack of evaluation) with diverse Latino populations and subgroups across a wide variety of significant psychosocial and health problems. The term psychosocial is used here to refer to the interaction between individual psychological factors and macro-social—including cultural institutional—factors that frame so many problem patterns affecting racial and ethnic minority groups given their link to historical and current issues of inequity, marginality, and social injustice. This definition includes many health problems related to racial/ethnic status (e.g., health disparities). Conceptualizing Latino psychosocial and health problems in this manner necessitates thinking about problems and solutions at multiple levels, from micro-individual (e.g., case management, therapy) to meso-community (e.g., comprehensive school-based services) to macro-societal strategies aimed at changing institutional practices and social policy, all of which are illustrated in Part II.

orga_a04fpref.qxd

xvi

2/5/07

10:50 AM

Page xvi

PREFACE

It is the overriding objective of Part II to provide detailed illustrations of culturally competent practice with Latinos by carefully selecting from among some of the best and clearest examples in the literature, including the author’s many years of experience in Latino health and mental health work. Because it is impossible to address all of the important psychosocial and health problems affecting Latinos in a single book, I instead chose to illustrate how the major dimensions of culturally competent practice (e.g., as laid out in Chapter 5) are applied in real-life examples of practice with Latinos aimed at some of the most pressing issues affecting families (domestic violence, dementia in the elderly), youth (school failure, gang involvement), health (diabetes, heart disease, HIV/AIDS), mental health (prevention of depression in the community, treatment of major depression), and policy concerns (economic development, immigration and welfare policy reform, health policy). As the single most important cultural institution across different Latino groups, even those varying in level of acculturation, la familia Latina must be adequately addressed as the site of both problems of and solutions to various psychosocial and health issues confronting U.S. Latinos. Thus, Chapter 6, “The Latino Family,” is purposefully broad but primarily focuses on family and community problems and issues pertinent to culturally competent practice. For example, how immigration and acculturation dynamics help and hinder family functioning, and how the Latino community is affected by disproportionate poverty and related problems (e.g., domestic violence, elderly abuse) are addressed. State-of-the-art and cutting-edge practice with Latino families and communities are also addressed by highlighting work by leaders in this area, such as Celia Falicov, José Szapocznik, Monica McGoldrick, and Ruth Zambrana. Chapter 7, “Latino Youth,” focuses on the experiences, problems, and issues affecting the burgeoning population of Latino youth in America. School failure, teen pregnancy, HIV/AIDS, and STDs, delinquency and gang involvement, and substance abuse are persistent and related psychosocial and health problems that significantly impact Latino youth, families, and communities. They require sensitive assessments that consider developmentally related issues of minority status and marginality, the negative incentives of poverty, and ecological-family system considerations of problem manifestations and resolution. Chapter 8, “Latino Mental Health,” provides an overview of Latino mental health in America followed by a selective review of best and promising practices in major problem areas (e.g., depression) and with various subpopulations (e.g., women). The disciplines of psychiatry and counseling and clinical psychology have made major advancements in the

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xvii

Preface

xvii

past 25 years that are highlighted before targeting important mental health issues that overaffect Latino refugees, immigrants, and urban poverty dwellers. An overview of the state of Latino health in America is presented in Chapter 9, “Latino Health,” with attention to pertinent macro-level social (e.g., access to health care) and cultural (e.g., culture-based health attitudes and beliefs) factors. With regard to best and promising practices in health assessment and practice, a selective review of significant health problems (e.g., diabetes, HIV/AIDS, cancer) and issues is provided to teach cultural competence through important key illustrations. Chapter 10, “Latino Power: Political Participation, Policy Benefit, and the Role of Service Providers, returns to a focus on socioeconomic vulnerability as the core issue undermining the health and well-being of the majority of Latinos in the United States today. This chapter provides an overview of Latino politics with an emphasis on political participation, policy benefit, and potential roles for social workers and other service providers in the frequently ambiguous political arena. Historical and current, formal and informal, grassroots movements and initiatives on the part of local and national Latino organizations are provided as illustrations of the historical agency and self-advocacy of Latinos that can be augmented by mainstream professionals and institutions. Chapter 10 brings the reader full circle to the major social justice issues raised in Part I that must be understood and addressed, simultaneous with micro-level problems, if we are to continue solving Latino psychosocial and health problems in America. The book ends with a brief Epilogue in which the author reflects on the challenges of this ambitious book project while also looking adelante or forward to what future editions of this book could contain as well as looking forward to the future contributions of other Latino and Latino interested scholars and practitioners. B O O K G OA L S A N D I N T E N DE D AU DI E N C E S Rarely are Latino-focused social science theory, research, and practice information all in the same place. For example, over the past decade and a half, I have repeatedly compiled thick course readers, packed with articles, book chapters, and various governmental and nonprofit agency reports, in order to teach Social Work Practice with Latinos, a course increasingly common in schools of social work throughout the country. While at times frustrating, it was from such experience that I learned to mine Latino-specific and Latino-relevant literature from throughout the social sciences to better capture the complexity of the Latino experience

orga_a04fpref.qxd

xviii

2/5/07

10:50 AM

Page xviii

PREFACE

and its links to socioeconomic status, consequent social welfare, and social and human service needs. It is a major goal of this book to integrate such literature in ways that make most of the chapters read like reviews of the literature in order to answer some basic and vital questions: How do we understand the tendency for Latinos to underutilize various human, social, and health services, while overutilizing others? What kinds of outreach or service development strategies can be employed to improve the situation? How do we assess problems in ways that consider cultural and social-environmental contexts, and then select interventions congruent with the lived realities of Latino groups and individuals? And while the multicultural literature is filled with mantra-like rhetoric about working within the culture, how and when do we work outside of Latino culture in a nonoppressive manner that is in the best interest of our clients? Although it is intuitively optimal to integrate multidisciplinary research, theory, and practice, such efforts continue to be more the exception than the rule. In some ways, the interdisciplinary-oriented field of social work, which regularly mines, integrates, and expands on all of the areas just enumerated, is an ideal domain for such knowledge development, integration, and sharing. Social work has indeed made its fair share of contributions to the cultural competence literature (cited throughout this text), yet general books on social work practice with Latinos have been very slow to emerge. This book is designed for students and professionals interested in and already serving Latino populations in social work and allied fields such as counseling and clinical psychology, marriage and family therapy, psychiatry, and public health care, who share a common commitment to providing Latino clients and patients with sensitive and effective care for a wide spectrum of psychosocial and health problems. As such, the book can serve as the primary text for the growing number of Latino-focused undergraduate and graduate courses in social work and allied fields (e.g., Latino health, Latino mental health, the Latino family). Further, because helping professionals are now serving Latino clients and addressing Latino issues more than before, the book can be a valuable guide in proving culturally competent health, mental health, education, and family- and youth-oriented services, as well as social policy analysis and development. In 1970, the Council on Social Work Education (CSWE) declared ethnic minority concerns its number one priority, following the lead of counseling and clinical psychology. This mandate included the integration of multicultural content into social work school curricula. A number of books and articles have appeared since then, but it is generally agreed

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xix

Preface

xix

that such publications continue to constitute only a small percentage of the professional knowledge base. For example, in Lum’s classic 1996 book, Social Work Practice and People of Color, he describes a study of 28 social work practice textbooks published between 1970 and 1995 in which he found no chapters devoted to multicultural issues. In fact, only 1% of the pages in this set of texts (121 of 12,570) were devoted to ethnicity. In this same study, Lum also reviewed three of the top social work journals (Social Work, Social Service Review, and Families in Society [formerly Social Casework]) from the same time period and found that 2% (87 of 3,716) of the articles related to general multicultural issues and 2% (80) related to African Americans, 1% (36) to Native Americans, 1% (44) to Asian Americans, and 1% (49) to Latinos. Thus, more than 35 years since the CSWE mandate, the field of social work continues to operate with too little information, illustration, and technology regarding how to conceptualize and respond to the various social welfare needs of Latinos and other people of color. And the situation is not markedly better in allied fields of professional practice. It is with this awareness of the state of the art in culturally competent practice with Latinos that the current book is offered as a sincere attempt to continue pushing this important topic of inquiry toward the cutting edge. R EFER ENCE S Lum, D. (1996). Social work practice and people of color: A process stage approach (4th ed.). Pacific Grove, CA: Brooks/Cole. Lum, D. (1999). Culturally competent practice: A framework for growth and action. Pacific Grove, CA: Brooks/Cole. Rogler, L. H., Malgady, R. G., Costantino, G., & Blumenthal, R. (1987). What do culturally sensitive mental health services mean? The case of Hispanics. American Psychologist, 42(6), 565 –570. Wakefield, J. C. (1996). Does social work need the eco-systems perspective? Pt. 1. Is the perspective clinically useful? Social Service Review, 1–32.

orga_a04fpref.qxd

2/5/07

10:50 AM

Page xx

orga_a05flast.qxd

2/5/07

10:50 AM

Page xxi

Acknowledgments

FIRST AND FOREMOST I’d like to fly my Latino colors by expressing my deepest appreciation to my loving family. My heart doubled in size when my wife, Pamela Balls Organista, decided to share her life with me, and with our two beautiful daughters, Zena Laura and Zara Luz Organista, it doubled again. I cannot express the profound joy and meaning that these extraordinary human beings give my life each day. But any personal and professional accomplishments would not even have been possible without the epic-size love and support of my extended Mexican family: My father, Ricardo Rico Organista, completes our two-generation quest to be what a Latino father and son can be, while trying to improve the Latino experience in the process; my grandmother, Adela Rico Organista, was exactly the mother that I needed growing up in East Los Angeles; and Alex Rico Organista continues to be the loving big brother that I never had. Fortunately, other family members have become too numerous to name over time, but I want to make sure to thank the Arriola family, especially Auntie Glo and prima-hermana Jo Ann; the Uncle Art and Aunt Olivia branch of the Organistas, including cousins “Guy,” Yvette, and Danny; my Aunt Norma and cousins Lauren “Tinker” and Dennis Beaman; cousins Debbie and Patricia, daughters of my much loved second father, Manny Organista. Compadres Celina and Pablo Ramirez, daughters Quetzali and Rubi, and my godson, Diego, provide much needed family support out here in the Bay Area. Though friends may come and go, David “T-Bone” Torres and his compañera, Jo Ann Orge, are loyal to the end. And while family and academia struggle to coincide, here’s to my touchstone colleagues who have enriched my experience at UC Berkeley: Former Dean Harry Specht was a genuine ally during my early years; Dean Jim Midgely gave me a handy compass to this book; Emeritus Professor Jewelle Taylor Gibbs continues to help me “keep it real” in this business; Paul Terrell has generously shared his friendship and Berkeley spirit; Joseph Solis, Rafael Herrera, and Peter Manoleas have been hermanos bien educados from day one; Lorretta Morales is a blessing xxi

orga_a05flast.qxd

xxii

2/5/07

10:50 AM

Page xxii

ACKNOWLEDGMENTS

of a support staff person whose talented mark has graced all of my work over the years, including this book; and Sharon Ikami provides friendly backup when Lorretta is away. Special thanks to my internship mentor, Ricardo F. Muñoz, and graduate school mentor, Manuel Barrera Jr., for guidance and support at critical times, and heartfelt gratitude to my editor Lisa Gebo, who manages to gracefully blend professionalism and human warmth in the creation of needed book projects and caring friendships. ¡Mil gracias!

orga_a05flast.qxd

2/5/07

10:50 AM

Page xxiii

About the Author

KURT C. ORGANISTA is an associate professor of social welfare at the University of California at Berkeley. Organista is a bilingual and bicultural Mexican American who was born and raised in predominantly Latino East Los Angeles. As such, he brings a sensitive insider’s perspective to his scholarly analysis of Latino social welfare. Organista conducts cross-cultural, interdisciplinary, and international research on a variety of Latino-related social welfare topics. He has published a series of journal articles and book chapters on the treatment of depression in Latinos with cognitive-behavioral therapy alone and in combination with case management. Organista is a nationally recognized expert in HIV/AIDS prevention with Mexican/Latino migrant laborers, with a second series of book chapters and articles published in social work, health, psychology, ethnic studies, and HIV/AIDSfocused journals. He was appointed by Secretary of Health Tommy Thompson to serve on the National Office of AIDS Research Advisory Council (2004 –2008). Organista is also a member of the editorial boards for the Hispanic Journal of Behavioral Sciences, Journal of Ethnic and Cultural Diversity in Social Work, and the American Journal of Community Psychology.

xxiii

orga_a05flast.qxd

2/5/07

10:50 AM

Page xxiv

orga_c01p01.qxd

2/5/07

10:51 AM

Page 1

PA R T I

Essential Social Science Theories, Frameworks, and Research to Enhance Culturally Competent Practice PART I IS DESIGNED to inform culturally competent practice by enhancing the reader’s awareness of, knowledge about, and sensitivity to Latino culture and experience in the United States, culminating with a new practice model that synthesizes some of the best elements of past and current thinking in social work, counseling, and clinical psychology, and other allied disciplines and fields. Although ambitious, such a foundational objective is accomplished by using an integrative approach to address the diversity within both the Latino population and social science theories and frameworks needed to best analyze and understand the Latino experience in the United States. Thus, essential theories of acculturation, social stratification, racial and ethnic identity, and human diversity, including feminism and perspectives on sexual orientation, are used to frame the historical and current group-level and individual experiences of U.S. Latinos. Further, rather than confining each major Latino group to its own separate chapter, all chapters in Part I compare and contrast different Latino groups for a more thorough and integrated analysis of Latino problems and issues needed to inform culturally competent practice.

1

orga_c01p01.qxd

2/5/07

10:51 AM

Page 2

orga_c01.qxd

2/5/07

10:50 AM

Page 3

CHAPTER 1

The Americanization of Latinos Patterns of Acculturation and Adaptation in the United States

THE PROCESS OF becoming Americanized can result in very different levels of adjustment and adaptation for different ethnic groups. Why is it that some ethnic groups have considerable success achieving the American Dream while others do not? That is, why is it that some ethnic groups achieve high levels of power and participation in mainstream culture, politics, and economics, while other groups struggle and suffer at the margins? Using socioeconomic status (SES) as perhaps the most central indicator of general social welfare, it’s fairly easy to rank-order ethnic groups, with Euro-Americans mostly at the top and people of color mostly at the bottom. Even focusing just on Latinos, we can see considerable differences in SES, with Cuban Americans ranking nearly as high as non-Latino White Americans, Puerto Ricans ranking much lower or about the same as African Americans, and Mexican Americans ranking in between. The ways we perceive and understand these social positions have tremendous implications for how we respond to ethnic group needs and problems. For example, do we view ethnic groups as primarily responsible for their locations in society, or do we view social structural and environmental factors as primarily responsible? To be most effective, human service professionals must be able to think deeply and critically about the origin and perpetuation of psychosocial and health problems affecting different groups. 3

orga_c01.qxd

4

2/5/07

10:50 AM

Page 4

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

It is a basic tenet of cultural sensitivity to make ourselves knowledgeable about the historical experiences of ethnic minority groups with whom we work as service providers. Thus, though practitioners don’t have to become historians, it is important that we obtain sufficient background information to better appreciate the current circumstances, problems, and postures of ethnic minority clients. This chapter uses an acculturation framework for organizing a brief yet salient review of Latino-relevant American history and sociology. As with the book in general, this review emphasizes the oldest and largest of U.S. Latino groups (i.e., Mexican Americans, Puerto Ricans, Cubans, Central Americans), comparing and contrasting their acculturation histories and related SESes and general levels of social welfare. An acculturation framework can help human service professionals understand the historical development of contemporary Latino psychosocial and health problems in a way that depathologizes Latinos without minimizing the gravity of their many life-compromising challenges. This framework will also help the reader to build cultural sensitivity by placing Latino problems and issues within a context that considers the dynamics of U.S. race relations, processes of dominance and subordination, and how majority and minority groups coevolve over time. It is worth noting that most U.S. Latinos generally refer to themselves based on historical national origins (i.e., Mexican American, Puerto Rican, Cuban American, Central American), while also using the U.S. government term, Hispanic, in more formal, institutional settings (e.g., when filling out forms) or when referring to U.S. Latinos in general. Because many U.S. Latinos have reacted unfavorably to the term Hispanic, which they perceive to be a top-down government-imposed label, they have instead elected to use Latino as a general term, in addition to their national origins labels. Of course, there are many regional variations on preferred terms (e.g., Puerto Ricans who self-identify as Boriquen as an assertion of indigenous heritage; Mexican Americans from New Mexico whose historical mistreatment led to an emphasis of their Euro-Spanish heritage through the terms Spanish and even Hispano long before Hispanic became the official term of the U.S. government). With such variety in Latino terminology, the sensitive service provider simply asks clients what they prefer to be called rather than making assumptions frequently likely to be wrong. T H E C O N C E P T O F AC C U LT U R AT I O N The classic definition of acculturation dates back to the mid-1930s when anthropologists Redfield, Lipton, and Herskovits (1936) defined it as

orga_c01.qxd

2/5/07

10:50 AM

Page 5

The Americanization of Latinos

5

those phenomena that result when members of different autonomous cultural groups come into continuous firsthand contact, with subsequent changes in the original cultural patterns and customs of either or both groups (e.g., language, values, lifestyle, attitudes, identity). Although many today use the terms acculturation and assimilation interchangeably, Redfield et al. specified that acculturation refers to cultural changes, whereas assimilation refers specifically to intermarriage between members of groups in contact. They noted that assimilation or intermarriage may or may not be a phase of acculturation for some groups. For example, the rate of intermarriage for Cuban American women is nearly 50%, compared to 16% for Mexican American women (Gonzales, 1993). This is quite a difference considering that the vast majority of Cubans have been in the United States less than 50 years, whereas Mexican Americans have been here for over a century and a half. ACCULTURATION AMERICAN STYLE More recently, Canadian psychologist John Berry (2003) studied the process of acculturation by focusing primarily on indigenous peoples and ethnic groups in North America and their historical experience with dominant European colonial powers. As such, Berry’s conceptualization of acculturation is particularly relevant to Native Americans, African Americans, and Latinos in the United States. For example, in discussing the nature of acculturation, Berry notes that although in theory two groups in contact can influence each other, in reality the larger and more powerful group usually dominates the smaller and less powerful group (see Figure 1.1). As such, the dominant group typically wields considerably more power to control, influence, and even oppress the nondominant group, and these dynamics set the stage for a process of acculturation that is usually resistant, stressful, and conflictual for the nondominant group. Just how stressful the acculturation process can be depends on its course. Berry (2003) summarizes the course of acculturation as a three-phase process characterized by contact, conflict, and adaptation. Contact refers to the conditions under which two cultural groups meet (e.g., invasion, immigration, seeking refuge); conf lict refers to the predictable tension and fighting that results when one group attempts to dominate another; and adaptation refers to the eventual form of accommodation between groups that is intended to reduce conflict. It is theoretically possible for conflict not to occur, as indeed some individuals may experience, but the all too common dynamics of group-level dominance and subordination make conflict a probable phase of acculturation. Accommodation can take many forms, ranging from assimilation, as when a nondominant group

orga_c01.qxd

6

2/5/07

10:50 AM

Page 6

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH In Theory

Culture A

Culture B

In Reality

Culture B

Culture A

Figure 1.1 The Nature of Acculturation

marries into the dominant group, to separation, as when a nondominant group exists mostly apart from the dominant group. Which form of adaptation an ethnic minority group eventually experiences depends on a number of factors, including the original conditions of contact, the degree of conflict between groups, and the dominant society’s tolerance for cultural diversity. All of these factors influence the degree to which the nondominant group attempts to maintain its culture of origin and the degree to which positive relations between groups is possible. According to Berry (2003), the four major forms of adaptation evident in most societies can be understood by listing all possible combinations of yes/no answers to the following two questions: Does the minority group attempt to retain its culture of origin? and Are positive relations possible between the minority and majority groups? (See Table 1.1.) For example, the historical experience of Mexican Americans has predominantly been one of segregation due to strained relations with the dominant culture and their relatively high retention of Mexican culture. The fact that Mexican American adaptation has slowly been shifting from segregation to integration speaks to the dynamic nature of acculturation of group relations not depicted in Table 1.1.

orga_c01.qxd

2/5/07

10:50 AM

Page 7

The Americanization of Latinos

7

Table 1.1 Varieties of Adaptation to Acculturation for U.S. Minority Groups Attempt to Retain Culture?

Positive Relations Possible with Dominant Culture?

No Yes Yes No

Yes Yes No No

Predominant Form of Adaptation Assimilation Integration Segregation Marginalization

Source: “Psychology of Acculturation: Understanding Individuals Moving between Cultures” (pp. 232–253), by J. W. Berry, in Applied Cross-Cultural Psychology, A. Brislin (Ed.), 1990, Newbury Park, CA: Sage. Reprinted with permission.

Still, the depiction of the four major forms of adaptation can give us a basic understanding of how stressful the acculturation process can be for different groups. Indeed, the four forms of adaptation can be viewed almost as a stress gradient in which the scenarios of assimilation and integration would be far less stressful forms of adaptation to American society than segregation and certainly marginalization. A solid conceptualization of acculturative stress is essential for understanding the basis of an ethnic minority group’s relative patterns of success and failure in America.

ACCULTURATIVE STRESS Berry and Annis (1974) define acculturative stress as collective confusion and anxiety, loss of identity, feelings of alienation, and striking out against the larger society. More specifically, acculturative stress refers to behaviors and experiences generated during acculturation that are pathological and disruptive to the individual and ethnic group (e.g., deviant behavior, psychosomatic symptoms, feelings of marginality). This definition can be extended to refer to the negative disparity in overall health and quality of life between majority and minority cultural groups. The Acculturation Stress Formula Based on extensive research of both ethnic immigrant and indigenous groups in North America, Berry (2003) has developed a useful formula for estimating a group’s general level of acculturative stress that can be used to examine the influential role of factors such as race, ethnicity, culture, and racism embedded in the process of acculturation. According to Berry (2003), acculturative stress will be highest when the cultural and behavioral similarity between two groups in contact is lowest

orga_c01.qxd

8

2/5/07

10:50 AM

Page 8

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

and where pressure is placed on the minority group to acculturate due to the dominant group’s low tolerance for racial and cultural diversity. For example, the acculturation experiences of Native Americans and African Americans rank highest in terms of stress given their low cultural and racial similarity to Anglo-Americans and the tremendous historical pressure placed on these involuntary Americans to relinquish their culture of origin. Such pressure has been especially stressful considering that the original contact experiences of these two groups involved invasion and forced relocation, followed by policies of rejection and separation from mainstream society (e.g., reservations for Native Americans and enslavement followed by legal segregation for African Americans). In contrast, European immigrants have historically experienced low acculturative stress relative to people of color, given their high cultural and racial similarity to the dominant group and because the pressure to acculturate has been buffered by their voluntary immigration to America (i.e., their collective inclination to relinquish their culture of origin in exchange for American culture and identity). However, this is not to say that European immigrants have not experienced acculturative stress stemming from America’s low tolerance for diversity even within European immigrants. Such low tolerance was most clearly exemplified by the famous “melting pot” philosophy, which strongly discouraged foreigners from retaining their culture of origin and served as the major guiding philosophy for socializing and including European immigrant groups into American society during the twentieth century. And although we would expect all societies to be nationalistic, the melting pot philosophy made immigration and acculturation overly stressful because it promoted the American standard while devaluing dissimilar cultures of origin, with no vision of healthy, functional biculturalism or multiculturalism. Classic research by Murphy (1965, 1975) established that a melting pot orientation places immigrants in the stressful position of having to either conform to or oppose the dominant group. In contrast, countries with higher tolerance for cultural diversity allow immigrants to maintain supportive cultural traditions and practices that buffer acculturative stress. In Murphy’s classic review of the relation between immigration and mental health, he found that immigrants had significantly higher rates of psychiatric hospitalization relative to nonimmigrants in countries with low tolerance for diversity such as the United States. In contrast, hospitalization rates did not differ between immigrants and natives in more tolerant societies such as Canada. Thus, even though European immigrants rank far lower than, say, Native Americans and African Americans in acculturative stress, they have experienced unnecessary degrees of stress prior to their assimilation.

orga_c01.qxd

2/5/07

10:50 AM

Page 9

The Americanization of Latinos

9

But as unnecessarily stressful as melting pot-driven acculturation was for European Americans, they were still eventually regarded as the “right stock” for the melting pot recipe, whereas non-European people of color were not. For example, although the Americans of predominantly Northern European ancestry were initially threatened by Southern and Eastern Europeans (i.e., Jews, Italians, Poles, Hungarians) of the second great immigration stream at the turn of the twentieth century, given their frequently darker Mediterranean appearance and impoverished peasant backgrounds, their current levels of SES parity and beyond, along with very high rates of marital assimilation, reveals that such initial rejection was short-lived compared to that of non-European ethnic minorities (McLemore, Romo, & Gonzalez Baker, 2001). Berry (1990) notes that acculturative stress is particularly high when countries develop policies that largely exclude certain groups from participation and access to power. Herein lies a precarious predicament for people of color in the United States who have historically been coerced not to practice their culture yet disallowed from fully joining American society. The result of this predicament is marginality (see Table 1.1), most evident for Native Americans and African Americans but also for subgroups of Latinos such as members of Chicano and Puerto Rican youth gangs who walk a line between cultures without sufficient guidance and support, role models, and self-affirming cultural values. In response to the double bind of melting pot pressure to assimilate and forced separation, segregated groups have urgently needed to retain their culture of origin, or, if necessary, reclaim and re-create it, in order to survive and feel human in an often hostile environment. For people of color, group survival and basic sense of humanity have depended on culturebased mutual aid and social traditions that have served as an organizing principle for physical and social survival. It is an irony of history that the racist exclusion of people of color from participation in mainstream America has done more to create and strengthen ethnic culture and identity than any nationalistic movement generated by people of color. Spurts of nationalism, often seen at the fringes of civil rights movements, are more reactions to rejection than proactive efforts to live as a separate nation. The majority of people of color have been and continue to be fiercely patriotic believers in America who would willingly integrate and assimilate in spite of their historical mistreatment. On a related note, it is a double irony that the most voluntarily self-segregated groups in America are of European background (e.g., Amish, Mennonites). While America continues to struggle to embrace diversity, this new multicultural philosophy of socialization and inclusion continues to face ample resistance, as seen in the recent rash of “English Only” laws

orga_c01.qxd

10

2/5/07

10:50 AM

Page 10

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

spreading across the country, the scapegoating of immigrants for economic problems, and widespread “diversity fatigue,” as exemplified by anti-affirmative action policies such as California’s recent Proposition 209. Ironically, current racial politics seem in direct opposition to the globalization of business that depends heavily on sophisticated levels of competence in working with multicultural people and countries. ACCULTURATIVE STRESS AND SOCIAL WELFARE In examining the acculturative experiences of different ethnic groups in America, it becomes apparent that the degree of acculturative stress is inversely related to a group’s general level of well-being or social welfare. That is, in general, the higher the degree of acculturative stress, the lower the overall level of social welfare for a group. Given this relation, Berry’s three-stage model of acculturation described earlier can be expanded to include degree of acculturative stress and social welfare in order to better connect acculturation dynamics with current levels of well-being in different groups in America (see Table 1.2).

Table 1.2 Model of Acculturation, Adjustment, and Social Welfare for Ethnic Groups in the United States Predominant Form of Adaptation

Degree of Acculturative Stress

General Level of Social Welfare

Ethnic Group

Conditions of Contact

Degree of Conflict

European Americans

Voluntary immigration

Low

Assimilation

Low

High

Native Americans

Invasion

High

Marginalization → Segregation

High

Low

African Americans

Forced relocation

High

Marginalization → Segregation

High

Low to medium

Old* Chinese, Japanese

Voluntary immigration

Medium

Segregation → Integration → Assimilation

Low to medium

Medium to high

Latinos

Varies by subgroup

Medium

Segregation → Integration →

Medium

Medium

*Old refers to Chinese and Japanese populations with immigration histories in the United States since the early 1800s. Note: Arrows indicate change over time.

orga_c01.qxd

2/5/07

10:50 AM

Page 11

The Americanization of Latinos

11

Table 1.3 Model of Acculturation, Adjustment, and Social Welfare for Latinos in the United States Degree of Acculturative Stress

General Level of Social Welfare

Conditions of Contact

Degree of Conflict

Predominant Form of Adaptation

Chicanos

Invasion + immigration

Medium

Segregation → Integration

Medium

Medium

Cuban Americans

Legal refugees

Low

Segregation → Integration → Assimilation

Low

High

Puerto Ricans

Colonization

Medium

Segregation

Medium to high

Low to medium

Central Americans

Illegal refugees

Medium

Segregation

Medium

Low

Latino Group

Note: Arrows indicate change over time.

The expanded model of acculturation explains general historical patterns of adaptation and consequent level of social welfare for different ethnic groups. No model is comprehensive enough to adequately explain all of the variance within or between groups, but the expanded model presented here provides a basic framework for beginning to understand major patterns of group-level adjustment in American ethnic groups. It is relatively easy to use the expanded model of acculturation to contrast the general adaptations of non-Latino Whites, African Americans, and Native Americans, yet different Latino groups also vary greatly in their conditions of contact with American society and subsequent degrees of acculturative stress and social welfare. The same is true of Asian groups, which is why the examples in Table 1.2 are confined to the oldest and largest Asian populations with immigration histories dating back to the early 1800s. A selective review of salient historical details is necessary to appreciate the conditions of acculturation that undergird current levels of social welfare and need for different Latino groups in the United States, as described in Table 1.3. M E X I CA N A M E R I CA N S Americans of Mexican ancestry constitute two-thirds of all Latinos in the United States, and their extensive, 150-year history in America predates

orga_c01.qxd

12

2/5/07

10:50 AM

Page 12

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

all other U.S. Latino groups. As such, application of the expanded acculturation model requires more analysis and serves as a salient point of reference for understanding Latino adaptation and adjustment in the United States. In this section, the term Mexican American is used to refer generally to this population; the term Chicano, self-imposed by civil rights activist members of this group, partly as a rejection of the government-imposed, hyphenated term Mexican-American, is also honored. Used historically by Mexican people as a derogatory term affixed to low-class people, Chicano activists chose to infuse it with pride, much as African Americans turned the term Black on its head during the 1960s. CONTACT Although contact for the vast majority of today’s estimated 14 million Mexican Americans might be best characterized as voluntary immigration, it is important to note that like Native Americans, Mexican people were native to what is now the southwestern portion of the United States. They are the only other minority group in U.S. history to be annexed by conquest and to have their rights “safeguarded” by treaty. As such, the stage for protracted conflict and difficult adjustment was set in motion long ago. Major forms of conflict include international war, major loss of land holdings, and continuous exploitation of labor, still highly in evidence in farmwork as well as the urban service sector. Prior to America’s westward expansion during the 1800s, Mexico extended north to include a vast area corresponding roughly to what we now know as Texas, California, New Mexico, Arizona, Oregon, Nevada, and parts of Utah and Wyoming. Although sparsely populated, it is estimated that as many as 100,000 Mexicans occupied this area (McLemore et al., 2001). Fearful of American encroachment, the Mexican government offered American settlers tracts of land to develop in the 1820s on the condition that they obeyed Mexican law and eventually became Mexican citizens and even members of the Catholic Church. A few American settlers complied with Mexican regulations; most did not and entered Mexico illegally, an interesting historical footnote given today’s widespread resentment of undocumented Mexicans in the United States. CONFLICT By 1835, American settlers outnumbered Mexicans five to one in northern Mexico and tensions mounted given Mexico’s tenuous control over the region and the settlers’ belief in manifest destiny, or the God-given

orga_c01.qxd

2/5/07

10:50 AM

Page 13

The Americanization of Latinos

13

right to expand American society from east to west or from “sea to shining sea,” as we would later learn to sing. Settlers strongly resented the idea of being governed by people they considered inferior and policies such as Mexico’s antislavery law, which many settlers violated. Major conflict soon ensued when Texas declared itself an independent republic in 1836, resulting in battles with the Mexican army sent to put down the rebellion. Remembering the Alamo(s) Americans generally imagine the Texas revolt as portrayed in the movie The Alamo in which American heroes Davy Crockett and Jim Bowie, along with nearly 200 other settlers, occupied the old Spanish mission of the same name and fought valiantly to their deaths in the effort to free Texas from an oppressive Mexican government. It is this Hollywood myth of the Texas revolt that continues to overshadow what many historians consider a rather calculated effort on the part of American settlers and the U.S. government to take Mexican land by force. Indeed, Mexicans and Americans “Remember the Alamo” quite differently. The Alamo (1960) The battle of the Alamo was forever mythologized in 1960 in the nearly 3-hour long, epic-size production directed and produced by John Wayne, who also played the lead role of Davy Crockett, the legendary coonskin hat-wearing frontiersman from Tennessee who was also a savvy congressman. Opening to gorgeous oil paintings of the Alamo mission beneath big Texas skies and the reverent choral sounds of the battle hymn The Siege of Alamo (Thirteen Days of Glory), the stage is quickly set by a pair of written narratives, the first of which tells us that in 1836 Texas was composed of settlers from throughout the United States who were all Mexican citizens. The next narrative informs us that General Santa Anna “was sweeping north across Mexico toward them, crushing all who opposed his tyrannical rule. They now face the decision that all men in all times must face . . . the eternal choice of men to endure oppression or resist.” Much of the film develops the characters of Crockett and Jim Bowie as hard-drinking yet brave and loyal freedom fighters, and of the equally brave Colonel Travis, who is nevertheless a hopelessly rigid and overly formal military man. Mexicans in the film are reduced to one-dimensional human props, though there is sparse intermittent dialogue about their dignity and bravery and even more dialogue about beautiful Mexican women who are seen dancing flamenco. Bowie even admits to marrying a Mexican woman, and Crockett defends the honor of a pretty señorita being harassed by the movie’s one bad, pro-Santa Anna, Anglo-American. Before the Alamo mission is eventually overrun by a heavily armed and beautifully uniformed Mexican army of 2,000, we’re privy to clever night raids led by Crockett and Bowie in which Mexican cannons are destroyed, soldiers are dispensed with over humorous dialogue, and in one amazing scene several hundred longhorns are stolen out from

orga_c01.qxd

14

2/5/07

10:50 AM

Page 14

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

under the noses of Mexican soldiers and then run back right through the front door of the Alamo! When it is learned that backup will not be coming and that the battle of the Alamo is really a suicide mission, all decide to fight alongside Colonel Travis to their death, despite the Mexican army’s granting them the option of surrender and allowing women and children to vacate, thus sparing the latter.

According to Acuña (1981), Mexican General Antonio Lopez de Santa Anna put down revolts at both the Alamo and the nearby town of Goliad and resumed control of the San Antonio area. The U.S. government responded by sending massive aid into Texas in the form of volunteers, arms, and money; on April 22, 1836, General Sam Houston coordinated a surprise attack on Santa Anna’s resting army, resulting in the slaughter of 630 of the 1,000-plus Mexican soldiers. Santa Anna was captured and had little choice but to sign away the Texas territory. From 1836 to 1846, Texas survived as an independent republic in constant conflict with a resentful Mexico over the highly disputed border between the nations. Texans regarded the Rio Grande River as the boundary, and Mexicans regarded the Nueces River as the proper boundary. As a result, this large tract of land between rivers became a bitter battleground and a metaphor for the protracted conflict and resentment that has characterized Anglo-American and Mexican race relations. McWilliams (1968, p. 101) notes, “In the bloody zone between the two rivers an uninterrupted guerrilla warfare continued throughout the life of the Texas Republic” and “murder was matched by murder; raids by Texans were countered by raids from Mexico. Because a peace treaty was never negotiated, no boundaries could be fixed.” The Alamo (2004) In the 2004 movie version of the Alamo little has changed in Hollywood-style myth making. This time two written narratives inform us that, established in 1718, the mission had become a makeshift fort against marauding Indians, rebels, and a succession of conquering armies, and its location, its proximity to settlements, and perhaps even fate made the Alamo a crossroads for siege and battle. Straight-arrow Colonel Travis claims, “As goes the Alamo, so goes Texas,” and is seen defiantly firing a cannon at the massive surrounding Mexican army as they grant the option to surrender. Slight improvements include Mexican mariachi music instead of Spanish flamenco and a muttered comment by a Mexican bystander that “Santa Anna may want to rule Mexico, but these wretched creatures want to rule the world!” This time a more subdued Davy Crockett, played by the talented Billy Bob Thornton, is seen being executed at the battle’s end, unlike John Wayne, who literally goes out with a bang, taking a band of would-be captors with him, as he explodes a barrel of gunpowder. In the more recent movie, Crockett is confronted just before his execution by General Santa Anna himself, to whom Crockett wisecracks, “I thought you’d be

orga_c01.qxd

2/5/07

10:50 AM

Page 15

The Americanization of Latinos

15

taller!” and “If you surrender, I’ll try and protect you.” General Santa Anna is portrayed as the consummate egomaniac that he was, but he did have more lines in this version. For example, in justifying his take-no-prisoners position, he exclaims that the fight must stop here or “our grandchildren will be begging the Americans for crumbs.” Toward the movie’s end, we learn that 9 years following the battle of the Alamo, Texas became the 28th state, as if preordained.

The War with Mexico As the Texas Republic prepared to join the Union, the president of Mexico declared that the annexation of Texas would be considered equivalent to a declaration of war (McLemore et al., 2001). After annexation in 1846, President Polk ordered General Taylor into the disputed land between the Rio Grande and Nueces rivers, provoking Mexico to battle over what was considered an invasion by the United States. Next, Polk petitioned Congress to declare war, claiming that Mexico had invaded the United States. Although Abraham Lincoln condemned Polk’s petition of war as unconstitutional, international war ensued, with far more at stake than the strip of land between Mexico and Texas. By 1848, Mexico surrendered under the terms of the Treaty of GuadalupeHidalgo, in which approximately half of Mexico (the current-day southwestern United States) was ceded to the United States. Mexicans who remained in this region became American citizens by default, constituting the new Mexican American minority group. It is important to note that, like a defeated neighbor, Mexico has never recognized the moral right of the United States to Mexican land. As late as 1943, maps in Mexican schools still designated northern Mexico as “territory temporarily in the hands of the United States” (McWilliams, 1968, p. 103). While the Treaty of Guadalupe-Hidalgo granted Mexican Americans full rights of citizenship, Anglos generally considered them a conquered, inferior people with rights not to be taken seriously. In fact, protection of property, under Article X of the treaty, was omitted during the treaty’s ratification by the U.S. Senate (del Castillo, 1990). As a result, Mexicans were rapidly dispossessed of their substantial land holdings through various devious means. Seizing Mexican Land Acuña (1981) describes the “land grab” in New Mexico as a well-organized seizure of land by the following methods: (a) Mexicans were required to register their land, often by inadequately posted announcements in English, and their land was seized when they failed to do so; ( b) Mexican lands were heavily taxed and seized when taxes could not be paid (taxes were later lowered after land was acquired by Anglos); and (c) land was

orga_c01.qxd

16

2/5/07

10:50 AM

Page 16

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

seized when Mexicans could not pay for agricultural land “improvements” provided by the government. An estimated 2 million acres of private land and 1.7 million acres of communal land were lost between 1854 and 1930 in New Mexico alone in a pattern that repeated itself throughout Texas, California, and the rest of the Southwest (Feagin & Booher Feagin, 1999a). Both elite and peasant Mexicans quickly found themselves landless laborers subjugated to the bottom of the new American stratification system. As recently as the 1960s, Chicano activist Reies Lopez Tijerina formed the Alianza Federal de Mercedes (Mercedes Federal Alliance of Land Grants) in New Mexico and sought to recover what he considered to be stolen Mexican land (Feagin & Booher Feagin, 1999a). In addition to marching and presenting grievances to Santa Fe officials, the Alianza also occupied Kit Carson National Forest, once part of a Mexican communal land grant. When forest rangers tried to remove the protesters, the rangers were seized and tried for violating old land-grant boundaries that the group had researched. Tijerina and other members of the Alianza were arrested after a shootout with police. Bandidos or Folk Heroes? Like Tijerina, Mexican people in the new frontier protested their outrage through a variety of methods, ranging from strikes and court battles to outright raids on Anglo settlers, who retaliated in return. Between 1850 and 1930 it is estimated that the number of Mexican Americans killed in the Southwest was greater than the number of African Americans lynched during this same period (Moquin & Van Doren, 1971). The enduring stereotypic image of Mexicans as bandidos ( bandits) has an interesting basis in anti-Anglo outlaw activity on the part of Mexicans. Whereas Americans have attempted to create images of these early outlaws simply as mere criminals, Mexicans and Chicanos see them more as folk heroes who revolted against Anglo imperialism and discrimination. For example, in 1859, Texas-born Juan Cortina organized a band of outlaws and invaded Brownsville, Texas, to protest violations of the Treaty of Guadalupe-Hidalgo. Later that same year, Cortina and 1,200 men fought and defeated local Brownsville militia, who were backed by the Mexican army. He also defeated the legendary Texas Rangers, well-known for their abuse of Mexicans, who pursued him after the Brownsville battle. In 1860, General Robert E. Lee, veteran of the war with Mexico, was sent to Texas to put down Cortina. But even with the cooperation of the Mexican army, Lee could not capture Cortina, who became a Mexican/Chicano hero of mythic proportions.

orga_c01.qxd

2/5/07

10:50 AM

Page 17

The Americanization of Latinos

17

In New Mexico, the famous Mexican revolutionary Francisco “Pancho” Villa raided the city of Columbus, killing a few Anglos, as a protest to the U.S. recognition of the New Mexico government (McLemore et al., 2001). General John J. Pershing spent 9 long and unsuccessful months pursuing Villa in Mexico as Pershing’s men sang “It’s a long way to capture Villa/It’s a long way to go/It’s a long way across the border/Where the dirty greasers grow” ( Jacobs, Landau, & Pell, 1971, p. 242). In California, folk heroes Joaquin Murrietta and Tiburcio Vasquez avenged Anglo wrongs perpetrated against Mexicans by terrorizing Anglo settlers and robbing Anglo establishments vigilante style. Exploiting Mexican Labor Despite the legacy of conflict between Mexicans and Anglos in the United States, significant Mexican immigration to the United States continues to the present day. In the decades following the war with Mexico, hundreds of thousands of Mexicans, pushed by the political upheaval and lack of work in Mexico, were pulled by the tremendous need for unskilled labor in the United States, which continues to this day. Throughout the Southwest, Mexican labor was essential to the early economic growth of this new region in such basic industries as agriculture, canning, mining, and the railroad. Fewer than 30,000 Mexicans “immigrated” between 1820 and 1900, but nearly 750,000 immigrated between 1900 and 1930, pushed by the Mexican Revolution and pulled by the American industrial revolution (McLemore et al., 2001). Most Americans today have little understanding of how essential Mexican labor has been and continues to be to American industries and services. Most Americans are also unaware of the historical pattern of exploitation of Mexican labor that continues to fan the flames of intergroup conflict. A decade-by-decade analysis of Mexican labor in the twentieth century reveals a distinct cyclical pattern of exploiting Mexican labor during labor shortages and then abusing Mexican civil rights during periods of diminished labor need and economic recession. During the 1910s, federal authorities waived immigration restrictions due to a World War I labor shortage in agriculture, allowing some 70,000 Mexicans to enter the United States. Improved canning and shipping technologies opened new markets during the 1920s, and some 500,000 Mexicans came to work. When the Immigration Act of 1924 barred most Southern and Eastern Europeans, Mexicans were exempted because they comprised the main source of cheap labor for the southwestern and midwestern United States (Feagin & Booher Feagin, 1999a). But when the Great Depression hit in 1929, undocumented entry into the United States was elevated to a felony and deportation campaigns

orga_c01.qxd

18

2/5/07

10:50 AM

Page 18

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

were initiated against Mexicans, who were scapegoated for the country’s economic problems. An estimated 500,000 or 40% of the Mexican American population, both documented and undocumented, were either deported or coerced to leave by U.S. authorities in a program called repatriation (Acuña, 1981). But as soon as the World War II labor shortage struck in 1942, the United States initiated a binational agreement with Mexico to import agricultural labor. The Bracero Program From 1942 to 1964, The bracero (arms—a very loose translation of work hand) program, as it was called, brought in approximately 5 million braceros (Feagin & Booher Feagin, 1999a) to fill U.S. labor shortages. The bracero program also stimulated a parallel stream of undocumented workers into the United States who were extremely desirable to employers who wished to avoid the bracero program’s bureaucratic red tape, including stipulations of fair pay and treatment of braceros. It is estimated that since 1920, between 6 and 9 million undocumented migrants have entered the United States, many of them temporary migrants who have returned to Mexico. Undocumented workers are essential to agriculture, industry, and tourism in southern California and elsewhere in the United States (L. R. Chavez, 1992). Mexican workers and U.S. employees are linked together in one international labor market. Today Mexican migrants still make up more than two-thirds of the nation’s migrant farmworkers, estimated by the U.S. Department of Labor (1992) to be between 2.7 and 4 million people. Zoot Suit Riots In 1943, conflict between Anglos and Chicanos came to a dramatic head during the so-called Zoot Suit Riots, in which U.S. sailors, off-duty police, and other servicemen staged mob-style attacks on Chicano street gang members. These gang members wore flashy zoot suits consisting of chesthigh baggy pants, fingertip-length broad shoulder jackets, a hat, and pointed shoes. In one highly publicized incident, 200 sailors in 20 taxicabs invaded the East Los Angeles barrio, beating and stripping zoot suiters. These “riots” made headline news across the country during an all-time high in WWII-fueled patriotism that condemned most things foreign (Mazon, 1984). Indeed, these second-generation, U.S.-born Chicanos displayed their alienation and marginality in their provocative dress and delinquent youth gang membership. These were culturally displaced youth looking for a sense of belonging and identity that made easy targets of what Mazon called “symbolic annihilation” on the part of the American military, local militia, and the press.

orga_c01.qxd

2/5/07

10:50 AM

Page 19

The Americanization of Latinos

19

Yet, in spite of national anti-Mexican sentiment, disproportionately high numbers of Chicanos joined the war effort, resulting in disproportionately high deaths, injuries, and medals of valor. In fact, Chicanos were the most decorated ethnic group in WWII, with 39 Congressional Medals of Honor. Sadly, some of these war heroes could not even get served a cup of coffee upon returning to their segregated barrios in the United States. Between 1950 and 1955, the U.S. border patrol initiated “Operation Wetback” in which an estimated 3.8 million Mexicans were deported (Healey, 1995). As in the 1930s, the civil rights of Mexican Americans were commonly violated as homes and businesses were raided for suspected illegal aliens. The bracero program was eventually halted by Mexico in 1964 due to mistreatment of Mexican laborers in Texas. This same year, the United States extended immigration quotas to Mexico and the rest of the Western Hemisphere. In addition to Mexico, Chicano farmworker activist Cesar Chavez also favored ending the bracero program, which he perceived as antithetical to his efforts to unionize farmworkers to gain bargaining leverage with agricultural growers. In 1962, Chavez and Dolores Huerta organized the United Farm Workers union (UFW) in California (McLemore et al., 2001). Unlike other Chicano protests, the UFW movement brought the plight of Mexican and other farmworkers to international attention, partly because of its nonviolent philosophy modeled on the works of Gandhi and Martin Luther King Jr. The Chicano Movement Between WWII and the 1960s, Chicano determination to fight injustice and inequality grew into the climax of the Chicano civil rights movement of the 1960s. Court battles and street battles pushed the movement forward. One climactic event was the National Chicano Moratorium of 1970 in which thousands of Chicanos marched on East Los Angeles to protest the disproportionately high death toll of Chicanos in the Vietnam War. The rally turned violent when busloads of sheriffs in full riot gear attacked the crowd with teargas and batons. A full riot ensued, with millions of dollars in damage to local merchants, thousands of injuries and arrests, and even a few deaths. The most famous death was that of Ruben Salazar, an L.A. Times columnist and the director of L.A.’s Spanishlanguage television station, KMEX. Salazar had been covering the moratorium and was killed when an L.A. County sheriff illegally shot a teargas canister into the Silver Dollar bar on Whittier Boulevard, striking him in the temple. Although four of seven jurors voted for the death penalty for the sheriff, District Attorney Evelle Younger concluded that the “split decision” and facts from the inquest did not justify criminal

orga_c01.qxd

20

2/5/07

10:50 AM

Page 20

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

charges, and thus closed the case before it could move on to trial. He also refused requests for further investigation from the Latino community, as well as from 22 California state legislators (M. T. Garcia, 1995). ADAPTATION The predominant form of adaptation for Mexican Americans, still considerably in evidence today, has been segregation. Segregation in residence, work, and school has historically been the rule for Chicanos, resulting in painstakingly slow yet steady progress toward integration and moderate levels of success compared to European immigrants. Neoconservative Mexican Americans like Linda Chavez (1991) applaud what they consider to be “real progress” on the part of Mexican Americans, yet such assertions minimize the blatant fact that it has taken Chicanos a century and a half to move from complete segregation to a moderate degree of integration. Worse yet, such assertions fail to recognize the urgency of Latino civil rights rooted in the human suffering that impeded progress can engender. Segregation continues to be the living legacy of racism and discrimination that still describes the general welfare of most Latinos and other people of color in America. For roughly 75 years after the end of the war between Mexico and the United States, Chicanos faced segregation in most public facilities, including schools, restaurants, movie theaters, swimming pools, barbershops, primary election procedures, and housing (McLemore et al., 2001). “Mexican schools” were instituted in Texas in 1902, and by 1940 separate schools for Mexicans existed throughout the state (Montejano, 1987). Bean and Tienda (1990) analyzed 1980 census data to calculate a segregation index for Chicanos. This index ranges from 0 (no segregation) to 100 (complete segregation) and represents the percentage of Chicanos that would need to move out of their residential tract to eliminate segregation. For example, the segregation index for Los Angeles is .57, indicating that 57% of Chicanos would need to move out of their residential tracts to produce an even residential distribution of Chicanos and Anglos in that city. Hence this index indicates moderately high segregation similar to indices from other heavily Chicano cities, such as Chicago (.63) and San Antonio (.57). RESEGREGATION? Gary Orfield and associates (e.g., Orfield & Yun, 1999) at the Civil Rights Project at Harvard University have been researching and writing on what they call the “resegregation” of American schools, especially in poor Black and Latino communities. They report that although most White

orga_c01.qxd

2/5/07

10:50 AM

Page 21

The Americanization of Latinos

21

Americans polled believe that equal educational opportunity is being provided, school data now show that the American South is resegregating after nearly 3 decades of civil rights laws that resulted in some of the highest integration rates in the nation. Further, the data show continuously increasing segregation for Latinos, who are now even more segregated than African American students. Finally, the majority of resegregated Black and Latino students are concentrated in poor schools, and the majority of White students are segregated in schools composed of middle-class peers. PU E R T O R I CA N S To understand the pride and predicament of Puerto Ricans is to understand the impact of a double legacy of conquest and colonization, the triple blending of races that compose this unique Latino group, and the rather unfortunate timing of Puerto Rican migration to the U.S. mainland. CONTACT Back in 1493, Spanish conquistadors landed on the Caribbean island of Borinquen, where they encountered and conquered an estimated 50,000 indigenous Taino people. The name of the island was changed to Puerto Rico and the native Taino people were soon decimated through a combination of forced labor, disease, and violent suppression of rebellion (Feagin & Booher Feagin, 1999b). African slaves were soon imported to compensate for the diminishing Taino population, and marriages between Spaniards, Africans, and remaining Taino created the rich racial blend of the Puerto Rican people. After four centuries of Spanish rule, Puerto Ricans pressured Spain for internal autonomy, which was granted in 1897. Puerto Ricans appointed their own governor, established a house of representatives, and enacted democratic laws. But this taste of freedom was extremely short-lived when Puerto Rico was ceded to the United States in 1898 following the brief Spanish-American War. The American warship Maine had been stationed in the turbulent waters of Havana’s harbor, where Cuban revolutionaries had been waging a 30-year fight for their own independence from Spain. The Maine mysteriously exploded, tragically killing 258 American sailors, giving the United States a reason to declare war on Spain. Assistant Secretary of the Navy Theodore Roosevelt quickly assembled his famous “Rough Riders,” and with patriotic cries of “Remember the Maine!” drove the Spanish out of Cuba. Within 4 months, Spain ceded Puerto Rico, as well as the Philippines, to the United States, and Cuba won a nominal independence.

orga_c01.qxd

22

2/5/07

10:50 AM

Page 22

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

The United States had long coveted the Caribbean islands, as well as the Philippines in the South Pacific, primarily for their militarily strategic locations and secondarily for developing agricultural business enterprises. There are currently 12 U.S. military installations in Puerto Rico. The Puerto Rican island of Vieques contains two U.S. military bases that are highly resented by natives, who claim that bombing raids and military maneuvers have destroyed their beach, fishing, and coral industries. During World War II, an estimated 15,000 American troops used Vieques as a military training site. With such military and industrial goals, the United States had little intention of fostering autonomy in Puerto Rico or Cuba, and to date Puerto Rico remains a controversial U.S. commonwealth (a polite term for colony), rife with long-term conflict that accompanies such dominantsubordinate nation relations. Cuba is discussed later in the chapter. CONFLICT Puerto Rico came under U.S. control with no input from autonomystarved Puerto Ricans. In 1898, U.S. General Nelson Miles invaded independent Puerto Rico while claiming to liberate it from Spanish oppression. Miles was well-known for his previous military work, which included arresting Chief Geronimo and driving the Nez Perce Indians out of Montana and into Canada. The United States soon installed an American governor, made English the official language, and reserved the right to veto any locally elected legislature (Feagin & Booher Feagin, 1999b). Seizing Puerto Rican Land Puerto Ricans, who were largely subsistence farmers, went from owning over 90% of the island’s lush farmlands to less than 33% within 30 years (Feagin & Booher Feagin, 1999b). By 1930, absentee-owned U.S. companies controlled 60% of Puerto Rican sugar and tobacco production as well as shipping lines. Massive land loss resulted from heavy taxation and credit restrictions imposed by the United States on Puerto Rican farmers, as well as forced devaluations of the Puerto Rican peso that compelled small farmers to sell their land. The United States also expelled European competitors to monopolize island industries and to relegate Puerto Ricans to low-wage farm laborers on lands they had previously owned. Puerto Ricans were also segregated from Americans in both private and public spaces. Although most Puerto Ricans favored autonomy during the first half of the twentieth century, Puerto Ricans were declared U.S. citizens in 1917, just in time to be drafted into World War I.

orga_c01.qxd

2/5/07

10:50 AM

Page 23

The Americanization of Latinos

23

During the 1930s, Puerto Ricans protested their exploitation by forming unions, staging strikes in the sugar cane fields, and even periodically attacking U.S. colonial government buildings on the island (Feagin & Booher Feagin, 1999b). This decade also saw the rise of the pro-independence nationalist movement. In 1930, Harvard-educated Pedro Albizu Campos was elected president of the Nationalist Party. Albizu’s passionate and unrelenting anti-U.S. platform was perceived as a threat, and President Franklin Delano Roosevelt appointed Georgia southerner Blanton Winship governor of Puerto Rico with the charge of quelling nationalism. Social Control of Island Nationalism Governor Winship had Albizu tried and jailed for insurrection. While in jail, Albizu was subject to torture by the military; it is believed the military used him for radiation experiments. Conflict soon came to a head in 1937, when unarmed Nationalist Party members organized a peaceful march in the Capital city of Ponce to celebrate the island’s early abolition of slavery. On Governor Winship’s orders, heavily armed police shot and teargassed the marchers, killing 20 and wounding 150. The Ponce Massacre, as it came to be known, marked a turning point for nationalists, who would now incorporate violence into their anticolonial cause. Like Albizu, Luis Muñoz Marin also favored independence, but he pursued his politics by forming the Popular Democratic Party (PDP) and seeking a seat in the U.S. Senate. The United States pressured Muñoz Marin and the PDP to oppose nationalism in exchange for supporting his bid for the Senate, which he won in 1938. Muñoz Marin quickly enacted pro-peasant land reform in the late 1930s and early 1940s, promoted voter registration, and earnestly combated poverty. In 1948, Puerto Ricans were allowed to elect their own governor, and Luis Muñoz Marin was the unanimous choice. Puerto Ricans were also allowed to draft their own constitution, raise their own flag, and reinstate Spanish as the official language. To date, Puerto Ricans have no vote in national elections, they cannot be elected to the U.S. House and Senate, and their sole U.S. Congress representative has only observer status with no vote. Exploitation of Puerto Rican Labor The pressure to repress nationalism was highly evident in the controversial “muzzle law” of 1948, which forbade nationalism and caused anticolonial resentment to smolder. Also in 1948, Muñoz Marin assisted the United States in enacting a program called Operation Bootstrap, ostensibly to stimulate economic development on the island by attracting U.S. corporations. Unfortunately, incentives for U.S. corporations

orga_c01.qxd

24

2/5/07

10:50 AM

Page 24

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

included a 10-year local tax exemption and the freedom to pay wages lower than on the mainland. Clearly, Puerto Rico’s poverty and exploitation wages were the program’s primary selling points to U.S.-based multinational corporations. According to Feagin and Booher Feagin (1999b), around 1,700 factories came to the island between the late 1940s and the mid-1970s, creating more than 140,000 new manufacturing jobs in the process. Capital investments grew from $1.4 billion in 1960 to $24 billion in 1970. But despite these impressive accomplishments, the new manufacturing jobs could never offset the island’s loss of agricultural jobs. In addition, the tax exemptions granted to corporations resulted in high personal income taxes for Puerto Ricans to pay for basic island infrastructure such as water, electricity, and sewer systems. Many corporations relocated after their 10-year tax-free status expired rather than pay Puerto Ricans a fair wage and contribute to the island’s welfare. This program of exploitation served to consolidate island poverty in the guise of an opportunity for Puerto Ricans to pull themselves up by their own bootstraps. Operation Bootstrap represents one of the many missed opportunities to genuinely invest in Latino social welfare for the mutual benefit of both the United States and Latinos in the United States. Militancy and Violence In 1950, armed revolts broke out in five island cities in which hundreds were killed and thousands were arrested. In 1952, Governor Muñoz Marin urged the Puerto Rican people to vote for commonwealth status, claiming that the island would become an area libre asociado (liberated associated area), and thus one step closer to independence. Despite opposition from nationalists, the measure passed. But commonwealth status and the repression of pro-independence politics proved to be explosive. In 1954, four armed radical nationalists led by Lolita Lebron broke into a meeting of the U.S. House of Representatives in Washington, DC, and opened fire, striking five senators in a volley of bullets before being subdued. A year later, pro-independence radicals attempted to assassinate President Truman by shooting up Blair House, his temporary residence. These are dramatic and desperate acts of political violence of which most Americans, including other Latinos, have little knowledge. During the 1960s, Governor Muñoz Marin retired and the conservative pro-statehood party gained prominence and elected party member Luis Ferer as governor in 1968, much to the chagrin of pro-independence forces. During the 1970s, divisive pro- and anti-statehood politics resulted in Puerto Rico’s bloodiest decade. U.S. military aircraft were

orga_c01.qxd

2/5/07

10:50 AM

Page 25

The Americanization of Latinos

25

bombed in San Juan and a bus of navy personnel was machine-gunned, killing two and wounding 10. Puerto Rican police retaliated by killing two independistas but were brought to trial and found guilty. To make matters worse, massive unemployment on the island resulted in nearly a third of the population relocating to the U.S. mainland during the 1970s. During this same decade hundreds of thousands of Puerto Ricans traveled back and forth between the United States and Puerto Rico in what has been called “revolving door” migration. On the U.S. mainland, pro-independence groups bombed a café in lower Manhattan, killing five and wounding many, and robbed a Wells Fargo armored truck in Hartford, Connecticut. In less violent protests, mainland Puerto Ricans organized dozens of civil rights-oriented groups addressing justice in schools, courts, and communities. In East Harlem, Puerto Rican radicals established the Young Lords Party, an organization styled after the Black Panther Party and advocating democratic-socialist reform and greater control of Puerto Rican communities. The Young Lords occupied the admissions building of the McCormick Theological Seminary in Chicago as well as the First Spanish Methodist Church in New York City. They organized a march to the United Nations that was 20,000 people strong. The Young Lords also set up free lunch programs for children and tuberculosis-testing clinics for adults in Puerto Rican communities. A young Geraldo Rivera served as the party’s lawyer. In 1980, former Puerto Rican Governor Muñoz Marin died, uniting Puerto Ricans in mourning despite the political divisions that colonialism engenders. Poverty reached new heights on the island, with as many as 50% needing government assistance in the form of food stamps and health aid. In 1983, Puerto Ricans again voted for commonwealth status over statehood, but this time only by a 3% margin, the lowest ever. Puerto Ricans also petitioned the United States to sign a sovereign bilateral compact to grant the island full autonomy in all areas except military defense, which is still pending. Unemployment peaked at 23% in 1983 and leveled off to 17% in the early 1990s (Feagin & Booher Feagin, 1999b). Today, manufacturing wages on the island are about half of those on the mainland, and Puerto Rico’s per capita income is less than that of the poorest state in the United States. In 1993, 37% of Puerto Ricans fell below the poverty line, compared to 10% for European Americans. Thus, the perennial push to the mainland is understandable. But what Puerto Ricans have historically encountered there has been traumatic in terms of general adaptation. Puerto Rico remains a pseudo-colony in the midst of dynamic conflictual transition. Puerto Ricans remain a people politically divided yet culturally united in their

orga_c01.qxd

26

2/5/07

10:50 AM

Page 26

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

assertion of their unique identity and need for greater control over their own fate. ADAPTATION The push of island poverty resulted in the first wave of Puerto Rican migration to the United States during the 1920s, shortly after being declared U.S. citizens (Feagin & Booher Feagin, 1999b). By 1940, there were approximately 70,000 Puerto Ricans on the mainland, almost exclusively in New York City. But the “great migration” occurred between 1940 and 1970, resulting in a 10-fold increase to approximately 887,000 Puerto Rican migrants, concentrated mostly in New York but with communities also in New Jersey, Connecticut, and Chicago. To understand the creation of today’s Puerto Rican underclass in the United States, we must understand not just colonization but the racialization of Puerto Ricans on the U.S. mainland and the poor timing of Puerto Rican migration as a result of mid-twentieth-century labor market shifts. Like Mexicans, thousands of poor Puerto Rican migrants came to the United States as contract farmworkers at the bottom of the economic ladder. During the 1950s, about 40,000 Puerto Ricans migrated to the mainland annually, often lured by U.S. Department of Labor propaganda films like ¡Trabajo Para Usted! (Work for you!), which depicted happy Puerto Ricans picking crops by day and dancing the rumba by night while making money in the United States. The Racialization of Puerto Ricans Most Puerto Ricans, however, poured into labor-intensive urban-based industries such as the textile and garment industry sweatshops of New York. Like European immigrants before them, this new group of workingclass Latinos hoped to succeed in America through industrial labor jobs. Unfortunately, Puerto Rican migrants soon learned the bitter lesson of racism in America when they were perceived and treated as Blacks. The color gradient on the island of Puerto Rico had fewer implications for marriage and social mobility, but Puerto Ricans on the mainland often faced intense anti-Black and anti-Latino discrimination. As is true for African Americans, discrimination in work and housing quickly contributed to a poverty scenario difficult for Puerto Ricans to escape. Labor unions often excluded Puerto Ricans or greatly restricted their participation (Feagin & Booher Feagin, 1999b). And like African Americans before them, Puerto Ricans faced significant housing discrimination, resulting in “hypersegregation” alongside African Americans. U.S. census data clearly show that whereas both Mexicans and Cubans

orga_c01.qxd

2/5/07

10:50 AM

Page 27

The Americanization of Latinos

27

are highly segregated from Blacks, Puerto Ricans are less segregated from Blacks and more segregated from Whites (Bean & Tienda, 1990). Underclass experts Massey and Denton (1989) warn that, like many African Americans, Puerto Ricans are in danger of becoming a permanent part of the urban underclass, or those lacking work and routes out of poverty. Unfortunate Timing of Puerto Rican Migration Puerto Rican migration to the United States peaked in the 1950s just as the American economy began its major economic structural shift from an industrial giant to a postindustrial service-oriented society. Most Americans have been affected by this nationwide shift, but unskilled and semiskilled poor people have been most frequently dislocated. In New York, where most Puerto Ricans have resided, nearly half a million manufacturing jobs were lost between 1960 and 1990 (Feagin & Booher Feagin, 1999b). According to C. E. Rodriguez (1989), manufacturing accounted for 60% of the Puerto Rican workforce in 1960. Between 1960 and 1970, manufacturing jobs in New York decreased by 173,000, and in the next decade another 268,000 jobs were lost. Further, this loss was not offset by an increase in lower-level service jobs, the other area of Puerto Rican workforce concentration. Today, almost 40% of Puerto Ricans in the United States live in poverty, with high rates of single female-headed households, patterns similar to African Americans. C U BA N A M E R I CA N S Cuban Americans have been called the Latino “model minority” for their remarkable success in America. Though complex, this success story comes down to the predominantly elite composition of this relatively recent Latino refugee group, coupled with unprecedented refugee support and aid provided by the U.S. government. CONTACT Cuba became “independent” in 1898 when the United States drove out Spain during the brief Spanish-American War. But the United States continued to occupy Cuba for the next 4 years, declaring it a U.S. protectorate in 1902 (Feagin & Booher Feagin, 1999b). Based on the 1900–1901 Platt Amendment to the U.S. military appropriations bill, the United States reserved the right to military intervention in Cuba, ostensibly to protect life, property, individual liberty, and the island’s independence.

orga_c01.qxd

28

2/5/07

10:50 AM

Page 28

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

In reality, however, the pseudo-colonization of Cuba resulted in political, economic, and military domination from 1898 to 1959, and of course the United States still occupies and operates a military base in Guantánamo Bay despite a trade embargo and no diplomatic relations. CONFLICT Within 15 years after Cuba’s independence from Spain, U.S. investments grew from $50 million to an estimated $220 million. By the late 1920s, the United States controlled 75% of Cuba’s sugar industry, and by 1960, the United States controlled 90% of Cuba’s mines, 80% of its public utilities, 50% of its railways, 40% of its sugar production, and 25% of its bank deposits (Feagin & Booher Feagin, 1999b). With regard to political domination, no elected Cuban president opposed to the United States could remain in office. Both U.S. military and diplomatic interference regulated American-friendly Cuban politics. During the first half of the twentieth century, international relations between the United States and Cuba epitomized general U.S.-Latin American relations in that the United States was instrumental in implementing repressive dictators who could be manipulated by U.S. economic interests. For this reason, grassroots rebellions constantly simmered beneath the tenuous Cuban political surface. The Castro Revolution During the 1950s, a young Fidel Castro made several attempts to overthrow the Cuban president and former army chief, Fulgencio Batista, who had come to power in 1952. By 1958, Batista was losing most battles with revolutionary factions and fled when the United States withdrew its support in 1959, leaving Castro and his bearded army to claim the country and implement a socialist-style government. Castro’s anti-American platform can be understood as a strong response to America’s historical choice to exploit Cuba instead of investing in a mutually beneficial relationship. The upshot is today’s miniature cold war with our Latino neighbor. To the majority of Cubans, Castro’s rise to power was regarded with hope and optimism that was initially validated by land grants to tenant farmers and guaranteed compensation to small sugar growers. Indeed, significant improvements were noted in the basic areas of quality universal health care and high educational level relative to international standards. But the new regime quickly became oppressive, as characterized by mass trials and executions to cleanse nonsupporters of the revolution. Phone tapping and spying were also common.

orga_c01.qxd

2/5/07

10:50 AM

Page 29

The Americanization of Latinos

29

Next, the stated goal of nationalizing both Cuban- and American-owned businesses (Feagin & Booher Feagin, 1999b), as well as a general lack of tolerance for U.S. manipulation, greatly threatened U.S. and Cuban business and political interests. Open hostility broke out between Cuba and the United States as well as between the new government and Cuban elites concerned about persecution and losing their considerable wealth. The United States broke off diplomatic relations with Cuba and established an “open door” policy of welcoming Cuban exiles fleeing “communist oppression” and seeking refuge in the “free world.” Between 1959 and 1962, about a quarter of a million Cuban exiles relocated to the United States, almost all to southern Florida, where they could be a mere 90 miles from home in the event of Castro’s anticipated demise (M. C. Garcia, 1996). Today, over half of all Cuban Americans continue to live in the area. Although they are highly integrated into the economic, political, and social networks of their environment, Cubans have also hung tenaciously to their culture given their history as exiles planning to return to their beloved country. The First Wave of Exiles Not surprisingly, the first major wave of Cuban exiles began with those whose success in Cuba was directly related to Cuba’s political and economic relations to the United States. These were elite government officials, bankers, and successful industrialists under the Batista dictatorship, followed by middle- and upper-class professionals, managers, merchants, landlords, and more than half of all of Cuba’s doctors and teachers (Feagin & Booher Feagin, 1999b). In contrast to Puerto Ricans, the overwhelming majority of first-wave Cuban exiles were White Cubans, even though over a quarter of Cubans on the island were Black. Castro greatly resented the exodus of such human capital and resources and labeled the exiles self-interested, disloyal gusanos, or worms. The Bay of Pigs Fiasco In the minds of both Cuban exiles and Americans, the Cubans were temporary exiles who would eventually return to their homeland once Castro was overthrown. On this note, President Kennedy and the CIA trained and funded some 1,500 Cuban exiles in a plan to take back Cuba. In what has come to be known as the Bay of Pigs fiasco, the ill-conceived plan failed miserably as the well-alerted Cuban army quickly put down the rebellion of the Cuban exile brigade soldiers. In just a few days, 120 brigade soldiers were killed and 1,125 were jailed. Castro later ransomed these prisoners of war for millions of dollars’ worth of medicines, baby food, pesticides, and other products.

orga_c01.qxd

30

2/5/07

10:50 AM

Page 30

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

The Cuban Missile Crisis Conflict between Cuba and the United States came to a head in 1962, when the United States staged a showdown with Russia over the presence of midrange nuclear warheads on the island. Castro had been cultivating relations with Russia and cleverly declared Cuba a socialist government on the night before the Bay of Pigs fiasco. His plan was to garner Russian support by exploiting the Bay of Pigs attack as an American invasion on a fellow socialist country. The plan worked well, with Russia supplying billions of dollars in aid to Cuba until the Soviet Union’s demise in the 1990s. Russia was also quite interested in establishing an armed communist stronghold in the Western Hemisphere. The American blockade of Russian ships into Cuba eventuated in negotiations between President Kennedy and Soviet Premier Nikita Khrushchev in which Russia agreed to remove the warheads in exchange for a promise that the United States would not invade Cuba. The Second and Third Waves of Exiles Although U.S.-bound flights out of Cuba were suspended in 1962, a second wave of 56,000 Cubans came to the United States between 1962 and 1965. Most were relatives of the first-wave immigrants, many of whom came by way of Spain and Mexico. Between 1965 and the late 1970s, a third wave of Cubans relocated to the United States (Feagin & Booher Feagin, 1999b). At a ceremony at the base of the Statue of Liberty, President Johnson guaranteed this wave of Cubans refuge in America and arranged for daily “freedom flights” to transport them (M. C. Garcia, 1996). Before flights from Cuba were permanently halted in 1973, more than 3,000 flights had transported almost 300,000 Cuban refugees to the United States. Again, this latter group was predominantly composed of White Cubans who were relatives of prior exiles, but also included more working-class and small business people than in previous waves. The majority of these individuals also settled in southern Florida, where they were quickly integrated into the thriving Cuban ethnic enclave that was beginning to accept its permanence in America. As with Puerto Ricans, the timing of Cuban immigration to the United States was not good in terms of labor market shifts. But unlike Puerto Ricans, poor timing was no obstacle to success for the following reasons: (a) Cubans were not racialized and treated as Blacks; ( b) they were predominantly middle- and upper-class professionals; and (c) they received tremendous support from public and private sectors of U.S. society. The magnitude of government and private assistance provided to help Cubans resettle in the United States is not only unique among Latino groups but

orga_c01.qxd

2/5/07

10:50 AM

Page 31

The Americanization of Latinos

31

also unprecedented for any refugee group in American history (M. C. Garcia, 1996). Investing in Cuban Americans President Eisenhower responded to the immediate resettlement needs of first-wave Cubans by allocating $1 million in federal funds to create the Cuban Refugee Emergency Center in Miami. In 1961, President Kennedy established the Cuban Refugee Program and expanded aid to include employment, health services, education, vocational training programs, surplus food distribution, and aid to more than 14,000 unaccompanied children who were sent by Cuban parents who feared their children being educated in a communist state as well as being conscripted into the military. Even Pan American Airlines assisted in smuggling these children out of Cuba in what was cleverly called “Operation Peter Pan.” Between 1961 and the mid-1970s, the Cuban Refugee Program provided nearly $1 billion of resettlement support across a wide array of services (Feagin & Booher Feagin, 1999b). In fact, between 1959 and 1965, government assistance to Cuban exiles actually exceeded what was granted to native-born Americans in Florida (M. C. Garcia, 1996). In Dade County, Florida, the nation’s first federally funded bilingual education program was set up for Cuban children. One exile problem area heavily targeted had to do with the significant downward mobility of Cubans whose professional skills needed to be adapted to the United States. For Cuban doctors, lawyers, and teachers, federal grant monies were poured into local universities and community organizations to create intensive retraining programs in which many could graduate with American licenses while others were prepared for licensing exams. Marielito Conf lict in the United States Although conflict between the United States and Cuba has been mostly confined to the island, some conflict did occur with the fourth wave of approximately 125,000 exiles that arrived suddenly in 1980. Known as Marielitos because they sailed from the Cuban port of Mariel, these exiles received a rocky reception for a number of reasons. Not only did Marielitos arrive during an economic recession, but 75% were blue-collar workers and up to 40% were dark-skinned Black Cubans. Some were forced to leave Cuba, but most were allowed to leave given their desire to escape growing island poverty. As such, they were initially denied the federal financial support granted to political refugees. However, an amendment to the Refugee Assistance and Education Act of 1980 eventually allowed them to receive full refugee benefits (M. C. Garcia, 1996).

orga_c01.qxd

32

2/5/07

10:50 AM

Page 32

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Still, the reception of Marielitos was harsh. They were housed in temporary “tent cities” upon arrival and flown to military detention centers to be screened for dangerousness. American apprehension over the Marielitos stemmed from Castro’s well-publicized “tainting” of the migration stream with hardened criminals, mental patients, homosexuals, and other undesirables. Although fewer than 4% of Marielitos were actually hardened felons and mental patients, the exaggerated media attention fueled Americans’ fears (M. C. Garcia, 1996). Scarface, the Movie The extremes of Americans’ fear of Cubans were best exemplified in movie director Brian DePalma’s 1983 remake of the classic James Cagney gangster film Scarface. The updated version begins with footage of the Mariel boatlift, followed by the detention center interrogation of Tony Montana, a Marielito criminal played by Al Pacino. The rest of the film depicts Tony’s violent rise as a cocaine drug lord who flaunts a buxom Anglo-American girlfriend, buries his face in a mountain of cocaine piled on his desk, and wields a bazooka-size gun while screaming “You want to fuck with me?!” in a feeble Cuban accent. But that’s not all. Tony is also a pervert who kills his sister’s boyfriend (formerly Tony’s best friend) to incestuously possess her. The film is so absurd that it has become a humorous cult classic in both the barrios and ghettos of America! But for all of the media hype about Cuban criminals, only 2% of Marielitos ever ended up in penitentiaries for serious violations of the law (Feagin & Booher Feagin, 1999b), and by the mid-1980s, the majority of Marielitos were well absorbed into Cuban American communities. Ironically, it was America’s almost neurotic overreaction and restrictiveness that resulted in Marielito protest and violence during the 1980s. Angered by their treatment and the crowded conditions in detention camps and prisons, several inmates rioted and clashed with National Guard troops. Between 1980 and 1983, a few Marielitos also protested by hijacking airliners back to Cuba. In 1987, riots broke out at the Atlanta federal penitentiary in Georgia and the Oakdale federal detention center in Louisiana, where about 3,000 Marielitos awaited deportation for committing serious crimes in the United States. Angry about being jailed indefinitely, these inmates burned several buildings and took more than 100 people hostage (M. C. Garcia, 1996). They demanded parole board reviews to remain in the United States but were difficult to negotiate with. It took Reverend Agustin Roman, auxiliary bishop of the Archdiocese of Miami, to negotiate with the inmates, resulting in the parole of the majority of inmates and the deportation of 400 back to Cuba.

orga_c01.qxd

2/5/07

10:50 AM

Page 33

The Americanization of Latinos

33

In 1994, the United States finally reversed its 3-decades long “open door” policy to Cuba in response to some 30,000 Cuban “boat people” who attempted to enter the United States when Cuba again lifted its ban on emigration. Hundreds of thousands of Cubans tried to escape the disastrous economic crisis in Cuba caused by the breakup of the Soviet Union, which had supplied Cuba with billions in annual foreign aid. This last wave was returned to Guantánamo Bay, and the United States and Cuba reached an agreement in which the United States would increase its number of visas granted to Cubans to 20,000 annually in return for Cuba’s halting the mass exodus of refugees. ADAPTATION According to Gonzales (1993), by 1990 there were more than 28,000 Cubanowned businesses in the Miami area; in Dade County there are more than 18,000 firms in the areas of finance, construction, textiles, leather, furniture, and cigar production. There were also 16 Cuban American bank presidents and 250 vice presidents, 3,500 doctors, 500 lawyers, 500 supermarket owners, 250 drug store owners, and 60 auto dealership owners. Cuban adaptation to the United States began with self-imposed segregation and retention of culture born of the exile dream to return to Cuba after a temporary stay in the United States. But with Castro’s lengthy stay in power, Cuban exiles became permanent Cuban Americans who rapidly became integrated into all spheres of American society. Although it was not Cubans’ original intention, the combination of high Cuban SES and high U.S. government investment in Cuban adjustment to the United States resulted in one of the best-case scenarios for a refugee group in America. Parenthetically, some writers warn that the portrait of Cubans as a model minority is a disservice to those struggling with poverty, discrimination, and adjustment to the United States. C E N T R A L A M E R I CA N S The majority of Central Americans currently living in the United States can be considered “cross-fire refugees” whose lives were interrupted by recent intense civil wars in El Salvador, Nicaragua, Guatemala, and Honduras. More than 1 million Central Americans have fled to the United States due to intolerable guerrilla warfare, counterinsurgency activities, and the incorporation of civilians into the conflict (Ferris, 1987). Although these refugees are grateful to have escaped La situación, as they refer to it, relocating to the United States has been a mixed blessing for many.

orga_c01.qxd

34

2/5/07

10:50 AM

Page 34

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

CONTACT The majority of Central Americans have sought refuge in the United States only since the late 1970s, beginning with Salvadorans, followed by Guatemalans in the early 1980s, and then Nicaraguans and Hondurans in the mid-1980s (N. Rodriguez, 1987). They leave behind countries characterized by extreme poverty, where 50% of the population cannot afford adequate food, where 75% of children under 5 years of age are malnourished, and where infant mortality can average as high as 200 per 1,000 births in rural areas (Chelala, 1990). Such immense poverty is due to the extreme concentration of wealth, land, and resources in the hands of tiny elite ruling classes that make up between 1% and 4% of the population, but that own between 33% and 80% of the land (Cordova, 1987; Ferris, 1987). Such economic factors create the perception of Central Americans as economic immigrants, yet civil war in El Salvador, Nicaragua, Guatemala, and Honduras has been the primary expelling factor. In addition to frequent displacements of civilians by Central American governments, violence and repression against civilian populations have been extreme and unconventional (Amnesty International, 1983). Whether it is government forces (e.g., military death squads) displacing and destroying communities as a way of weakening rebel factions, or rebels conscripting civilians into the struggle, civilians have been routinely pulled into the conflict in ways that make them more than simply casualties of war.

CONFLICT Despite these factors, the United States has generally elected to deny refugee status to Central Americans. As a result, no more than 25% of Central Americans claim legal documentation (Leslie & Lietch, 1989; Montes Mozo & Garcia Vasquez, 1988). The adaptation of Central Americans in the United States is hampered by a general denial of refugee status and consequent lack of government assistance and entitlement to social services due to their limited ability to prove direct political persecution (Ferris, 1987). Denial of political asylum also leads to inhibited social and community life, mistrust, and perceptions of the U.S. government as supporting repressive governments in Latin America (Dorrington, 1995; Farias, 1991). Denial of refugee status has to do with two macro-level factors that compromise the well-being of Central Americans. The first factor involves how a refugee is defined. Based on the United Nation’s 1967 protocol on the status of refugees, the most widely used definition is that of a person

orga_c01.qxd

2/5/07

10:50 AM

Page 35

The Americanization of Latinos

35

outside of his or her country of origin who is unwilling to return due to fear of persecution for reasons of race, religion, nationality, or social or political group membership (Ferris, 1987). Unfortunately for Central Americans, this definition excludes displaced persons not individually singled-out for persecution. Further, current U.S. policy fails to recognize that economic repression has been a common tool of warfare in Central America, blurring the distinct between political refugees and economic immigrants. The second reason involves a long-standing national policy of accepting refugees when relations are poor between the United States and the Latin American government in question (e.g., Cuba). Such a policy often places politics above compelling refugee needs. Thus, although most Central American refugees are poor, unskilled, undocumented, and traumatized by war, they are not entitled to the kinds of government support that was so essential to Cuban exile adaptation to the United States. The predicament is complicated by U.S. policies that support pseudodemocratic rebels opposed to new socialist governments. During the 1980s, the Reagan administration enthusiastically supported the Contra rebels in Nicaragua in their opposition to the new socialist Sandanista government, despite the fact that Contra rebels routinely used U.S. aid and military training to destroy public facilities such as water supplies, schools, clinics, and mills, as well as killing workers within those facilities (Ronstrom, 1989). Eventually, Congress voted against such support. ADAPTATION Central Americans typically migrate to small but established enclaves in major U.S. urban centers such as Los Angeles, New York, Houston, San Francisco, and Washington, DC. A handful of studies on community samples found that Central Americans report a higher than average number of stressful life events, primarily of a work-related nature and secondarily having to do with housing, health, mental health, and documentation problems (Leslie & Lietch, 1989). Two studies of Central Americans in Los Angeles found that the primary stressors reported by participants were not having a job, not knowing English, and lack of help with these problems (Padilla, Cervantes, Maldonado, & Garcia, 1988; Plante, Manuel, Menendez, & Marcotte, 1995). Most cope with such problems by relying almost exclusively on friends and family and by pooling their resources (Dorrington, 1995; Leslie & Lietch, 1989; Padilla et al., 1988; Vlach, 1992). Despite these pressing basic needs, Leslie and Lietch (1989) found that 65% of their Central American sample had never sought social services despite the availability of Spanish-language services that do not

orga_c01.qxd

36

2/5/07

10:50 AM

Page 36

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

inquire about documentation in the Washington, DC, area. The few services utilized by subjects in this study included community colleges and churches. CONCLUSION Armed with knowledge about the varied acculturation histories of different U.S. Latino groups, service providers can begin to understand that the various patterns of Latino success and failure in America, including psychosocial and health patterns, are neither random nor simply of Latinos’ own making. What emerges from a careful analysis of historical conditions of acculturation is recognition of the living legacies of people actively coping with forces of racism and discrimination, partly by maintaining their life-supporting and self-affirming Latino culture. Acculturation knowledge quells naive questions, such as “Why can’t Mexican Americans be like Cubans or Asians?” and provides human and social service providers with an empathic understanding of the role of social injustice in the general social welfare of U.S. Latinos. Understanding the conditions of acculturation and their connections to ensuing patterns of SES and psychosocial adjustment is essential for working sensitively with Latinos and other ethnic minority groups in need of culturally competent social service assessment and intervention. Knowledge of conditions of acculturation for Latinos can form a primary foundation for sensitively understanding the Latino experience in America. The acculturation framework also forms the basis for proceeding to the next theoretical framework, involving a sociological analysis of the stratification of power and Latino ethnicity in America. It is within the process of stratification that the generalities of acculturation dynamics become particularized, institutionalized, rationalized, ignored, or addressed in American society. R EFER ENCE S Acuña, R. (1981). Occupied America (2nd ed.). New York: Harper & Row. Amnesty International. (1983). Annual report. Washington, DC: Author. Bean, F. D., & Tienda, M. (1990). The Hispanic population of the United States. New York: Russell Sage Foundation. Berry, J. W. (1990). Psychology of acculturation: Understanding individuals moving between cultures. In A. Brislin (Ed.), Applied cross-cultural psychology (pp. 232–253). Newbury Park, CA: Sage. Berry, J. W. (2003). Conceptual approaches to acculturation. In K. M. Chun, P. Balls Organista, & G. Marin (Eds.), Acculturation: Advances in theory, measurement, and applied research (pp. 17–34). Washington, DC: American Psychological Association.

orga_c01.qxd

2/5/07

10:50 AM

Page 37

The Americanization of Latinos

37

Berry, J. W., & Annis, R. C. (1974). Acculturative stress: The role of ecology, culture and differentiation. Journal of Cross-Cultural Psychology, 5, 382– 406. Chavez, L. (1991). Out of the barrio: Toward a new politics of Hispanic assimilation. New York: Basic Books. Chavez, L. R. (1992). Shadowed lives: Undocumented immigrants in American society (p. viii). Orlando, FL: Harcourt Brace Janovich. Chelala, C. A. (1990). Central America: The cost of war. Lancet, 335, 153 –154. Cordova, R. (1987). Undocumented El Salvadorans in the San Francisco Bay Area: Migration and adaptation dynamic. Journal of La Raza Studies, 1, 9–35. del Castillo, R. G. (1990). The treaty of Guadalupe Hidalgo: A legacy of conf lict. Norman: University of Oklahoma Press. Dorrington, C. (1995). Central American refugees in Los Angeles. In R. E. Zambrana (Ed.), Understanding Latino families: Scholarship, policy, and practice (pp. 107–129). Thousand Oaks, CA: Sage. Farias, P. J. (1991). Emotional distress and its socio-political correlates in Salvadoran refugees: Analysis of a clinical sample. Culture, Medicine, and Psychiatry, 15, 167–192. Feagin, J. R., & Booher Feagin, C. (1999a). Mexican Americans. In J. R. Feagin & C. Booher Feagin (Eds.), Race and ethnic relations (6th ed., pp. 291–335). Upper Saddle River, NJ: Prentice-Hall. Feagin, J. R., & Booher Feagin, C. (1999b). Puerto Ricans and Cuban Americans. In J. R. Feagin & C. Booher Feagin (Eds.), Race and ethnic relations (6th ed., pp. 336 –379). Upper Saddle River, NJ: Prentice-Hall. Ferris, E. G. (1987). The Central American refugees. New York: Praeger. Garcia, M. C. (1996). Havana USA: Cuban exiles and Cuban Americans in south Florida, 1959–1994. Berkeley: University of California Press. Garcia, M. T. (1995). Ruben Salazar: Border correspondent. Berkeley: University of California Press. Gonzales, J. L., Jr. (1993). The Cuban American experience. In J. L. Gonzales Jr. (Ed.), Racial and ethnic groups in America (2nd ed., pp. 275 –288). Dubuque, IA: Kendall/Hunt. Healey, J. H. (1995). Race, ethnicity, gender, and class: The sociology of group conf lict and change. Thousand Oaks, CA: Pine Forge Press. Jacobs, P., Landau, S., & Pell, E. (1971). To serve the devil: Vol. I. Natives and slaves (pp. 229–249). New York: Vintage Books. Leslie, L. A., & Lietch, M. L. (1989). A demographic profile of recent Central American immigrants: Clinical and service implications. Hispanic Journal of Behavioral Sciences, 11(4), 315 –329. Massey, D. S., & Denton, N. A. (1989). Trends in the residential segregation of Blacks, Hispanics, and Asians: 1970–1980. American Sociological Review, 52, 802–825. Mazon, M. (1984). The zoot-suit riots: The psychology of symbolic annihilation. Austin: University of Texas Press. McLemore, S. D., Romo, H., & Gonzalez Baker, S. (2001). Mexican Americans: From colonized minority to political activists. In S. D. McLemore, H. Romo, &

orga_c01.qxd

38

2/5/07

10:50 AM

Page 38

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

S. Gonzalez Baker (Eds.), Racial and ethnic relations in America (pp. 187–220). Boston: Allyn & Bacon. McWilliams, C. (1968). North from Mexico: The Spanish-speaking people of the United States. New York: Greenwood Press. Montejano, D. (1987). Anglos and Mexicans in the making of Texas, 1936–1980. Austin: University of Texas Press. Montes Mozo, S. M., & Garcia Vasquez, J. J. (1988). Salvadoran migration to the United States: An exploratory study. Washington, DC: Hemispheric Migration Project, Center for Immigration Policy and Refugee Assistance. Moquin, W., & Van Doren, C. (Eds.). (1971). A documentary history of the Mexican Americans. New York: Bantam Books. Murphy, H. B. M. (1965). Migration and the major mental disorders: A reappraisal. In M. B. Kantor (Ed.), Mobility and mental health (pp. 204 –341). Springfield, IL: Thomas. Murphy, H. B. M. (1975). The low rate of mental hospitalization shown by immigrants to Canada. In C. Zwingmann & M. Pfister-Ammende (Eds.), Uprooting and after (pp. 221–231). New York: Springer-Verlag. Orfield, G., & Yun, J. T. (1999). Resegregation in American schools. Cambridge, MA: The Civil Rights Project, Harvard University. Padilla, A., Cervantes, R. C., Maldonado, M., & Garcia, R. E. (1988). Coping responses to psychosocial stressors among Mexican and Central American immigrants. Journal of Community Psychology, 16, 418– 427. Plante, T. G., Manuel, G. M., Menendez, A. V., & Marcotte, D. (1995). Coping with stress among Salvadoran immigrants. Hispanic Journal of Behavioral Sciences, 17(4), 471– 479. Redfield, R., Linton, R., & Herskovits, M. J. (1936). Memorandum on the study of acculturation. American Anthropologist, 38, 149–152. Rodriguez, C. E. (1989). The political-economic context. In C. E. Rodriguez (Ed.), Puerto Ricans: Born in the U.S.A. (pp. 85 –105). Boston: Unwin Hyman. Rodriguez, N. (1987). Undocumented Central Americans in Houston: Diverse populations. International Migration Review, 21(1), 4 –26. Ronstrom, A. (1989). Children in Central America: Victims of war. Child Welfare, 68(2), 145 –153. U.S. Department of Labor. (1992). Findings from the National Agricultural Workers Survey (NAWS), 1990: A demographic and employment profile of perishable crop farmworkers. Washington, DC: Author. Vlach, N. (1992). The quetzal in f light: Guatemalan refugee families in the United States. Westport, CT: Praeger.

orga_c02.qxd

2/5/07

2:09 PM

Page 39

CHAPTER 2

The Social Stratification of Latino Ethnicity, Power, and Social Welfare in the United States THE SOCIOLOGICAL CONCEPT of social stratification is extremely helpful for understanding where Latinos are located relative to other racial/ethnic groups in the American hierarchy of success, power, and social mobility and welfare. This discussion picks up where Chapter 1’s discussion of acculturation and adaptation left off. That is, while acculturation theory helps us to understand the general historical dynamics of group-level dominance and subordination, stratification clarifies how a group’s general level of socioeconomic status (SES) and well-being become institutionalized in various ways and even justified by mainstream ideologies, values, and myths. In describing the stratification of Latinos in America, this chapter provides socioeconomic profiles of the major Latino groups under study that underscore uneven levels of integration into mainstream society. These profiles emphasize the occupational and educational dimensions of the Latino experience in America, with some attention to the political (an important dimension of Latino social welfare to which Chapter 10 is dedicated). T H E C O N C E P T O F S T R AT I F I CAT I O N According to Marger (2000a), stratification refers to the structured inequality of society’s resources and power as determined by key social institutions such as government, business, education, and social services. That is, stratification refers to how all societies are unfairly biased in favor of those groups with the most power and against those with the least. Such glaring social inequities are not denied but justified by ideologies that rationalize and “explain” inequality in ways that serve to 39

orga_c02.qxd

40

2/5/07

2:09 PM

Page 40

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

stabilize stratification or the status quo and that impede progress toward distributive social justice. Because stratification is the rule the world over, it appears that human beings characteristically monopolize power and organize themselves into unequal social hierarchies that promote endless discord. International comparisons allow some evaluation of our own system. For example, Central American countries such as El Salvador, Nicaragua, and Guatemala can be depicted as primitive pyramid-shaped stratification systems in which small elite ruling classes that comprise only between 1% and 4% of the population own between 34% and 80% of the land, resulting in extreme, third world labor exploitation, oppression, and dramatic abject poverty (Cordova, 1987; Ferris, 1987). By comparison, our own, more diamond-shaped stratification system ensures better distribution of wealth and resources, resulting in most people being middle class and fewer people being either rich or poor. For example, Table 2.1 shows that between 50% and 60% of Americans are middle class, whereas only 20% to 25% are poor and 1% to 2% are superrich or elite. Table 2.1 The Stratification of Social Class in America Social Class Elite Upper middle class Professionals Managerial Lower middle class Sales workers Technicians Clerical Working class Craf t workers Operatives Transportation workers Protective services Farm workers Service workers The poor Food and cleaning services Domestic workers Unskilled workers Unemployed

Percent of the Population

Number Employed

1–2 28–30 20,883,000 19,584,000 27–29 16,118,000 4,355,000 18,448,000 27–29 14,593,000 7,386,000 5,516,000 2,440,000 3,426,000 6,164,000 14–16 8,480,000 831,000 5,265,000 6,008,000

Source: “Employed Persons by Detailed Occupation,” Employment and Earnings, 47 (January 2000), Table 11, pp. 177–183, and “Unemployed Persons by Reasons for Unemployment,” Monthly Labor Review, 123 (June 2000), Table 8, p. 59.

orga_c02.qxd

2/5/07

2:09 PM

Page 41

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

41

But a critical analysis of our relatively good stratification system reveals inequities between ethnic groups that have led Marger (2000a) to conclude that the United States continues to have one of the most castelike systems in the world, citing the legacy of African American segregation and Blacks’ extremely low intermarriage rates with Whites as but one index of impeded assimilation. Marger’s (2000a) point is driven home by analysis of persistent gaps between Whites and people of color with respect to wealth. For example, Rothman’s (1999) analysis of household net worth in America reveals that the average White household has a net worth of $45,740 as compared to only $499 for Latinos and $250 for African Americans! Net worth refers to the total value of private assets, including bank accounts, stocks and bonds, home and business equity, pensions and life insurance, and all personal property. Further, the top 20% of households in America (with regard to income) own 44% of all private assets, whereas the bottom 20% of households own only 7.2%. The same patterns emerge with respect to wages earned in the United States. That is, the wealthiest 20% of Americans earn half of all wages (average annual income = $98,589), whereas the bottom 20% earn only 3.6% of all wages (average annual income = $7,411). In fact, the richest 5% of all Americans earn 20% of all wages in the United States. Hence, even within our decent stratification system (relative to other countries) extreme concentrations of wealth among small percentages of Americans are highly evident.

DIMENSIONS

OF

STRATIFICATION

With regard to dimensions of stratification, Karl Marx is most famous for his predominantly one-dimensional description of societies as composed of those who control the means of production and those who do not (i.e., the famous “haves” and “have nots”). In Marx’s theory of economic determinism, he views the classic division between the ruling and working classes as the basis for social-political tension and struggle. But whereas the economic dimension is obviously central to stratification, it is only one of several interrelated dimensions that work in concert to influence probabilities of success and failure for different groups in a given society. Further, Marxism does not give much attention to multicultural societies where class and racial/ethnic differences are conflated. Lenski’s (1966) classic multidimensional model of stratification is composed of several hierarchical class systems, each of which is based on a key social criterion such as wealth, occupation, or education. Together, these interacting class systems compose a society’s system for distributing its resources. Lenski’s distributive model of stratification is important

orga_c02.qxd

42

2/5/07

2:09 PM

Page 42

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

because it reveals the relative importance of each class system in determining a group’s location throughout a society’s stratification system. Central to the current discussion of Latinos is Lenski’s inclusion of an ethnic class system showing the relation between ethnicity and other class systems, or the consistency of locations across related class systems for different ethnic groups in multicultural societies. E T H N I C S T R AT I F I CAT I O N : P OW E R A N D I N E Q UA L I T Y Marger (2000a) has used Lenski’s (1966) theory to illustrate the American distributive system that shows the various locations of major ethnic groups within the U.S. hierarchy. As can be seen in Table 2.2, four major subclass systems are included in Marger’s illustration: the political, property, occupational, and ethnic class systems. More class systems can be added to the extent that they are relevant to the discussion at hand (e.g., educational, home ownership). Of utmost importance in this discussion is the powerful relationship between ethnicity and a group’s placement or location across all other class systems, that is, the consistent relationship between ethnicity and resources, power, and consequent well-being. As with the acculturation framework, this model of stratification elucidates nonrandom patterns of social welfare that have been and continue to be linked to race and ethnic background in America. Marger (2000a) emphasizes the concept of power in his discussion of stratification as the capability to control the flow of resources in society. Obviously, groups and individuals at the top of a stratification system are the most powerful. People at the top are also highly invested in maintaining and justifying a stratification that distributes a disproportionately greater amount of resources to themselves. Complex ideologies, value systems, and myths are generated and infused into the socialization process through mainstream institutions and culture to rationalize and justify a society’s particular distribution of precious, life-enhancing resources. For example, as we saw in Chapter 1, historical accounts of American territorial expansion are described by historians and depicted in movies as righteous patriotic myths of defending freedom and defeating oppression (e.g., “Remember the Alamo!” and “Remember the Maine!”). Thus, the maintenance of power is accomplished by exercising a wide range of power, from creating and sustaining biased ideologies (e.g., via the educational system and media) to controlling resistance and protest (via the military or militia) that challenge attempts to redistribute power.

orga_c02.qxd

2/5/07

2:09 PM

Page 43

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

43

Table 2.2 The Social Stratification of Race and Power in America The Distributive System Class System Political

Property

Occupational

The Elite

The Upper Class

Capitalists

The bureaucracy

The upper-middle class

(A) The electorate

(A) The middle class

(B)

(B) The working class

The apolitical populace (C)

Professionals, managers, entrepreneurs

Ethnic

Anglo Americans

(A)

(A)

Skilled workers, technicians (B)

Other EuroAmericans

Unskilled workers

Asian Americans

(B)

(C) The poor

The unemployed

Latino Americans

(C) The underclass

African Americans (C) American Indians

Note: A, B, and C represent three individuals. From Power and privilege: A theory of social stratification, by G. Lenski, 1966, New York: McGraw. Copyright University of North Carolina Press. Adapted with permission.

IMMIGRATION AND POWER Control of immigration is an extremely important dimension of power that has been used historically and currently not only to regulate our capacity to absorb immigrants, but to further consolidate power at the top and to regulate the ethnic composition of American society. Consider, for example, the evolution of policies to restrict immigration that took place when the color and ethnicity of European immigrants changed from White northern Europeans during the 1800s to darker southern and eastern Europeans at the turn of the century and into the early 1900s. In response to the second great immigration wave at the turn of the twentieth century, Congress passed the Emergency Quota Act of 1921 that limited each European immigrant group to 3% of its U.S. population

orga_c02.qxd

44

2/5/07

2:09 PM

Page 44

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

size based on the 1910 census. Because northern and western Europeans made up the largest groups in America in 1910, this immigration policy effectively allowed far greater numbers of these groups to immigrate and far fewer numbers of southern and eastern Europeans (McLemore, Romo, & Gonzalez Baker, 2001). Then, in 1924, the limit was change to 2% based on the 1890 census, further limiting the percentage of southern and eastern European immigrants relative to northern and western. Today, we continue to experience effects of the third major immigration stream, composed this time of even more ethnically distinct peoples from Latin America, Asia, and other non-European countries. This stream dates back to around the middle of the twentieth century and has elicited its share of ethnic-linked immigration policies. For example, the Western Hemisphere Act of 1976 limited immigration to 20,000 per country of origin, and the Immigration Reform and Control Act (IRCA) of 1986 attempted to curb Mexican immigration by imposing penalties for employers of undocumented workers (McLemore et al., 2001). The 1986 act also attempted to deal with the high number of undocumented workers by granting them citizenship if they could prove long-term residency, which most did. Sanctions against employers, however, were rarely, if ever, implemented because undocumented workers have been able to produce false documents and because some employers are able to sidestep their role as employers by using labor contractors to provide workers (e.g., in farmwork). The latest nativistic backlash against predominantly Mexican/Latino undocumented immigrants is the current congressional proposal to not just criminalize but felonize the estimated 11 million such immigrants who compose an estimated 5% of the U.S. workforce. Couched in the usual debatable rhetoric of taking American jobs and sponging social services, as well as the new rhetoric of undermining homeland security, the proposal is sparking the expected national debate. This time, however, the Catholic Church is branding the proposal a human rights violation and Latino communities are quickly mobilizing on a national level to assert both their U.S. patriotism and their condemnation of the proposal. THE FUNCTION

OF

RACISM

In the context of stratification, the ideology of racism, or the belief in the inherent racial and/or cultural inferiority and superiority of different groups, becomes a major driving belief system for justifying discrimination and the unequal distribution of society’s opportunities and resources across racial groups. For example, the historical conviction that African Americans were genetically inferior subhumans relative to Whites justi-

orga_c02.qxd

2/5/07

2:09 PM

Page 45

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

45

fied the practice of slavery for nearly two centuries, followed by another century of separate and unequal segregation. In the less extreme example of Latinos, the belief that Mexicans and Puerto Ricans were an inferior and docile peasant class was frequently used as a rationale for maintaining exploitive dual-wage systems, excluding Latinos from unions, and subduing strikes and protests. It is only when stigmatizing and dehumanizing ideologies are challenged that shifts in the stratification system lead to more just distributions of power and resources (e.g., civil rights movements). But when members of various minority groups internalize and believe such ideologies, the unchallenged stratification system remains stable and minorities remain at risk for self-compromising conformity as well as ethnic identity problems (to be reviewed in Chapter 4). A central American ideology that continues to stabilize structured inequality is the belief that our society is fair and that opportunity structures are open to all who have enough achievement motivation, intelligence, talent, and industriousness to take advantage of such opportunities. This core ideology of meritocracy continues to justify the stratification of ethnicity and power because it attributes a group’s social position only to the internal and cultural characteristics of its members, while minimizing the external effects of prolonged dominance and subordination and the dynamics of stratification. The current national movements to abolish affirmative action and reform the welfare system are emblematic of the core American ideology that people of color need to solve their own problems and that the role of racism and discrimination has minimal impact. ETHNIC PRESTIGE Ethnic stratification is also a ranking of social prestige and acceptance based on a group’s racial and cultural similarity to Anglo-Americans. Perceptions of prestige are also a function of popular cultural and formal educational information and stereotypes that a society generates about different groups. Culture-wide prestige rankings are part of interpersonal norms and socialization that influence minority-majority relations, formally and informally, and have a direct relation to probabilities of integration and assimilation. Sadly, prestige rankings follow a familiar color gradient, from positive White to negative Black. For example, using intermarital assimilation rates as one index of ethnic prestige and interpersonal acceptability, we find that although over 50% of Japanese, Chinese, Filipino, and Cuban Americans are married to non-Hispanic Whites, the figure is about 30% for Mexican Americans and an amazingly low 3.5% for African Americans (Zweigenhaft & Domhoff, 1998).

orga_c02.qxd

2/5/07

46

2:09 PM

Page 46

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

WHITE PRIVILEGE Recently, discussions of White privilege and the new area of critical studies (McIntosh, 1998; Tatum, 1997) have invigorated the tired national debate about race and ethnic problems in America. Critical White studies aim to de-center White power and privilege by reinserting White people into the mix of American race problems, whereas focusing just on minority disadvantage conveniently distances Whites from their major role in such problems, thereby making it easy for them to either ignore or superficially respond. Reinvolving Whites is partly accomplished by focusing on what they have accrued and continue to gain from historical and contemporary racism and discrimination, in both their informal and institutional forms. It is understandably a touchy subject because although most Whites are generally willing to admit that ethnic minorities have been discriminated against and disadvantaged, they are too often oblivious to or only vaguely aware of how Whites have been simultaneously advantaged by such conditions of inequality. Historically and through today, being racially White has meant having tremendously better life chances, opportunities, and general social welfare in America. Whites have generally succeeded not only because of their considerable hard work and talent, but also because they have not been stigmatized and limited by race. Such a privileged condition does not guarantee Whites success, but it allows them to take fuller advantage of their human potential, and this is exactly what ethnic minorities in America continue to demand. Critical White studies also include historical analyses of how various European immigrant ethnic groups (e.g., the Irish, Italians, Jews) became White and thus privileged in America, and distant from people of color, despite centuries of inter-European rivalries and tensions in the old country. In McIntosh’s (1998, p. 71) now classic article on White privilege, she states: I have come to see white privilege as an invisible package of unearned assets that I can count on cashing in each day, but about which I was “meant” to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, assurances, tools, maps, guides, code books, passports, visas, clothes, compass, emergency gear, and blank checks.

McIntosh discloses: For me, white privilege has turned out to be an elusive and fugitive subject. The pressure to avoid it is great, for in facing it I must give up the myth of meritocracy. If these things are true, this is not such a free country; one’s life is not what one makes it; many doors open for certain people through no virtues of their own. These perceptions mean also that my moral condi-

orga_c02.qxd

2/5/07

2:09 PM

Page 47

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

47

tion is not what I had been led to believe. The appearance of being a good citizen rather than a troublemaker comes in large part from having all sorts of doors open automatically because of my color. (pp. 75 –76)

The concept of White privilege is emphasized here to remind us that Whites even have the privilege to be average or to fail without its being attributed to their race. In contrast, people of color who benefit from affirmative action cannot be average or fail without its being used as evidence of their racial inferiority and/or proof that affirmative action is a failure. The irony here is that affirmative action has never advantaged people of color in the way White privilege has unfairly advantaged Whites throughout the American experience. The more conscious Whites become of their race privilege, the more likely they will fairly consider their coevolution with people of color. Surrendering White privilege runs counter to mainstream culture and daily lived experience, yet the benefit for all Americans is immense in scope: fuller overdue human rights for people of color, a less distorted sense of self and society on the part of Whites, more authentic interpersonal majority-minority relations, and unlimited multicultural potential in America.

MULTIPLE STATUS DIMENSIONS Needless to say, racial and ethnic minorities are not the only groups singled out for discrimination leading to lower positions in the social hierarchy. Historical and contemporary ideologies of sexism, homophobia, and prejudice against people with mental and physical disabilities continue to justify discrimination against these groups on the basis of characteristics that distinguish them from society’s more powerful members. The struggle for a fairer distribution of resources, and even special accommodations for these individuals, to overcome tenacious legacies of prejudice and discrimination continues to be an uphill battle led primarily by members of these groups who most feel the sense of urgency. Issues of multiple status dimensions and identities, even within the same individual, are addressed in Chapter 4 (“Diversity within Latinos”). Hence, the matrix of intertwined ethnic, economic, educational, and political class systems has tremendous implications for the mobility and general social welfare of different groups in America, including their concentrations within particular social classes, types of work, levels of education, political clout, formal and informal relations with members of the dominant and other subordinate groups, and consequent well-being or social welfare.

orga_c02.qxd

48

2/5/07

2:09 PM

Page 48

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH T H E S O C I O E C O NOM I C P O S I T I O N S O F U. S . L AT I NO S

As reviewed in Chapter 1, most Latinos were historically incorporated into the American stratification system at the lowest social class, characterized by segregation and economic exploitation with little collective bargaining power. In particular, Mexican Americans and Puerto Ricans were incorporated into local, distinct labor markets with limited advancement opportunities and high vulnerability to structural changes in the labor market (e.g., farmwork, low-skilled industrial work). As such, the rate of Latino progress has been painfully slow and poorly understood, leaving too many compromised lives in the balance. Thus, any comprehensive analysis of Latino SES must move beyond the overused immigrant model and recognize the distinctiveness of Latinos as a national minority group as well as their heterogeneity and shared characteristics with Native and African Americans and European immigrants (Melendez, Rodriguez, & Figueroa, 1991a). Such an approach will help us make better sense out of continuing SES problems in Latino communities that are the major determinants of related psychosocial and health problems. INCOME AND OCCUPATION Marger (2000b) maintains that Latinos generally occupy a space in the stratification system approximately between European and African Americans. A comparison of socioeconomic indicators appears to substantiate this point. As can be seen in Table 2.3, median annual family income for Latinos ranges from a high of $35,616 (Cubans) to a low of $23,646 (Puerto Ricans), with an average of $25,347 (closest to Mexican Americans). As compared to a fairly impressive 8.6% poverty rate for European Americans, Latino poverty rates are twice as high for Cubans, over three times as high for Mexican Americans, and over four times as high for Puerto Ricans. With the exception of Cubans, Latinos are generally underrepresented in high-status occupations and vice versa. As reviewed in Chapter 1, historical discrimination set the stage for this distinct economic pattern, especially for Mexicans in the Southwest and Puerto Ricans in the Northeast. The consequent pattern of Latino job concentration is presented in Table 2.4. As can be seen, the underrepresentation of Latinos in upper-white-collar (i.e., managerial and professional) and lower-white-collar (technical, sales, and administrative support) jobs is due mostly to the historical locations of Mexicans and Puerto Ricans, in addition to the relatively

26,179 25,347 23,646 35,616 29,960 26,171 49,636

29.4 31.0 35.7 17.3 20.8 29.9 8.6

7.7 7.7 9.8 6.6 7.0 7.6 2.8

Unemployed (%)

54.7 48.6 61.1 65.2 63.3 66.6 83.1

High School Graduate or Higher (%)

10.3 7.4 10.8 19.7 14.8 14.9 24.6

Bachelor’s Degree or Higher (%)

Sources: Money Income in the United States, 1997 (CPR P60-200); Poverty in the United States, 1997 (CPR P60-201); and Statistical abstracts of the United States, 1998, by the U.S. Bureau of the Census, 1998c, Washington, DC: Government Printing Office.

Hispanic Mexican Puerto Rican Cuban Central/South American Other Hispanic Non-Hispanic White

)

Group

Families in Poverty (%)

2:09 PM

Median Income ($)

2/5/07

Table 2.3 Latino Socioeconomic Status

orga_c02.qxd Page 49

49

50

Managerial and professional specialty Technical, sales, and administrative support Precision production, craf t, and repair Operators, fabricators, and laborers Service occupations Farming, forestry, and fishing Totals

8.7 13.8 20.5 29.9 15.2 11.9 100.0

15.5 18.0 15.1 27.3 22.4 1.8 100.1

Puerto American (%) 30.9 43.9 1.7 6.6 16.0 0.9 100.0

White American (%)

13.6 40.7 2.8 15.2 24.9 2.8 100.0

Mexican American (%)

18.5 48.4 2.4 10.8 19.9 — 100.0

Puerto American (%)

Source: “Mexican Americans” (pp. 291–335), by J. R. Feagin and C. Booher Feagin, 1999, in J. R. Feagin and C. Booher Feagin (Eds.), Racial and Ethnic Relations, sixth edition, Upper Saddle River, NJ: Prentice-Hall.

29.2 21.7 18.7 17.8 8.8 3.7 99.9

Employment Category

Mexican American (%)

2:09 PM

White American (%)

Women

2/5/07

Men

Table 2.4 Concentration of Latinos in the U.S. Labor Market

orga_c02.qxd Page 50

orga_c02.qxd

2/5/07

2:09 PM

Page 51

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

51

constant immigration of Mexicans to the United States. The same is true for Latino overrepresentation in lower-blue-collar and service sector work (e.g., operatives, laborers). STRATIFICATION

VERSUS

HUMAN CAPITAL THEORY

One of the predominant current economic theories for understanding occupational gaps between ethnic groups in America is human capital theory, which attributes group differences to differences in human capital or accrued characteristics such as education, job skills, and experience needed to secure good jobs and mobility. But although such variables clearly predict SES for everyone, the theory has serious shortcomings for understanding the SES of Latinos, as well as other people of color. Bean and Tienda (1987b) note that human capital theory does not consider how “ascribed” characteristics such as race or gender influence the allocation of labor rewards, and how dominant groups are prone to protect their interests beyond human capital variables. That is, “fixed” characteristics such as race and ethnicity are simply rewarded differently, and work opportunities are influenced by social and ethnic affiliations. For example, Rothman (2002) has constructed a table of unequal wage earnings for different races/ethnicities and sexes within different economic classes (see Table 2.5).

Table 2.5 Class, Minority Status, Gender, and Income in the United States Men Social Class Upper middle class Professions Managers Lower middle class Technicians Sales Clerical Working class Craf t workers Semiskilled The poor Service work Unskilled

Women

White

Black

Hispanic

White

Black

Hispanic

$36,975 39,273

$28,775 29,712

$32,846 32,264

$19,324 20,800

$21,122 20,281

$21,302 19,819

27,238 28,242 20,018

19,404 16,358 17,590

20,402 20,494 16,417

17,250 10,752 12,712

16,227 7,937 14,068

n/a 9,336 12,498

22,068 19,249

18,066 15,501

17,246 15,214

14,040 10,684

13,378 11,167

12,994 8,560

10,510 12,110

8,595 11,041

10,282 11,930

6,756 8,615

7,855 8,113

7,022 7,865

Source: Money Income of Households, Families and Persons in the United States, 1989, Table 40, by U.S. Bureau of Census, Washington, DC: U.S. Government Printing Office.

orga_c02.qxd

52

2/5/07

2:09 PM

Page 52

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

As can be seen, people privileged by race and sex earn more money than those stigmatized by these dimensions, even within the same occupational categories (i.e., comparable education and work experience). According to Torres and De La Torre (1991), human capital theory, though partly correct, minimizes labor history and the starting place of ethnic groups, continuing job discrimination, and the disproportionately negative impact of structural labor market shifts on Latinos and other economically vulnerable groups (i.e., downsizing, outsourcing, relocating industry outside of the United States, the rise of dead-end service sector work). Latino Vulnerability to Labor Market Shifts Two-thirds of Latinos are currently located in what has been called the “secondary labor market,” characterized by low wages and benefits, higher unemployment, poor working conditions, low advancement, less unionization, high turnover and low investment in employees, arbitrary and poor management, and sectoral decline. As a result, they are disproportionately dislocated by negative labor market changes. For example, during the 1980s, Latino SES dramatically declined 21% relative to Whites’ (Melendez et al., 1991a). Whereas Latino SES had been 85.1% of White SES in 1970, it declined to 64.2% in 1980, largely due to the disappearance of work for Puerto Ricans in the Northeast and declines in wages for Mexicans in the Southwest. And although declines in manufacturing jobs were offset by service sector jobs for Mexican Americans, wages and hours in the service sector declined throughout the 1980s. Harrison (1987) found that workers in the service sector are seven times more likely to earn below the poverty line than workers in manufacturing jobs. Further, the current trend of converting full-time jobs to part-time work is overly impacting Latinos in the secondary labor market. Estimates of part-time jobs indicate an increase from 8 million in 1980 to 18 million in 1991 (Torres & De La Torre, 1991). Such employees not only earn less than full-time employees but have fewer benefits, if any at all. For example, 70% have no retirement pension and 42% no health insurance, according to Ehrenberg, Rosenberg, and Li (1988), and they are thus almost certain to remain segmented in secondary labor market work. Thus, the traditional lower rungs on the economic ladder to advancement have practically disappeared, threatening to create an hourglassshaped distribution of SES in America. Proof of this unfortunate scenario can be found in the income gap between rich and poor in America that has continued to widen since the 1960s. For example, between 1974 and 1994, the income share for the top 20% of Americans rose from around

orga_c02.qxd

2/5/07

2:09 PM

Page 53

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

53

43% to 49%, while the income share of the poorest 20% of Americans shrank from 4.3% to 3.6% (and this occurred regardless of recession and expansion and successive Republican and Democratic administrations during this period; Rothman, 1999). Zhou (1997) notes that whereas the economic dislocations of the poor during the 1970s and 1980s were offset by accessible welfare (e.g., subsidized housing), the current policy of welfare reform exacerbates poverty by gutting accessible welfare while doing nothing to reverse the hourglass configuration of economics in America. Labor Market Discrimination Not only has historical discrimination shaped Latino economic vulnerability, but contemporary discrimination persists, to the disbelief of many. For example, a report by the Urban Institute (Cross, Mell, & Zimmerman, 1990) concluded that discrimination accounted for the hiring of Whites over Latinos for low-skilled, entry-level jobs in both Chicago and San Diego, where Mexican Americans are numerous. Even after controlling for human capital variables (which were essentially irrelevant in these low-skilled work settings) the study found that Whites were favored over same-age Latinos when using similar resumes that differed only in indicating a different national origin for Latinos. On a related note, Telles and Murguia (1990) found that Mexican American workers with darker skin received significantly less money than those with lighter skin. Their analysis was based on a national survey of Latinos conducted in 1979 that included ratings of participants’ skin color. Another interesting way of understanding the stratification of ethnicity and power in the United States is to examine the extreme underrepresentation of ethnic minorities in the upper echelons of corporate America. In the most comprehensive study of diversity in the power elite, Zweigenhaft and Domhoff (1998) found that Latinos constitute less than 1% of corporate directors of Fortune 1,000 boards and only 1.4% of executives at vice presidential levels and above. In fact, the actual number of corporate directors went from a mere 40 in 1990 to 51 in 1995. Furthermore, an analysis of the backgrounds of the Latino corporate elite revealed that the majority were Cuban Americans from middle-class and elite backgrounds. In fact, a subsequent analysis of skin color and facial features by a pair of independent raters also revealed this group to be light in complexion and more European- than Indian-looking. Hence this group is highly unrepresentative of most Latinos in America and far more advantaged with regard to both SES and skin color. Thus, discrimination based on fixed characteristics continues to happen irrespective of human capital variables.

orga_c02.qxd

54

2/5/07

2:09 PM

Page 54

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

The Cuban Enclave Not surprisingly, Cubans are the glaring exception to Latino underemployment. Their historical experience in America has resulted in a vibrant ethnic enclave subeconomy as a mechanism for economic livelihood and mobility. Torres and De La Torre (1991) define “ethnic enclave” as business enterprises that serve both the ethnic and mainstream markets and also offer subsequent immigrants jobs when work in the regular labor market is less available. Ethnic enclaves provide opportunity for advancement, and there is even a sense of solidarity in that workers are expected to be loyal and employers are expected to provide skills and advancement. The Cuban enclave has been able to take full advantage of its location by working with Caribbean and Latin American companies. Over 20 years ago, Boswell (1985) offered the following awesome profile of Cuban Americans during the mid-1980s: In Dade County, Florida, there are more than 18,000 Cuban-owned firms, most in construction, finance, textiles, leather, furniture, and cigar making. In addition 16 Cuban Americans are presidents of banks and 250 are vice presidents; 3,500 are doctors, 500 are lawyers, and they own 500 supermarkets, 250 drug stores, and more than 60 auto dealerships. T H E S T R AT I F I CAT I O N O F L AT I NO E DU CAT I O N With the exception of Cubans, Latinos are second to Native Americans in scholastic underachievement, which of course drives occupational mobility and related well-being. Only 54.7% of Latinos over the age of 25 have graduated from high school, as compared to 83.1% for European Americans (Marger, 2000b). More specifically, the percentages of Latinos over age 25 without a high school diploma are over 50 for Mexicans, 39 for Puerto Ricans, and 35 for Cubans. With regard to higher education, about 25% of non-Latino Whites graduate with a bachelor’s degree or higher, as compared to 7.4% of Mexicans, 10.8% of Puerto Ricans, and 20% of Cubans. While in school, Latino students score lower than their non-Latino White counterparts on educational tests and have higher rates of “school delay” (a polite term for flunking; Bean & Tienda, 1987a). Such student profiles lead to placement into lower curriculum tracks (e.g., vocational rather than college preparation) and low expectations on the part of teachers, career counselors, and, unfortunately, many of the students themselves. The Richest Latino in America? Hailing from a wealthy sugar plantation family in Cuba and of Spanish-Basque heritage, Roberto Goizueta worked for a subsidiary of Coca-Cola from 1954 to 1960

orga_c02.qxd

2/5/07

2:09 PM

Page 55

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

55

after graduating from Yale with a degree in engineering. But with Fidel Castro threatening to nationalize capitalist enterprises, Goizueta fled Cuba in 1960 with his family to become the assistant to the senior vice president of Coca-Cola in the Bahamas. Over the next 20 years, he would relocate to company headquarters in Atlanta and receive a series of major corporate promotions, culminating in chairman of the board and CEO of Coca-Cola in 1981, with an annual salary of almost $5 million. But that was just the beginning! In addition to introducing the ill-fated New Coke (a Pepsi taste alike) in 1985, Goizueta also gained notoriety in 1992 for arranging a compensation package so immense that it made Johnny Carson’s monologue on The Tonight Show. ABC’s Nightline devoted an entire show to it, and David Cay Johnston (2003) recently devoted a chapter to it in his book, Perfectly Legal: The Covert Campaign to Rig Our Tax System to Benefit the Super Rich—And Cheat Everybody Else. On top of his annual income of nearly $5 million, Goizueta arranged to be paid 1 million shares of Coke worth $81 million, and at a federal income tax rate of less than 2%!

In one of the most thorough analyses of Latino education, Bean and Tienda (1987a) analyzed census data from 1960 to 1980 to both profile and analyze predictors of educational success and failure in Latinos. Their report begins with a descriptive comparison of adult education differences between Latino national origin groups from 1960 to 1980. As can be seen in Table 2.6, there has been a slow but steady increase in adult education levels since the 1960s. Included in these trends is more years of schooling in native-born versus immigrant Latinos and younger versus older individuals, and in Latinos more proficient in English (gender differences were not included in this profile because they were very small overall). At first blush, these descriptive data would seem to suggest that the scholastic problems of Latinos are basically due to lack of English skills and high immigration rates (e.g., over 40% of Mexicans in the United States are immigrants). Such reasoning is consistent with the immigrant model of assimilation that drives social (anti-immigrant) and educational (e.g., current efforts abolishing bilingual education) policies. Such simple explanations, however, do not come close to explaining the most glaring difference in Table 2.6: The large and persistent gap between Mexicans and Puerto Ricans on the one hand and Cubans and non-Latino Whites on the other. To better understand this discrepancy, Bean and Tienda (1987a) performed a series of regression analyses designed to assess the net effect of social class and Latino cultural variables on school success and failure. What these researchers consistently found was that cultural factors (i.e., limited English and immigrant status) do contribute to school failure, as expected, but only in combination with disadvantaged social class rooted in the acculturation histories of Latinos in the United States (reviewed in Chapter 1). That is, the effects of limited English and

56 7.6 9.8 8.4 11.6 10.7 8.0 11.0

3.6 7.1* 8.4 11.5 7.6 8.0 8.0

Foreign 6.4 7.5 8.4 11.6 8.0 8.0 11.0

Total 9.2 11.5 11.8 12.0 10.5 10.0 12.0

Native 5.6 7.9* 10.0 11.6 9.2 12.0 9.0

Foreign 8.2 8.2 10.0 11.7 10.0 10.0 12.0

Total

11.1 12.0 12.1 12.4 11.9 12.0 12.0

Native

6.1 9.2* 11.7 11.7 11.3 12.0 12.0

Foreign

9.1 10.0 11.7 11.7 11.8 12.0 12.0

Total

*Foreign refers to island born. Source: “Hispanics in the U.S. Labor Force” (pp. 280–337), by F. D. Bean and M. Tienda, 1987b, in F. D. Bean and M. Tienda (Eds.), The Hispanic Population of the United States, New York: Russell Sage Foundation. Reprinted with permission.

Mexican Puerto Rican Cuban Central/South American Other Hispanic Black Non-Hispanic White

Native

1980

2:09 PM

1970

2/5/07

1960

Table 2.6 Median Years of Schooling of the Adult Population Aged 25 and Over by Race, Hispanic Origin, and Nativity, 1960–1980

orga_c02.qxd Page 56

orga_c02.qxd

2/5/07

2:09 PM

Page 57

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

57

foreign-born immigrant status on school delay were overshadowed by family income and parental education. In fact, for Cubans, school delay was higher in children from homes that were monolingual English or English-dominant! For Mexican Americans, the probability of school delay decreased 2% for each yearly increment in parental education. Similarly, dropping out of high school was inversely related to family income yet generally unrelated to household language for Latinos overall. Thus, the gap between Mexicans and Puerto Ricans on the one hand and Cubans on the other cannot be explained by Spanish-language maintenance nor immigration rates because these background factors are shared by all three of these Latino groups. Where these groups differ is in their SES and historical conditions of acculturation (i.e., treatment) in the United States. Unfortunately, these informative analyses of U.S. census data are ignored in heated public and political debates about bilingual education. THE BATTLE

OF

BILINGUAL EDUCATION

Californians attempted to abolish bilingual education by passing Proposition 227 in 1999. The rationale is that such programs do not help immigrant children to learn English; they retard assimilation and, even worse, contribute to the “decay of the core parts of our civilization” according to the former speaker of the U.S. House of Representatives Newt Gincrich. Just as bold as Gincrich’s assertion is the opinion of bilingual education expert Hakuta (1986), who claims that such condemnations result from the fact that bilingual education affirms the legitimacy of non-English languages and cultures, which in turn threatens the high status of English and the domination of Whites over people of color. The latter assertion is consistent with the stratification perspective as well as the definition and history of bilingual education in America. Californians today would never imagine that the first California state constitution of 1849 was published in both Spanish and English and legislated that all state laws, degrees, regulations, and provisions were printed in both languages (Feagin & Booher Feagin, 1999). But since then, Spanish has been declared “foreign” despite the fact that it is an indigenous language that predates English in America. Another irony is that bilingualism has historically been equated with “mental confusion,” whereas research shows that advanced bilingualism promotes academic achievement (Moran & Hakuta, 1995). Worse yet, the so-called language deficiency of Mexican children was also the main historical rationale for segregating Mexican Americans in the Southwest and thereby stratifying their inferior education. Viewed in its historical context, the bilingual

orga_c02.qxd

58

2/5/07

2:09 PM

Page 58

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

education movement has been an effort to protect Latinos, and other nonEnglish-speaking children, from being pathologized, marginalized, and undereducated. As early as 1939, the Congress of Spanish Speaking Peoples denounced racist segregation and demanded that the bilingual needs of Mexicans be addressed by Spanish-speaking teachers, materials, and programs. But it took a series of demonstrations and protests by Mexican parents to eliminate the segregation of their children. For example, in Lemon Grove, California, Mexican parents, backed by the League of United Latin American Citizens, protested the placement of their children in “Mexican schools” and an appeals court ruling that the school district had the right to separate Mexican kids based on “their English language handicaps.” San Diego Superior Court overruled the appeals court. In 1946, 8 years before the landmark Brown v. Topeka Board of Education decision, which declared segregation illegal, the court in Mendez v. Westminster School District ruled that Mexican schools in this district were unconstitutional. But despite these victories, the punishment of children speaking Spanish was commonplace, eventuating in a series of civil rights laws passed to protect the human rights of non-Englishspeaking children. In 1974, the court in Lau v. Nichols ruled that inattention to the language needs of Asian and other English-limited children in California was a denial of their participation in public education. Bilingual education was recommended by the Office of Civil Rights as the best solution to this problem. But whereas most people view bilingual education as a way to transition children from their native language to English, it was originally intended to provide instruction in both languages in order to affirm and maintain native language and culture while simultaneously acquiring English and American culture (i.e., the bicultural model). Unfortunately, the majority of bilingual education programs have been transitional in design, reflecting deep resistance to legitimating languages such as Spanish or Chinese. Best-Case Scenario for Bilingual Education With regard to the effectiveness of bilingual education, we need look no further than the Cuban American experience to study the best-case scenario, which involved high U.S. investment in Latino bilingualism and biculturalism. In the early 1960s, the Ford Foundation funded an experimental bilingual education program in which equal numbers of Cuban refugee and non-Latino White children from a middle-class school district were instructed in both English and Spanish. Refugee Cuban teach-

orga_c02.qxd

2/5/07

2:09 PM

Page 59

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

59

ers, highly invested in the success of Cuban children, were hired to assist. Not only did White children learn an extremely valuable second language, but both groups of children also improved their reading scores (Hakuta, 1986)! In 1982, the U.S. Supreme Court ruled that all children will be provided an education and cannot be discriminated against on the basis of parent immigrant status. This is why former governor Pete Wilson’s California Proposition 187, passed by voters in 1994, was ruled unconstitutional in its intention to deny public education (and nearly all other human services) to the predominantly Latino children of undocumented Californians. L AT I NO P O L I T I CA L ( DI S ) E M P OW E R M E N T Latino political power is addressed in Chapter 10, but the topic is introduced here as an essential element of understanding the social stratification of Latino ethnicity and power. Historically, Mexicans in the Southwest and Puerto Ricans in New York have been victimized by many of the same kinds of explicit voting deterrents used against African Americans, such as poll taxes, literacy tests, gerrymandering, and outright intimidation. Current lack of participation is more a function of age, nativity, continuing poverty, and less explicit discrimination. For example, 35% of Latinos are too young to vote, and over 50% are ineligible noncitizens (Marger, 2000b). Further, the continuous immigration of Mexicans and the revolving-door migration of Puerto Ricans slow the development of political loyalties, interests, and invest ments. Finally, considering that political participation is largely a function of SES resources (i.e., time and money, relevant work experience), the current lack of political power on the part of Latinos is not that difficult to understand.

THE LATINO NATIONAL POLITICAL SURVEY One of the best sources of recent data on Latino political power comes from the Latino National Political Survey (LNPS), which was the first national probability survey of Mexican Americans, Puerto Ricans, and Cuban Americans in the United States. The LNPS randomly surveyed 2,816 adult Latinos in 40 primary sampling units in 28 metropolitan areas. This sample included 1,546 Mexican Americans, 589 Puerto Ricans, 679 Cuban Americans, and, for the sake of comparison, 598 European Americans from the same primary sampling units.

orga_c02.qxd

60

2/5/07

2:09 PM

Page 60

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

In Garcia’s (1997) analysis of LNPS findings, he begins by noting that 46% of Mexican Americans and 54% of Cuban Americans are ineligible to vote because they are either too young or aren’t citizens. All Puerto Ricans are citizens, but they are also younger than mainstream Americans. Table 2.7 shows Latino rates of voting activities relative to nonLatino Whites. As can be seen, Mexican and Puerto Rican rates of registration and voting are comparable but significantly lower than Cuban Americans’, which in turn are lower than Anglos’. This overall pattern of political participation is highly consistent with SES differences for all comparison groups. The high correlation between SES and political participation is especially evident for Puerto Ricans, who have voting rates as low as Mexicans even though all Puerto Ricans are citizens. In contrast, Island Puerto Ricans have much higher rates of registration and voting than mainstream Puerto Ricans (as well as all mainstream Americans!). Interestingly, Garcia (1997) also examined LNPS findings on involvement in Latino-focused political activities such as signing petitions, attending public meetings, writing letters or making phone calls to public officials, and contributing time or money to Latino-focused campaigns. He found that less that 10% of all Latinos surveyed had been involved in these types of activities and concluded that such activities depend on organizing and mobilization efforts that have limited success in lowresource communities.

Table 2.7 Patterns of Latino Political Participation Mexican Origin (%)

Puerto Rican (%)

Cuban (%)

Anglo (%)

Ever been registered to vote in the United States

76.0

73.0

82.0

89.0

Currently registered to vote in the United States

65.0

63.0

77.0

86.0

Voted in November 1988 elections

49.0

50.0

67.0

89.0

Voted for U.S. representative in 1986

36.0

32.0

51.0

61.0

Voting Activity

Note: Percentages represent proportion of Latinos who are eligible to be registered to vote (i.e., citizen, over 18 years). Noncitizens not included. Source: “Political Participation: Resources and Involvement among Latinos in the American Political System” (pp. 44–71), by J. A. Garcia, 1997, in F. C. Garcia (Ed.), Pursuing Power: Latinos and the Political System , Notre Dame, IN: University of Notre Dame Press. Reprinted with permission.

orga_c02.qxd

2/5/07

2:09 PM

Page 61

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

61

In his analysis of Latinos’ low to moderate political participation, Garcia (1997) examined the role of socioeconomic factors as well as politically relevant occupational skills and experience. Not surprisingly, he found that the various forms of political participation assessed in the LNPS (e.g., registration, voting, nonvoting political activities) were predicted by higher SES, higher age, being born in the United States, and possessing politically relevant work skills such as being involved in collective efforts to work on local problems. Garcia (1997) concludes that implications for future Latino political power are mixed. On the downside, because Latino SES continues to lag behind that of non-Latino Whites, considerable grassroots organizing and political mobilization on the part of willing Latino leadership will continue to be crucial in counteracting the negative effects of low SES on political participation. Many such efforts are described in detail in Chapter 10. Ironically, the current wave of antimulticulturalism and antiimmigration and the frequently nativistic political climate is one of the biggest motivators of future Latino political participation and activism! On the upside, the Latino political base will grow significantly in the next few years as this generally young group approaches a median age of 30 (political participation generally increases after 30), and naturalization rates are uniformly high across all Latino groups. Marger (2000b) notes that there has been a 50% increase in the number of elected Latino public officials since 1984, for a total of 5,500 at local, state, and federal levels. However, Latinos continue to constitute only 1% of all elected officials in the United States. CONCLUSION Whereas acculturation theory helps to explain the general historical dynamics of group-level dominance and subordination, stratification theory clarifies how a group’s general level of SES and consequent quality of life become institutionalized in many different ways and justified by mainstream narratives, values, and cherished myths. The historical and current roles of key institutions (e.g., educational, political, occupational) in stratifying society not only by human capital assets but also by race and ethnicity are compelling and elucidate how influential stigma and privilege continue to be in unfairly penalizing and rewarding different groups in society. Latinos continue to be overrepresented at lower levels of SES, with consequential psychosocial and health vulnerabilities. At the same time, slow but steady progress continues for U.S. Latinos despite frequent political backlash in the form of anti-bilingual-education ballot initiatives and anti-immigration policy deliberation at the national level. In addition

orga_c02.qxd

62

2/5/07

2:09 PM

Page 62

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

to high rates of work participation, retention of traditional Latino culture helps to push Latinos forward with occasional high-profile accomplishments, such as the recent election of a Latino mayor in Los Angeles, who represents the experiences and values of most local Latinos. L.A.’s First Latino Mayor (in 134 years) the Real Deal The election of Antonio Villaraigosa as mayor of Los Angeles in 2005 is a victory of immense significance for many different reasons: the size of both L.A. (the secondlargest city in the United States) and its Latino population (just under 50%), its historical precedence (first Latino elected as mayor of L.A. in 134 years), Villaraigosa’s ability to deftly weave an all too rare multicultural coalition to oust a sitting mayor, and the fact that Villaraigosa’s Latino credentials are impeccable. That is, Villaraigosa’s liberal-progressive values and politics truly reflect his being born in East Los Angeles and raised, along with his siblings, by his single-parent mother in poverty. His street credibility was honed by shining shoes and selling newspapers as a boy, tattooing “Born to Raise Hell” on his shoulder, and, like too many Chicanos, getting kicked out of one high school and dropping out of another. But his resilience would not deny him going back to finish high school, earning a bachelor ’s degree from the University of California, Los Angeles, and earning a law degree at night. Villaraigosa’s career included working as a union representative for African American public school workers and later as the director of the L.A. chapter of the American Civil Liberties Union. In 1994, he was elected to the California State Assembly and served as a highly effective speaker of the house who was able to broker agreements between rival factions. In the George W. Bush era of appointing only ethnic and racial minorities and women that mirror his ultraconservative political ideology, including the first Latino attorney general, Alberto Gonzales, and thus creating merely an illusion of diversity at the top, Villaraigosa’s life, values, politics, and victory bode well for the majority of U.S. Latinos, as well as the rest of America.

R EFER ENCE S Bean, F. D., & Tienda, M. (1987a). The educational standing of Hispanics: Signs of hope and stress. In F. D. Bean & M. Tienda (Eds.), The Hispanic population of the United States (pp. 233 –279). New York: Russell Sage Foundation. Bean, F. D., & Tienda, M. (1987b). Hispanics in the U.S. labor force. In F. D. Bean & M. Tienda (Eds.), The Hispanic population of the United States (pp. 280–337). New York: Russell Sage Foundation. Boswell, T. D. (1985). The Cuban Americans. In J. O. McKee (Ed.), Ethnicity in contemporary America: A geographical appraisal (pp. 95 –116). Dubuque, IA: Kendall/Hunt. Cordova, R. (1987). Undocumented El Salvadorans in the San Francisco Bay Area: Migration and adaptation dynamic. Journal of La Raza Studies, 1, 9–35. Cross, H. G., Mell, K. G., & Zimmerman, W. (1990). Employer hiring policies: Differential treatment of Hispanic and Anglo job seekers. Washington, DC: Urban Institute Press.

orga_c02.qxd

2/5/07

2:09 PM

Page 63

The Social Stratification of Latino Ethnicity, Power, and Social Welfare

63

Ehrenberg, R., Rosenberg, P., & Li, J. (1988). Part-time employment in the United States. In R. Hart (Ed.), Employment, underemployment, and labor utilization (pp. 256 –287). Boston: Unwin Hyman. Feagin, J. R., & Booher Feagin, C. (1999). Mexican Americans. In J. R. Feagin & C. Booher Feagin (Eds.), Race and ethnic relations (6th ed., pp. 291–335). Upper Saddle River, NJ: Prentice-Hall. Ferris, E. G. (1987). The Central American refugees. New York: Praeger. Garcia, J. A. (1997). Political participation: Resources and involvement among Latinos in the American political system. In F. C. Garcia (Ed.), Pursuing power: Latinos and the political system (pp. 44 –71). Notre Dame, IN: University of Notre Dame Press. Hakuta, K. (1986). Mirror of language: The debate on bilingualism. New York: Basic Books. Harrison, B. (1987). The impact of corporate restructuring on labor income. Social Policy, 18(2), 6 –11. Johnston, D. C. (2003). Big payday. In D. C. Johnston (Ed.), Perfectly legal: The covert campaign to rig our tax system to benefit the super rich—And cheat everybody else (pp. 45 –58). New York: Portfolio. Lau v. Nichols. 414 U.S. 563 (1974) Lenski, G. (1966). Power and privilege: A theory of social stratification. New York: McGraw-Hill. Marger, N. N. (2000a). Ethnic stratification: Power and inequality. In M. N. Marger (Ed.), Race and ethnic relations: American and global perspectives (5th ed., pp. 36 –68). Belmont, CA: Wadsworth. Marger, N. N. (2000b). Hispanic Americans. In M. N. Marger (Ed.), Race and ethnic relations: American and global perspectives (5th ed., pp. 282–321). Belmont, CA: Wadsworth. McIntosh, P. (1998). White privilege and male privilege: A personal account of coming to see correspondence through work in women’s studies. In M. L. Andersen & P. H. Collins (Eds.), Race, class and gender: An anthology (pp. 95 –105). Belmont, CA: Wadsworth. McLemore, S. D., Romo, H., & Gonzalez Baker, S. (2001). The golden door. In S. D. McLemore, H. Romo, & S. Gonzalez Baker (Eds.), Racial and ethnic relations in America (pp. 75 –107). Boston: Allyn & Bacon. Melendez, E., Rodriguez, C. E., & Figueroa, J. B. (1991a). Epilogue. In E. Melendez, C. Rodriguez, & J. B. Figueroa (Eds.), Hispanics in the labor force (pp. 289–299). New York: Plenum Press. Melendez, E., Rodriguez, C. E., & Figueroa, J. B. (1991b). Hispanics in the labor force: An introduction to issues and approaches. In E. Melendez, C. Rodriguez, & J. B. Figueroa (Eds.), Hispanics in the labor force (pp. 289–299). New York: Plenum Press. Mendez v. Westminster School District. 64 F.Supp. 544 (D.C. Cal. 1946), aff ’d, 161 F.2d 774 (9th Cir. 1947). Moran, C. E., & Hakuta, K. (1995). Bilingual education: Broadening research perspectives. In J. A. Banks & C. A. McGee Banks (Eds.), Handbook of research on multicultural education (pp. 445 – 462). New York: Macmillan.

orga_c02.qxd

64

2/5/07

2:09 PM

Page 64

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Rothman, R. A. (1999). Inequality and stratification: Race, class and gender (3rd ed.). Upper Saddle River, NJ: Prentice-Hall. Rothman, R. A. (2002). Inequality and stratification: Race, class and gender (4th ed.). Upper Saddle River, NJ: Prentice-Hall. Tatum, B. D. (1997). Why are all the Black kids sitting together in the cafeteria? New York: Basic Books. Telles, E. R., & Murguia, E. (1990). Phenotypic discrimination and income differences among Mexican Americans. Social Science Quarterly, 71, 682–696. Torres, R. D., & De La Torre, A. C. (1991). Latinos, class, and the U.S. political economy: Income inequality and policy alternatives. In E. Melendez, C. Rodriguez, & J. B. Figueroa (Eds.), Hispanics in the labor force (pp. 265 –287). New York: Plenum Press. U.S. Bureau of the Census. (1998a). Money Income in the United States, 1997 (CPR P60-200). Washington, DC: Government Printing Office. U.S. Bureau of the Census. (1998b). Poverty in the United States, 1997 (CPR P60201). Washington, DC: Government Printing Office. U.S. Bureau of the Census. (1998c). Statistical abstracts of the United States, 1998. Washington, DC: Government Printing Office. Zhou, M. (1997). Segmented assimilation: Issues, controversies, and recent research on the new second generation. International Immigration Review, 31(4), 1–22. Zweigenhaft, R. L., & Domhoff, W. D. (1998). Latinos in the power elite. In R. L. Zweigenhaft & W. D. Domhoff. Diversity in the power elite: Have women and minorities reached the top? (pp. 118–139). New Haven, CT: Yale University Press.

orga_c03.qxd

2/5/07

10:51 AM

Page 65

CHAPTER 3

Latino Ethnic Identity Psychological Impacts of Structured Inequality

THE SOCIAL SCIENCE frameworks of acculturation and adjustment in Chapter 1 and social stratification in Chapter 2 are valuable in helping us to understand the historical and continuing experiences of Latino populations in the United States, especially with respect to strained race relations, stigmatized ethnic minority status, and social-structural forms of racism and discrimination that ultimately disadvantage the majority of Latinos. But what are the individual-level, psychological, and emotional impacts of such group-level dynamics? More specifically, in what ways does being Chicano, Puerto Rican, Cuban, or Dominican affect one’s self-concept as a Latino or one’s ethnic identity? These are exceedingly complex questions with a wide variety of answers. There has accrued, however, a fair amount of literature on ethnic identity in Latinos and other racial/ethnic groups in America that is informative for conceptualizing key dimensions of identity, including healthy and less adaptive forms, as well as implications for intervening at psychological and social levels.

E T H N I C I DE N T I T Y In her exhaustive review of 70 published studies on ethnic identity, Phinney (1990) notes that very few studies actually bothered to define ethnic identity, although its importance was widely presumed. For the sake of this chapter, ethnic identity is defined as one of several role identities within the self-concept, each of which varies in importance depending 65

orga_c03.qxd

66

2/5/07

10:51 AM

Page 66

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

on the different contexts of a person’s experience. For example, role identities related to age group (child, adolescent, young adult, elderly, etc.), gender, and sexual orientation have tremendous psychosocial importance for the ways they structure our lives and how we are socialized to enact such roles (e.g., how we are socialized to be a child, male, or female). The term role identity is meant to convey both the internal psychological conception of self (e.g., artist) as well as associated external behaviors (e.g., artistic activities and productions). Given the various degrees of influence that role identities have in our lives, the self-concept is viewed here as consisting of a flexible hierarchy of role identities that vary and change over time, typically becoming more numerous and complex as we take on adult career and relationship roles (e.g., lover, wife, parent, professional), as well as other group memberships and activities (e.g., Democrat, record collector). T H E SA L I E N C E O F E T H N I C I DE N T I T Y Ethnic identity is important in the lives of ethnic minorities because of the way American society has historically socialized us to define, prejudge and perceive, and treat people of different racial and ethnic backgrounds. Given the negative stereotypic content and mistreatment historically associated with people of color, members of these groups continue to struggle with the meanings and feelings associated with their group membership and how to regard the ethnic component of self. That is, as the ethnic/racial component of self, ethnic identity is generally a force to be reckoned with given its potential influence on psychosocial adjustment. As a Chicano child growing up in East Los Angeles from the mid-1950s to the mid-1970s, the author can share an experience in which Chicanos were virtually absent from mainstream media such as television, newspapers, and magazines or were negatively characterized, on the rare occasions when they were represented, as gang members, prostitutes, bandidos ( bandits), and servile Sí señor peasants. Further, as with too many Latino barrios in the United States, ELA residents were predominantly poor and often struggling, whereas barrio-based police, firefighters, teachers, supermarket managers, and lifeguards were predominantly White. So, what’s a Latino child to conclude from such a social environment, too often without the positive role models or messages from parents and other trusted authority figures needed to instill pride, explain subordination, and inoculate one from distorted negative images, feelings, and conclusions about one’s ethnic group and self? Although societywide Latino representation has begun to expand con-

orga_c03.qxd

2/5/07

10:51 AM

Page 67

Latino Ethnic Identity

67

siderably, it remains inadequate, with problematic ethnic identity development too much of a possibility. T H E E T H N I C I DE N T I T Y C R I S I S O F “ H A N K ” Imagine a young Latino adult named Enrique who insists on being called “Hank,” which is short for Henry, the English translation of Enrique. He takes pride in speaking English with little if any Latino accent and of moving out of the barrio as soon as he could. He works in the software industry, and his coworkers and friends are predominantly White. He married an Anglo woman after years of dating exclusively White women and has a beautiful young son. Politically, Hank is very conservative and supports such initiatives as “English Only,” antibilingual education, anti-affirmative action, immigration and welfare reform, and U.S.-Mexico border control. When asked about the lingering social problems of Latinos, Hank says that they lack initiative and motivation, that their culture holds them back, and that they should spend more time learning to be like Anglos and less time complaining and depending on the federal government. Hank encourages his son to work twice as hard as Anglos to prove his worth. On the surface nothing is inherently wrong with this portrait of Hank (i.e., people have the right to their political opinions, loving whom they please, and living their own law-abiding lifestyle). But conversations with him reveal that he considers White women to be more physically attractive than Latinas, and all other women of color for that matter. More important, he also believes that marrying a White person is a sign of getting ahead and that his child is more attractive and smarter than Latino children because he is half White and being raised to be American in all respects and Latino in none. Hank’s friends from back home, and even some of his family members, say that Enrique wants to be White and that he is ashamed of his culture and family. Sometimes they feel resentful of him and call him a vendido, or sellout. On the infrequent occasions that he visits his family of origin, he often gets into heated debates about political issues or about how family members should be running their lives. There is something troublesome in this vignette, not because we don’t all have the right to live the life that we choose, but because some of our perceptions, feelings, behaviors, and lifestyles may be overly influenced by internalized racism and oppression. At the heart of such internalized oppression is an unnecessary and preventable dislike of one’s own racial or ethnic group and self, as well as the consequences of being socialized to believe in the inferiority of one’s ethnic group and the superiority of the dominant Anglo group.

orga_c03.qxd

68

2/5/07

10:51 AM

Page 68

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Many of us are capable of recognizing ethnic identity problems. They can be subtle, complex, energy draining, and ultimately debilitating. For example, one could imagine this vignette without the rejection of ethnic group and self. That is, a Latino marrying an Anglo could simply be a matter of mutual love and compatibility rather than bettering oneself, and finding Anglo women and friends attractive but not necessarily more attractive than women of color and Latino friends. Conservative political views can also be based sincerely on how one weighs both sides of political issues and arguments. For many progressive Latinos, it is tempting to dismiss conservative Latinos as Latino rejecting, partly because such views are overly welcomed and publicized by the dominant group that has become weary of minority “complaints.” That is, there are excessive rewards and attention for the Linda Chavezes and Ward Connerlys who espouse ultraconservative views and policies that perpetuate the status quo by essentially blaming minorities for their problems versus holding society accountable for its mistakes. Thus, understanding when beliefs and behaviors do and do not reflect ethnic identity problems is important in both our personal relationships and our professional work with clients and can be informed by a substantial amount of race and ethnic identity research and theory.

M I NOR I T Y S TAT U S A N D S E L F - E S T E E M : PR I DE OR S E L F - R E J E C T I O N ? CLASSIC THEORETICAL FOUNDATIONS Prior to the 1970s, most social scientists, as well as the public, assumed that because African Americans and other devalued minority groups were so negatively treated and stereotyped, they passively internalized these messages. Challenges to this national mind-set came from many scholarly sources, including a definitive review of the minority selfesteem literature by Wylie (1979), who found that presumptions of low self-esteem in African Americans could not be supported given the generally flawed methodology of previous work and the fact that race group comparisons generally have shown the self-esteem of Blacks to be equal to or greater than that of their White counterparts. But how can this be, when the social psychological principle of “reflected appraisal” has been used in past research to demonstrate that people appraised negatively by society eventually reflect or internalize such appraisals? How can this be, when the social psychological principle of “social comparison” explains low self-esteem in lower status people as a result of comparing themselves to people of higher status?

orga_c03.qxd

2/5/07

10:51 AM

Page 69

Latino Ethnic Identity

69

These questions were addressed by Rosenberg (1979) in his classic book Conceiving the Self, in which he demonstrated that the principle of reflected appraisal is valid only if four assumptions are met: (1) that a minority individual is aware of negative appraisals; (2) that the minority individual agrees with such appraisals; (3) that the individual considers the negative appraisals to be personally relevant; and (4) that the minority individual considers the appraisals of dominant society to be interpersonally significant or important. Rosenberg also demonstrated that the principle of social comparison does explain self-esteem but depends on to whom people compare themselves. Utilizing a sample of more than 5,000 public high school juniors and seniors from New York and just under 2,000 students from grades 3 through 12 from Baltimore city public schools, Rosenberg was able to impressively demonstrate the validity of his four assumptions, as well as clarify how the principle of social comparison operates: 1. Awareness: Rosenberg found that most White students were aware of the low ranking of Blacks in society, but most Black students were not. That is, when asked to guess where most people rank Blacks from among four racial-religious groups ( Jewish, White Catholic, Negro, White protestant), only 2% of Black children guessed “last” as compared to 72% of White students. It should be noted, however, that as Black children grew older, their rankings became more “accurate.” 2. Agreement: About 33% of White students considered Whites to be superior to Blacks in the areas of intelligence, good behavior, and honesty, as compared to only 8% of Blacks. In fact, the majority of Black students considered Blacks and Whites to be equal. 3. Personal relevance: Although he did not directly test personal relevance, Rosenberg found no differences in the self-esteem scores of the four groups of Black children who guessed that Blacks were ranked either first, second, third, or fourth by society. He also found no appreciable differences in the self-ratings of Black and White students on 21 positive characteristics (e.g., smart, good-looking, well-behaved, friendly). Thus, he concluded that it is possible for minorities to be aware of and even agree with their group’s stigma yet see themselves positively (i.e., as exceptions to the rule). For example, it is not unusual for some Latinos to make disparaging comments about other members of their ethnic group, such as recent or undocumented immigrants or those struggling with significant problems. When confronted by what appears to be self-disparagement, such people will often responded ¡Pero somos diferentes! (But we’re different!).

orga_c03.qxd

2/5/07

70

10:51 AM

Page 70

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

4. Interpersonal significance: Rosenberg examined the relationship between self-esteem and student ratings of how favorably they were perceived by significant others such as mothers, fathers, teachers, kids in class, brothers and sisters, and best friends. He found that 70% of Black children who perceived the attitudes of significant others as favorable also had high self-esteem, allowing him to conclude that Black children’s self-esteem was influenced more by the “interpersonally significant” appraisals of the important people in their life than the negative appraisals of dominant society. Still, as noted in Chapter 2, it’s difficult to diminish the power of dominant images and narratives from mainstream society that pervade our social environment and compete with the inconsistent messages of family and friends. 5. Social comparison: Interestingly, Rosenberg did find lower self-esteem in Black children attending predominantly White schools as compared to Black children attending predominantly Black schools, despite the fact that the integrated Black children had higher grades than their segregated counterparts. He concluded that when Blacks are a tiny minority in White schools, they most likely compare themselves to more advantaged majority Whites than to their less advantaged and segregated Black counterparts. Thus, the social psychological principle of social comparison can predict self-esteem depending on who the comparison group is. This is a noteworthy finding considering the frequency with which upwardly mobile minorities find themselves a tiny numerical minority in mainstream American settings (e.g., college campuses, professional work sectors, and networks). The potential impact of social comparison on self-esteem for such individuals will depend on how adaptively their ethnic identity serves them. The classic works of Wylie (1979) and Rosenberg (1979) are reviewed here to convey three important and durable points: (1) We cannot assume what the effects of ethnic minority status are on an individual member’s psychological adjustment, (2) we should be impressed with the extent to which ethnic minorities develop healthy ethnic identities in spite of mainstream messages about their group, and (3) it is important to understand the messages and circumstances that influence the development of ethnic identity in both negative and positive directions. T H E OR E T I CA L MO DE L S O F E T H N I C A N D R AC I A L I DE N T I T Y In their pioneering text, Counseling the Culturally Diverse: Theory and practice (4th ed.), Sue and Sue (2003a) address the issue of racial and ethnic

orga_c03.qxd

2/5/07

10:51 AM

Page 71

Latino Ethnic Identity

71

identity by introducing their racial/cultural identity development model (R/CID) based on past stage models of African American racial identity (Cross, 1978; Parham & Helms, 1981) and oppressed groups in general (Atkinson, Morten, & Sue, 1989). The R/CID is designed to describe the development of ethnic identity in all oppressed ethnic minority groups in the United States. Indeed, the authors assert that the R/CID can also be applied to Anglo-American racial identity development.

Table 3.1 Racial/Cultural Identity Development (R/CID) Model Stages of Minority Development Model

Attitude toward Self

Attitude toward Others of the Same Minority

Attitude toward Others of Different Minority

Attitude toward Dominant Group

Stage 1: Conformity

Selfdepreciating

Groupdepreciating

Discriminatory

Groupappreciating

Stage 2: Dissonance

Conflict between selfdepreciating and selfappreciating

Conflict between groupdepreciating and groupappreciating

Conflict between dominant-held views of minority hierarchy and feelings of shared experience

Conflict between groupappreciating and groupdepreciating

Stage 3: Resistance and Immersion

Selfappreciating

Groupappreciating

Conflict between feelings of empathy for other minority experiences and feelings of culturocentrism

Groupdepreciating

Stage 4: Introspection

Concern with basis of selfappreciation

Concern with nature of unequivocal appreciation

Concern with ethnocentric basis for judging others

Concern with the basis of groupdepreciation

Stage 5: Integrative Awareness

Selectiveappreciation

Selectiveappreciation

Selectiveappreciation

Selectiveappreciation

Source: From “Racial/cultural minority identity development: Therapeutic implications” (pp. 205–233), by D. W. Sue and D. Sue, in Counseling the culturally diverse: Theory and practice, fourth edition, D. W. Sue and d. Sue (eds.), 2003b, Hoboken, NJ: Wiley. Reprinted with permission.

orga_c03.qxd

72

2/5/07

10:51 AM

Page 72

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

As can be seen in Table 3.1, the R/CID model is a matrix consisting of five stages of minority identity development which are inferred from four corresponding sets of psychosocial attitudes toward oneself as a minority, one’s own minority group, other ethnic minority groups, and the dominant group. Sue and Sue (2003b) qualify that the five stages are continuous and blending, neither sequential nor irreversible, and that many individuals do not experience all five stages in their lifetime. Further, minority individuals may begin at any of the stages, depending on their parenting and socialization, and may even skip stages, forward or backward, depending on their life experiences. Despite such qualifiers, the R/CID and similar stage models have been criticized for being overly linear and typological. Nevertheless, it remains a handy introduction to the complex world of ethnic identity development. STAGE 1: CONFORMITY Ethnic identity problems are most evident in the conformity stage in which, in Rosenberg’s (1979) terms, members of oppressed minority groups are aware of, agree with, consider personally relevant, and consider interpersonally significant the negative perceptions and messages generated by the dominant group. Historically, such stereotypes have assaulted every conceivable dimension of a group’s humanity (e.g., intelligence, culture, behavior, physical appearance, sexuality). Melting-Pot Theory Conformity is reflected in the famous melting-pot theory of twentiethcentury America that was the guiding philosophy for socializing European immigrant groups for inclusion. Even diverse European immigrant groups were viewed as inferior to the American WASP-based amalgam of assimilation. Southern and Eastern European immigrants were especially mistreated and negatively stereotyped in ways that we continue to stereotype people of color (i.e., inferior intelligence and culture, criminal, dirty, clannish). It was the goal of social institutions to pressure immigrants to discard their inferior cultures, leave their ethnic ghettos, and assimilate or “melt” into American society. With regard to non-White minorities, Ramirez and Castañeda (1974) were among pioneering Latino scholars to clarify how the American melting pot was historically exclusive of non-Whites, creating marginalization by rejection even for those minority groups that might have exercised the assimilation option had it been available to them. Thus, people of color were the “wrong stock” for the American melting pot, and their stigma of race continues to be an immensely greater ob-

orga_c03.qxd

2/5/07

10:51 AM

Page 73

Latino Ethnic Identity

73

stacle than the stigma of ethnicity historically attached to European immigrants. In the vignette describing Hank, Latino cultural and physical markers (e.g., Spanish name, accent, skin color, Latino features, and affiliations) are sources of shame and embarrassment for Hank and are thus to be minimized and avoided. Hank has also bought into the idea that White people are physically, intellectually, and morally superior to Latinos and other people of color. Historically, the predominantly positive and normative representations of White people versus the mostly negative and abnormal portrayals (or lack of portrayals) of minorities contributed to a conformity mind-set, especially in the absence of contradictory images and messages regarding people of color. It is theorized that conformist minorities can never be fully psychologically adjusted because race and ethnically linked reminders are difficult to avoid or conceal. Even if one could conceal one’s race and/or ethnicity and “pass” for White, there remains the burden of expending energy to hide a dimension of self too frequently salient in the social psychological world. For example, Hank’s average Latino features often prompt majority Whites in his social world to ask him “What are you?” and to seek his opinions about Latino issues of the day (forced role taking). Hank views the problematic social position of Latinos and other people of color as a product of their own making. Such a belief denies social injustices and fails to challenge the status quo because it does not comprehend how powerful historical and social forces have dramatically and systematically shaped Latino realities, as described in Chapter 2. Most minority individuals who conform to the majority culture don’t consciously register self-rejection and may have other compensating identities and assets (e.g., Hank is an attractive guy with an outgoing personality, good athletic skills, and talented enough to succeed in the software industry). Awareness of internalized oppression would require ethnic identity development beyond conformity. In a penetrating personal exposé, Iwata (1991) reveals how self-rejection as an Asian American caused him to undergo blepharoplasty, a form of cosmetic surgery designed to transform almond-shaped Asian eyes into round Anglo eyes by removing some of the epicanthic fold of the upper eyelid to simulate double eyelids. Such cosmetic surgery is not that unusual among Asian Americans graduating from college and embarking on their career paths in mainstream America. Further, Iwata underwent rhinoplasty to give his relatively flat Asian nose “more definition.” Such needless surgeries are like the hundreds of thousands of nose jobs for which many Jewish and African American people are famous. When, on national television in the early 1990s, Oprah Winfrey asked Michael Jackson about surgical alterations to make him look White, he

orga_c03.qxd

74

2/5/07

10:51 AM

Page 74

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

insisted that he was a proud Black man. He also attributed his new white skin to a rare disease. But though he directly denied racial self-rejection, the pattern that has emerged suggests otherwise (i.e., marrying and having children with exclusively White women, straightening his hair, having a series of nose jobs, and showing off his supposedly diseased skin by wearing nothing more than a scant loincloth in his “You Are Not Alone” music video). The example of Michael Jackson is poignant for its illustration of the power of racial self-rejection in spite of immense artistic talents, riches, world fame, and pre-surgery good looks. As stated by Iwata (1991), ultimately nothing is more attractive than self-acceptance. STAGE 2: DISSONANCE Cognitive dissonance occurs when people in the conformity stage are exposed to experiences or information that contradicts their prejudiced socialization. “Disconfirmatory” experiences need not be directly experienced, as in the case of news stories or the negative experiences of others in one’s social environment. For example, Hank denied accusations of racial profiling until high-profile investigations and headlines substantiated such systemic problems. Even then, he reasoned that criminal Latino and African Americans provoke such action from exasperated police— until he was one day pulled over for “driving while Latino.” When he eventually complained about being stopped for no apparent reason, he was sternly put in his place under the threat of arrest and bodily harm. This minitrauma created a dilemma in which Hank’s overvaluing of the police competed with his ethnic-linked experience of discrimination. It should be noted that the dissonance created by Hank’s experience can be resolved by either recognizing discrimination previously denied, or by using a conformity explanation (i.e., Hank could blame his misfortune on bad Latinos who make the world worse for good Latinos like himself).

STAGE 3: RESISTANCE AND IMMERSION The hallmarks of this stage are resistance to and wholesale condemnation of the dominant culture along with a passionate, ethnocentric immersion into one’s culture of origin as a way of experiencing newfound ethnic pride and expressing anger at social injustice. Resistance and immersion are frequently exemplified by ethnic political activism, overvaluing of all things ethnic, and near total devaluation of the dominant group’s culture, history, and humanity, including harsh criticism and rejection of Latinos in the conformity stage, who are viewed as brainwashed Tío Tacos (Uncle Tacos, the Chicano version of “Uncle Tom”).

orga_c03.qxd

2/5/07

10:51 AM

Page 75

Latino Ethnic Identity

75

The author recalls that while growing up in East Los Angeles during the 1960s and 1970s, a Stage 3 piece of Chicano political literature claimed that the blue-eyed, white-faced Jack in the Box fast-food restaurant clown was oppressing Chicano people by staring down on the barrio from his perch on the corner of Brooklyn Avenue (now Cesar Chavez Avenue) and Mott Street in Boyle Heights (this was long before “Jack” starred in TV commercials as a talking, able-bodied, smart-aleck clown). Though humorous, this example is reminiscent of the Nation of Islam or Black Muslim rhetoric of White people as blue-eyed devils placed on earth to torture Black people. Such beliefs, though understandable, are overly reactive and fall into the racist trap of counter-dehumanization and Black supremacy (West, 1993). During the 1960s and 1970s, resistance and immersion at their extreme were best exemplified by the Brown Berets in the Chicano community and the Young Lords in the Puerto Rican community, both modeled after the Black Panther Party. These groups represented organized militant resistance that stirred fears in mainstream society of armed retribution that was occasionally provoked by the overreaction of the law enforcement and legal systems. More often, however, these groups generally organized marches and public demonstrations against discrimination well within their constitutional rights. The anger and activism of resistance and immersion can be politically productive and viewed as a healthy and logical departure from the ignorance of conformity or the confusion and paralysis of dissonance. However, this stage can also result in the problem of overresponding to all manner of provocation and insinuation of injustice versus fighting the good fight. For example, a Latino client once relayed a story to his social worker about speeding on a Texas highway with his Stage 3 brother, who overreacted to a patrolman who pulled the client over. Although disappointed to be cited, the client did not perceive the patrolman or the situation as unfair, given that he had been doing 80 miles per hour. His brother, however, whose strong dislike of police was rooted in a racist beating by police during his youth, looked menacingly at the ranger and began confronting him with angry questions, such as “What’s the problem here?” and “What law are we really breaking on this empty highway, anyway?” The client became quite anxious when the officer harshly reminded the brother that he was speaking to the driver and not him, and that he’d better mind his business. When the client’s brother persisted, the officer sternly stuck his head partially into the driver’s window and warned him that if he did not shut up, he would arrest him for interfering. The client promptly pleaded with his brother to allow him to handle the situation. The

orga_c03.qxd

76

2/5/07

10:51 AM

Page 76

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

brother has an impressive record as a community organizer and advocate for Latino rights. However, he appears to be susceptible to overresponding to cues and situations perceived as race-linked that, even if they are, may not be worth the fight. STAGE 4: INTROSPECTION This pensive stage of development involves looking within and seriously questioning the basis for one’s idealized attitudes toward one’s own and other ethnic groups, as well as one’s overdevaluation of the dominant group. Such personal analyses typically result in more balanced and fairer assessments of the negatives and positives in all groups. For example, although majority Whites have exercised excessive racist power historically, they have also promoted a democratic ideal and vision for the world, in addition to creating a technologically advanced, modern nation to which people want to belong. The twentieth century was undoubtedly the American century, and it is precisely for this reason that Latinos and other ethnic minorities continue to believe in the American dream despite race-linked obstacles to its full realization. Holding society accountable is ultimately a patriotic act designed to advance the democratic ideals of America. Latinos in the introspective stage recognize that though they have many wonderful culture-based values and practices, there are also elements that need to change or to be discarded in order to progress in a healthier manner, for example, extreme forms of machismo that are oppressive to women and homophobia resulting in the rejection of family members and friends. Thought is also given to shaping one’s own identity in a less reactive (e.g., feeling obligated to serve Latinos in Stage 3) and more proactive (feeling free to address other causes beyond Latinos) manner. Many successful Latinos are frequently reminded by Latino advocates of their “obligation” to give back to Latinos and the community; perhaps a better motivator is one’s own personal desire to address injustice within the Latino experience and beyond. STAGE 5: INTEGRATIVE AWARENESS There’s something inherently funny about this stage’s portrayal of such a highly evolved, advanced, almost cosmic humanistic stage of identity development. Partly, this has to do with integrative awareness being perceived as an end state of enlightenment rather than a keenly conscious and responsive place from which to operate in a society characterized by both

orga_c03.qxd

2/5/07

10:51 AM

Page 77

Latino Ethnic Identity

77

democracy and social injustice at various levels both within and outside of the individual. Individuals with integrative awareness are described as taking social justice issues to the highest level by addressing human rights for all oppressed groups. The example of Martin Luther King publicly opposing the Vietnam War is instructive for the criticism that it drew from Black activists who feared that not focusing on the Black agenda would dilute King’s time and energy. Although the logic of this criticism makes sense from a resistance and immersion perspective, it is inherently reactive and limiting. Individuals at this more developed level are also critical of oppression within their own group, such as sexism and homophobia, that are viewed as dehumanizing and divisive. There is also faith that because majority Whites are human, they can rise to the occasion and become allies, while not minimizing the obstacles to this challenge. Proactive personal development attempts to integrate a variety of overlapping identities, such as being Latino, American, and a human being. Such development is reflected in more autonomous choices, ranging from lovers and friends to occupational calling. Herein lies the dilemma of trying to gauge someone’s level of ethnic consciousness by merely observing social affiliations, career paths, and political behavior. Stage 5 individuals may be viewed with suspicion and confusion, yet they are empathic and understanding of such views and work to form alliances between factions within their ethnic group, as well as between their ethnic group and other minorities, and the dominant group. SO WHERE DOES RICHARD RODRIGUEZ FIT

INTO THE

MODEL?

The R/CID model reflects enough of the ethnic identity puzzle to be a useful starting place. But the fact that people are too complex to simply fit into, or move between, five ethnic identity types becomes evident when we ponder ourselves or people we know, or consider in which stage someone like writer Richard Rodriguez would fall in this model. Rodriguez is an American of Mexican ancestry who claims that human beings are “fluid” with everyone they encounter, whether real or fictional. For example, he claims to be Chinese while riding the bus through Chinatown in San Francisco and even imagines himself as a woman giving birth while pondering this miracle. Rodriguez’s artistic worldview and fundamental rejection of simple social categories of people are a sobering reminder of our basic humanity and potential freedom to construct ourselves in creative ways (integrated awareness?). In his acclaimed and controversial book Hunger of Memory: The Education of Richard Rodriguez, Rodriguez (1982) eloquently describes his process of

orga_c03.qxd

78

2/5/07

10:51 AM

Page 78

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

assimilation while eschewing affirmative action, bilingual education, and ethnic identity politics along the way. You’ve got to admire Rodriguez’s unshakable insistence on his claim to America and its enchantments, but does this reflect integrated awareness or something beyond? In an intriguing book entitled Postethnic America, David Hollinger (1995) similarly advocates “cosmopolitanism” as a freer and more fluid alternative to multiculturalism and what he considers to be its limiting identity politics. In his view, people now have the opportunity to form freer, less forced affiliations and can creatively experiment with multiple identities and “ethnic options” to emphasize ethnicity and other identities as they please. But however alluring the stories and visions of Rodriguez (1982) and Hollinger (1995), they need to be balanced with the sobering realities of persistent stigma and the oppression of various groups in society whose human potential, fluidity, and options remain severely constrained. For example, how fluid and free are Latino youth gang members whose maladaptive response to marginality too often pins their lives between rival gangs, prisons, and the cemetery? And though Richard Rodriguez may indeed be speaking about something that he considers radically above identity politics, he is far too smart not to realize that his immense popularity among majority Whites comes from how conveniently his antibilingual education and anti-affirmative action views fit into their conservative identity politics! The visionary scenarios described by Rodriguez and Hollinger ultimately depend on freedom and social justice extended to all groups in the United States. Hollinger confuses multiculturalism and ethnic identity politics for movements that advance pluralism or even nationalism, when such movements have generally sought to advance civil and human rights (i.e., full inclusion) and ultimately the freedom needed to make his vision a truly viable option. RESEARCH

ON

ETHNIC IDENTITY DEVELOPMENT

Despite the limitations inherent in stage models of ethnic identity development, there is some empirical evidence that higher stages are associated with better psychological adjustment. For example, research shows higher levels of self-esteem in Mexican American, African American, and Asian American adolescents (Phinney, 1989) and minority college students (Phinney & Alipuria, 1990) at higher stages of ethnic identity development, in which they have actively grappled with negative racial and ethnic messages and have come to a decision about who they are with respect to this domain of self-concept. With this in mind, we can

orga_c03.qxd

2/5/07

10:51 AM

Page 79

Latino Ethnic Identity

79

turn to empirical research on the complexity of ethnic identity in Latinos and others. A N E M P I R I CA L MO DE L O F C H I CA NO E T H N I C I T Y Keefe and Padilla (1987) developed an empirically derived model of Chicano ethnicity that impressively demonstrates the complex, multidimensional, linear, and nonlinear nature of both ethnicity and the process of acculturation. Based on a review of past research, these researchers theorize that ethnic identity and acculturation are related but separate processes and that cultural change occurs at different rates across different cultural dimensions (e.g., language, social affiliations, self-identifications). Further, they theorize that ethnic identity is composed of two distinct developmental dimensions: (1) cultural awareness (CA), which refers to more objective knowledge of one’s culture of origin, such as the ability to speak Spanish, knowledge of Mexican values, history, and traditions, and cultural heroes, as influenced by parents’ and spouse’s backgrounds as well one’s own; and (2) ethnic loyalty (EL), which refers to more subjective feelings of ethnic-related pride, preferences in social affiliations, and perceived discrimination. Keefe and Padilla then developed a questionnaire to assess CA and EL and administered it to a stratified random sample of 370 Chicanos in southern California. Factor analysis of the questionnaire data revealed that CA and EL did indeed emerge as the two major dimensions comprising ethnic identity. CULTURAL AWARENESS, ETHNIC LOYALTY, AND GENERATION THE UNITED STATES

IN

An examination of CA and EL over time in the United States reveals that CA drops sharply from the first to the second generation, and then steadily declines from the second to the fourth generation. In contrast, EL drops somewhat from the first to the second generation but then remains stable from the second to the fourth generation (see Figure 3.1). Thus, although Chicanos lose much of their Mexican culture from one generation to the next, they retain pride in and preference for members of their own group while continuing to perceive discrimination. This finding suggests that the development of ethnic identity in Chicanos is heavily influenced not so much by retention of Mexican culture, as many believe, but by ethnic minority status in the United States with its characteristic segregation (i.e., limited in affiliation choices) and discrimination

orga_c03.qxd

2/5/07

10:51 AM

Page 80

Cultural Awareness and Ethnic Loyalty Score

60

50 Ethnic Loyalty

40

Cultural Awareness

30 1

2

2M

3

4

Generation

Figure 3.1 Cultural Awareness and Ethnic Loyalty by Generation in Chicanos. (Note: 2M refers to having one first-generation parent and one second-generation parent. From Chicano Ethnicity, by S. E. Keefe and A. M. Padilla, 1987, Albuquerque: University of New Mexico Press. Adapted with permission.)

and the need to accentuate ethnic pride often as a defense against stigma, as well as a political vehicle for civil rights or identity politics. Whereas high EL can be helpful in fueling identity politics as well as Stage 3 cultural explorations, ethnic identity void of sufficient cultural content can be a vulnerability when opportunities to integrate or assimilate into mainstream society are limited. For example, many Chicano gang members claim intense ethnic pride, loyalty to their own, and perceived discrimination, yet their brown-on-brown violence betrays labels and symbols with too few prosocial adaptive cultural elements to prevent acting out their psychosocial marginality. THE LINEAR AND NONLINEAR NATURE

OF

ETHNIC IDENTITY

Linear Ethnic Identity Types A cluster analysis of their data allowed Keefe and Padilla (1987) to derive five Chicano ethnic identity types based on different combinations of CA and EL scores. As can be seen in Table 3.2, Types I, III, and V conform to a linear model of ethnic identity development in that their respective CA and EL scores are high, average, and low. That is, the high CA and EL scores of Type I describe Chicanos generally low in acculturation and 80

14 86 14 0 74 14 8 4

25 79 12 9 74 16 10 0

30 33 23 14

18 58 24

35

Type III (N = 129) CA EL Average Average

26 23 37 14

16 63 21

21

Type IV (N = 78) CA EL Medium Low Medium Low

5 37 42 16

0 22 78

05

Type V (N = 19) CA EL Low Medium Low

From Chicano Ethnicity, by S. E. Keefe and A. M. Padilla, 1987, Albuquerque: University of New Mexico Press. Adapted with permission.

Percentage of sample Generation First Second Third Education 0–8 grades 9–11 grades 12 grades College

Questionnaire Scores

Type II (N = 50) CA EL High Average

10:51 AM

Type I (N = 94) CA EL High High

2/5/07

Table 3.2 Empirically Derived Model of Chicano Ethnic Identity Based on Cultural Awareness (CA) and Ethnic Loyalty (EL) Questionnaire Scores

orga_c03.qxd Page 81

Latino Ethnic Identity 81

orga_c03.qxd

82

2/5/07

10:51 AM

Page 82

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

with high identification with their ethnic group. In fact, correlational analysis reveals Type I Chicanos to be mostly first-generation, low SES, and barrio-dwelling. However, almost 10% of Type I Chicanos were thirdgeneration, with many years in the United States! At the other extreme, the low CA and EL scores of Type V describe Chicanos high in acculturation or Anglicized with low knowledge of or connections with their ethnic group. Correlational analysis reveals Type V to be predominantly third-generation or higher, out of the barrio, and of slightly higher SES than all other types. Type III is the most common ethnic identity type (i.e., 35%), with average scores on both CA and EL, representing the most bicultural participants. Indeed, Type III Chicanos are mostly second-generation, with higher SES than Types I and II. Nonlinear Ethnic Identity Types But here’s where it gets messy (and closer to real life): In contrast to Types I, III, and V, Types II and IV conform less to a linear model of Chicano ethnic identity. That is, the 14% of respondents that compose Type II had high CA scores like Type I, yet had average EL scores like Type III. As such, they were low in acculturation yet not highly identified with their ethnic group despite having low SES and being barriodwelling. Similarly, 21% of Chicanos are categorized as Type IV because of below-average scores on both CA and EL. Like Type III, Type IV individuals are mostly second-generation, but they are also higher in SES, out of the barrio, and more likely to be Protestant than Catholic. Interestingly, 16% of Type IV Chicanos are first-generation! Thus, Keefe and Padilla’s (1987) empirically derived typology demonstrates the existence of linear trends in ethnicity related to acculturation as well as nonlinear exceptions. More research is needed to better understand how such ethnic identity types self-identify and function in different social situations and roles.

T OWA R D I N C R E A S I N G LY C OM P L E X C O N C E P T UA L I Z AT I O N S O F R AC I A L A N D E T H N I C I DE N T I T Y Recent theory and research on racial identity in African Americans by Sellers, Chavous, and Cooke (1998) describes how various cognitive structures and situational factors influence how people think and feel about being Black and how they might actually behave and perform in situations that suddenly become racially charged.

orga_c03.qxd

2/5/07

10:51 AM

Page 83

Latino Ethnic Identity

83

COGNITIVE STRUCTURES With regard to cognitive structures, centrality refers to how central racial or ethnic identity is within a hierarchy of identities that compose an individual’s self-concept. Regard refers to an affective evaluation of one’s own group. More specifically, public regard refers to one’s sense of how society views one’s group; private regard refers to one’s personal evaluation of oneself as a group member. Ideology refers to political beliefs about the most desirable direction for one’s group in society, including assimilation, Black nationalism, building coalitions with other groups to fight oppression, and humanism in which race has low centrality either because one is highly developed or because one is defending against stigma. Surely there is plenty of room for other ideologies (e.g., integration) as well as uncertainty (e.g., as discussed in Sue & Sue’s, 2003b, dissonance and introspection stages). Cognitive structures mediate the relation between social situations and responses to them on the part of people of color and stigmatized groups more generally. Such situations vary in terms of how important or salient race/ethnicity is. SALIENCE In addition to cognitive structures, Sellers et al. (1998) use the term salience to convey the fluctuating importance of race or ethnicity in different social situations. That is, race is not uniformly salient but is situationally important, as when a particular situation or interaction invokes race. For example, poor service in a restaurant could be an indiscriminant problem for all customers or it could be aimed at African Americans, as in the recent case of Denny’s restaurants. Thus, one’s perception of a situation as race-linked or not, and to what degree, is influenced by the interaction of cognitive structures and the particular situation. In the case of Denny’s, African American customers organized to file a class action suit that resulted in public apologies, financial compensation, and managerial policies designed to reduce discrimination. So how might the thinking of Sellers et al. (1998) play out with Latinos? With regard to our vignette, Hank’s identity as a Latino would be low in centrality, but not because of advanced humanism given his conformist ideology. Hank’s public regard would justify society’s negative view of Latinos, and his private regard would either view himself as an exception to his ethnic group or as marked and needing to compensate for it. How Hank would react to Latino salient situations would depend on complex interactions between such situations and his cognitive structures. For example, when his White peers ask him what he is or seek his opinion on Latino issues, Hank is liable to be annoyed by these reminders of his

orga_c03.qxd

84

2/5/07

10:51 AM

Page 84

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

ethnicity because of its low centrality and his efforts to blend in with White affiliates. If pressed, he might quickly mention his Latino background and spend more time emphasizing his American side and lifestyle. He might also publicly blame Latinos for their social problems with a mix of disgust and perhaps embarrassment. The work of Sellers et al. (1998) is a sober reminder of the complexity of ethnic identity with its many cognitive structures that interact with situations to influence feelings, perceptions, and the behaviors of ethnic minority people. Unfortunately, situations that invoke stigma related to one’s race, ethnicity, or gender can actually impact the performance of people. T H E R E A L - L I F E I M PAC T O F S T E R E O T Y PE S Let’s say you’re a member of a minority group who is committed to performing well on tests of ability in areas in which your group has traditionally been stereotyped as inferior (e.g., women in math and physical sciences, African Americans and Latinos on standardized tests, Asian Americans in majors other than math and science). How can such stereotypes hurt your performance when you don’t believe them to be true? In his research on what he calls “stereotype threat,” Steele (1997) has demonstrated that in important performance situations where such stereotypes are invoked, even subtly, minority performance can suffer. For example, Steele administered a challenging math exam to academically matched male and female college students who were strongly identified with mathematics (e.g., math majors). In one condition, the test was introduced as being able to detect sex differences; in another condition it was not described as such. Results showed significantly poorer performance on the part of women in the sex-primed condition, yet no significant differences in the nonprimed condition. Steele and Aronson (1995) demonstrated comparable results when they administered a verbal GRE test to African American and White college students at Stanford University. In the race-primed condition, the test was presented as diagnostic of intelligence and students were asked to indicate their race on the test form; in the nonprimed condition, no such description or request was made. Steele (1997) concludes that institutionalized racism and sexism can undermine identification with school and performance in areas important to even qualified women and minority students. Whereas school disidentification may protect self-esteem in the face of chronically experiencing low expectations, it can also result in a lack of sustained motivation in important performance situations where such expectations fill the air. Steele’s work does much to explain continuing performance gaps

orga_c03.qxd

2/5/07

10:51 AM

Page 85

Latino Ethnic Identity

85

between majority and minority individuals in educational performance, even on the part of equally qualified women and minorities. It also alerts us to the real and pernicious impact of stereotypes on various important forms of work and performance. W H I T E R AC I A L A N D C U LT U R A L I DE N T I T Y A N D T H E N E W C R I T I CA L W H I T E S T U DI E S It is now understood that it is impossible to speak of minority identity without implying its counterpart, majority identity. There has been a recent shift toward directly analyzing who White Americans are in the racial identity mix, and why it is they think they do not have much of an “ethnic” identity despite their historical insistence on labeling and categorizing ethnic minority groups. The term critical White studies has recently emerged to describe a growing trend toward analyzing and de-centering Whites in the discussion of race relations so as to highlight their historically dominant role toward minorities and to render them amenable to study under the microscope, the same as minorities. In her widely cited article, McIntosh (1988) generated a long and revealing list of 46 different ways in which White privilege makes life better for her as a White person and worse for Blacks with whom she has worked on a daily basis, in ways she was socialized not to notice. Among the 46 instances of White privilege she cited in her autobiographical article are the following: • I can turn on the television or open to the front page of a newspaper and see people of my race widely and positively represented. • I can be reasonably sure that if I ask to talk to “the person in charge,” I will be facing a person of my race. • I can go home from most meetings or organizations I belong to feeling somewhat tied in, rather than isolated, out of place, outnumbered, unheard, held at a distance, or feared. • I can worry about racism without being seen as self-interested or selfseeking. • If my day, week, or year is going badly, I need not ask of each negative episode or situation whether it has racial overtones. • I can be pretty sure that my children’s teachers and employers will tolerate them if they fit school and workplace norms; my chief worries about them do not concern others’ attitudes toward their race. • I can do well in a challenging situation without being called a credit to my race. • I can be sure that if I need legal or medical help, my race will not work against me. • I can be late to a meeting without having the lateness reflect on my race.

orga_c03.qxd

86

2/5/07

10:51 AM

Page 86

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Even more important than McIntosh’s (1988) now famous list is her explanation of how members of the dominant group are socialized, directly and indirectly (i.e., indoctrinated), to be “oblivious” to their race privilege, and how such lack of awareness serves to perpetuate a biased status quo. That is, the White experience in America is one that generally recognizes, reflects, validates, and supports its members. From the overrepresentation of Whites in virtually all social positions of power to their predominance in popular cultural media, theirs is a world that largely elicits comfort, security, and confidence, as opposed to the disproportionately high discomfort, alienation, and insecurity experienced by too many people of color. That is, America generally is “as advertised” for Whites, whereas minorities more frequently experience false advertising. Frankenberg (2000) refers to Whiteness as an “unmarked” racial category and to White people as the “unmarked markers of others” for their historical practice of labeling and defining non-Whites while assuming themselves to be the desirable central racial norm. This colonial practice conveys immense privilege and an inverse relation between how well defined an ethnic identity is and its degree of power in America. That is, Whites have historically been an unexamined norm (Tatum, 1997). Frankenberg also asserts that progress in race relations must include decentering and de-norming White Americans by insisting that they are also a cultural group, despite historical homogenizing forces. A CLOSER LOOK AT PRIVILEGE Johnson (2001) suggests how Whites can avoid the trap of feeling defensive about their race privilege by explaining that privilege has nothing to do with who one is as a White person, and that belonging to a privileged group does not automatically make one an oppressive person. Further, it is important to realize that one can be privileged without feeling privileged. For example, there are plenty of poor and working-class Whites in America whose daily experience would make them balk at the idea of being advantaged in any way. Yet compared to Blacks and other nonWhites within the same social class, their lives are better on average because they are free of race stigma and its impediments. This point easily escapes the awareness of poor Whites because they usually do not use Blacks or poor Latinos as their basis of social comparison (i.e., they make negative social comparisons to higher SES Whites). Interestingly, about the only time Whites bother to compare themselves to ethnic minorities is when the latter become beneficiaries of affirmative action. The irony of such a comparison is that Whites feel threatened and resentful because they perceive minorities as receiving an unfair advan-

orga_c03.qxd

2/5/07

10:51 AM

Page 87

Latino Ethnic Identity

87

tage akin to privilege. There’s no awareness of how being privileged by race has historically given Whites the ultimate unfair advantage in America versus how affirmative action has produced only minuscule numbers of minorities in power positions and no significant displacement of Whites from the power structure. On the other hand, some Whites see affirmative action as a necessary extreme solution to an extreme problem and also see both themselves and society as the beneficiaries of enhanced diversity and social justice at all levels of society. APPLYING THE RACIAL/CULTURAL IDENTIFY DEVELOPMENT MODEL TO WHITE IDENTITY DEVELOPMENT Sue and Sue (2003c) assert that the R/CID should also be used to analyze racial identity development in majority group White Americans. Although the dominant group has no history of racial oppression in the United States, Sue and Sue maintain that Whites can experience a parallel form of racial identity development ranging from White conformity to White multiculturalist identity: 1. White conformity: Whites are viewed as overwhelmingly socialized within Stage I, where there is little questioning of the status quo (i.e., social stratification of race, ethnicity, and power) because the generally higher social positions of Whites and generally lower positions of ethnic minorities are attributed to individual-level, internal factors such as intelligence, hard work, and cultural values, as opposed to external social factors such as racism and discrimination. Thus, inequities between Whites and others are viewed as normal and natural. Indeed, White culture is experienced as central and normal, and different cultures are viewed as deviations. Vaguely aware of past and continuing racism, White Americans in the conformity stage generally minimize the intensity of its legacy and do not perceive themselves as personally responsible for racism, even though they have inherited the advantages of this legacy. Tatum (1997) asserts that whereas it is the task of oppressed minorities to resist and challenge racism and to try to develop positive identities, it is simultaneously the task of Whites to develop a nonracist, reality-based identity that requires letting go of a distorted view of themselves as superior and as having earned all that they have accumulated. This requires a complete view of racism, not just as occasional blatant acts on the part of mean individuals but as an entrenched social, cultural, institutional system that differentially rewards and punishes different categories of people.

orga_c03.qxd

2/5/07

88

10:51 AM

Page 88

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

2. White dissonance: In Sue and Sue’s (2003c) dissonance stage, information and experiences that disconfirm the perceptions of conformitystage Whites cause them to question their socialization around racial inequality and White superiority. Awareness of one’s own membership in the privileged race group sometimes elicits feelings of guilt and shame, although ultimately these are unhelpful emotions in the quest for human rights. Although dissonance sets the stage for progression into a White version of resistance and immersion (Stage 3), it is important to note that the subjective discomfort of dissonance can potentially cause Whites to minimize the truth and retreat into their privileged White experience with rationales such as “It can’t be that bad,” “There’s really nothing I can do about it,” and “It’s not really my problem.” But retreating is yet another option within the invisible knapsack of privilege. That is, whereas people of color must deal directly with the White experience on a daily basis, Whites can generally avoid and minimize their interactions with people of color. In addition to the option of withdrawing from dissonance, Whites at this stage also run the risk of overresponding to the racism all around them and sometimes alienating other Whites in the process. In her revealing book The Education of a WASP, Lois Stalvey (1989), herself a majority American, describes how becoming aware of, discussing, and taking action against racism frequently alienated her majority White friends and neighbors who could not imagine why she was bothering with such issues that they viewed as irrelevant to their comfortable lives. Tatum (1997) discusses Whites at the dissonance stage as tending to get frustrated and angry at people of color for supposedly bringing on their own problems. There’s an urgent sense that people of color should change and “get with the program” as well as an insistence that everybody is an individual, overlooking the fact that Whites are uniquely privileged to make such a claim. Part of the distress this stage engenders for Whites is a growing awareness that their prideful well-being and accomplishments were obtained partly by race privilege and not solely by their individual efforts and abilities. 3. White resistance and immersion: In Sue and Sue’s (2003c) resistance and immersion stage, Whites become angry about their biased socialization and begin to devalue their group while idealizing minorities, with whom they sometimes overidentify. Although this stage represents significant growth on the part of Whites, Sue and Sue caution that some in this stage get caught up in a “White liberal

orga_c03.qxd

2/5/07

10:51 AM

Page 89

Latino Ethnic Identity

89

syndrome” in which their guilt-driven efforts to help minorities are unintentionally paternalistic in nature. Such paternalism is viewed as part of the White script to take charge, especially where the affairs of people of color are concerned. The author recalls being in high school during the early 1970s when a group of Anglo college students were sent to Roosevelt high school to enrich our poor East Los Angeles public school curriculum. These talented students did indeed enhance the modest course offerings with advanced arts and science classes and activities, but we slick continental-style dressers were a bit shocked when they arrived on the scene dressed in ponchos and guarachi sandals! We couldn’t articulate it at the time, but they were overidentifying with an off-putting stereotype of Mexicanness despite their otherwise good deeds and intentions. 4. White introspection: For Whites, introspection is a way to question the basis of their wholesale rejection of their own majority group, including themselves, as well as their overidentification and occasional valorization of minorities. It is a way to more fairly evaluate both majority and minority groups, to begin to reject racism in all groups, and to distill the best elements in each. Tatum (1997) describes the need to advance beyond White guilt and shame and the role of victimizer or oppressor. Such growth requires a search for White allies, historical as well as contemporary, fictional as well as real. Sometimes there is a need to vent to other Whites about how genuinely challenging it is to be an antiprivilege, multiculturalist White person, especially when such expressions of pain fall on the deaf ears of minorities whose larger race-linked pains make it difficult, and sometimes impossible, to hear and validate such legitimate White suffering. Ignoring the pain of Whites struggling with their racial development is often seen as giving them a taste of their own medicine, yet such reactions do not advance multicultural alliances. One of the fundamental shifts for Whites in this stage of development is a refocusing of energies from helping poor minorities to challenging the institutional racism and inequality in one’s own daily life. 5. White integrative awareness: In this advanced stage Whites develop a nonracist White identity that actively explores the best in White culture while not denying racism and effectively ending one’s paralysis to do something about it. There is also selective appreciation for the humanistic values in all cultures. Privilege is properly viewed as damaging to Whites and society for the distortions that it creates regarding social inequalities, beliefs about who merits reward and support and who does not, and how it perpetuates inequality.

orga_c03.qxd

90

2/5/07

10:51 AM

Page 90

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH Tatum (1997) refers to this stage of development as a basis for authentic cross-group alliances that ultimately promote human rights and a fairer world. She reminds us that this stage is a work in progress because salient race-linked situations can unexpectedly trigger primitive, counterproductive reactions in diverse people. Still, this advanced stage is characterized by fewer negative reactions to uncomfortable race-linked experiences. The bottom line is no longer denying the ever-present effects of group memberships. CONCLUSION

How does all this theory and research on ethnic identity play out in the lives of women as compared to men, or in the lives of sexual minorities? How does Latino ethnicity become complicated by within-Latino diversity, such as being a racially Black Latino (e.g., from Puerto Rico, Cuba, Dominican Republic, or Panama)? And where do Latinos of mixed racial and ethnic heritage (e.g., Latino and Anglo or Latino and African American) fit into the racial/cultural minority identity puzzle? These questions are beginning to emerge with increasing frequency and intensity and deserve our attention as service providers, researchers, and simply as people. Though potentially deeply influential, ethnic identity is but one dimension of the self-concept, coexisting and often evolving alongside so many other identities and roles in our complex lives. The next chapter considers how other human status dimensions and identities, such as gender and sexual orientation, play out in the lives of American Latinos, as well as other salient dimensions receiving greater attention these days. R EFER ENCE S Atkinson, D. R., Morten, G., & Sue, D. R. (1989). Counseling American minorities: A cross-cultural perspective (3rd ed.). Dubuque, IA: Brown. Cross, W. (1978). The Thomas and Cross models of psychological nigrescence: A literature review. Journal of Black Psychology, 4, 13 –31. Frankenberg, R. (2000). Whiteness as an “unmarked” cultural category. In K. E. Rosenblum & T. C. Travis (Eds.), The meaning of difference: American constructions of race, sex and gender, social class, and sexual orientation (3rd ed., pp. 92–98). Boston: McGraw-Hill. Hollinger, D. A. (1995). Postethnic America: Beyond multiculturalism. New York: Basic Books. Iwata, E. (1991, May). Race without face. San Francisco Focus, 51–53, 128–132. Johnson, A. G. (2001). The trouble we’re in. In A G. Johnson. Privilege, power, and difference (pp. 12– 41). Mountain View, CA: Mayfield. Keefe, S. E., & Padilla, A. M. (1987). Chicano ethnicity. Albuquerque: University of New Mexico Press.

orga_c03.qxd

2/5/07

10:51 AM

Page 91

Latino Ethnic Identity

91

McIntosh, P. (1988, July/August). White privilege and male privilege: A personal account of coming to see correspondence through work in women’s studies (Working Paper 189). Wellesley, MA: Wellesley Collage Center for Research on Women. Parham, T., & Helms, J. (1981). The influence of Black students’ racial identity attitudes on preferences for counselor’s race. Journal of Counseling Psychology, 28, 250–257. Phinney, J. S. (1989). Stages of ethnic identity in minority group adolescents. Journal of Early Adolescence, 45, 1297–1303. Phinney, J. S. (1990). Ethnic identity in adolescents and adults: Review of research. American Psychologist, 45, 1297–1303. Phinney, J. S., & Alipuria, L. (1990). Ethnic identity in older adolescents from four ethnic groups. Journal of Adolescence, 13, 171–183. Ramirez, M., III, & Castañeda, A. (1974). The ideology of assimilation. In M. Ramirez III & A. Castaneda (Eds.), Cultural democracy, bicognitive development and education (pp. 1–20). New York: Academic Press. Rodriguez, R. (1982). Hunger of memory: The education of Richard Rodriguez. New York: Bantam Books. Rosenberg, M. (1979). Minority status and self-esteem. In M. Rosenberg (Ed.), Conceiving the self (pp. 149–176). New York: Basic Books. Sellers, R. M., Chavous, T. M., & Cooke, D. Y. (1998). Multidimensional model of racial identity: A reconceptualization of African American racial identity. Personality and Social Psychology Review, 2(1), 18–39. Stalvey, L. M. (1989). The education of a WASP. Madison: University of Wisconsin Press. Steele, C. M. (1997). A threat in the air: How stereotypes shape intellectual identity and performance. American Psychologist, 52(6), 613 –629. Steele, C. M., & Aronson, J. (1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69(5), 797–811. Sue, D. W., & Sue, D. (2003a) Counseling the Culturally Diverse: Theory and practice (4th ed.). Hoboken, NJ: Wiley. Sue, D. W., & Sue, D. (2003b). Racial/cultural minority identity development: Therapeutic implications. In D. W. Sue & D. Sue (Eds.), Counseling the culturally diverse: Theory and practice (4th ed., pp. 205 –233). Hoboken, NJ: Wiley. Sue, D. W., & Sue, D. (2003c). White racial identity development: Therapeutic implications. In D. W. Sue & D. Sue (Eds.), Counseling the culturally diverse: Theory and practice (4th ed., pp. 235 –264). Hoboken, NJ: Wiley. Tatum, B. D. (1997). The development of White identity: “I’m not ethnic, I’m just normal.” In B. D. Tatum (Ed.), Why are all the Black kids sitting together in the cafeteria? (pp. 93 –113). New York: Basic Books. West, C. (1993). The pitfalls of racial reasoning. In C. West (Ed.), Race matters (pp. 23 –32). Boston: Beacon Press. Wylie, R. C. (1979). Racial/ethnic status, integration/segregation, and self-concept variables. In R. C. Wylie (Ed.), The self-concept: Theory and research on selected topics (Rev. ed., Vol. 2, pp. 117–240). Lincoln: University of Nebraska Press.

orga_c03.qxd

2/5/07

10:51 AM

Page 92

orga_c04.qxd

2/5/07

10:52 AM

Page 93

CHAPTER 4

Diversity within Latinos Subgroups, Identities, and Social Welfare

IT WAS THE project of Chapter 3 (on racial/cultural identity development) to bring down to an individual level of analysis some of the psychological impacts of Latino-relevant macro-level historical and social forces reviewed in Chapters 1 (acculturation) and 2 (social stratification). But how do such macro- and micro-level (racial/cultural identity) phenomena play out across the many within-group differences among Latinos? For example, how might the dynamics of migration and acculturation play out differently for Latino men and women? What salient identity issues emerge for Latinos who are gay, lesbian, bisexual, or transgender (GLBT), in addition to the racial/ethnic identity issues raised in Chapter 3? Further, how does the Latino experience vary for those who are darker in skin color, more indigenous-Indian-looking, or for racially Black Latinos? Addressing such questions can lead to a more in-depth analysis of the uneven impacts of oppression across Latino subgroups. S O C I A L C O N S T RU C T I O N I S M The consideration of multiple social status dimensions and identities within a group or even within the same person is becoming more apparent in the literature, as well as graduate and professional training. The tradition of separately examining race, ethnicity, or sex has begun to shift toward focusing on human diversity or inequality on the basis of social constructions of human difference. Social constructionism is the 93

orga_c04.qxd

94

2/5/07

10:52 AM

Page 94

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

position that what we believe to be true about ourselves, others, and the world can only be the result of perceptions and interpretation-driven beliefs that are ultimately bounded by the historical era in which we live, our social and political context, our network of social affiliations, and so on. Thus what we believe to be true and real is more an arbitrary function of how far knowledge has advanced (e.g., the world is round versus flat) and/or what powerful social leaders claim to be true, right and wrong, good and evil. The latter point emphasizes the inevitable relation between power and perceptions of reality in that those with power have more resources with which to project their view of what’s real and right to members of society. As was mentioned in the discussion of social stratification in Chapter 2, the rich, powerful, and elite are highly invested in maintaining a stratification system that distributes a disproportionately greater amount of resources to their own groups. Thus, status quo maintenance is accomplished through the production of pervasive narratives and ideologies, value systems, and myths and legends that are infused into the socialization process, through mainstream institutions and culture, in order to rationalize and normalize a society’s uneven distribution of life-sustaining power and resources (Marger, 2000). Social constructivism does not deny the world available to our perceptions, including the tremendous biodiversity around and within it, but it does define as arbitrary our interpretations of things or their social meanings. For example, sex is considered a social construction not because men and women aren’t biologically different, but because our culture has developed elaborate constructions of what such biological differences mean, with tremendous consequences for how men and women are socialized and treated differently. Thus the fact that we’ve never had a female president in the United States is rooted in a traditionally sexist, albeit changing, conception of women as not biologically (i.e., emotionally, intellectually) suited to the task. Fortunately the women’s movement ( both old and new) has challenged stigmatizing and limited social constructions of women, resulting in considerable social liberation and less oppressive conceptions of sex and gender. For the purposes of this book, and for the human diversity movement in general, the social constructivist perspective can be a liberating and humanistic view that challenges essentialist and stigmatizing constructions of minority groups as the sole creators of their own problems due to individual and groupwide flaws. This is because it can inspire those experiencing oppression to question authority and contest the truth: “Says who, and based on what evidence?” and “Does this social construction

orga_c04.qxd

2/5/07

10:52 AM

Page 95

Diversity within Latinos

95

allow some groups to benefit at the expense of others?” (e.g., the monopolization of power by men). Social constructionism flies in the face of essentialism, or the position that an objective reality exists apart from human perceptions and interpretations. But because in our youth we are raised in an essentialist manner, and because important human enterprises such as science purport essentialist truths, social constructivism can be initially hard to grasp and is often harshly criticized (“If you think that gravity is a social construction, then try jumping off the roof!”). But such criticisms miss the point. Zen Buddhists have long known that just because you attach a term such as “gravity” to some phenomenon doesn’t make the word “gravity” real. This lesson is driven home by the famous Zen koan in which the master first shows his fist to a student and asks, “See the fist?” Then, once the student nods, the master quickly unballs his hand and asks, “Where did the fist go?” It is the student’s job to realize that there is no such thing as a fist, merely a label that we invent and attach to a conception of something that may serve a useful purpose (e.g., in verbal communication). Thus, the critical questions become: Which social constructions are useful and adaptive, and which are not? and By whom are they used, and for what purpose? Shifting our focus to social injustice on the basis of social constructions of human differences makes clearer the links between the many “isms” in society that privilege some categories of people at the expense of others, thus rendering more visible the overarching nature of human systems of oppression in society. This chapter focuses on human diversity within Latino groups by first outlining a broad social justice approach to understanding the dynamics and consequences of multiple yet related systems of oppression, which result in variations in problem patterns, as well as many unique problems and special needs among subgroups of Latinos. Following this framework of oppression and social justice, a brief review of major Latino subgroups and issues is ventured. DI V E R S I T Y, OP PR E S S I O N, A N D S O C I A L J U S T I C E Interestingly, the vast majority of most human service providers come from academic and professional training with very strong ethics about promoting social justice, fighting oppression, respecting human differences, and providing culturally competent services. In the National Association of Social Workers’ (1999, p. 5) Code of Ethics, it explicitly states on the very first page of the Ethical Principles section:

orga_c04.qxd

2/5/07

96

10:52 AM

Page 96

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Value: Social Justice Ethical Principle: Social workers challenge social injustice Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’ social change efforts are focused primary on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people.

Then the links between social justice, human diversity, and culturally competent services are further fused: Cultural Competence and Social Diversity • Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures. • Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups. • Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, martial status, political belief, religion, and mental or physical disability. (p. 9)

RHETORIC AND REALITY Such progressive professional ethics provide ideals worth striving for. But they can be difficult to approximate in practice unless social workers and other service providers have a solid conceptual grasp of the complex nature of human oppression and how we are all socialized to play various roles within its social matrixlike structure. With deeper understanding of how the dynamics of oppression operate, we can better recognize and respond to oppressive tendencies at structural and individual levels, both outside of and within ourselves. As both practitioners and citizens, it is our ethical responsibility to recognize the collective legacy of oppression that we all inherit, through no volition of our own, and that must be challenged in an informed manner to truly promote social justice. Such insight minimizes our knee-jerk reaction of denying any personal responsibility for past or ongoing oppression of minority groups (“I’m not responsible for what happened in the past!”) and maximizes our motivation to work for a fairer society for all.

orga_c04.qxd

2/5/07

10:52 AM

Page 97

Diversity within Latinos

97

DE F I N I N G F E AT U R E S O F OP PR E S S I O N It is helpful to take note of the word press embedded in the word oppression given that oppression refers to a pressing down on a person or group to limit movement, expression, power, freedom, and indeed life itself. Bell (1997) notes five defining features of oppression that capture its complexity: (1) restricting life chances by limiting access to material and structural resources; (2) hierarchical, characterized by dominant-subordinate relations of power; (3) pervasive, consisting of a complex web of relations in socially structured environments; (4) composed of individuals who occupy complex, multiple, and cross-cutting relations with varying degrees of internalized subordination and dominance; and (5) consisting of an overarching system that includes the many “isms” that privilege some categories of people at the expense of others. Most people are aware of the first two defining features of oppression (i.e., that some powerful individuals and groups occasionally abuse the less powerful); but many are unaware of the pervasive and institutionalized nature of oppression and how it structures their daily social experiences, or how we all occupy multiple status dimensions simultaneously, some of which are privileged (e.g., being White and middle class) and some of which are stigmatized (e.g., being female and nonheterosexual). This latter point reminds us that we are talking about social categories of people and not individuals per se, whereas the former point stresses the degree to which such categories shape our social existence (i.e., the social class and predominant racial group in which we grow up). Bell’s (1997) fifth dimension of oppression is meant to emphasize the ideal of addressing all forms of oppression given that each is part of the same overarching system of dehumanization. This can be very difficult to achieve given our tendency to rank-order the suffering of various groups, from most to least, and/or to prioritize our own group’s cause above others perceived as less urgent. THE SOCIAL OPPRESSION MATRIX All of the dimensions of oppression can be thought of as forming a matrixlike social structure in which members of society are socialized to live, work, think, feel, and love. This idea is illustrated in Hardiman and Jackson’s (1997) social oppression matrix, which contains at least three levels of oppression about which we need to remain aware (see Figure 4.1): (1) individual, where conscious and unconscious cognitive and behavioral activities are experienced (although we should also include subconscious here to capture our occasional semi-awareness of oppressive tendencies); (2) institutional, where family, government, educational,

orga_c04.qxd

98

2/5/07

10:52 AM

Page 98

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Conscious

Subconscious

Unconscious

Attitudes

ta l ie So c

tio itu In st

In

di

vi

du a

na l

l

Behaviors

Figure 4.1 The Social Oppression Matrix. (Source: “Conceptual Foundations for Social Justice Courses,” by R. Hardiman and B. W. Jackson, in Teaching for Diversity and Social Justice: A Sourcebook, pp. 16–29, M. Adams, L. A. Bell, and P. Griffin, Eds., 1997, New York: Routledge. Reprinted with permission.)

and corporate-industrial-work activities play out (e.g., historical social policies of inclusion and exclusion); and (3) social and cultural, which refers to societywide cultural norms that serve to bind institutions and individuals (e.g., values, life philosophies, and role prescriptions that contain rationales and justifications for practices of exclusion, persecution, and social control of certain groups and individuals that challenge oppressive conditions). The social oppression matrix helps us to better envision ourselves immersed within oppressive social structures and cultural forces. As such we can become more aware and critical of oppressive psychosocial processes, such as when privileged individuals and groups perceive their attractive locations within the matrix as normal (e.g., the sole result of honest hard work and merit) rather than partly resulting from unfair advantages at the expense of others. The matrix metaphor also helps us un-

orga_c04.qxd

2/5/07

10:52 AM

Page 99

Diversity within Latinos

99

derstand how we have been socialized in biased ways to perceive and interact (or not interact) with other categories of people. DIVERSITY: CAN WE TALK ABOUT IT? Unfortunately, we can’t talk about diversity very easily. The urgently needed dialogue and critical debates about social justice and human difference continue to be undermined by our socialization around human difference. How often have we heard those we most love and trust while growing up (parents, teachers, clergy) resort to superficial hyperbole about race (e.g., “Everyone is the same”; “It doesn’t matter if you’re black, white, green, or purple”) and merit (“Anyone can make it if they try!”) in place of more honest and informed critical discussion about how the unequal treatment of different groups of people leads to different life chances? Within a social matrix of oppression, questions, and experiences about stigmatized human differences elicit considerable discomfort and anxiety throughout the life cycle with which we are ill prepared to deal. Hence, it is difficult to think and act outside of the matrix. Thandeka (2003) has come up with a helpful explanation of our impaired ability to genuinely think and talk openly about the categories of human differences that we all occupy along the stigma-privilege differential. With regard to race, she contends that our racial self-awareness too often emerges through what she calls naive transgressions of the “racial order” that result in punishment (e.g., admonishment or rejection and consequent feelings of shame, guilt, and discomfort). Consider the example of a White colleague of mine who recalled that as a young child, raised on her family’s small farm, she invited the children of Mexican farmworkers into her home to play, only to be sternly reprimanded by her parents and told that they didn’t socialize with those children, whose families were there only to pick crops on the farm. According to Thandeka, the result of such encounters is that normal, naive, and innocent curiosity is quickly transformed into a “transgression” of racist cultural norms, resulting in the child’s experiencing a harsh lesson about what it means to be White. On a gut level, such “transgressions,” many of them early and even preverbal, may include a sense of something being wrong with oneself for having interests and feelings at odds with powerful, trusted, and even loved authority figures (i.e., parents). My colleague recalls feeling very sad, unable to understand why it was wrong to want to play with the Mexican children milling around the house as their parents worked the farm. No wonder feelings about being White and about racially different others commonly become walled off, compartmentalized, and shrouded in vague tension and discomfort. Later in life, racial encounters and

orga_c04.qxd

100

2/5/07

10:52 AM

Page 100

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

experiences can automatically trigger anxiety and avoidance without much understanding or analysis. As another example, I recall observing the outrage of a father in response to his 4-year-old son’s polishing his nails while at Montessori day care. When the teacher patiently explained that the children are free to explore all of the different stimuli and activities in the classroom, later discussed for their learning value, the angry father demanded that his son not be allowed to engage in activities for girls. As Thandeka (2003) would argue, on the day of his father’s display of rage, the little boy learned a harsh lesson about what it means to be a boy. Visibly disabled people note that when out in public, children who innocently stare at them or ask what’s wrong with them are frequently admonished by their parents and told not to stare or ask such questions. Such parents justify their actions as curbing rudeness, but it has more to do with the anxiety we experience around disabled people based on our negative social constructions of the disabled (e.g., as pitiful, miserable, dependent), and hence our need to render them invisible. PRIVILEGE AND STIGMA Implicit in the preceding discussion is the profound role of privilege and stigma in limiting human understanding across differences. Whether we are privileged by race (White), sex (male), sexual orientation (heterosexual), or disability status (able-bodied), we are socialized to minimize the experience of those stigmatized in these domains (a person of color, a female, a nonheterosexual, a disabled person) because such stigmas play little if any negative role in our lives. Simply put, privilege makes our lives better in a variety of ways; stigma does the opposite. Thus, people mistreated on the basis of race are keenly aware of racism, whereas those treated better on the basis of race are less aware of racism because race doesn’t limit their ability to make society work for them the way it should. If this sounds abstract, consider the horrendous bombing of the Oklahoma federal building in 1995 by American terrorist, and former Gulf War veteran, Timothy McVey. Viewed solely as an individual, McVey incited no backlash of hate crimes against White men because no such stigma exists for these categories. In contrast, Americans of Middle Eastern background were randomly beaten and even killed in the wake of 9/11 because they belong to a group stigmatized on the basis of racial/ethnic background. The point is that the social oppression matrix, which endows us with both privileges and stigmas, reinforces structured inequality by making it exceedingly difficult for us to recognize our privileges or to understand

orga_c04.qxd

2/5/07

10:52 AM

Page 101

Diversity within Latinos

101

the pervasive inequality experienced by stigmatized individuals. Yet the unfair advantages and disadvantages of privileged and stigmatized backgrounds, respectively, have real-life consequence of which we are too often unaware, despite research that should raise our consciousness. For example, in the first large-scale study of treatment decisions made by primary care physicians (Schulman et al., 1999), it was found that when faced with videotapes of identical complaints of chest pain, doctors were less likely to recommend African American women for further cardiac testing (79% of the time) compared to patients that were either White or male (91% of the time). Such findings do not mean that doctors are necessarily racist and sexist at the individual level, but that they are socialized at the institutional and cultural levels to perceive the complaints of African American women and the concerns of Whites and males through lenses biased by racism and sexism. Interestingly, this study controlled for access to medical care, thereby minimizing the bias of social class, and also suggests how a pair of stigmas may work against a person (i.e., being a Black female) and how a pair of privileges can work for a person (i.e., being White or male). Given such limited and biased socialization that distorts our perceptions of human difference, it’s no wonder our emotional tolerance for genuinely thinking (and feeling) about and discussing human differences rarely goes beyond the kind of defensive and superficial hyperbole that leaves social oppression unchallenged. Additional costs noted by Thandeka (2003) include the early suppression of natural curiosity, a low probability of authentic relationships across categories of human difference, and decreased openness to oneself, to others, and to human possibilities. A basic grounding in social injustice on the basis of stigmatized and privileged social constructions of human differences beckons us to explore differences within differences as we struggle to comprehend the variegated effects of oppression on various members of society. Some of these effects within U.S. Latino subgroups, and their unique experiences, problems, and engendered needs, are selectively considered next. In some cases, groups and issues are raised and pursued in the second half of the book, where culturally competent interventions are addressed. In other cases, important groups and issues are merely raised given the limited state of the literature and available space herein. S E X A N D G E N DE R Hurtado (1997) asserts that traditional sociological theorizing about the acculturation and assimilation of minority groups to American society has traditionally neglected the role of sex in such processes.

orga_c04.qxd

102

2/5/07

10:52 AM

Page 102

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Surely acculturation has different impacts on men and women, in part because of male-dominated sexist structures operative in both majority and minority cultures. Thus while people of color have been racially and ethnically subjugated, as described in Chapters 1 and 2, women within these groups have been further subjugated on the basis of gender in both majority and minority cultural contexts. There’s a great scene in Chicano, the documentary about the Chicano movement of the 1960s and 1970s: At the first national conference to discuss political empowerment, Chicanas confront their compañeros (male counterparts or companions) for relegating them to the coffee- and food-serving periphery despite their consistent participation in the movement. That is, while the hombres were keenly aware of their stigma on the basis of ethnicity, they were less aware of, or considered less important, their privileged status as males in both Mexican and U.S. cultures. The predictable logic in such situations runs along the lines of “Let me get mine first, and yours will follow.” This is why a broad social justice framework is imperative if we are to avoid the oppression-related blinder of not seeing the links between different forms of oppression (e.g., racism and sexism), and if we are to lessen our tendency to rankorder oppressions in terms of importance (a tempting yet ultimately derisive endeavor). GENDERED ACCULTURATION In their pioneering work on acculturation in Cuban American refugee families in Miami, Szapocznik, Scopetta, Kurtines, and Arnalde (1978) demonstrated that the degree and speed of acculturation varies with the age and sex of family members, as depicted in Figure 4.2. For example, Cuban children generally acculturated much faster to the United States than their parents, and females within both younger and older age groups acculturated more slowly than their male counterparts, given the cultural bias of allowing males more freedom and latitude to explore their environment. Although only a preliminary analysis, the consideration of sex and age in acculturation became critical in Szapocznik and colleagues’ understanding of Latino family problems. They found that tensions occurred most often between what they called overacculturated children and underacculturated parents trying to adapt to life in the United States. Further, some of the worst conflicts and behavior problems occurred between the most and least acculturated family members (i.e., between male adolescents engaged in substance use and mothers abusing prescription drugs). Such attention to sex and age spawned a prolific line of clinical work, research, and theorizing by Szapocznik and colleagues

orga_c04.qxd

2/5/07

10:52 AM

Page 103

ale

Diversity within Latinos

103

M

Youths

e

Acculturation

al m Fe

s l/ le na c e Ma tio eren a r f ne Dif rge onal e t i In rat ltu le cu c Fema A

Parents

Time Figure 4.2 Rates of Acculturation by Age and Gender. (Source: “Theory and Measurement of Acculturation,” by J. Szapocznik, M. A. Scopetta, W. Kurtines, and M. A. Arnalde, 1978, Interamerican Journal of Psychology, 12, pp. 113–130. Reprinted with permission.)

about how to help Latino families deal with dysfunctional acculturation gaps. Such family interventions are discussed in more detail in Chapter 6.

GENDERED MIGRATION Although traditional Latino gender roles may generally slow the acculturation for women relative to men, Espin (1987) asserts that changes in gender roles may actually be more dramatic for Latina versus Latino immigrants, given the pressing need for women to work outside of the home and the consequent larger changes in lifestyle for such women compared to changes for their male counterparts. Indeed, in Guendleman’s (1987) research on female Mexican migrants, she noted considerable gender-role expansion in terms of women’s earning power and subsequent gains in decision making in family matters. On this same topic, Hondagneu-Sotelo (1994) conducted an ethnography of a Mexican migrant settlement

orga_c04.qxd

2/5/07

104

10:52 AM

Page 104

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

community in the San Francisco Bay Area based on the participantobservation of 44 men and women from 26 different migrant families. She concluded that the relation between international “push and pull” factors and individual-level decisions to migrate is mediated by gender roles in the family and broader social networks that serve to constrain or facilitate migration for men and women: While patriarchal practices and rules in families and social networks have persisted, through migration women and men reinterpret normative standards and creatively manipulate the rules of gender. As they do so, understandings about proper gendered behavior are reformulated and new paths to migration are created. When exclusionary practices persist in the networks, Mexican women have devised their own systems and networks of support. (p. 96)

Hondagneu-Sotelo found that the usual migratory scenario, in which men leave wife and family behind to seek work in the United States, primes both husbands and wives for greater gender-role flexibility. The husband’s absence in the family, and inadequate remittances from the United States, push wives to take charge of family matters and to earn wages by working. Meanwhile, husbands fending for themselves in the United States hone domestic skills such as cooking and cleaning. Upon family reunification in the United States, gender-role expansion continues, with wives entering the world of work, including its social dimension, and making further gains in family decision making, division of household responsibilities, and interests outside of the family, including local civic involvement and even community activism (see Chapter 10 for more indepth discussion). Hondagneu-Sotelo (1994) further noted that in cases where migrant husbands opposed their wife’s urgency regarding reunification, many of the wives used various strategies to undermine patriarchy, including directly challenging the decision, using their own networks to gather money for the move, and even surprising husbands by showing up on their U.S. doorstep, children and all. Understanding the gendered nature of Latino migration provides insights into both negative and positive aspects of the migration process for family members. Without sufficient support and understanding, rapidly shifting gender roles can result in family breakdown and dysfunction (e.g., domestic violence, covered in Chapter 6); they can also result in more adaptive egalitarian relations in Latino couples. Such flexibility and resilience in migrant and immigrant families are strengths that can be integrated into the provision of human services.

orga_c04.qxd

2/5/07

10:52 AM

Page 105

Diversity within Latinos

105

U N D O C U M E N T E D L AT I NO S In his book Shadowed Lives, Chavez (1998) provides richly detailed personal case histories of undocumented Mexican and Central American individuals and families living in San Diego County. Migration is an economically driven part of family history for a segment of Latino societies, yet Chavez notes other, less frequent yet compelling reasons for moving, such as escaping family conflict (e.g., divorce, abandoned woman with child, conflict with siblings), seeking adventure and to satisfy curiosity, and to escape war-related hardship and persecution on the part of Central Americans (as noted in Chapter 1). THE THREAT

OF

DEPORTATION

With regard to the dilemma of seeking a livelihood in a country where one is contested as an illegal alien and constantly vulnerable to legal persecution and deportation, Chavez (1998) describes how undocumented Latinos generally endure the chronic threat of apprehension, even multiple deportations, in exchange for what they are able to accomplish in the United States. In his analysis of social, cultural, and personal incorporation in the United States, Chavez concludes: In sum, despite lacking a guarantee of full incorporation, over time undocumented immigrants develop the kinds of ties to the local economy and society that results in their staying and settling in U.S. communities. Experiences such as finding a job, maintaining steady employment, acquiring job responsibility, learning English, forming a family, giving birth to children in the United States, having them attend U.S. schools and acquire American culture, learning to navigate in the larger society, and ultimately legalizing their immigration status incorporate undocumented immigrants into the new society. (p. 186)

With regard to legalizing immigration status, Chavez (1998) notes that such efforts on the part of undocumented Latinos increase with time spent in the United States and can involve hiring lawyers to plead their case or requesting a hearing before an immigration judge upon apprehension and refusing to sign a voluntary departure form (and being escorted to Tijuana, Mexico). Chavez explains that recent migrants are likely to sign a voluntary departure form because it renders the apprehension an informal deportation and thus cannot be held against them in future applications for legal immigrant status. However, longer term migrants are disinclined to sign voluntary departure forms because doing so erases their years in the United States, which are helpful in mounting a case for legal immigrant status. Thus, long-term migrants who are apprehended

orga_c04.qxd

106

2/5/07

10:52 AM

Page 106

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

are more likely to consider requesting an immigration judge to stop or suspend their deportation and to grant them legal status on the grounds of “noneconomic hardship.” The term refers to a compelling need to remain in the United States other than losing a job and/or assets, or not being able to earn much money in Mexico. For example, an undocumented family with a disabled child might successfully argue that the child would be adversely affected by a move to Mexico, where proper care for his or her condition is less likely. Apprehended undocumented Central Americans might request a hearing for political asylum, although proof of political persecution is typically difficult, as noted in Chapter 1. In either case, failed appeals result in the deportation of undocumented individuals and families. The high probability of returning to the United States is a function of investments ( jobs, schools, and communities to which to return) and the perennial scarcity of economic opportunity in one’s country of origin. To Serve or Not to Serve? Aside from the calculated risks of illegal migration, Chavez (1998) documents the considerable stress and heart-wrenching hardship of mothers whose husbands are deported, of parents whose children are picked up by the Immigration and Naturalization Service (INS), and of whole families deported and making multiple exhausting and dangerous attempts to return to the United States. Yet most Americans dismiss such hardship as the self-imposed consequence of breaking the law and entering the United States illegally, a violation not to be reinforced in any manner. Indeed, this view was the thrust of California’s Proposition 187, which was passed by voters in 1994 to deprive the undocumented of health care, education, and other publicly funded benefits (its unconstitutionality resulted in its quick demise). Social policy is addressed in Chapter 10; it should be noted here that Proposition 187 called on all California educators and human service providers to police the citizenship of clients and to deny services accordingly. However, most refused to do the work of the INS and continued to provide services, primarily for humanitarian reasons but perhaps also because of their awareness of the hypocrisy involved in the state’s dependence on massive Latino labor and the reluctance to respond to migrants’ basic human needs. The central distortion in Proposition 187 was its claim that the primary motivation of undocumented migration is to use public social services, which of course is a natural by-product of the real reason why migrants come: to work. This crafty proposition was never intended to stop the flow of Mexican labor into California, or to crack down on law-breaking

orga_c04.qxd

2/5/07

10:52 AM

Page 107

Diversity within Latinos

107

corporations that routinely hire hundreds of thousands of undocumented workers. It was intended only to drastically reduce the human service costs of Latino laborers by inhibiting the migration of families, who are the major consumers of basic health care and educational services (Chavez, 1998). In fact, former California Governor Pete Wilson, who spearheaded the inflammatory “Save Our State” campaign to pass and enforce Proposition 187, consistently advocated Mexican guest worker programs, even discouraging the immigration commissioner from raiding companies and disrupting California businesses. Interestingly, the nativist, anti-immigrant, and anti-Latino tone of Proposition 187, and of more recent debates on undocumented immigration, have had the unintended consequence of galvanizing Latino political organizing and voting like never before in the state; participation in the political process has increased dramatically and continues to this day (addressed in Chapter 10). As long as Mexico and California and the rest of the Untied States continue to compose interlocking economic systems characterized by massive flows of Latino labor essential to multibilliondollar corporations, Latino migration, documented or otherwise, will continue to be formally and informally institutionalized, as it has been throughout the twentieth century. As such, aren’t human service providers, as well as informed citizens of both Latino and non-Latino backgrounds, ethically obligated to respond to the human needs of a workforce that helps to make California the eighth most powerful economy in the entire world? S E X UA L OR I E N TAT I O N Scholars writing on the experience of GLBT Latinos have found some interesting links with the migration process. Diaz (1998, p. 103) describes the frequent practice among gay Latino men of immigrating to the United States as a “geographical pseudo-cure” to the problem of needing to escape their closeted lives in Latin America. But while immigration brings relief, distance from one’s country (and family) of origin does not usually end the uncomfortable double lives of many gay Latinos. As Diaz explains, familismo (i.e., the centrality of the family in the lives of Latinos) is generally a major resource for Latino family members, but it can also hamper the psychosocial development of Latino gay men who feel compelled to live secret sexual and romantic lives to avoid family dishonor and rejection. In fact, Diaz underscores the link between homophobia in Latino culture and HIV risk in Latino gay men, whose sexual lives often become relegated to the shameful domain of secretive and impersonal sexual encounters full of risk (see Chapter 9).

orga_c04.qxd

108

2/5/07

10:52 AM

Page 108

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Espín (1997a) surveyed 16 Cuban American lesbians and found that though the majority identified as Latina and valued both Latina and lesbian identities, two-thirds said that if forced to choose, they would prefer living among non-Latina lesbians with little awareness of Latino culture, rather than live closeted among Latinos (indeed, many claimed to have already made that choice). In a more in-depth case study of two women from that sample, both connected coming out as lesbians with coming to the United States (Espín, 1997b). The choice between ethnicity and sexual orientation is highly relevant to GLBT Latinos given that their sexual orientation represents a cultural transgression, to use Thandeka’s (2003) term, against traditional Latino gender roles and expectations. Feeling forced to choose between one’s Latino family and community on the one hand, and an open sexual orientation and social life on the other, can result in a painfully divided self. Espín (1997a) notes that when a lesbian orientation is known or suspected in the family, the tendency is to silently tolerate the individual, provided that she remain closeted, and to make excuses for her not being married (e.g., too religious, too smart, too busy with career). Espín also noted that 14 of the 16 lesbians interviewed reported being Catholic, yet only three were practicing Catholics who chose to worship at Dignity, an organization designed to meet the religious needs of gay and lesbian Catholics who are estranged from their church. ETHNIC

VERSUS

SEXUAL IDENTITY

Although GLBT Latinos face the basic racial/ethnic identity development issues raised in Chapter 3 due to their ethnic minority status in the United States, it could be argued that their sexual identity presents a more pressing dilemma because it is stigmatized within Latino culture, family, and community, in addition to the larger society. On the other hand, Rodriguez (2004), reflecting on his clinical work with Chicano gay men as well as the literature, claims that he is just as likely to work with clients on sexual identity as to work on ethnic identity, or both at the same time. To assist with such work, GLBT scholars have developed models of sexual identity development based on the logic of racial/ethnic identity models reviewed in Chapter 3. One such model, by Cass (1990), posits early stages of sexual identity confusion and ambivalence; middle stages of exploration, tolerance, and pride, including resentment of homophobia; and ultimately a more advanced and integrated stage of synthesis in which public and private lives fit in a fulfilling manner. How sexual and ethnic identity development co-occur in GLBT Latinos warrants fur-

orga_c04.qxd

2/5/07

10:52 AM

Page 109

Diversity within Latinos

109

ther research to illuminate how such individuals cope with two stigmatized identities. Interestingly, Espín (1997b) professes faith in the power of familismo, noting that if familismo is strong, not even homosexuality can split the bonds between family members. Some, though certainly not all, GLBT Latinos do enjoy family support, and Espín’s optimism speaks to the promise of enhancing familism through public education campaigns about the negative consequences of rejecting GLBT children and other family members, and the need for the family to be the central buffer in the lives of GLBT youth as they encounter heterosexism and racism. THE TRANSGENDER CHALLENGE Just when you think you’re beginning to understand the basic human rights issues of gays and lesbians, along come transgender people, who seem to “transgress” not only sex and gender roles, but biology itself! If people are capable of relinquishing their biased socialization regarding transgender people, and are able to recast them as fully human and thus deserving of full human rights, figuring out the rest of the human diversity puzzle should be easy. Part of the challenge resides in the dilemma that transgender people are not only stigmatized and rejected by heterosexuals, who frequently (mis)perceive them as homosexuals, but they have also been historically stigmatized by gays and lesbians, who have frequently (mis)perceived them as renouncing their homosexuality and attempting to pass as the opposite sex in a conformist manner (Green, 2000). Not surprisingly, such multiple marginalities and major transgressions of the sexual and gender social order result in compounded vulnerabilities and unique needs. At the core of the umbrella term transgender are transsexuals who experience a mismatch between their biological sex and their gender identity. For example, male-to-female (MTF) and female-to-male (FTM) transsexuals feel more congruent with the gender identity, role, and appearance of the opposite sex, whether or not they pursue hormonal treatment or reassignment surgery. Green (2000) notes that the term transgender more broadly refers to a preponderance of characteristics of the opposite sex (e.g., physical and/or behavioral) that cause people to question their perceptions, regardless of an individual’s gender identity. Service providers and researchers working with transgender people believe that they may be at the greatest risk for the long list of vulnerabilities that result from pervasive oppression or transphobia (e.g., physical and sexual abuse, harassment and hate crimes, and consequent depression

orga_c04.qxd

2/5/07

110

10:52 AM

Page 110

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

and suicidality, alcohol and substance abuse, survival sex, and HIV and STDs). Research on HIV among MTFs is still in its infancy, but infection rates of between 25% and 33% of fairly large San Francisco-based community samples have been reported (Clements-Nolle, Guzman, & Katz, 2001; Nemoto, Luke, Mamo, Ching, & Patria, 1999). With regard to transgender Latinos, extremely little research exists, although the MTF Transgender of Color Study in San Francisco is helping to clarify some of our strongest fears, as well as raise hopes, by revealing the transphobic context of HIV risk in this unique population. In the context of HIV risk, research by Nemoto, Operario, Keatley, and Villegas (2004) based on focus groups with 48 MTFs (16 Black, 15 Asian, 12 Latinas, and 5 other) and with service providers familiar with the population documents several central contextual themes for MTFs of color. First, significant involvement in commercial sex work emerged as an important means of economic survival, in which almost all had participated, including about half currently, often beginning in adolescence. Transphobia-related reasons for sex work include early rejection from families and consequent homelessness, job discrimination against transgenders, and money needed for survival, for costly gender-maintenance medical procedures, and for drugs (including injection drugs) used to cope with all of the above. Participants even noted that sex work and drug use were often viewed as a right of passage among transgenders. It was also found that sex with customers was generally regarded as a business transaction in which to practice safe sex, whereas sex with primary partners involved love, trust, and penetration without condoms. However, unsafe sex with customers was reported when more money was offered for not using condoms, or when needing money for survival, medical procedures, or drugs. The fact that transgender people are so frequently the victims of violent hate crimes, including murder, is a tragic indicator of their degree of stigma and oppression, so well captured by a focus group member’s brutally honest statement: No one’s going to kill a gay man if he finds a dick between his legs. No one’s gonna kill a gay woman if he finds a pussy. But they will definitely put a knife through a tranny’s throat if they see breasts and dick. (p. 729)

The recent conviction of three young men for the brutal murder of Gwen Araujo, a young MTF transgender Latina, is significant. Following a hung jury, the men were retried and the jury refused to buy their “transgender panic” defense, which held that they killed Araujo in a fit of panic after discovering that they were sexually involved with an MTF transgender person.

orga_c04.qxd

2/5/07

10:52 AM

Page 111

Diversity within Latinos

111

With regard to sexual risk, Nemoto, Operario, Keatley, Han, and Soma (2004) found the following self-reported HIV infection rates in their MTF sample: 41% for African Americans, 23% for Latinas, and 13% for Asian/ Pacific Islanders. Both Latinas and African Americans reported lower incomes and higher rates of sex work, including unprotected receptive anal sex (URAS), and substance use, compared to Asian/Pacific Islanders. Participants who were HIV-positive were almost 4 times as likely as HIVnegative participants to report URAS with casual (not customer) sex partners. And although only 12% reported URAS with customers in the past 30 days, this behavior was 4.5 times more frequent in African Americans and those with the lowest income level ($500/monthly). A unique obstacle to condom use was noted in the finding that rates of URAS were higher with primary partners than with casual or commercial sex partners. In the focus groups conducted by Nemoto, Operario, Keatley, and Villegas (2004), the interpersonal context of (un)safe sex was clarified in that condoms were perceived as undermining intimacy with primary partners as well as undermining gender validation (i.e., attention, affection, and sex for being a woman) with casual sex partners. And although most used condoms with commercial sex clients, economic vulnerability did occasionally undermine this intention. These findings underscore some of the unique relationship-based vulnerabilities for MTFs that can leave them at a power disadvantage for negotiating safe sex if it is perceived and experienced as secondary to the need for money, intimacy, and gender validation. Among the many implications for service providers of these results are the need for transgender-competent early intervention to curtail and prevent interpersonal abuse and the need to provide alternatives to survival sex and substance use to cope with transphobia. A comprehensive approach should also include assisting transgender clients with work- and housing-related discrimination, counseling aimed at preventing the need for gender validation from becoming a risk liability, and referring clients to transgender-sensitive health services. Such thoughtful and progressive services, often spearheaded by transgender individuals, are sparse yet exemplify the humanism at the core of diversity-competent practice. R AC E A N D S K I N C O LOR I recently met with a dark and Indian-looking Latino community outreach worker in Oakland, California, to ask him about his impressive HIV prevention work with local Latino migrant day laborers. Shortly after ordering a spicy bowl of sopa Azteca (Aztec soup) at a local Mexican restaurant, the outreach worker wasted no time in sizing me up by asking, “You’re

orga_c04.qxd

112

2/5/07

10:52 AM

Page 112

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

such a huero [light-skinned] Latino . . . do you think that has helped you to become successful?” Without skipping a beat, I swallowed my spoonful of soup and said, “In a racist society like ours? How could it not be an advantage?” He smiled knowingly at my quick, honest, and correct response and proceeded to orient me to his excellent work with the local migrant day laborers and to assist with access to this hard-to-reach population (see Chapter 9). Because Latinos can be of any racial background, there is tremendous variety in skin color and other aspects of physicality. In our racialized society, we should expect that phenotypic differences within Latino groups will result in differences in social welfare. Such differences have been studied more extensively in African Americans, yet similar research and findings are available for Latinos. Arce, Murguia, and Frisbie (1987) examined the relation between phenotype and life chances in a probability sample of just under 1,000 Chicanos from the southwestern United States and Chicago. Phenotype was assessed by interviewer ratings of skin color and racial features, each of which were rated on 5-point scales, from very light to very dark, and from very European-looking to very Indian-looking. As predicted, results showed significantly higher SES in light/European-looking Chicanos as compared to those rated dark/Indian-looking. More specifically, significant differences were found in annual income ($12,721 and $10,450, respectively), years of education (9.5 versus 7.8), occupational prestige scores (25.3 and 20.7), and perceived discrimination ratings (25.6 and 27.2). In a fascinating analysis of the extremely few Latinos on Fortune 1000 corporate boards, Zweigenhaft and Domhoff (1998) found that the majority were Cuban Americans from upper-class and elite backgrounds. Analysis by two independent raters of skin color and facial features also revealed these corporate elite Latinos to be light in skin color and more European- than Indian-looking. Latinos constitute less than 1% of corporate directors of Fortune 1000 boards, and only 1.4% of executives at vice presidential levels and above. Thus, factors such as social class, skin color, and ethnic minority appearance have tangible implications for Latino life chances and social welfare. M I X E D R AC I A L A N D E T H N I C H E R I TAG E Mixed racial heritage is an inherent part of being Latino, given their mestizaje, or “mixture” of Spanish and indigenous Indian heritage and the blending of Indians with Africans during the slave trade. The term here refers to the American usage of being from two predominant racial/ethnic parental backgrounds (e.g., African American and European Ameri-

orga_c04.qxd

2/5/07

10:52 AM

Page 113

Diversity within Latinos

113

can, Latino and European American, Latino and African American). Despite the reductionism of such a narrow social construction of racial/ ethnic background, its real consequences for psychosocial adjustment warrant attention. For example, in a 15-family study of biracial children, Winn and Priest (1993) found that 82% of the 34 children interviewed claimed that they felt obligated to assume a monocultural racial designation, with many feeling like traitors to the parent with whom they did not racially identify. These youth also consistently claimed that their parents did not adequately prepare them for the negative reactions of both Whites and minority peers, and a third expressed a desire to learn about the cultures of both parents. Interestingly, two of the three Cuban/White adolescents in the study identified as Cuban, the other as White, and all three reported dating both Cuban and White friends. The one Puerto Rican/Anglo participant identified as Puerto Rican and socialized mostly with Puerto Rican peers. This study documents many of the potential problems that mixed youth are likely to face in a society with rigid constructions of race, and where most people, let alone parents, are not adept at preparing such youth for mixed racial socialization (i.e., inoculation from internalizing society’s stereotypes and biases). On the positive side, Winn and Priest (1993) found that most of the adolescents in the sample indicated feeling good about their racial identity and reported socializing (e.g., dating) with a mix of friends. These researchers end their report by urging counselors and parents to help children explore their dual heritage but stop short of saying how. One obvious key to adjustment in such youth is close ties to both parents and avoiding the pressure to identify with only one side of their family. For example, de Anda and Riddel (1991) studied a sample of 70 mixed adolescents (22 Asian/White, 23 Black/White, 25 Latino/White) who reported identifying as multiethnic, high comfort and acceptance by both majority and minority peers and settings, strong bonds with both sides of their family, and a preference for ethnically diverse friends. Interestingly, of the 23 Latino/White respondents, 15 reported being perceived as White by strangers, yet all but two identified as Latino. de Anda and Riddel (1991) stressed the importance of not drawing samples of mixed-race individuals from clinical settings, where maladjustment is more likely. Their sample (obtained through both convenience and snowball sampling) was characterized by a high number of intact homes (61.4%), although with notable differences across the three groups: 81.2% in the Asian/White group, 64% in the Latino/White group, and 39.1% in the Black/White group. Although these three groups did not differ on the healthy outcomes, it makes one wonder about the challenges of

orga_c04.qxd

114

2/5/07

10:52 AM

Page 114

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

integrating a dual racial/ethnic heritage if one is from a divorced background. Also, because participants in de Anda and Riddel’s study were all “half-White,” we must also wonder how being from two stigmatized minority backgrounds (e.g., Latino and African American) might affect adjustment. BLACK LATINOS In the classic Puerto Rican coming-of-age novel, Down These Mean Streets, author Piri Thomas (1967) describes the challenges of growing up in Spanish Harlem as including being perceived and treated as African American. Job discrimination and interpersonal rejections are poignantly detailed, and there’s even a chapter titled “How to Be a Negro without Really Trying.” Other than Thomas’s work, there is extremely little literature about the experience of Black Latinos (i.e., those who are racially Black and culturally Latino), although it’s not hard to imagine some of the negative consequences that could result from such a combination of stigmatized identities in both the U.S. and Latino cultures. Based on his professional experience as a family therapist, Baptiste (1990) wrote one of the earliest papers on this topic. The author made mention of some of the identity problems faced by adolescent family members trying to figure out who they are in America’s color-conscious society. Later, Comas-Diaz (1996) wrote about the Latinegra, or Black Latina of Caribbean background, and the myriad potential and actual problems reported by such women. In addition to identity issues, ComasDiaz highlights sex and class issues such as being stereotyped as sexually exotic yet unsuitable marriage material for adelantar la raza (lifting up the race). She notes that terms of endearment, such as negrita (little Black one) and prieta (dark one), contain ambivalence and often mean something like, “You’re Black and ugly but we love you anyway.” All of the problems outlined by Comas-Diaz have roots in racismo, or Latino-style racism in which dark family members are held in lower esteem and treated in kind as a result of internalized oppression. Also described are ways in which Latinegras have begun to empower themselves by forming organizations such as the Unión de Mujeres Puertorriquenas Negras (Union of Black Puerto Rican Women) to bring attention to this divisive intracultural manifestation of racism. Such writings veer close to a “tragic mulatto” portrait of Black Latinos, but a shred of empirical support comes from a rare study by Ramos, Jaccard, and Guilamo-Ramos (2003), who compared symptoms of depression in four groups of adolescents in grades seven through 12: AngloAmericans, African Americans, Black Latinos, and non-Black Latinos

orga_c04.qxd

2/5/07

10:52 AM

Page 115

Diversity within Latinos

115

from the National Longitudinal Study of Adolescent Health survey of more than 20,000 students. These researchers found that Latinegra adolescents had the highest levels of depression, which was attributed not just to their dual racial/ethnic status, but to being female and perhaps less able than their Latinegro male counterparts to negotiate both minority group experiences. That Latinos in this study, including Afro-Latinos, were predominantly Puerto Rican in background, further supports the writings of Comas-Diaz (1996). While much more research is needed on human diversity within Latino subgroups, human service providers need to be better prepared to address potential dilemmas in mixed racial heritage or being a Black Latino. Because traditional racial/cultural identity models were developed with single racial/ethnic groups in mind, they are limited in their application to many Latinos. Still, familiarity with the racial/cultural and White identity models reviewed in Chapter 3 provides a basis on which to help mixed race and mixed ethnic individuals to resist negative social conceptions of either side of their family backgrounds and to pursue the objective of selectively sorting out cultural strengths from each particular background with which to create a more integrated multiracial, multiethnic sense of self. CONCLUSION This chapter has barely scratched the surface regarding the immense human diversity within U.S. Latino subgroups and of the differential impacts of oppression, as well as privilege, on various major subgroups of Latinos categorized by society on the basis of social constructions of gender, sexual orientation, immigration status, phenotype, and mixed racial heritage. So many other categories and their consequences should be addressed in the future (e.g., disability status), including even finer gradations and various combinations of identities and status dimensions within the same individuals. Hopefully we will continue to connect the many dots of oppression affecting various categories of people in the United States in order to promote a more just society for all Americans. R EFER ENCE S Arce, C. H., Murguia, E., & Frisbie, W. P. (1987). Phenotype and life chances among Chicanos. Hispanic Journal of Behavioral Sciences, 9(1), 19–32. Baptiste, D. (1990). Therapeutic strategies with Black-Hispanic families: Identity problems of a neglected minority. Journal of Family Psychotherapy, 1, 15 –38. Bell, L. A. (1997). Theoretical foundations for social justice education. In M. Adams, L. A. Bell, & P. Griffin (Eds.), Teaching for diversity and social justice: A sourcebook (pp. 3 –15). New York: Routledge.

orga_c04.qxd

116

2/5/07

10:52 AM

Page 116

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Cass, V. C. (1990). The implications of homosexual identity formation for the Kinsey model and scale of sexual preference. In D. P. McWhirter, S. A. Sanders, & J. Machover Reinish (Eds.), Homosexuality/ heterosexuality: Concepts of sexual orientation (pp. 239–266). New York: Oxford University Press. Chavez, L. R. (1998). Shadowed lives: Undocumented immigrants in American society (2nd ed.). Fort Worth, TX: Harcourt Brace College Publishers. Clements-Nolle, K., Guzman, R., & Katz, M. (2001). HIV prevention, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. American Journal of Public Health, 91, 915 –921. Comas-Diaz, L. (1996). Latinegra [Black Latina]: Mental health issues of African Latinas. In M. Root (Ed.), The multiracial experience (pp. 167–190). Thousand Oaks, CA: Sage. de Anda, D., & Riddel, V. A. (1991). Ethnic identity, self-esteem, and interpersonal relationships among multiethnic adolescents. Journal of Multicultural Social Work, 1(2), 83 –98. Diaz, R. M. (1998). Family loyalty and sexual silence: Splitting off sexuality. In R. M. Diaz. Latino gay men and HIV: Culture, sexuality, and risk behavior (pp. 89–111). New York: Routledge. Espín, O. M. (1987). Psychological impacts of migration on Latinas: Implications for psychotherapeutic practice. Psychology of Women Quarterly, 11, 480–503. Espín, O. M. (1997a). Issues of identity in the psychology of Latina lesbians. In O. M. Espín, Latina realities: Essays on healing, migration, and sexuality (pp. 97–109). Boulder, CO: Westview Press. Espín, O. M. (1997b). Leaving the nation and joining the tribe: Lesbian Latinas crossing geographical and identity borders. In O. M. Espín, Latina realities: Essays on healing, migration, and sexuality (pp. 186 –192). Boulder, CO: Westview Press. Green, J. (2000). Introduction to transgender issues. In P. Currah & S. Minter (Eds.), Transgender equality: A handbook for activists and policymakers (pp. 1–12). Washington, DC: National Center for Lesbian Rights and the Policy Institute of the National Gay and Lesbian Task Force. Guendelman, S. (1987). The incorporation of Mexican women in seasonal migration: A study of gender differences. Hispanic Journal of Behavioral Sciences, 9, 245 –264. Hardiman, R., & Jackson, B. W. (1997). Conceptual foundations for social justice courses. In M. Adams, L. A. Bell, & P. Griffin (Eds.), Teaching for diversity and social justice: A sourcebook (pp. 16 –29). New York: Routledge. Hondagneu-Sotelo, P. (1994). Gendered transitions: Mexican experiences of immigration. Berkeley: University of California Press. Hurtado, A. (1997). Understanding multiple group identities: Inserting women into cultural transformation. Journal of Social Issues, 53(2), 299–327. Marger, N. N. (2000). Ethnic stratification: Power and inequality. In M. N. Marger (Ed.), Race and ethnic relations: American and global perspectives (5th ed., pp. 36 –68). Belmont, CA: Wadsworth.

orga_c04.qxd

2/5/07

10:52 AM

Page 117

Diversity within Latinos

117

National Association of Social Workers. (1999). Code of Ethics of the National Association of Social Workers. Washington, DC: Author. Nemoto, T., Luke, D., Mamo, L., Ching, A., & Patria, J. (1999). HIV risk behaviors among male-to-female transgenders in comparison with homosexual or bisexual male and heterosexual females. AIDS Care, 16(6), 724 –735. Nemoto, T., Operario, D., Keatley, J., Han, L., & Soma, T. (2004). HIV risk behaviors among male-to-female transgender persons of color in San Francisco. American Journal of Public Health, 94(7), 1193 –1199. Nemoto, T., Operario, D., Keatley, J., & Villegas, D. (2004). Social context of HIV risk behaviors among male-to-female transgenders of color. AIDS Care, 16(6), 724 –735. Ramos, B., Jaccard, J., & Guilamo-Ramos, V. (2003). Dual ethnicity and depressive symptoms: Implications of being Black and Latino in the United States. Hispanic Journal of Behavioral Sciences, 25(2), 147–173. Rodriguez, R. A. (2004). Psychotherapy with gay Chicanos. In J. C. Velasquez, L. M. Arellano, & B. W. McNeill (Eds.), Handbook of Chicana/o psychology and mental health (pp. 193 –214). Mahwah, NJ: Erlbaum. Schulman, K. A., Berlin, J. A., Harless, W., Kerner, J., Sistrunk, S., Gersh, B. J., et al. (1999). The effect of race and sex on physicians’ recommendations for cardiac catheterization. New England Journal of Medicine, 340(8), 618–626. Szapocznik, J., Scopetta, M. A., Kurtines, W., & Arnalde, M. A. (1978). Theory and measurement of acculturation. Interamerican Journal of Psychology, 12, 113 –130. Thandeka. (2003). The cost of Whiteness. In K. E. Rosenblum & T. C. Travis (Eds.), The meaning of difference: American constructions of race, sex and gender, social class, and sexual orientation (3rd ed., pp. 254 –263). Boston: McGraw-Hill. Thomas, P. (1967). Down these mean streets. New York: Signet Books. Winn, N. N., & Priest, R. (1993). Counseling biracial children: A forgotten component of multicultural counseling. Family Therapy, 20(1), 29–36. Zweigenhaft, R. L., & Domhoff, W. D. (1998). Latinos in the power elite. In R. L. Zweigenhaft & W. D. Domhoff, Diversity in the power elite: Have women and minorities reached the top? (pp. 118–139). New Haven, CT: Yale University Press.

orga_c04.qxd

2/5/07

10:52 AM

Page 118

orga_c05.qxd

2/5/07

10:52 AM

Page 119

CHAPTER 5

A New Practice Model for Working with Latinos THE THEORETICAL FRAMEWORKS presented in Chapters 1 through 4 (acculturation, social stratification, racial/ethnic identity development, subgroups and identities) are designed to educate and sensitize readers to the social and cultural experiences of U.S. Latinos. These specialized frameworks, constructed from pertinent social science research and theory, provide a foundation for conducting culturally sensitive assessment and culturally competent practice across various Latino problems and subpopulations. Unfortunately, the terms cultural sensitivity and competence have been used so repetitively in the past 30 years, often with such superficiality, that just reading them again can evoke a kind of a cultural fatigue currently afflicting many practitioners and the general population alike. However, if defined, framed, and illustrated clearly, cultural sensitivity and competence become real, and practitioners become capable of conducting assessments of proper depth and understanding to maximize the probability of effectively intervening with Latinos. The purpose of this chapter is to present a new model of culturally and socially competent practice with Latinos that spans both generalist and specialized practice domains and that is solidly grounded in the literature. It should be noted that the state of the art in such model building is still young, with plenty of room to grow. Hopefully, more research and service attention to Latinos will ensue. The new practice model is designed to provide practitioners and service administrators with a comprehensive yet user-friendly approach that can easily be called on in service and practice settings. Presentation of the practice model is preceded by two major sections designed to provide the reader with conceptual background information on the potential intervention field as well as critical thinking about cultural competence. Given the practice model’s frequent use of the terms cultural sensitivity and competence, working definitions of these popular constructs are provided next. 119

orga_c05.qxd

120

2/5/07

10:52 AM

Page 120

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Cultural sensitivity to Latinos refers to being sensitized to the cultural and social realities of Latinos in ways that render them fully human in the eyes of service providers, administrators, and researchers in the social sciences and services. This brand of sensitivity involves developing an increasingly keen awareness of oneself, both as a person and a professional, and how one’s own multiple group memberships and socialization can influence relationships with others. Thus, developing cultural competence is no small accomplishment when we ponder the ways that we as Americans have historically been socialized to view people of color, first as genetically inferior, later as culturally inferior, still mostly to blame for their poverty and related problems, and thus undeserving of assistance. Parallel forms of socialization around gender and sexual orientation within all American ethnic groups similarly render women and sexual minorities less than fully human and thus deserving of discrimination. The culturally sensitive human service provider or social scientist is aware of the social and interpersonal dynamics of dehumanization and is committed to not inadvertently perpetuating them. Cultural sensitivity advances the essential need to continue to “rehumanize” Latinos and other dehumanized groups via educational and interpersonal teaching and experiences. Cultural competence with Latino clients presumes adequate cultural sensitivity and uses such understanding to acquire, and often create, assessment and intervention skills and abilities based on the social and cultural realities, as well as the assets and human potential, of Latino clients. As such, cultural competence maximizes the probability of being effective in problem solving and minimizes the probability of insensitive and incompetent approaches that reveal and reify our biased socialization.

C O N C E P T UA L BAC K G RO U N D T O T H E P O T E N T I A L I N T E RV E N T I O N F I E L D THE ECOLOGICAL-SYSTEMS PERSPECTIVE Elaborate writings and discussions of the ecological-systems (E-S) perspective can help service providers develop a more comprehensive cognitive map of human beings in the social environment (e.g., Bronfenbrenner, 1979; Germain, 1987). The bottom line of the E-S perspective is to help social and human service providers consider multiple problem levels and solutions and to think outside of the box of their traditional disciplinary training. This is accomplished by learning to use the E-S perspective to help visualize how multiple interactions between human systems of various sizes, over the life cycle and across biological, psychological, and social

orga_c05.qxd

2/5/07

10:52 AM

Page 121

A New Practice Model for Working with Latinos

121

domains, result in varying degrees of adaptation and adjustment for individuals and groups. Using an E-S map is no small feat considering the boundaries and confines of disciplinary training, which are narrow by design and tend to overproduce practice specialists while underproducing generalists better able to grasp the bigger human picture. Even in the field of social work, which subscribes to the E-S perspective as its general practice framework, there has been a tendency to set this perspective aside in the process of specialization in areas such as health, mental health, gerontology, and school social work. Part of the problem is that the E-S perspective can be detailed to a fault, overwhelming in the practice arena, and is ultimately descriptive and not prescriptive regarding solutions to problems (Wakefield, 1996a, 1996b). This is not to say that authors have not advocated methods for applying the E-S perspective to diverse populations (e.g., Greene & McGuire, 1998), but even these attempts are overreaching in their attention to seemingly all aspects and relationships in the social environment. For these reasons, only a brief and, I hope, retainable overview of an E-S map is provided on which a user-friendly practice model is built. At minimum, ecosystemic experts describe a social environment such as that depicted in Figure 5.1. The individual at the center is herself a system Theoretical Framework I

Theoretical Framework II

Macro Systems Meso Systems Micro Systems (The Individual)

Theoretical Framework III

Biological System

Social System

Theoretical Framework IV

Psychological System

Theoretical Framework V

Theoretical Framework VI

I: Oppression and Social Justice II: Acculturation and Adjustment III: Social Stratification of Ethnicity and Power

IV: Ethnic Identity V: Diversity within Populations VI: What else?

Figure 5.1 Conceptualizing the Potential Practice Field

orga_c05.qxd

122

2/5/07

10:52 AM

Page 122

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

of biological, psychological, and social subsystems, reminding practitioners to ask the basic question, “How much of the problem before me is a function of this individual’s biological makeup, psychological makeup, or social makeup?” This biopsychosocial perspective is thus a perspective within a perspective and represents a significant advancement over being trained to see human problems as overdetermined by any one subsystem. For example, a former client shared that his son suffered from terrible headaches as a toddler that baffled the family’s general medical provider, who eventually referred the child’s parents to mental health professionals, who attributed the headaches to marital problems. But when the painful problem persisted after weeks of couple therapy, the client’s wife concluded that couple therapy was not the solution despite some initial buy-in to working on marital issues. She and her husband took their son to a university hospital where it was discovered that he was suffering from a large benign brainstem tumor. Emergency brain surgery followed and fortunately was successful in resolving the problem. Micro-Level Systems The story just related illustrates the semiporous boundaries between biopsychosocial and other E-S levels. That is, a problem arising primarily in the biological system of the child dramatically spilled over into the child’s temperament and behavior (psychological system), and into the social system of the family, in which confused siblings and exasperated parents struggled to understand and remedy the problem. The micro system in Figure 5.1 refers to any human system containing an individual (e.g., family, day care center) or containing a basic human relationship such as a couple or family (e.g., health center, mental health center). Defining the problem as marital and treating it at the local mental health center represents a micro system containing the couple, as does the hospital setting in which the child was eventually correctly diagnosed and treated. Meso-Level Systems Meso systems refer to interactions between micro systems that contain an individual, couple, or family (e.g., the family practitioner referring the family to the mental health center). Theoretically, the more meso-systemic activity on behalf of a client, family, or group, the more comprehensive the care because more problem levels and solutions can be considered. Obviously the current example reminds us of the need to perform all of our respective jobs well within our specific domains and to strive for greater continuity between systems of care (e.g., the family practitioner could have done a physical work-up before referring the family to mental health

orga_c05.qxd

2/5/07

10:52 AM

Page 123

A New Practice Model for Working with Latinos

123

professionals, who in turn could have communicated more with the physician about ruling out a physical health problem). Macro-Level Systems Beyond meso systems are broader societal norms, values, ideologies, and numerous institutions and organizations that influence and govern meso and micro human systems. Macro systems include pervasive American ideologies and practices such as democracy, capitalism, and the free enterprise economic system, and related values and narratives such as the American dream, rugged individualism, and meritocracy. Predominant patterns of national and cultural lifestyles are also included under macro systems; these are the general social, political, economic, and religious lives of people. Though abstract, macro systems remind us of the power of overarching social forces to shape specific social and human service policies, funding streams, and the specific designs of formal and informal helping institutions. They also remind us of ways we as a society define and respond to problems. For the most part, problem definitions and solutions have been generated by and for mainstream Americans in an ethnocentric manner that often ignores the problems and needs of people of color, or has attributed them to cultural or individual factors within these groups rather than compelling external factors and forces reviewed in Chapters 1 through 4. As the arrows in Figure 5.1 illustrate, the purpose of this book is to infuse our E-S cognitive map with several Latino-relevant social science theories and bodies of knowledge, organized in Chapters 1 through 4, to enhance cultural sensitivity. Although not definitive, such a basic set of frameworks lowers the probability of perpetuating past mistakes, provides a foundation on which to integrate state-of-the-art culturally competent practice with Latinos, and advances such practice by constructing cutting-edge, social justice-oriented approaches. T H E C U R R E N T S TAT E O F T H E A R T I N C U LT U R A L LY C OM PE T E N T PR AC T I C E A N D B E YO N D THE THREE DIMENSIONS

OF

CULTURAL COMPETENCE

After scouring the social science literature, pioneers in the field of social work (e.g., Lum, 1996, 1999; Manoleas, 1994) have fashioned a threedimensional model of culturally competent practice that captures the complexity of this multidimensional concept and also nicely complements the three major levels of the ecosystemic perspective (see Table 5.1). By blending the three dimensions of cultural competence with the three

orga_c05.qxd

124

2/5/07

10:52 AM

Page 124

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH Table 5.1 Conceptual Background for Potential Practice Field Three Major Levels of the Ecological-Systems Perspective

Three Major Dimensions of Culturally Competent Practice

Micro

Meso

Macro

Knowledge Formal Informal

Skills Assessment Intervention

Lifelong commitment and development Personal Professional

major levels of the E-S perspective, practitioners can better visualize the vast potential intervention field. Such a 3 × 3 matrix is meant not to overwhelm practitioners and administrators but to provide them with a comprehensive cognitive map on which to build manageable practice models in their areas of concern and interest. Knowledge As can be seen in Table 5.1, knowledge is the first major dimension of cultural competence. This consists of the formal kinds of knowledge, conveyed in Chapters 1 through 4, as well the informal knowledge acquired in the daily lives of practitioners as people (e.g., in daily interactions with people and society, experiences of popular culture). By its nature, the dimension of knowledge refers to both the storage of pertinent information and to increasing awareness of the social, cultural, and historical experiences of Latinos and other diverse groups, including those to which practitioners may belong. Such specialized knowledge includes a fundamental understanding of oppression and social justice, as discussed in Chapter 4.

orga_c05.qxd

2/5/07

10:52 AM

Page 125

A New Practice Model for Working with Latinos

125

Skills But knowledge is not enough to facilitate needed change with Latinos. Thus the skills dimension refers to the ongoing development of assessment and intervention skills with which to address problems in a culturally competent manner. Mostly we think of such skills as formal and disciplinary-related. But we should be open to discovering, tapping, and building on informal, culture-based, and socially adaptive skills already within clients and groups. Frankly, it is exactly these kinds of “indigenous” skills and natural support systems that have been primarily responsible for the survival and adaptation of ethnic minorities in the United States (e.g., development of ethnic communities and extended family systems that engage in mutual help, adherence to or reinvention of cultural practices that reaffirm the humanity of group members under dehumanizing conditions). In his model of culturally competent practice, Lum (1999) goes into great detail in his description of skill development, which includes the following basic skills: • The skill to generate profiles of the communities in which one practices that include sociodemographic data on community members and locations of community resources that can be tapped to address local patterns of psychosocial, health, and economic problems: Such profiles also include awareness of local history and the community’s struggles to empower itself, some of which may have directly involved the practitioner’s place of work! For example, a few years ago when I approached a community Latino health center with the idea of evaluating their HIV prevention services for farmworkers, I expected and understood the immediate reaction of staff, who protested the number of times my university had “used them like guinea pigs” in the past to collect data from which only the researchers benefited (called “hit and run” research by some community members). I smiled knowingly and agreed, “That’s what universities frequently do!,” and proceeded to ask how we could work together differently to minimize exploitation and help the agency obtain what it needed. • The skill to engage in culturally based relationship protocols with diverse clients that enhance initial rapport and facilitate engagement in the helping relationship: The typical mainstream approach of beginning professional relationships by immediately addressing the task at hand (e.g., “What seems to be the problem?” or “How can I help you?”) is frequently misperceived by Latinos as impersonal,

orga_c05.qxd

2/5/07

126

10:52 AM

Page 126

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

even cold and rude, if a small amount of time is not taken in the beginning to personalize the relationship (e.g., introducing oneself with some background information, expressing warmth and care by asking clients how they are feeling, whether they are comfortable, if they need a glass of water). • The skill to view problems from a nonpathological perspective or as unmet needs or ways of coping that promote survival under trying circumstances: This idea is like the popular strengths perspective that stresses taking inventories of client and community assets instead of seeing them only as containers of problems that need to be fixed (e.g., Rapp, 1998). But though refreshingly positive, the strengths perspective is a reaction to the historically biased tradition in the social sciences of constructing minorities as defected and in need of repair by mainstream society. It is my contention that optimal assessment skills need to be as comprehensive and balanced as possible in identifying strengths and weaknesses, health and pathology, at both individual and larger social levels. If we do not lose sight of the full humanity of our diverse clients, problematizing issues or labeling serious problems as pathology need not be dehumanizing. For example, and as discussed in Chapter 7, the pathology of gang involvement (i.e., violent deaths, major injuries, crime) should not be minimized, but neither should the multiple unmet needs of these marginalized youth (i.e., developmental, familial, sociological) that leave them vulnerable to the lure of street gang activity as a misdirected way of getting basic needs met. • At more advanced practice levels, Lum discusses the skill of designing and administrating culturally competent social services. Taking cultural competence to administrative levels involves incorporating its major dimensions into agency mission statements, policies, and objectives, staff training, student supervision, and client services. • Applying research in an informed manner to client problems involves being on top of research in one’s area to provide evidencebased treatments rather than doing merely what is familiar or what one prefers to do. For example, many graduate students frequently express an antimedication bias as they approach mental health services despite research evidence showing that antidepressant medications are as effective as different forms of psychotherapy. Getting beyond such biases frees practitioners to consider more treatment options, to educate clients about such choices, and to better match treatments to clients with regard to their social-psychological and cultural makeup.

orga_c05.qxd

2/5/07

10:52 AM

Page 127

A New Practice Model for Working with Latinos

127

Lifelong Professional Commitment Lifelong development of cultural competence is a personal and professional commitment to an ongoing process of formal and informal education and skill acquisition that continues to enhance practice with Latinos and other diverse groups. To a significant degree, mandated continuing professional education and conferences are the formal mechanism for keeping practitioner knowledge and skills up to date in both general and diversity-specific ways. Lum (1999) describes the culturally competent practitioner as conscientiously keeping up with the latest in diversity-related practice knowledge and skills, in addition to generating and passing on such expertise via supervision, program evaluation, teaching, and consultation. A N E W PR AC T I C E MO DE L F OR WOR K I N G W I T H L AT I NO S Bumper sticker wisdom urges us to “Think globally and act locally,” and that is exactly what a viable model of culturally competent practice can help us do. That is, all of the foregoing conceptual background information helps us to think more broadly about Latino problems and issues so as to more effectively address local problems and clients in our domainspecific work settings. Thus, the new practice model presented here is a 2 × 4 matrix composed of 2 practice levels and 4 major dimensions of service that are essential to culturally competent practice with Latinos and other diverse groups (see Table 5.2). This matrix is the culmination of various models of general multicultural and Latino-specific practice from counseling and clinical psychology, from which the bulk of such literature comes, as well as from the field of social work which has proven resourceful at mining psychology and other disciplines for approaches that can be expanded to more comprehensively address human systems in the social environment. GENERALIST AND SPECIALIZED PRACTICE The fact of the matter is that most practitioners in society are trained to be specialists in specific domains of health, mental health, education, or social or economic services. Even social workers, whose training is generalist by design, typically develop domain-specific expertise in specific problems and populations. Though highly desirable, true multidisciplinary service and treatment collaborations are still the exception to the specialization rule, and our model must reflect this reality. Thus the new practice model describes four major service dimensions discussed mainly

orga_c05.qxd

128

2/5/07

10:52 AM

Page 128

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH Table 5.2 New Practice Model for Working with Latinos Four Major Dimensions of Culturally and Socially Competent Practice

Practice Levels

Increase Service Availability and Access

Problem Assessment in Social and Cultural Contexts

Select Culturally and Socially Acceptable Interventions

Increase Service Accountability

Generalist

Specialized

at the generalist level of practice (i.e., what virtually all culturally competent services need to address). How such generalist skills are applied to specific practice domains is addressed in the practice-oriented chapters that follow. INCREASE SERVICE AVAILIBILITY AND ACCESS Understanding Latino Underutilization Way back in the 1950s and 1960s, mental health service providers concluded that Mexican Americans had better mental health than AngloAmericans because their rates of mental health service use were much lower (Padilla, 1978). Though it was tempting for Mexican Americans to believe that they were less crazy than Anglos, pioneering Latino mental health experts began to challenge this assumption, citing all of the risk factors surrounding the Chicano experience (e.g., poverty, immigration and acculturation stress, discrimination). Indeed, some of the first prevalence studies to include Mexican Americans began to document rates of mental disorders roughly equivalent to the general U.S. population (e.g., Karno et al., 1987). It was eventually concluded that the low rates of men-

orga_c05.qxd

2/5/07

10:52 AM

Page 129

A New Practice Model for Working with Latinos

129

tal health service use had more to do with barriers to services than a lack of problems. Initially, Latino underutilization was also blamed on factors within Latino groups, such as mistrust of Anglo professionals, reliance on the family to solve problems, and even preferring indigenous folk healers and medicine over formal services. It was not until the late 1970s that evidence began to accrue pointing to major barriers to service outside of Latino groups. In 1978, President Carter’s Task Force on Minority Mental Health published a landmark report on underutilization that attributed the pervasive problem to four major social structural barriers (Parron, 1982). These obstacles all begin with the letter “A” and can be used as a convenient checklist to quickly assess the degree to which an agency or service provider is culturally competent: • Availability: This obstacle refers to the pervasive lack of available mental health services to ethnic minority populations and communities. • Accessibility: This obstacle refers to lack of accessible mental health services due to clinics’ inconvenient locations and limited hours of operation, lack of transportation to such services, and lack of health insurance and other financial resources to pay for available services. • Acceptability: This obstacle refers to the pervasive lack of mental health services that are culturally acceptable to ethnically diverse patients. Basic to this obstacle is the chronic lack of staff and practitioners who are bilingual and bicultural. Other dimensions of culturally acceptable services include the modification of conventional treatments to include elements of the ethnic client’s culture and social experience (e.g., language, values, culture-based interpersonal styles, ways of defining and solving problems, flexible hours, provision of child care). In a review of the literature comparing culturally responsive to conventional mental health services, Atkinson and Lowe (1995) found that the former were superior in increasing perceived credibility of therapists, willingness to return to treatment, satisfaction with therapy, and depth of disclosure in therapy on the part of ethnic minority clients. • Accountability: This obstacle refers to a lack of accountability to the ethnic community in terms of developing and providing desired mental health services with multiple forms of client and community input. Rarely are ethnic community leaders, members, and mental health service consumers consulted about service development and provision. There is also a pervasive lack of formal mechanisms of practice and agency accountability, ranging from service evaluation research to client suggestion boxes.

orga_c05.qxd

130

2/5/07

10:52 AM

Page 130

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

The Outreach Imperative Latinos and other populations overaffected by segregation, exclusion, and poverty require concerted efforts on the part of service providers to make them aware of and encourage them to use available services. Service providers need to routinely institutionalize multiple forms of outreach to Latinos, ranging from advertisements in popular media to the use of community outreach workers who go to where Latinos live and work to educate them about services and to provide them with on-the-spot prevention education as well as referrals. In general, Latinos at highest risk for serious problems are also the most marginal and in need of outreach efforts. For example, poor, urban-based, IV-drug-abusing Puerto Ricans are at highest risk for HIV/AIDS and require customized outreach efforts to decrease risk where it hits hardest (addressed in Chapter 9). PROBLEM ASSESSMENT

IN

SOCIAL AND CULTURAL CONTEXTS

Imagine defining Latino client, group, community, and national problems in ways that link them to the Latino historical experience of oppression and its living legacies of oversegregation, poverty, and marginality. Although it is a bit abstract, Lum (1999) would begin such an endeavor with a bias toward defining problems as unmet needs, coping efforts to survive, and as “psycho-individual reactions” (at the micro level) to environmental impacts (at the macro level). Some problems may seem more amenable to such consideration than others (e.g., gang involvement versus diabetes), but it is a worthwhile exercise for practitioners to use the practice background matrix in Table 5.1 to consider multiple problem levels and whether or not a specific problem may be part of a problem pattern linked to Latino ethnicity or some other dimension of diversity. For example, although the problem of diabetes seems neatly confined to the domain of biology, why is it so disproportionately high among the poorest of Mexican Americans and Puerto Ricans, as well as the poorest of African and Native Americans? Further, why are diabetes risk factors, such as obesity, poor diet, and sedentary lifestyle, also disproportionately high in these groups? And finally, why do people of color experience more complications and die sooner from diabetes than their White counterparts? If links between diabetes and racial/ethnic experiences can be made, this problem should be understood and treated as such (e.g., public health campaigns, measures to reduce poverty, further discussed in Chapter 9). Biopsychosocial Problem Levels As mentioned earlier, a biopsychosocial perspective allows us to consider the possible contribution of each of these domains to a problem such as

orga_c05.qxd

2/5/07

10:52 AM

Page 131

A New Practice Model for Working with Latinos

131

diabetes. For example, in the social domain, research shows that many Latinos with diabetes are less aware of it due to lack of effective public health information and problematic access to health services. In the psychological domain, what Latinos think and feel about this disease bear serious consideration for optimal intervention. For those who become diagnosed, the prospect of changing, say, a traditional Mexican diet, so often tied to cultural lifestyle, may result in pessimism to control the course of this serious medical problem. The bottom line is that even the most formal medical diagnosis may require a healthy co-construction of the disease on the part of physicians and patients in such a way that patients become knowledgeable, skilled, and motivated to manage problems like diabetes. Empowerment as Practice Theme As the diabetes example illustrates, the problem assessment process is generally improved by actively soliciting the client’s or the community’s conception of the target problem and collaborating in a process of codefining problems, intervention goals, and methods. This is consistent with an empowerment approach to providing services to Latinos and other groups with a history of significant disempowerment. According to Gutierrez, Parsons, and Cox (1998), empowerment practice imbues traditional professional help with consciousness raising that makes clients aware of the connections between personal and public problems. That is, while immediate problems require immediate actions to relieve suffering, dialogue between practitioners and clients about the links between problems and social and political forces should be gradually pursued. As such, problem definition and understanding is performed with rather than for clients, as are intervention efforts that increasingly involve clients along the continuum from self-care to helping others affected by communitywide problem patterns. Empowerment is thus both process and outcome. Conscious effort on the part of practitioners is required to include this theme in assessment and intervention efforts. But how do we empower disempowered clients in an era of dwindling and fragmented public services and privatization of social services that emphasize cost containment and profit over entitlements, and in traditional service organizations characterized by hierarchical power structures and professionals in the roles of experts and authorities? Advocates of empowerment practice who have studied its application at the administrative and service levels have identified a number of major obstacles and supports, some of which are listed in Table 5.3 (Cox & Randal Joseph, 1998; Gutierrez, Glenmaye, & DeLois, 1995). Constraints to empowerment

orga_c05.qxd

132

2/5/07

10:52 AM

Page 132

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH Table 5.3 Practice Theme of Empowerment Obstacles

• • • • • •

Expectations of funding body Severe/abusive clients Competition between agencies Different service approaches Discontinuity between services Difficulty measuring empowerment

Supports • • • • • • • • • • • •

Administer vision/values/philosophy Broad-based flexible funding Teamwork to achieve goals Peer supervision Staff in-service and empowerment training Delegation to action groups by constrained administrators Staff self-care institutionalized “Personal is political” perspective regarding client problems Broad-based support networks Revolving leadership on teams Advisory/decision-making groups Political participation and community organizing

From “The Organizational Context of Empowerment Practice: Implications for Social Work Administration,” by L. M. Gutierrez, L. Glenmaye, and K. DeLois, 1995, Social Work, 40(2), pp. 249–258.

practice can be considerable, and developing supports involves a challenge to the dominant paradigm of practice in the social services. Thus, objectives for accomplishing empowerment practice necessarily involve both short- and long-term goals and a conscious effort to practice against the grain of conventional service delivery. The idea that clients, practitioners, and administrators can be empowered by developing egalitarian collaborative relationships flies in the face of conventional human services as we know and practice it. Yet we must strive to approximate this ideal by decreasing the obstacles and increasing the supports listed in Table 5.3. One starting place is to openly discuss power imbalances inherent in these different relationships and to acknowledge that there are legitimate uses of greater power, as when a client is out of control, not capable of assuming a more collaborative role, or in danger of hurting self or others. Attention to such Latino problem themes is illustrated throughout the second half of this book (Chapters 6 through 10). Common Latino Problem Themes Assessment as described earlier assumes a historical and ongoing environmental context in which most of the major problems affecting Latino

orga_c05.qxd

2/5/07

10:52 AM

Page 133

A New Practice Model for Working with Latinos

133

populations form patterns linked to their ethnic minority experience in America. As such, there begins to emerge for culturally competent practitioners various large and overlapping patterns of problems and issues for most U.S. Latinos: (a) immigration, acculturation, and adaptation issues; ( b) poverty, segregation, and marginalization issues; (c) breakdown of the ethnic community and extended family systems; (d) ethnic identity issues; and (e) the different ways these problem themes play out across multiple status dimensions within Latino populations (e.g., for women versus men). SELECT CULTURALLY AND SOCIALLY ACCEPTABLE INTERVENTIONS Currently, little research exists that indicates the superiority of one type of treatment approach or service over another for different Latino problems and subpopulations. This problem is partly due to the general lack of outcome research that includes Latinos. Without empirical evidence to guide us in the selection of best intervention strategies for Latino problems, we must strive to select, modify, and design conceptually sound intervention efforts based on the general assessment strategies outlined earlier. The intent is to provide interventions that are congruent with the lived reality of Latino clients, and thus experienced as relevant and helpful. This is another way of conceptualizing so-called evidence-based practice when evidence in the form of research results is missing. Latino Client Expectations and Needs Much has been written on the service and treatment expectations of traditionally oriented and low-income Latinos (e.g., immigrants, lower in acculturation), who continue to constitute huge portions of the major U.S. Latino groups. Because of their social and cultural circumstances, service expectations are likely to include immediate symptom relief, direct attention to problems of daily living, prescriptions for medications, advice on how to remedy problems, and preferences for practitioners who are active and directive but also warm, personable, and bien educado (well-mannered, cultured, raised well). From this description of Latino client expectations, it makes practical sense to begin with interventions that are short term and that emphasize prevention, psychoeducation, and coping and problem-solving skills applied to the here and now. In the area of mental health, for example, these expectations provide a rationale for using behavioral or cognitive-behavioral rather than psychodynamic approaches, although ultimately which is best is an empirical question that also considers the particular client and type of problem.

orga_c05.qxd

134

2/5/07

10:52 AM

Page 134

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Practitioners should also experiment with being flexible enough to help with needs and requests not directly a focus of professional attention (e.g., a recent immigrant client seeks the service provider’s help recovering a car that has been towed away, with a letter from the county that she can’t understand, or with the emotional problems of a relative back in Central America). But though it often makes sense to begin at such a traditional starting place, service providers should gradually strive to imbue services with the practice theme of empowerment. Family-Centered Services Given the centrality of the family in the lives of most Latinos, it certainly makes sense to consider service approaches that involve members of the extended family in the assessment and intervention processes. Family therapy is an obvious mental health example, but virtually any human service can involve family members who can help by providing greater insight into problems as well as participate in concerted efforts at problem solving. Community-Based Services The location of most Latino families in heavily Latino-populated communities and the location of most Latino problems in ethnically linked communitywide patterns compel practitioners to provide more comprehensive community-based services that interact with natural support systems and community resources. Rapp and Wintersteen (1989) found that when the strength model of case management was used by agencies caring for the chronically mentally ill, social workers performed the majority of their client contacts in the community and achieved client goals utilizing community resources. Gutierrez et al. (1998) similarly advocate teaching clients to make the connection between personal and social problems and to address them through informal and formal self-help groups, community organizing, and political action. The growing popularity of comprehensive school-based services for both students and their families represents needed movement toward community-based and family-centered efforts toward intervening at several points along the problem continuum, from private to public (described in Chapter 7). Attention to Diverse Subgroups Once viable treatment and service approaches have been identified for Latinos affected by certain problems, practitioners must then engage in the exercise of asking how such an approach would play out over different

orga_c05.qxd

2/5/07

10:52 AM

Page 135

A New Practice Model for Working with Latinos

135

subgroups within the Latino population (i.e., female versus male, gay/lesbian versus straight, elderly versus young adults), as discussed in Chapter 4. Deviating from Culture of Origin? In their classic article on culturally sensitive mental health service for Latinos, Rogler, Malgady, Costantino, and Blumenthal (1987) note that although it makes sense to work within the culture of the client, as the literature uncritically advocates, it is in the best interests of Latino clients to sometimes work outside of their culture of origin. This recommendation is consistent with consensus in the literature that bicultural Latinos probably possess more adaptational skills than their monocultural counterparts. For example, nobody would question the value of monolingual Spanish speakers learning English in the United States, right? Thus, the frequent assertion to work within the culture can sometimes be viewed as a well-intentioned overreaction to the historical practice of cultural imperialism on the part of social institutions, in which Latino culture was pathologized and Latinos were pressured to abandon their culture of origin and replace it with mainstream American culture (e.g., punishing U.S. Latinos for speaking Spanish). Thus the delicate task of the culturally competent practitioner is to understand clients’ oppressive history and still be prepared to work outside of traditional Latino culture, when necessary, in a nonoppressive manner. For instance, Latinos as well as Asians are frequently stereotyped as interpersonally submissive and passive and are offered assertiveness training to decrease these deficits. That is, assertiveness is offered as a superior substitute for traditional Latino communication protocol instead of being introduced as a different cultural style of communication that can be added to the client’s repertoire in the spirit of flexible biculturality in the United States (more on this in Chapter 8). INCREASE SERVICE ACCOUNTABILITY As noted, federally mandated research in the area of minority mental health has documented the pervasive lack of accountability to ethnic and racial minorities on the part of service providers nationwide. Thus the current model of cultural competence advocates multiple institutionalized methods and mechanisms of actively and frequently involving minority clients and their communities, as well as practitioners, in the development, delivery, and evaluation of well-intentioned services. On the client side, such methods range from simple suggestion boxes in waiting rooms (to which responses are posted) to exit interviews following

orga_c05.qxd

136

2/5/07

10:52 AM

Page 136

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

service use to elicit client feedback. The development of community advisory boards composed of key community players (i.e., leaders, advocates, service consumers) is an excellent way to institutionalize Latino community input. At the service provider and agency level, periodic staff surveys regarding service provision and agency environment are another fairly easy way to implement accountability, as is periodic evaluation research to assess the effectiveness of services provided. Although these recommendations make intuitive sense, service providers sometimes dread outcome evaluations, and hence avoid them, because they are perceived as—and can be— overly faultfinding. Such provider concerns are understandable and can be addressed by involving providers directly and early in the planning of evaluations (What do they want to know and why?). Implications of such measures of service assessments range from staff trainings in areas of desired improvement, to the improvement of existing and the development of new Latino-focused services. CONCLUSION We struggle to construct conceptually sound and user-friendly practice models based on a literature still lacking in sufficient theory and empirical research on Latino populations as well as other minority groups. Nevertheless, we need to start from where we are and proceed to outline the next best steps. In the chapters that follow, the working model of culturally competent practice with Latinos presented in this chapter is used as a guide for reviewing and critiquing state-of-the-art and cutting-edge interventions across a wide variety of Latino problems and populations. More specifically, practice efforts are analyzed with respect to the degree to which they increase access, assess client and community problems in a culturally and socially informed manner, select intervention strategies that are congruent with the cultural and social reality of the target population, deviate from Latino culture as needed, and build in multiple mechanisms of accountability. The advantage of selectively reviewing the best Latino practice literature from throughout the social and health sciences to teach culturally competent practice is that doing so presents real-life examples while providing a conceptually grounded critique rather than overwhelming readers with long and impractical wish lists of all the things they should but so often can’t do. Further, because all psychosocial and physical health problems affecting Latinos cannot be addressed in a single text, it makes sense to carefully select and describe in detail a few best and promising practices aimed at solving some of the most important problems affecting Latinos today.

orga_c05.qxd

2/5/07

10:52 AM

Page 137

A New Practice Model for Working with Latinos

137

R EFER ENCE S Atkinson, D. R., & Lowe, S. M. (1995). The role of ethnicity, cultural knowledge, and conventional techniques in counseling and psychology. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 387– 456). Thousand Oaks, CA: Sage. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press. Cox, E. O., & Randal Joseph, B. H. (1998). Social service delivery and empowerment: The administrator’s role. In L. M. Gutierrez, R. J. Parsons, & E. O. Cox (Eds.), Empowerment in social work practice: A sourcebook (pp. 167–186). Pacific Grove, CA: Brooks/Cole. Germain, C. B. (1987). Human development in contemporary environments. Social Service Review, 61, 565 –580. Greene, R. R., & McGuire, L. (1998). Ecological perspective: Meeting the challenge of practice with diverse populations. In R. R. Green & M. Watkins (Eds.), Serving diverse constituencies: Applying the ecological perspective (pp. 1–27). New York: Aldine de Gruyter. Gutierrez, L. M., Glenmaye, L., & DeLois, K. (1995). The organizational context of empowerment practice: Implications for social work administration. Social Work, 40(2), 249–258. Gutierrez, L. M., Parsons, R. J., & Cox, E. O. (1998). A model for empowerment practice. In L. M. Gutierrez, R. J. Parsons, & E. O. Cox (Eds.), Empowerment in social work practice: A sourcebook (pp. 3 –23). Pacific Grove, CA: Brooks/Cole. Karno, M., Hough, R. L., Burnam, M. A., Escobar, J. I., Timbers, D. M., Santana, F., et al. (1987). Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic Whites in Los Angeles. Archives of General Psychiatry, 44, 695 –701. Lum, D. (1996). Social work practice with people of color: A process-stage approach. Pacific Grove, CA: Brooks/Cole. Lum, D. (1999). Culturally competent practice: A framework for growth and action. Pacific Grove, CA: Brooks/Cole. Manoleas, P. (1994). An outcome approach to assessing the cultural competence of MSW students. Journal of Multicultural Social Work, 3, 43 –57. Padilla, A. M. (1978). Psychological research and the Mexican American. In C. A. Hernandez, M. J. Haug, & N. N. Wagner (Eds.), Chicanos: Social and psychological perspectives (pp. 152–159). St. Louis, MO: Mosby. Parron, D. L. (1982). An overview of minority group mental health needs and issues as presented to the President’s Commission on Mental Health. In F. V. Munoz & R. Endo (Eds.), Perspectives on minority group mental health (pp. 3 –22). Washington, DC: University Press of America. Rapp, C. (1998). The strengths model: Case management with people suffering from severe and persistent mental illness. New York: Oxford University Press. Rapp, C. A., & Wintersteen, R. (1989). The strength model of case management: Results from twelve demonstration projects. Psychosocial Rehabilitation Journal, 13(1), 23 –32.

orga_c05.qxd

138

2/5/07

10:52 AM

Page 138

ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

Rogler, L. H., Malgady, R. G., Costantino, G., & Blumenthal, R. (1987). What do culturally sensitive mental health services mean? American Psychologist, 42(6), 565 –570. Wakefield, J. C. (1996a, March). Does social work need the eco-systems perspective? Pt. 1. Is the perspective clinically useful? Social Service Review, 1–32. Wakefield, J. C. (1996b, March). Does social work need the eco-systems perspective? Pt. 2. Does the perspective save social work from incoherence? Social Service Review, 183 –213.

orga_c06p02.qxd

2/5/07

10:53 AM

Page 139

PA R T I I

Selective Reviews of Major Problem Areas, Latino Groups, and Best and Promising Practices PART II PROVIDES DETAILED illustrations of culturally competent practice with various groups of Latinos across a broad variety of some of the most compelling psychosocial and physical health problems affecting U.S. Latinos today. A pair of chapters focuses on issues and interventions specific to the Latino family and Latino youth, and remaining chapters tackle Latino health and mental health, as well as the past and present politics of being Latino American and how they relate to social welfare. One of the overriding objectives of Part II is to transcend past practice rhetoric (i.e., wish lists of things that should be done) by using the new practice model, introduced in Chapter 5, to guide and critique the selective presentation of best and promising practices with Latinos. By design, the selective review of practice illustrations is intended to both address important contemporary Latino problems and issues but also to emphasize principles and practice methods that can be generalized to other, equally important problems not addressed given space limitations.

139

orga_c06p02.qxd

2/5/07

10:53 AM

Page 140

orga_c06.qxd

2/5/07

2:08 PM

Page 141

CHAPTER 6

The Latino Family NO BOOK ON Latinos would be complete without a chapter dedicated to the central social-psychological and cultural institution of the Latino experience: la familia. This chapter provides a descriptive and empirical overview of the Latino family, followed by a selective review of pressing family-related problems and issues and culturally and socially competent responses. Reviews of the literature on Latino families (Baca Zinn, 1982–1983; Garcia-Preto, 1996; Ramirez & Arce, 1981; Vega, 1990) describe a variety of organizational and functional characteristics that derive from a blend of residual traditional Latino culture (e.g., Mexican, Cuban, Puerto Rican) and adaptation responses to life in the United States. Descriptions have evolved from static, stereotypic portraits of the traditional Latino family, to more dynamic descriptions that consider heterogeneity in response to the demands of acculturation to a modern society, and across various social subgroupings of family members. For example, Falicov (1998) uses the term culture to refer to a community of people that partially share the same meaning systems to describe and ascribe meaning to the world (e.g., preferred values, norms, behaviors, and role prescriptions). Cultural similarities and differences, both between and within group members, reflect different degrees of inclusion and exclusion across subgroups within the culture (e.g., gender, age, sexual orientation), as well as outside of it (e.g., Anglos and other ethnic groups). Each individual member of the culture develops within a plurality of subgroups that exert multiple influences of varying degrees depending on the salience of the subgroups to the individual across different situations as well as across time. Falicov (1998) further asserts that the ecological niche or unique combination of multiple contexts and partial perspectives define each individual’s and each family’s variation on major cultural themes. This niche guides the evolution of values and behaviors (for better or worse) 141

orga_c06.qxd

142

2/5/07

2:08 PM

Page 142

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

given its link to the social and physical environment (e.g., social class) and such crucial issues as access to power and resources necessary for healthy development.

C U LT U R E - A N D S O C I A L LY- BA S E D FA M I LY S T RU C T U R E , F U N C T I O N S , A N D C H A N G E S CORE VALUES Traditional Latino cultural values that constitute the basis of norms, behaviors, and role prescriptions, and that become modified in response to the American social environment and personal agency, provide a convenient way of describing Latino family structures and functioning. For example, although there is an expanding variety of Latino families (i.e., single- and two-parent, nuclear and extended, immigrant and multigenerational, transnational, gay and lesbian), they are partially based on the core cultural value of familismo, which refers to the central importance of the family as manifested in strong emotional and instrumental interdependence between members, within and across generations, over the life cycle. More modern Anglo-American norms and values generally stress individualism, competition, independence, and even individuation from the family in members over time; familism promotes close contact, loyalty, and even a lifelong sense of “self-in-family” that serves as a psychosocial guide for family members with regard to their values, actions, and identity in the world. Reviews of the empirical literature on the Latino family generally demonstrate greater participation in family networks within and across generations (e.g., social support) compared to their Anglo counterparts. Sabogal, Marin, Otero-Sabogal, Marin, and Perez-Stable (1987) studied the effects of acculturation on familism in a diverse Latino sample (n = 452) compared to non-Latino Whites (n = 227) and found that perceptions of the family as highly supportive remained constant across Latinos of varying levels of acculturation, and that even the most acculturated Latinos were more family-oriented than their non-Latino White counterparts. On the other hand, other dimensions of familism, such as sense of family obligation and use of family as behavioral and attitudinal referents, did decrease with acculturation. Similarly, Perez and Padilla (2000) studied a three-generation sample of 203 Chicano adolescents and found that although Mexican cultural orientation decreased from first to third generations and American cultural orientation increased, participants retained their allegiance to Latino family values.

orga_c06.qxd

2/5/07

2:08 PM

Page 143

The Latino Family

143

Latino families also partially share the traditional value of respeto (respect), paying deference to those of higher status in the traditional sense (i.e., by virtue of older age or higher social position, including male gender relative to female). Related values include affiliation and cooperation, which are traditionally stressed in family relations more than independence and assertiveness. Simpatía refers to the valuing of smooth, pleasant relationships that minimize and avoid conflict and confrontation (even when hurt feelings and anger are aroused). Closely related is the value of personalismo, which emphasizes the personal dimension of relationships, including task-oriented professional relationships in mental health and other social services. The mainstream clinical practice of almost immediately focusing on the presenting problem can be perceived as impersonal or rude by Latino patients, especially if it comes at the expense of the social lubrication needed to build confianza, or trust (Roll, Millen, & Martinez, 1980). Personalismo is not informality. That is, it would be a mistake for a service provider to come across too casually or overly friendly. As described by Roll et al. (1980), culturally sensitive service providers need to find the balance between task-oriented formality and personalized attention to the client. To achieve such a balance, it is necessary for providers to engage in sufficient small talk, or plática, that includes judicious self-disclosure. CHILD REARING Latino child-rearing practices partially reflect the traditional values just discussed, along traditional age and gender hierarchies, in which conformity is praised and deviations are disciplined. For example, children are expected to obey and respect parents; being right is secondary to respecting elders by not disagreeing or arguing a point. The term bien educado (well educated) refers to children (and adults) who have been raised properly, as reflected in their adherence to traditional values and interpersonal protocol. Mal criado (poorly raised) means the opposite. But child-rearing practices among U.S. Latinos also partially reflect modern Anglo-American values, resulting in much bicultural variation. The patriarchal basis of traditional Latino families can be hard to understand in mainstream America, which stresses more egalitarian and “friendly” relations within and between generations, and increasingly between men and women. The clash of values experienced by Latino youth can become especially difficult when there are few if any models of flexible bilculturality in their families or in society. The problem is exacerbated by family dysfunction and uneven levels of acculturation between members.

orga_c06.qxd

144

2/5/07

2:08 PM

Page 144

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

NATURAL SUPPORT SYSTEMS Most discussions of natural support systems (NSS) center on the role of the extended family and informal resources and helping networks in the community that provide a wide range of social support that buffers stress and boosts the enjoyment and meaningfulness of positive events (e.g., Delgado, 1999; Valle & Vega, 1980). Service providers are advised to learn about and make use of the NSS of the clients and communities they serve but should also avoid overtaxing NSS, which have partly evolved to compensate for social neglect and exclusion. CATHOLICISM The overwhelming majority of Latinos continue to be Catholic. Falicov (1996) notes that the Catholic Church provides continuity to families across generations throughout the life cycle for its central role in rites of passage such as baptism, first Holy Communion, marriage, and funerals. The church also creates community by providing a central place for Sunday mass, religious and Latino holiday celebrations, and community activities. Parochial school provides many Latino children with the rare opportunity for a quality private education to enhance their life chances. Feagin and Booher Feagin (1999) note that, like Italian Americans, Mexican American Catholics demonstrate general allegiance to the church but less active participation than Irish Americans. As such, Mexican Americans are able to compartmentalize religion, resulting in behaviors that do not always conform to the church despite feelings of being very Catholic. For example, research on contraceptive use in samples of Mexican and Mexican American Catholic women consistently reveals high use of a variety of methods despite church teachings to the contrary (Amaro, 1988; Balls Organista, Organista, & Soloff, 1998). The expression “The Pope is not going to take care of my children” is not uncommon among these women. Thus, although the spiritual and supportive dimensions of Catholicism should be assessed and utilized as needed with religious clients, we should not assume passive conformity to the Catholic Church, nor should we overlook progressive movement on the part of many parishes on sexand gender-related issues, or on immigration reform. Although a major cultural resource, familism alone cannot compensate for the Latino family’s social ecological context, in which ethnically linked, poverty-related stressors can overtax the family system. Gomel, Tinsley, Parke, and Clark (1998) studied coping strategies in Latino families struggling with economic hardship and found that unemployment, perceptions of economic hardship among members, and using the family

orga_c06.qxd

2/5/07

2:08 PM

Page 145

The Latino Family

145

to cope with such hardship resulted in negative changes in family relations. In contrast, individual coping strategies resulted in more positive relations. With regard to child mental health, Weiss, Goebel, Page, Wilson, and Warda (1999) found that emotional and behavioral symptoms in Mexican preschool children were predicted, not by SES or acculturation, but by family immigration status, parental dissatisfaction with family functioning, and internal versus external coping strategies. Such research underscores the need to expand Latino coping strategies and supports beyond overreliance on the family. I N C R E A S I N G AC C E S S T O N E E DE D S E RV I C E S : G E N E R A L I S S U E S Access for poor and segregated Latino families in need of services has historically happened through the bottom-up, community-based efforts on the part of Latino-focused “ethnic agencies” designed to compensate for inadequate mainstream services (Iglehart & Becerra, 1995a). Community-based family health, mental health, and multiservice centers are examples of such efforts. In addition, some mainstream institutions have developed Latino-focused services as part of their usual array of services, staffed with bilingual/bicultural staff and professionals. Iglehart and Becerra (1995b) have diagramed a useful 2 × 2 model of the degree to which culturally competent services have penetrated a particular agency or ethnic community that is helpful for thinking about different types of human service delivery systems for Latino families and communities (Figure 6.1). As can be seen in Figure 6.1, low agency penetration and low community penetration represent the worst-case scenario, where there is a lack of needed services in either sphere (e.g., lack of bilingual/bicultural staff or ethnic programs within the agency, as well as no outreach into or input from the ethnic community). High agency penetration and low community penetration describe the existence of special ethnic-focused programs within an agency or mainstream institution. Culturally and socially competent practice is reflected in such a program’s ideology, technology, personnel, and structures, but not necessarily in the agency as a whole. Such a disjunction between program and agency can be advantageous in that it allows the freedom to conduct services in ways different from the agency but that are responsive to the special needs of clients (e.g., serving Spanish-speaking, the undocumented). The problem with this arrangement is that there is typically little formalized input from the community, and a change in staffing or agency organization can jeopardize these less institutionalized programs.

orga_c06.qxd

2/5/07

146

2:08 PM

Page 146

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

High

Ethnic Programs in the Community

No Services

In-Community Training

Agency Penetration

Specialized Programs Within the Agency

Low

High

Community Penetration Figure 6.1 Overview of the Penetration of Culturally and Socially Responsive Services into Agencies and Ethnic Communities. (Source: “Service Delivery to Diverse Communities: Agency-Focused Obstacles and Pathways” (pp. 205–239), by A. P. Iglehart and R. M. Becerra, in Social Services and the Ethnic Community, A. P. Iglehart and R. M. Becerra (Eds.), 1995b, Boston: Allyn & Bacon (Reissued, Prospect Heights, IL: Waveland Press, 2000). Copyright by Authors. Reprinted with permission.)

The low agency and high community scenario reflects an agency conducting programs with little input from the community and few activities within the agency itself. The lower right quadrant of the model might be expanded to include bottom-up grassroots efforts to develop needed services (e.g., self-help and support groups, small nonprofit agency development around an important issue). For example, in Richmond, California,

orga_c06.qxd

2/5/07

2:08 PM

Page 147

The Latino Family

147

survivors of domestic violence formed self-help groups and, with the assistance of a neighborhood center, wrote a grant and received funding for a small nonprofit center in which to conduct self-help groups and train group participants as lay outreach workers and group leaders. Often the life span of such noble efforts depends heavily on connecting to larger and better funded agencies that can incorporate the program under their umbrella of services. High agency penetration and high community penetration are the ideal: An ethnic focused-agency is based in the community, provides needed services, and has formal and consistent input from the community via community boards, employment of community members, use of volunteers, and client exit interviews.

PRO B L E M A S S E S S M E N T : G E N E R A L I S S U E S LATINO FAMILY SOCIOECONOMIC STATUS AND STABILITY As mentioned in Chapter 2, the vast majority of Latino families is large, urban-based, and disproportionately poor and struggles with a cluster of risk factors related to a mix of poverty and ethnic minority status. Approximately 4 times as many Latino families live in poverty compared to non-Latino White families (26.4% and 7.3%, respectively); 40% of Mexican American and Puerto Rican children younger than 18 live below the poverty line compared to 10.5% of Anglo children (see Table 6.1). Further, the percentages of children below the age of 18 who live in “deep Table 6.1 Sociodemographic Profile of Major U.S. Racial/Ethnic Groups

Group

Median Income ($)

In Poverty (%)

High School Completion (%)

College Graduation (%)

Latinos Mexican Puerto Rican Cuban Central/South American Other Hispanic Non-Latino Whites

23,912 23,714 20,310 31,015 23,649 28,562 40,420

26.2 26.4 32.5 15.4 27.0 21.3 7.3

53.1 46.2 59.8 62.1 62.9 68.9 82.0

9.0 5.9 8.0 16.5 15.1 15.1 22.9

Sources: The Hispanic Population in the United States: March, 2000 (Current Population Reports, pp. 20–535), by M. Therrien and R. R. Ramirez, 2000, Washington DC: U.S. Census Bureau; Hispanic Population in the United States, 1993 (Current Population Reports, pp. 20–475), by U. S. Bureau of the Census,1994, Washington, DC: U.S. Government Printing Office.

orga_c06.qxd

148

2/5/07

2:08 PM

Page 148

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

poverty,” defined by being more than 50% below the poverty line, is 12.4% for Mexican Americans and 4.2% for Anglos. Latinos are generally younger than their Anglo counterparts (M = 26.5 and 36.5, respectively), and Chicanos are the youngest of all Latinos (M = 24.6 for Chicanos, 26.9 for Puerto Ricans, and 43.6 for Cubans; U.S. Bureau of the Census, 1994). Mexican Americans also have larger families with more children than most other groups in the United States. Mexican Americans are similar to Anglos with respect to rates of two-parent households (i.e., 61 % and 58%, respectively) but have a larger average household size (4.5 and 3.1, respectively). Mexican American women have higher fertility rates than most other groups in America. In 1990, the number of children born to Mexican women between the ages of 15 and 44 was 1,620 per 1,000 compared to 1,176 for Anglos and 1,461 for African American women (Frisbie & Bean, 1995). Given these SES data, we should expect an above-average number of family-related problems in Latinos linked to poverty, but also to minority status and acculturation. Problem themes frequently discussed in the Latino family literature include role reversals between members of (especially immigrant) Latino families in which (a) women are increasingly entering the paid labor force, thereby expanding their experience beyond traditional gender socialization, and ( b) children are becoming Americanized at faster rates than their parents, occasionally having to assume parental responsibilities (e.g., translating for or representing the family to social institutions) and absorbing modern American values and behaviors sometimes at odds with parental socialization. Although most Latino families cope admirably with acculturation-related changes and view them as part of progressing in the United States, overly stressed and resource-poor families can have multiple maladaptive reactions. For this reason, Latino family experts have begun to take an increasingly ecosystemic view of Latino family problems and solutions. In their classic article, Bernal and Flores-Ortiz (1982, p. 357) assert, “Where the genesis of dysfunction with Black families may be traced to the legacy of slavery, the genesis of dysfunction in Latino families (particularly Puerto Rican and Mexican-American families) may be connected to a legacy of colonialism and neocolonialism.” THE LATINO FAMILY IN ECOSYSTEMIC PERSPECTIVE The overriding goal of an ecosystems approach to Latino families is to promote family stability and adaptive functioning by addressing multiple needs, as well as promoting greater bicultural flexibility among family members. For example, In Falicov’s (1998) multidimensional

orga_c06.qxd

2/5/07

2:08 PM

Page 149

The Latino Family

149

ecosystems comparative approach to Latino family therapy, she considers the multidimensionality of families and individual members as reflected in the plurality of cultures and subgroups to which they belong. Rather than viewing a family member as being influenced only by the preferred values, norms, and worldview of some monolithic Latino culture, her model considers the multiple influences of varying degrees of inclusion and exclusion across various subgroups (e.g., age, sex, social class, race/ethnicity, sexual orientation). Here, ecosystemic refers to the unique combination of sociocultural contexts and related perspectives that define each family’s culture; the term comparative refers to attending to differences both within and between families and individual members that are relevant to stability and well-being. With regard to family assessment, Falicov (1998) achieves problem understanding by evaluating four key generic domains: (1) family history of migration and culture change, which includes the influence of pre- and postmigration factors and acculturation-related changes (e.g., between gender roles and generations); (2) ecological context, which includes the family’s sociocultural niche, including SES, minority status, and degree of marginalization; (3) family organization, which includes traditional and modern influences; and (4) family life cycle, with its culturally patterned transitions (e.g., rights of passage) that are challenged and enriched in the United States. Gender-Role Expansion Falicov (1996) notes that although a patriarchal view of gender roles persists in Latinos, complexities and contradictions continue to evolve in such a way that traditional family structures and functions typically coexist with American norms and behaviors, resulting in varying degrees of biculturality across different cultural dimensions. For example, a double standard in gender socialization and sexuality has generally persisted in Latino families, but shared decision making between husbands and wives increases as women enter the workforce (Ybarra, 1982). Along these lines, Guendelman (1987) found that seasonal migration to the United States expanded the traditional roles of Mexican women to include greater purchasing power, family decision making, division of household responsibilities with husbands, feelings of autonomy, and even less stress compared to nonworking immigrant women. Thus, in some scenarios, families adaptively negotiate acculturation to the United States, expand their bicultural repertoires, and reap the benefits of both cultures. In other cases, acculturation-related stressors, exacerbated by poverty and minority status, can result in various forms of family dysfunction, necessitating culturally and socially appropriate understanding and attention.

orga_c06.qxd

150

2/5/07

2:08 PM

Page 150

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Next, overarching problem themes in Latino families are reviewed briefly, followed by a detailed analysis of such serious Latino family problems as domestic violence, sexual assault, and issues surrounding the Latino elderly. OVERARCHING PROBLEM THEMES

IN

U.S. LATINO FAMILIES

Differences Latino families from different national-origin groups are likely to have some relatively unique problem themes, based on their different acculturation experiences, in addition to many overlapping problem areas based on common social and cultural experiences as Latinos in the United States. For example, the Cuban American experience is strongly rooted in its relatively recent “community in exile” experience, characterized by strong anti-Castro sentiment and conservative cold war politics, combined with rapid socioeconomic success and concomitant marital assimilation into mainstream society. One way that this historical and political backdrop plays itself out within the Cuban American community and family is through tensions that emerge between the older generation’s expectation of loyalty to exile politics and pressure to maintain culture of origin and the younger generation’s diminishing concern with what they see as remote history, not only less relevant to their own American lives but perhaps politically antiquated as well. The younger generation may develop more liberal and progressive views on lifting the embargo against Cuba, assimilation, and even about the recent Elian Gonzales fiasco that pitted traditional Cuban American politics against family unity and U.S. federal law (see Chapter 10). Central American families continue to be influenced by the many dislocations and disruptions caused by their violent civil war backgrounds, generally low SES, and adjustment to the United States with mixed formal recognition of their refugee status. Depression and Posttraumatic Stress Disorder related to wartime traumas and losses can be debilitating for family members, and there are frequent unresolved family reunification problems between those living in the United States and those left behind due to lack of resources and stability. Given the pervasive denial of refugee status, many members of Central American communities keep a low profile and seek services less than they should for some problems. It is also worth noting that the designation Central American obscures several national origin groups with different histories, civil war backgrounds, and experiences in the United States. More research on each of these groups separately is needed and is beginning to emerge. Mexican Americans today are almost evenly divided between relatively recent economic immigrants, who have frequently followed well-worn

orga_c06.qxd

2/5/07

2:08 PM

Page 151

The Latino Family

151

migrant streams in search of a better life, and multigenerational U.S.-born Mexican Americans who struggle with the living legacy of discrimination and segregation, as well as the varied pressures, conflicts, and benefits inherent in the acculturation process. Puerto Rican families continue to experience the trade-offs of “revolving door” migration between Puerto Rico and the mainland, political divisions between those favoring statehood for the island and those favoring their current commonwealth status, and oversegregation and poverty in the United States, where their profile is closer to that of African Americans in terms of negative social and economic indicators (e.g., poverty rates, female heads of household, vulnerability to psychosocial problems such as IV drug use, HIV/AIDS). In addition to these “big four” Latino groups, other smaller, recent and rapidly growing Latino groups are gaining visibility in the United States. Dominicans now number over 1 million and are creating their niche on the East Coast. In some ways they are like Puerto Ricans in their rich African lineage, yet more similar to Cubans in their persistence in business ventures (albeit small businesses). Similarities In their review of 28 published reports on group therapy with Latinos, Delgado and Humm-Delgado (1984) found that the most common problem themes centered around interpersonal conflicts regarding marriage and family. Other common problem themes long reported in the group therapy literature include family breakdown, acculturative stress, and discrimination (Acosta, 1982), and in the case of depressed Puerto Rican women, conflict with spouses/partners and children, culture shock, and psychological distress (Comas-Diaz, 1985). Culturally and socially competent interventions for Latino families are discussed next, beginning with a general description of family therapy, followed by a more detailed analysis of some timely and critical Latino family problems that require comprehensive interventions, ranging from group and family therapy to communitywide and even national policydirected efforts. Problems and issues more specific to Latino youth are addressed in the subsequent chapter. S E L E C T I V E R E V I E W O F L AT I NO FA M I LY PRO B L E M S A N D C U LT U R A L LY C OM PE T E N T R E S P O N S E S For an impressive description of exemplary, wide-ranging programs serving Latino families, the reader is referred to Supporting Latino Families:

orga_c06.qxd

152

2/5/07

2:08 PM

Page 152

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Lessons Learned from Exemplary Programs (Resumen en Español) Volume 2: InDepth Profiles (Shartrand, 1996). Highlighted here are but a few very important Latino family-focused problems and interventions to illustrate cultural competence in action (i.e., teaching cultural competence by examples). ECOSYSTEMIC LATINO FAMILY THERAPY: GENERAL ISSUES Falicov (1998) views the primary role of the family therapist to be that of an intermediary in family conflict whose job is to reframe trouble between family members as “cultural transitions” in need of better understanding. Typically, uneven levels of acculturation between parents and children are addressed in the context of migration history and acculturation experience and remedied by heightening mutual understanding and appreciation as well as improving communication, negotiation, and compromise skills that promote greater flexibility, biculturality, and adjustment to the United States. Trouble between parents resulting from shifts in gender roles, where women work outside the home and consequently request more help from husbands with housekeeping and child care, are similarly framed as normal acculturation problems. In addition to working with whole families and separately with individual members as needed, Falicov notes that therapists need to be “culture brokers” who help families obtain needed basic resources from social services, as well as natural support systems. Based on over 20 years of direct service and research at the Spanish Family Guidance Center in Miami, Szapocznik and colleagues (1997) have developed an acculturation-sensitive, structural ecosystemic approach to family therapy with Cuban and other Latino immigrant families. Like Falicov (1998), Szapocznik et al. attribute family problems to “acculturation gaps” that can exacerbate the normal generation gap between parents and adolescents, as well as typical problems between husbands and wives (e.g., financial, household duties, parenting). Szapocznik and colleagues emphasize the goal of aligning family members to work together against acculturation gaps that threaten the family. The overriding goal of therapy is to foster cross-generational alliances within families by connecting parents to the positive aspects of more modern American values, while connecting children to positive aspects of more traditional Latino values. (Family therapy is covered in more detail in Chapter 7.) Evaluation of Family Therapy The literature on Latino family therapy is predominantly descriptive, with the exception of the work of Szapocznik and associates, who have

orga_c06.qxd

2/5/07

2:08 PM

Page 153

The Latino Family

153

conducted considerable outcome research. For example, in Szapocznik et al.’s (1997) summary of their research, they report that their culturespecific family approaches are as effective as more generic forms of family therapy (e.g., structural family therapy) as well as individual psychodynamic therapy in reducing symptoms, but are superior at engaging and retaining Latino families and preserving family cohesiveness. Family therapy was also found to be superior to group therapy. Thus, family therapy approaches to pressing Latino family problems can be a viable intervention strategy alone or, ideally, as part of a continuum of care, ranging from micro- to macro-level efforts.

I N T I M AT E PA R T N E R ( D OM E S T I C ) V I O L E N C E I N T H E L AT I NO FA M I LY PROBLEM ASSESSMENT The pressing and increasingly recognized problem of domestic violence in Latino families provides an excellent example of how to begin thinking about and responding to important family problems in a culturally and socially competent manner. For some Latino families, the challenges discussed earlier threaten an already impoverished and strained situation, resulting in increased rates of marital disruption and divorce, family dysfunction, and, at the extreme, domestic violence, or what is now being referred to as intimate partner violence (IPV), a term not confined to the private realm of the home nor to heterosexual relationships. Although much research remains to be done in this problem area, Latinos have been included in a number of large surveys and community studies of IPV, and researchers and practitioners have advanced ideas and models that consider the historical, cultural, and social experiences of U.S. Latinos. PREVALENCE RATES AND

THE

PROBABLE ROLE

OF

ACCULTURATION

With regard to rates of IPV in Latinos relative to other racial/ethnic groups in America, Sorensen (1996), a leading researcher on this topic, noted that three major surveys provided mixed findings: Latino rates greater than Whites’ (Straus & Smith, 1990), equivalent to Whites’ (Sorensen & Telles, 1991), and lower than Whites’ (Sorensen, Upchurch, & Shen, 1996). However, Sorensen also astutely noted that acculturation must be factored in to get a more accurate picture. For example, she noted that Straus and Smith’s report from the 1985 National Family Violence Resurvey included only English-speaking Latinos, and that when Sorensen and Telles examined the role of acculturation in their survey, they found that rates of IPV were clearly higher in U.S.-born Mexican

orga_c06.qxd

154

2/5/07

2:08 PM

Page 154

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Americans (31%) compared to Mexico-born Mexican Americans (20%), whose rate was equivalent to Whites’ (21.6%; percentages refer to one or more incidents of hitting or throwing things at spouse). Exposure to the Latino experience in America appears linked to IPV, but how? In an effort to tease out factors related to poverty and culture, Kaufman Kantor, Jasinski, and Aldarondo (1994) compared Latino (n = 743) and White (n = 1,025) families from the National Alcohol and Family Violence Survey with respect to the influence of economic stressors and cultural norms sanctioning wife assault. Similar to Sorensen and Telles (1991), Kaufman Kantor et al. found that wife assault was predicted by being born in the United States for Mexican American and Puerto Rican men. Rates for these U.S.-born Latinos were higher than for Mexican immigrants and for the predominantly immigrant Cuban group. With respect to economic stress, unemployment was a significant predictor of IPV. With respect to culture, attitudinal norms sanctioning wife assault also predicted IPV but for both Latino and White families. In fact, rates of wife assault were the same for these two groups when controlling for economic stressors and pro-wife assault norms. Thus, although more research is needed, social factors such as poverty play major roles in IPV, and so-called cultural factors are not exclusive to Latinos. In fact, most of the IPV research thus far shows that Latinos most steeped in their traditional culture of origin (i.e., immigrants low in acculturation) are those at lowest risk for IPV. These data are noteworthy in view of the popular idea that traditional Latino culture (e.g., machismo) is at the root of IPV. Although we should not rule out the role of culture-based sexism, we should not view it apart from social factors such as poverty, which is consistently linked to IPV for all women. In Weinbaum et al.’s (2001) analysis of the 1998 California Women’s Health Survey (N = 4,006), the major predictors of IPV were participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during the previous 2 years, unemployment, feeling overwhelmed in the previous 30 days, and smoking. Prevalence rates of IPV during the previous year were 6% overall, but a breakdown by race/ethnicity revealed highest rates for Latinas (9.3%), followed by African American women (8.7%), Asian women (5.4%), and White women (4.4%). Weinbaum et al. found no differences between foreign-born and U.S.-born Latinas in their sample; however, an analysis of survey data for the years 1999 through 2001 did reveal such a difference (Weinbaum & Thorfinnson, 2006). TOWARD A MODEL TO UNDERSTAND LATINO INTIMATE PARTNER VIOLENCE In an effort to make sense of IPV in U.S. Latino families, Flores-Ortiz (1993) has introduced the concept of “cultural freezing” to describe

orga_c06.qxd

2/5/07

2:08 PM

Page 155

The Latino Family

155

rigid and stereotyped adherence to traditional values and behaviors in response to difficult acculturation, as well as adherence to intergenerational legacies of family violence and abuse. For example, husbands may adhere to extreme forms of machismo but without control, or desenfrenado (without brakes), resulting in excessive drinking, aggressiveness, and intrusive overprotection and control of wives and children. This results in a rigid boundary between the family and the outside world, and even isolation from the Latino community. Wives may resign themselves to martyrdom and children may become parentified and straddled with inappropriate adult roles in the family that not only stunt healthy psychological development but serve to maintain family dysfunction (e.g., secrets in the family, parental communication through the child). At the extreme, husbands may punish their wives for working and social mobility-related changes (e.g., going out with coworkers, greater assertiveness). In response, some Latinas may tolerate abuse for the sake of family unity, to avoid the stigma related to divorce, and due to other ingrained cultural scripts. Research on a small sample of abused Latinas does show a correlation between domestic violence and the financial contributions of wives in Latino families (Perilla, Bakeman, & Norris, 1994), and data from sheltered abused women show that Latinas do remain longer in abusive marriages compared to African American and White women (Gondolf, Fisher, & McFerron, 1988). Rodriguez, Bauer, and Flores-Ortiz (2001) advocate striking a balance between the consideration of cultural and social factors in the dynamics of Latino IPV. For example, they note that although traditional values such as machismo and its submissive female counterpart, Marianismo, probably lend themselves to domestic violence in their extreme forms, other factors need to be considered: America’s glorification and sexualization of violence, gender-based power inequality in both mainstream and Latino cultures, barriers to IPV education and services for women in general, lack of culturally responsive services for Latinos in particular, and the considerable economic dependency of Latinas on their husbands, especially among undocumented women. In fact, Sorensen (1996) asserts that so long as federal immigration law requires undocumented women to remain married while their citizenship applications are being processed, IPV will inadvertently be structurally built into the system. In her model of Latino IPV, Flores-Ortiz (1993) connects the private interpersonal realm of family violence to the public social realm of structural violence toward Latinos and other people of color. That is, life under historical conditions of oppressive power imbalances finds its way into family life, especially where there is alcohol and drug use by abusers, and where Latino families face social isolation and lack traditional social

orga_c06.qxd

156

2/5/07

2:08 PM

Page 156

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

supports. Again, research supports these ideas. A study of 142 abused women in Mexico revealed that so long as married couples lived with the wife’s family, no abuse took place, even from previously abusive alcoholic husbands (Finkler, 1997). The power of extended family to mitigate IPV is diminished in the United States as immigrant Latino families transition into more nuclear and sometimes isolated family units. THE ROLE

OF

ALCOHOL

The problem of alcohol abuse in IPV families has been well documented in the literature, and more recently with U.S. Latino couples and families. Using data from the 1995 National Alcohol Survey, Cunardi, Caetano, Clark, and Schafer (1999) examined the relation between IPV and alcohol-related problems in African American (n = 358), Latino (n = 527), and White (n = 555) couples. They found that in couples reporting male alcohol-related problems, rates of IPV were two times higher in Latinos, three times higher in Whites, and seven times higher in African Americans compared to couples without male alcohol-related problems. Overall rates of male-to-female IPV were 23%, 17%, and 11% for African Americans, Latinos, and Whites, respectively. A similar pattern was found for female-to-male IPV, at 30%, 21%, and 15%. Although generally not as injurious or lethal, it is noteworthy that the latter rates are higher than the former and deserve much more attention in all racial/ethnic groups. With regard to alcohol use, Cunardi et al. (1999) found that rates of male alcohol dependency were twice as high in African Americans and Latinos compared to Whites, and that male alcohol-related problems were twice as high in African Americans and three times as high in Latinos compared to Whites. The presence of male alcohol problems predicted IPV in all three racial/ethnic groups. It should be noted that when predictor analysis controlled for sociodemographic factors, psychosocial factors (e.g., experiencing physical child abuse), and alcohol consumption, alcohol-related problems no longer predicted male-to-female IPV in Latino couples. Rather, sociodemographic problems such as unemployment and low family income (less than $20,000 annually) predicted IPV. Thus, although male problem drinking is high in Latino couples and is related to higher rates of IPV, it appears to be secondary to, and perhaps a result of, poverty-related factors. Perilla et al. (1994) also found a relation between IPV and husband’s intoxication, as well as immigration-related stress (i.e., in the realms of work, parenting, marriage, and family), in their small sample of 60 immigrant Latinas, half of whom were experiencing IPV. Interestingly, they

orga_c06.qxd

2/5/07

2:08 PM

Page 157

The Latino Family

157

also found that this relationship was mediated by perceived mutuality in close relationships, as reflected in empathy, communication, respect, and understanding. Thus, high relationship quality can attenuate the relation between abuse and acculturative stress/drinking, but such quality is vulnerable to the problems noted earlier. Flores-Ortiz (1993) asserts that oppression at societal and family levels ultimately results in inauthentic human relationships because family members isolate, disconnect from feelings, and assume a defensive stance of stoicism and disregard for the nurturing and well-being of others. The pain at the center of such families can result in multigenerational legacies of violence and other problems, but intervention can transform such pain into genuine care and resilience. The fact that IPV exits the world over, and not just in specific cultures, has led thinkers like Perilla (1999) to cast the problem as a broader human rights issue. She notes that the legal status of married women, or coverture, makes it difficult for men to imagine women having separate equal identities and freedoms apart form their traditional role of serving men. Thus, any assertive movement toward equality can trigger threat in men and the need to control and dominate with various degrees of force. With respect to Latinos, Perilla notes that Latino men batter because they have learned that violence is an effective option for which there are minimal consequences in society and the immediate culture. She also notes that in her own clinical work, the vast majority of battering men and battered wives had witnessed such violence in their family of origin and that Mexican immigrants are frequently surprised that there are U.S. laws against domestic violence. In response to the persistent question of why abused Latinas remain in violent relationships, Perilla (1999) reminds us that many abused women leave their abusers only to be injured or killed. Thus, although remaining tends to be viewed by mainstream America as a failure of abused women, it shouldn’t be hard to imagine given issues of financial dependence, confusion, and self-blame on the part of women socialized by culture, including their religion, to remain married no matter what, and the social isolation that is typically a part of the terrifying aspects of domestic violence. Interviews with 5,708 abused women utilizing shelters in Texas found that, compared to White (57% of sample) and Black women (15%), Latinas (29%) were poorer and younger, had more children, had been married longer, and were more likely to have remained 5 years or longer in abusive marriages (31% of Latinas versus 21% of the other women; Gondolf et al., 1988). For IPV interventions to succeed, they must be informed by such findings and thinking.

orga_c06.qxd

158

2/5/07

2:08 PM

Page 158

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

C U LT U R A L LY A N D S O C I A L LY R E S P O N S I V E I N T E RV E N T I O N S W I T H I N T E R PE R S O NA L V I O L E N C E COMMUNITY-LEVEL EFFORTS Though short on outcome data, some instructive and detailed descriptions of community-based and even national efforts to address Latino IPV, both in the United States and Latin America, have begun to appear in the literature. These reports convey the considerable time, care, and persistence required to develop large-scale approaches that fit with the local historical, social, and cultural experiences of the populations involved. The results are conceptually sound community- and policy-level efforts that address sexist macro-social values and create the infrastructure necessary for helping affected families and communities at the micro level. Southwestern Detroit La Vida (Life) is a community-based partnership to prevent IPV against women in a poor southwestern Detroit barrio of approximately 20,000 Latinos (60% Mexican American, 30% Puerto Rican). Maciak, Guzman, Santiago, Villalobos, and Israel (1999) describe La Vida’s lengthy developmental process of establishing a broad-based coalition of key players (i.e., Community Based Organizations, academics, health and social service providers, including the police and even the INS) on a community advisory board who developed a viable network, as well as an institutional identity, and who conducted participatory, formative research to inform a comprehensive, communitywide prevention and treatment plan. An evaluation plan of both the collaborative process and the impact of IPV prevention strategies is built into La Vida. Lessons learned while encountering frequent challenges (e.g., the need to balance informative research with meeting the immediate needs of clients) are described in the form of the following recommendations: (a) Maintain ownership and control of the IPV project within the local Latino community; ( b) involve strong and stable leadership partners in the Latino community with a long-term commitment; and (c) conduct IPV community diagnosis and needs assessment via formative research to situate the program within the history and social and cultural experience of the Latino community. Efforts such as La Vida are occurring throughout Latin American, including Mexico. Mexico City Fawcett, Heise, Isita-Espejel, and Pick (1999) describe the use of formative research (e.g., focus groups and interviews with key informants, IPV

orga_c06.qxd

2/5/07

2:08 PM

Page 159

The Latino Family

159

needs assessment) to assess IPV in the Iztacalo district of Mexico City. Focus groups explored community IPV norms and beliefs, and participants were asked to identify resources in response to different IPV vignettes. In-depth interviews with women in present or past abusive relationships were conducted to explore their experiences and responses. Findings from the study reveal a curious mixture of traditional and modern norms and thinking about IPV used for developing local prevention efforts: (a) high community consensus regarding the attribution of IPV to economic hardship, lack of education, past experiences of family violence on the part of men, and alcohol problems, yet no mention of gender inequality; ( b) overattribution of responsibility for IPV to women (e.g., women not complying with gender role; three abused women said they were unable to change IPV when it began early in relationships); (c) descriptions of violent men by their wives were divided between compliments (i.e., good father and provider) and criticism; (d) views of marital separation as a solution divided between agreement and citing deterrents such as loss of income, of family support, and of a father for the children; (e) strategies used by abused women were both passive (patience, tolerance, avoidance, submission to requests for sex) and aggressive (i.e., withholding sex and meals, insulting man as sexual partner and provider, locking man out of home); (f) help-seeking preferences included other women, especially mothers, rather than formal support, and abused women expressed considerable shame and reluctance to reach out; and (g) reluctance on the part of community members to get involved in the private lives of others, as reflected in a dicho shared by participants, “El que mete paz, saca mas” (He who tries to make peace, gets more than he bargains for). Given the excellent community diagnosis of IPV, Fawcett et al. (1999) developed an intervention plan with the overarching goal of getting women to recognize abuse and getting family and friends to support rather than blame the victims of abuse. More specifically, the intervention plan consisted of two interrelated communitywide components: • A 12-session workshop to support and help actual victims of abuse, including those participating in the workshop. Workshop content challenged cultural norms by providing education about family violence as a community problem that is everyone’s responsibility; the role of gender inequality; social and personal consequences of IPV; relevant legislation and available service alternatives; the cycle of violence, including different forms of violence and their objectives; and crisis intervention skills. • A communitywide campaign to challenge local norms consisting of peer outreach, popular theater, and special community events (e.g.,

orga_c06.qxd

160

2/5/07

2:08 PM

Page 160

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

conducted by workshop women) and use of local media to communicate types of violence, domestic violence laws, and where to go for help. Organizers also developed IPV fotonovelas (comic-book-like forms of Mexican/Latino entertainment that contain actual photos instead of illustrations, bubble dialogue, and storylines that blend both comedy and drama), posters, and buttons to distribute. Intimate partner violence self-assessment questionnaires were also distributed. Even the dicho mentioned earlier was challenged by a new one: “La mujer maltratada te necesita: Acercate, apoyala, ayudala, acompañala” (The abused woman needs you: Approach her, support her, help her, accompany her). Unfortunately, this new positive dicho is long, doesn’t rhyme, and is thus not as catchy as the old one. (Can Spanish-speaking readers think of a better one?) Nicaragua Even from politically conservative Nicaragua, where the government has sponsored campaigns promoting traditional culture, comes a remarkable report of a grassroots movement of women against family violence that not only pressed the government for the improved handling of IPV in health care and law enforcement, but also strategically engineered the passage of a national family violence law that protects women, includes psychological abuse in the definition of IPV, and imposes prison sentences for abusers in place of the previous infrequently imposed fine of $10 (Ellsberg, Liljestrand, & Winkvist, 1997). The 1996 passage of the law was the culmination of years of organizing, which included (a) coalition building with health centers, academic researchers, and professionals in law and mental health; (b) an epidemiological survey revealing significant rates of IPV; (c) a national convention to present survey results to the public and government officials; and (d) drafting family violence legislation and lobbying the national assembly, which included a 40,000-signature petition, testimony by legal and mental health professionals, and the results of participatory action research that conveyed information on the severity of the problem and lack of resources. When it appeared that the poorly received bill would stall, the women’s network took advantage of the current election year by publicizing research findings in the media, writing 21,000 letters urging legislators to act, and providing legislators with briefing packets. The family violence law was passed unanimously a few days before the national elections. Ellsberg et al. (1997) report that a year after passage of the domestic violence law, progress has been mixed, ranging from prosecution in a case of psychological abuse, to reluctance to implement restraining orders on

orga_c06.qxd

2/5/07

2:08 PM

Page 161

The Latino Family

161

the part of the legal system. Thus, a “No more impunity” follow-up campaign by the women’s network was mounted.

FAMILY THERAPY FOR LATINO INTIMATE PARTNER VIOLENCE Flores-Ortiz, Esteban, and Carrillo (1994) present a case study of IPV Latino family therapy in which they describe three broad phases of therapy: (1) assessing legacies of intergenerational violence and presenting them to the family as painful patterns of injustice that can be changed (rituals are sometimes prescribed, such as making altars to abusive parents and forgiving them for their abusive shortcomings); (2) conducting couple sessions for parents to review desired relationship, including modeling couples whom they admire, and discussion of Latino cultural prescriptions of a healthy family as well as Anglo-American models of more egalitarian relationships; and (3) teaching fair argument and negotiation skills. Immediate treatment goals address urgent issues such as the symptoms and lethality of abuse, stopping the violence, a safety plan for the woman, sobriety requirement for the man, psychoeducation about domestic violence, assessing the mental health needs of each family member, and reviewing steps involved in a nondestructive temporary or permanent separation, if necessary. Multiple modes of treatment are recommended to accomplish these goals, such as individual and group therapy for the man and woman, couple therapy, and family therapy. If progress is made early, treatment continues and focuses on “unfreezing” rigid cultural scripts by increasing respect, direct and healthy communication, and problem-solving skills and rebuilding trust and forgiveness. The couple is also taught how their seemingly private problems are reinforced by historical and cultural patters of colonization, patriarchy, and gender oppression in both the United States and their country of origin. The first phase of therapy typically involves constructing a family genogram, likened to an espejo (mirror). In the case study the genogram revealed intergenerational IPV on both sides of the couple’s families of origin (i.e., violent fathers abused both their wives and children). The couple married young and the man drank excessively and began hitting the woman shortly after marriage. He also journeyed alone to the United States, where he lived with an amante, or lover, until he was later joined by his wife and children. After a couple of arrests (neighbors called the police) for physically assaulting his wife, the man was given the option of jail or treatment; he participated in 18 months of group therapy for violent Latino men. The group for Latino men helped him maintain sobriety,

orga_c06.qxd

162

2/5/07

2:08 PM

Page 162

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

reduce violence, prepare for family therapy, and reflect on destructive versus responsible male cultural scripts. The couple was highly reinforced for their disclosures and for attending therapy. The man had an exaggerated macho self-image, and the woman passively resigned herself to the situation, like a martyr. Therapists challenged the couple’s disbelief in the possibility of change and their view of their behaviors as “normal.” Therapists stressed how unfair their legacy of violence was to all family members and helped them process their emotional pain. In the second phase, the couple’s own daughter’s marital relationship was discussed as a happier, violence-free, and fairer relationship to emulate. The advantages of acting a little more like Anglo couples, with the intent of “unfreezing” their rigid gender roles and increasing their bicultural repertoire, was discussed. The couple was also encouraged to go out more alone and to function as a team where child care was concerned. Interestingly, the man had little to do with the children and sometimes felt isolated as a result. The couple was also helped to negotiate desired changes, which included the man helping more with household responsibilities. The third phase continued the practice of couple negotiation and extended it to negotiations with their children and discussions of proper child discipline, with attention to issues of acculturation. SELF-HELP WITH INTIMATE PARTNER VIOLENCE Zambrana (1985) wrote a thoughtful and comprehensive, bilingual selfhelp book with a pearl of wisdom title that plays off on a popular Latino dicho: Mejor Sola que Mal Acompañada: Para la mujer golpeada (Better Off Alone Than with Bad Company: For the Battered Latina). Several chapters define and describe abuse scenarios for Latinas, address social and cultural reasons for abuse (e.g., traditional cultural scripts in which men are taught to be overcontrolling and women are taught to relinquish control to men), and help the woman consider the decision to stay or leave, followed by how to use resources such as emergency medical and police assistance, shelters, legal help, and support groups, even if Latina readers lack English proficiency, documentation, or money. Other chapters address creating a life and relationships without violence, and there’s even a chapter for counselors working with Latinas. S E X UA L A S SAU LT It is worth discussing the problem of sexual assault against Latinas in tandem with the discussion of IPV, given its community and, ultimately,

orga_c06.qxd

2/5/07

2:08 PM

Page 163

The Latino Family

163

family contexts. Latina sexual assault is even more underresearched than Latino IPV yet has become an increasingly important topic requiring a proper consideration of social, cultural, and familial factors to better understand, prevent, and treat. PREVALENCE Low and Organista (2000) reviewed the scant literature on Latina sexual assault and found that lifetime prevalence rates of sexual assault were consistent with national crime data: 8.1% for Latinas compared to a 19.9% for non-Hispanic Whites (Sorenson & Seigel, 1992). However, similar to Latino IPV patterns, U.S.-born Mexican American women were 3 times more likely than those born in Mexico to have been sexually assaulted, underscoring yet again the often precarious experience of Latinos in the United States. Koss, Gidycz, and Wisniewski (1987) were among the first to examine rape by ethnic status in their administration of the Sexual Experiences Survey to a national sample of 6,159 male and female college students from 32 educational institutions. Though the findings are limited to college students, the following differences between racial/ethnic groups were found: 16% of European American women (n = 2,655), 10% of African American women (n = 215), 12% of Latinas (n = 106), 7% of Asian American women (n = 106), and 40% of Native American women (n = 20), although the latter sample was too small from which to generalize. CULTURAL DIFFERENCES Lefley, Scott, Liabre, and Hicks (1993) conducted a study of culture-based beliefs about rape in a sample of 101 rape victims selected from 881 consecutive admissions to the Rape Treatment Center of the University of MiamiJackson Memorial Medical Center in Dade County, Florida. Women were excluded if they had a prior history of rape or incest, psychiatric history, or cognitive impairment, and the sample was almost evenly divided between African American, Latina, and non-Hispanic White rape victims. The Latina participants were of Cuban and Central American background and were restricted to those whose parents were from Spanish-speaking countries and who were married to Latinos (if married). Assessment of rape myths and their internalization was conducted by presenting nine rape scenarios to the participants. In each it was clear that the female was forced to have sex with the man, but the scenarios varied in ways that the literature suggests are important to the concept of rape, such as use of a weapon, victim-rapist relationship, social role of the

orga_c06.qxd

164

2/5/07

2:08 PM

Page 164

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

victim, and the context of the rape. Analogous to IPV reserach, results revealed that Latinas had the highest acceptance of rape myths that hold that women contribute to rape through their dress or behavior and that women are responsible for controlling men’s sexuality as well as their own. Latinas also were highest in perceptions of people in their community as subscribing to rape myths and as having punitive attitudes toward victims. With regard to psychological distress, Latinas were highest, White women were lowest, and African American women were intermediate. Further, Latinas were most likely to employ avoidance as a coping mechanism. These results are consistent with other studies on attitudes toward rape that consistently reveal more traditional attitudes and greater subscription to rape myths on the part of Latinos as compared to Whites and African Americans. For example, Williams conducted a multicultural study of both rape victims and community residents in San Antonio, Texas, and found that Mexican Americans were more likely than both Anglo (Williams, 1985) and African American community residents (Williams & Holmes, 1981, 1982) to subscribe to rape myths. This study used the same rape scenarios used by Lefley et al. (1993; i.e., more victim blaming, less inclined to prosecute assailants, more antifeminist in judgment). The community sample consisted of 335 Whites, 336 African Americans, and 340 Mexican Americans; the small female sample of rape victims consisted of 32 Whites, 11 African Americans, and 18 Mexican Americans. Compared to White and African American rape victims, Mexican American rape victims had the highest mean scores on the study’s crisis scale, which assessed degree of threat, inability to respond with adequate coping mechanisms, and disruption of routine functioning. Consistent with these studies, Fischer (1987) found that even among bilingual and bicultural Latino college students, attitudes toward women and forcible date rape were more traditional than those of their White counterparts (i.e., less rejecting of date rape, less likely to blame male perpetrators). As a group, these studies imply that Latino genderrole ideologies facilitate self-blame in Latina victims of sexual assault. The result can be a context of shame and blame that prohibits women from talking about their experience with their family and community. Moreover, victim blaming following sexual assault has documented negative effects on a woman’s healing process. For example, Ullman (1996) found that the relation between negative social reactions to rape and negative psychological outcome in victims was mediated by avoidant coping. Apparently, sexism embedded in both Latino and American gender-role systems can produce a dual dilemma for Latina victims of sexual assault.

orga_c06.qxd

2/5/07

2:08 PM

Page 165

The Latino Family

165

SERVICE UTILIZATION AND NEEDS With regard to postsexual assault service utilization, Sorensen and Siegel (1992) found that both Latinas and non-Latina Whites were equally likely to report to police, although the actual numbers are characteristically unimpressive (i.e., 9.6% and 10.8%, respectively). It was also found that Latinas were less likely than their non-Latina White counterparts to seek any health service regardless of need, the nature of the assault, age, and medical insurance. Further, Latinas were less likely than non-Latina Whites to see a psychologist but more likely to see a member of the clergy. When compared to nonassaulted Latinas in the Los Angeles Epidemiologic Catchment Area Study (the LA-ECA is a large psychiatric survey discussed in detail in Chapter 8), Latinas with a history of sexual assault were more likely to have utilized medical services in the past 6 months. Thus, underutilization of specialized services is a problem for sexually assaulted Latinas, and outreach efforts via general medical providers and clergy would be logical starting places. Community-based agencies specializing in Latina sexual assault are also needed; a model of such an agency is discussed next.

A MODEL SEXUAL ASSAULT AGENCY FOR LATINAS In a cross-site analysis and case study of “exemplary” rape crisis programs funded by the National Institute of Mental Health (Harvey, 1985), the Sexual Assault Center of San Joaquin County in Stockton, California, was chosen as one of nine programs nationwide considered to be particularly effective in addressing the needs of victims in their community. One of the unique aspects of this program is that its clientele corresponds proportionately to the racial and ethnic demographics of San Joaquin County, which has a large Latino population. Some factors that might explain the center’s success in serving the local Latino population include its multiservice orientation that incorporates comprehensive advocacy and counseling services to adult and child victims of sexual assault, and community education and prevention services. It is housed in an accessible downtown office space, in the same building as a job program for lowincome women and an advocacy organization for abused women. Whenever possible, Latina clients are matched with Latina staff and a concerted effort is made to maintain a representative group of bilingual and bicultural staff and volunteers. According to Harvey: At all levels of programming, The Sexual Assault Center puts a special emphasis on the importance of multicultural, bilingual services. The staff is culturally and racially diverse; volunteers are recruited and services publicized

orga_c06.qxd

2/5/07

166

2:08 PM

Page 166

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

through the Spanish-speaking radio and television stations and bilingual presentations to church groups. Materials are developed in both English and Spanish and much consideration is given to issues facing minority communities. Client record keeping and program evaluation regularly examine the center’s service to minority and Spanish speaking groups. (p. 73)

The agency has developed a credible reputation in the community due to its outreach efforts and high quality of services. Unfortunately, evaluative outcome research is not a part of this program, as is generally the case with direct services. COGNITIVE-BEHAVIORAL THERAPY Organista and Valdes Dwyer (1996) describe how cognitive-behavioral group therapy (CBT) combined with clinical case management is an effective treatment strategy for Latinas suffering from depression and traumatic experiences, including sexual assault. For example, a severely depressed woman from Guatemala disclosed how she felt permanently “stained” for having been sexually abused as an adolescent by her mother’s live-in boyfriend. The problem had been exacerbated by her mother’s reaction, a mixture of disbelief, denial, and victim blame. Group members were asked if it was true that rape or other forms of sexual assault permanently stain women for life, thus initiating a dialogue about traditional Latino and more modern beliefs about sexual abuse. Next, to begin shifting the client’s beliefs in a healthier direction, she was asked to complete the following sentence: “Yes, it is true that I feel stained from being sexually abused, but . . . ,” to which the woman was able to respond, “but I was the one taken advantage of!” From such a beginning, work proceeded to place proper blame on the perpetrator and to redefine the stained victim role to an injured survivor in need of healing via healthy thinking, activities, social supports, and sensitive services. Even the estranged relationship with the client’s mother was discussed, with a focus on helping the client to better understand that such negative reactions are problems located in the mother, family, and culture (e.g., the role of denial, rigid gender roles), as well as the role of economic dependency. (Chapter 8 contains a more expanded description of CBT as applied to depression in Latinas.)

E L DE R LY L AT I NO I S S U E S The intergenerational nature of familismo, combined with the significant growth of the elderly Latino population, render problems and issues af-

orga_c06.qxd

2/5/07

2:08 PM

Page 167

The Latino Family

167

fecting such family members increasingly important to conceptualize and address. Falicov (1998) notes that elderly U.S. Latinos face physical and psychosocial adjustment tasks similar to their Anglo-American counterparts: grandparenthood, retirement, illness, and of course death. However, she also notes a frequent “multiple jeopardy” encountered by elderly Latinos having to do with minority status and acculturation-related issues that can exacerbate problems linked to old age. For example, elderly Latinos lack pensions and health insurance more than their Anglo counterparts. Elderly Latino immigrants also retain varying degrees of culture-of-origin values and expectations about retirement, illness, and death that may or may not match those of their U.S. families and local services. Falicov further notes that it is simply wrong to stereotype the Latino family as ready to meet all of the needs of its elderly members. While there are culture-of-origin norms prescribing extended family care of elderly parents and grandparents, such norms change with acculturation, as does the quality of family relations. Thus, the trick is to assess actual and potential resources of the elderly within and beyond the family system, broker for needed resources, and help the elderly establish mutually beneficial relationships where possible. What follows are some general and topical issues pertaining to elderly Latinos and their unique needs. Such a discussion invariably involves health status and elderly health problems and solutions (also included in Chapter 9). ELDERLY LATINO POVERTY, FUNCTIONING, AND SUPPORTS Expected links between problems related to poverty, functioning, and social-familial connectedness in the Latino elderly are borne out in reports from large-scale surveys and research. One major source of such reports is the 1988 National Survey of Hispanic Elderly People (NSHEP; Andrews, 1989), which included 2,299 elderly Latinos, age 65 and older, from the East Coast, with all of the major Latino groups represented. Comparisons of NSHEP data to national data on the elderly show lower life satisfaction and peace of mind in elderly Latinos related to multiple economic, health, and social problems such as higher poverty rates, medical bills, sick spouses, loneliness, and dependency on others (Andrews, Lyons, & Rowland, 1992). Tran and Williams (1998) used NSHEP data to examine the relation between poverty and health status and concluded that the widespread poverty among elderly Latinos (i.e., ranging from 50% in Cubans to 63.7% in Puerto Ricans) has an usually large negative impact on activities of daily living such as getting in and our of bed, light housework, and

orga_c06.qxd

168

2/5/07

2:08 PM

Page 168

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

bathing. Factors that protected Latino elderly from impairment included being married, more educated, and bilingual. Not surprisingly, elderly Cubans were the least impaired and Puerto Ricans the most. Given such substantial needs, what kinds of formal and informal supports are elderly Latinos using? FORMAL AND INFORMAL SUPPORTS With respect to formal service use, Deitz, John, and Roy (1998) used NSHEP data to show low use of the following formal services across all of the major Latino groups, including Central and South Americans: little if any use of senior center services (e.g., meals, social gatherings) and inhome services (e.g., health aide, housekeeping, meal preparation), and low use of federal entitlement programs such as Medicaid and Medicare (e.g., doctor’s services and hospitalizations). Cuban Americans and Puerto Ricans were higher in use of entitlement programs, and Mexican American and other Latinos were less integrated into such federal programs. Deitz (1997) also compared use of formal support to family support and found that while Latino elderly did receive some family support for activities of daily living (e.g., food shopping), their needs were not adequately being met this way. For example, 66% of participants reported difficulty with at least one (from a list of 11) activity of daily living, yet less than half of these participants received family assistance. In addition, between 21% and 43% of participants paid for help with things like housework, eating, and bathroom assistance, despite meager incomes. Dietz also noted the following low rates of formal assistance use by participants to supplement their low incomes: 36% used SSI, 15.4% food stamps, 12% senior centers, and only 4.1% used home health care. Despite such low use, Latino elderly are likely to be hit hardest by shrinking public benefits and cutbacks in federal income maintenance programs. For example, Zsembik, Drevenstedt, and McLane (1997) used data from the 1990 Panel Study of Income Dynamics (PSID) to assess the impact of social program cutbacks and related policies on the Latino elderly. The PSID contains data on 2,000 Latino families, representative of Mexicans, Cubans, and Puerto Ricans in the United States. These researchers found that, compared to the elderly in general, Latino elderly relied more heavily on vulnerable publicly funded health insurance (i.e., Medicaid) than private property (home ownership), insurance, and other assets. Puerto Ricans in particular were the least economically secure across all indicators of economic status, most dependent on Medicaid health insurance, and thus the most vulnerable to shrinking benefits in the states where they are most numerous (e.g., New York, Florida).

orga_c06.qxd

2/5/07

2:08 PM

Page 169

The Latino Family

169

Thus, survey research on elderly Latinos documents high poverty and functional needs exacerbated by inadequate formal and family assistance, problems especially pronounced in the poorest Latino elderly: those without a spouse, low in education and English fluency, and of Puerto Rican background. From this portrait we should suspect pronounced stress and depression in Latino elderly with less than adequate coping resources. Using the NSHEP database to examine how the elderly cope with depression and family problems, Starrett, Todd, Decker, and Walters (1989) found that less than 10% of participants utilized mental health professionals or physicians, 17% used the church, and 36% indicated that they used nothing. BUT DON’T LATINO FAMILIES CARE

FOR

THEIR ELDERLY?

The answer to this question is yes and no. Reviews of the literature on this topic do indeed show that Latino elders are more likely than their White counterparts to live with their family and less likely to be institutionalized in long-term care facilities, including nursing homes ( Johnson, Schwiebert, Alvarado-Rosemann, Pecka, & Shirk, 1997; Zsembik, 1996). However, the determinants for such living arrangements, as well as questions regarding how optimal this is for the elderly, have only recently begun to be addressed. Reports from the NSHEP that examine the preferences of elderly Latinos for living alone (Zsembik, 1992) as well for living with others (Zsembik, 1996) show that the traditional cultural norm of caring for the elderly within the family changes with acculturation and related factors, such as the availability and willingness of family to care for the elderly, as well as economic resources and health status. For example, elderly Latinos with retirement incomes were much more likely to live on their own than those with smaller and less stable incomes. Puerto Rican elderly were found to be most likely to live alone and to prefer it this way; this was attributed to their greater poverty, dependency on restrictive public housing, and having children less able to afford to take in their parents. Johnson et al. (1997) conducted a small qualitative study of 10 Mexican American elderly to assess residential preferences and found an interesting mix of results: desire to live alone as long as possible; preference to live with families if unable to live alone, coupled with concern about being a burden; and a view of nursing homes as a negative last resort and place to die. Service implications from this study, as well as the others discussed, include working closely with families of the elderly to assess ability and willingness to provide care and to teach them about formal service care options, beginning with alternatives to nursing homes such

orga_c06.qxd

170

2/5/07

2:08 PM

Page 170

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

as home health care, assisted living, home nurse care, and congregate living. If a nursing home is the best option, the family should be involved with placement and should be helped to remain involved with visits and care decisions. The goal is to decrease fears on the part of the elderly of being a burden, being abandoned, and even being disrespected by family by what they may think of as a culturally incompatible option. Writing with elderly Puerto Ricans in mind, Delgado (1995) advocates that providers of formal care for the Latino elderly should assist them by collaborating with community-based NSS in which the elderly are embedded. Members of the NSS can be educated about existing formal services and can be utilized as key informants, consultants, agency board members, volunteers, and paid employees who lend their personal, cultural, and community-based expertise to the development and improvement of elder care. Interestingly, Delgado interviewed six academic experts on elderly Puerto Ricans who defined their NSS not only as (in)formal support networks, but also as mechanisms of cultural maintenance and dignity-maintaining reciprocal networks in which the elderly provide as well as receive help. LATINO ELDER ABUSE Elderly abuse is the most recent form of predominantly family-based violence to come to the attention of service providers and the public. Because attention to this problem only goes back a couple of decades, information is quite limited, even more so for Latinos and other communities of color. For this reason, writings about elderly abuse in Latinos have had to fuse the little we know about this problem in general with what we do know about the (elderly) Latino experience in the United States. Vasquez and Dinelia (1999) reviewed data from the National Elder Abuse Incidence Survey (National Center on Elder Abuse, 1998) and reason that many risk factors for elder abuse, such as physical and economic dependency and cognitive impairment, coincide with poverty- and acculturation-related stress in Latino families. These writers also note that female elderly are at greatest risk for physical (71.4%), financial (63%), and neglect (60%) forms of abuse at the hands of male perpetrators (e.g., husbands, male adult children). Otiniano, Herrera, and Hardman-Muye (1997) present such a case study, emphasizing the mutual dependence of a wheelchairbound elderly Mexican woman collecting SSI and her unemployed and alcohol abusing adult son who lives with her. Using Adult Protective Services (APS) data from Texas, Otiniano et al. note that while Latinos make up 28.1% of the state, they make up just under 23% of APS cases, although they attribute this rate to underreporting due to language and

orga_c06.qxd

2/5/07

2:08 PM

Page 171

The Latino Family

171

legal barriers as well as misinformation about elderly abuse in the Latino community. These researchers also note that neglect accounts for 44% of elderly Latino abuse cases, that adult children make up about 45% of perpetrators, and that elderly Latinas are twice as likely to suffer abuse as their male counterparts. Montoya (1997) echoes this line of reasoning and lists logical recommendations, such as educational campaigns about elderly abuse and APS at community, family, and individual levels. He notes that culture-based messages such as “No es bien disrespetar el anciano” (It’s not okay to disrespect the elderly) can be used to combat reluctance to recognize and disclose elder abuse in Latino families stressed by social isolation and lack of access and resources. Obviously much more research is needed to better understand and respond to this emerging problem area in effective ways. DEMENTIA AND CAREGIVER BURDEN

IN

LATINO FAMILIES

The Alzheimer’s Association (2004) has issued special reports specifically on Latinos noting mounting evidence that elderly Latinos are at higher than average risk for cognitive disorders for several reasons. First of all, the Latino elderly population will triple, from 5% of all elders today to 16% in 2050, and will continue to be disproportionately represented in the older age groups at greatest risk for dementia. In fact, Latino life expectancy is projected to surpass all other groups in the United States by midcentury. It is well documented that the prevalence of Alzheimer’s doubles every 5 years beyond the age of 65, reaching an astounding 50% for those 85 years or older. Other Latino-relevant risk factors include very low educational levels that limit the protective benefits of formal education against Alzheimer’s disease and greater risk for Alzheimer’s and stroke-related dementia due to diabetes, which affects 1 in 3 elderly Latinos. In the first representative, population-based study of dementia in older Mexican Americans (N = 1,789), Haan et al. (2003) found an overall prevalence of dementia of just under 5%, a rate comparable to similar studies of the elderly in the United States and Canada, yet lower than among Caribbean Latinos in New York. However, they also found that 43% of dementia in these elderly Mexican Americans was attributable to Type 2 diabetes mellitus, stroke, or a combination of both. Haan et al. (2003) conclude that, at a minimum, screening for dementia needs to be combined with screening for diabetes given that a third of their sample had diabetes. Further, even though 90% of their sample had medical insurance and 88% had a regular doctor, the vast majority were diagnosed with dementia for the first time in the study! Thus we

orga_c06.qxd

2/5/07

172

2:08 PM

Page 172

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

must understand and address the underdetection of dementia in elderly Latinos at both the external service level and the internal cultural level. Ortiz and Fitten (2000) studied barriers to health care access in a sample of 65 cognitively impaired elderly Latinos and found that participants indicated the following three most frequent obstacles to health care access: personal beliefs about aging and illness (38%), language (33%), and economic problems (13%). Personal beliefs that interfere with seeking needed health care included viewing memory problems as normal in old age, not feeling sick, and feeling too old to be helped, as well as fear of discrimination and the effects of medication and believing that God is more helpful than medications. These findings are rich with implications for addressing treatment obstacles beyond money and health care access problems. Fortunately, the Alzheimer’s Association has been active at a variety of levels, from health policy lobbying efforts to developing a contact information center with Spanish-language capacity and organizing coalitions of Latino-focused community and health organizations to educate and respond to Latino community needs in this specialty health area. DEMENTIA CAREGIVER BURDEN AND SUPPORT In response to the underuse of caregiver support groups for Latino family members struggling to cope with parents and other elderly family members affected by Alzheimer’s disease (AD), Henderson, Gutierrez-Mayka, Garcia, and Boyd (1993) describe a 2-year effort to involve Latinos and African Americans in AD caregiver support groups. Though lacking formal evaluation, their report is valuable for its careful documentation of the culturally and socially responsive efforts taken to involve more than 100 Latino and African American caregivers with no prior utilization. The authors note that prior to their work, only Anglo-Americans attended AD caregiver groups in the two Florida cities where the study took place. The following steps represent a careful review and synthesis of prior pertinent literature on culturally competent service delivery. Though effortful, this is the kind of groundwork needed to connect Latinos and other underutilizing groups with needed human services. • Develop a community demographic profile by using census data, local records and newspaper archives, local medical association, and ethnic minority organization information. • Develop a list of ethnic minority organizations (e.g., review of phone book headings such as “Hispanic,” “Black,” “Minority,” “Government Agencies”).

orga_c06.qxd

2/5/07

2:08 PM

Page 173

The Latino Family

173

• Identify ethnic minority media from entertainment guides from local and ethnic minority communities and radio and TV outlets. • Identify key community leaders from ethnic organizations, ethnic radio and newspaper, and word of mouth. • Interview identified key community leaders: This was done by project staff that were given the time to get out and learn about the community they were attempting to serve via semistructured interviews viewed as data collection. • Maintain vigilance in ongoing learning process by fine-tuning project activities following implementation. In a companion article, Henderson and Gutierrez-Mayka (1992) present case studies of care to AD patients in Latino families. They note that improving quality of care involved decreasing the stigma related to AD via psychoeducation about the organic nature of this problem, encouraging caretakers to use their “culture broker” skills to connect relatives with AD to needed social services, and being aware of the well-documented “female burden-barer” role in traditional Latino families and how this diminishes with acculturation (e.g., between generations). Recently, Gallagher-Thompson et al. (2003) published the only randomized controlled evaluation of two different approaches to reducing caregiver stress in Latinas and their Anglo counterparts caring for relatives with dementia. This study employed many of the points listed earlier to compare a typical community-based support group intervention with a psychoeducational skill-building approach that utilized cognitive-behavioral techniques to teach specific coping strategies. These interventions were 3 months in duration, and results showed that the skill-building approach was the most effective in reducing depressive symptoms, increasing adaptive coping strategies, and decreasing negative coping. Latinas and Anglo women benefited similarly; this was attributed to special care taken to tailor the intervention to Latinas by addressing their language needs and by making the cognitive-behavioral techniques compatible with Latino culture (e.g., urging stressed caretakers to take some restorative time out for themselves as a way to provide better care for their relative). El Portal (the doorway or entrance) is a carefully developed and coordinated model program for Latino caregivers of AD-affected family members (Aranda, Villa, Trejo, Ramirez, & Ranney, 2003). Based in Los Angeles, home to the nation’s largest population of elderly Latinos, El Portal is a community-based collaboration that uses a variety of care services by a consortium of nonprofit human services providers, program consumers, community representatives, and government entities. Careful attention is paid to community outreach, networking, and community

orga_c06.qxd

174

2/5/07

2:08 PM

Page 174

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

awareness, ranging from major and minor Spanish- and English-language media outlets and campaigns to grassroots, word-of-mouth efforts by former caregivers. Fragmented services are minimized by locating educational, support, respite, and legal services within two community-based health care agencies and by training a servidora to provide full-time service coordination.

CONCLUSION As the central cultural institution of Latinos, la familia will continue to be discussed and researched as a major site for understanding and responding to various family-related problems and issues. Given the immensity of the topic, only a selective review of a few timely, complex, and increasingly important problems areas were addressed in this chapter, with the overriding objective of illustrating how to better understand and respond to Latino family-related problems in a culturally and socially competent manner. These illustrations can be extrapolated to myriad other family problems and issues of interest and importance to the reader.

R EFER ENCE S Acosta, F. X. (1982). Group psychotherapy with Spanish-speaking patients. In R. M. Becerra, M. Karno, & J. I. Escobar (Eds.), Mental illness and Hispanic Americans: Clinical perspectives (pp. 183 –197). New York: Grune & Stratton. Alzheimer’s Association. (2004). Hispanic/ Latinos and Alzheimer’s disease. Chicago, IL: Author. Amaro, H. (1988). Women in the Mexican American community: Religion, culture, and reproductive attitudes and experiences. Journal of Community Psychology, 16, 6 –20. Andrews, J. W. (1989). Poverty and poor health among elderly Hispanic Americans. Baltimore, MD: Commonwealth Fund Commission on Elderly People Living Alone. Andrews, J. W., Lyons, B., & Rowland, D. (1992). Life satisfaction and peace of mind: Comparative analysis of elderly Hispanics and other elderly Americans. In T. L. Brink (Ed.), Hispanic aged mental health (pp. 21– 42). New York: Haworth Press. Aranda, M. P., Villa, V. M., Trejo, L., Ramirez, R., & Ranney, M. (2003). El portal Latino Alzheimer’s project: Model program for Latino caregivers of Alzheimer’s disease-affected people. Social Work, 48(2), 259–271. Baca Zinn, M. (1982–1983). Familism among Chicanos: A theoretical review. Humboldt Journal of Social Relations, 10(1), 224 –238. Balls Organista, P., Organista, K. C., & Soloff, P. (1998). Exploring AIDS-related knowledge, attitudes and behaviors in female Mexican migrant laborers. Health and Social Work, 23(2), 96 –103.

orga_c06.qxd

2/5/07

2:08 PM

Page 175

The Latino Family

175

Bernal, G., & Flores-Ortiz, Y. (1982, July). Latino families in therapy: Engagement and evaluation. Journal of Marital and Family Therapy, 357–365. Comas-Diaz, L. (1985). Cognitive and behavioral group treatment with Puerto Rican women: A comparison of content themes. Hispanic Journal of Behavioral Sciences, 7, 273 –283. Cunardi, C. B., Caetano, R., Clark, C. L., & Schafer, J. (1999). Alcohol-related problems and intimate partner violence among White, Black, and Hispanic couples in the United States. Alcoholism: Clinical and Experimental Research, 23(9), 1492–1501. Deitz, T. L. (1997). Family and formal assistance with activity limitations: Who helps the Mexican American elderly? Hispanic Journal of Behavioral Sciences, 19(3), 333 –352. Deitz, T. L., John, R., & Roy, L. C. (1998). Exploring intra-ethnic diversity among four groups of Hispanic elderly: Patterns and levels of service utilization. International Journal of Aging and Human Development, 46(3), 247–266. Delgado, M. (1995). Puerto Rican elders and natural support systems: Implications for human services. Journal of Gerontological Social Work, 24(1/2), 115 –130. Delgado, M. (1999). Social work practice in nontraditional urban settings. New York: Oxford University Press. Delgado, M., & Humm-Delgado, D. (1984). Hispanics and group work: A review of the literature. Ethnicity in Group Work Practice, 7(3), 85 –96. Ellsberg, M., Liljestrand, J., & Winkvist, A. (1997, November). The Nicaraguan network of women against violence: Using research and action for change. Reproductive Health Matters, 10, 82–92. Falicov, C. J. (1996). Mexican families. In M. McGoldrick, J. Giordano, & J. K. Pearce (Eds.), Ethnicity and family therapy (2nd ed., pp. 169–182). New York: Guilford Press. Falicov, C. J. (1998). Latino families in therapy: A guide to multicultural practice. New York: Guilford Press. Fawcett, G. M., Heise, L. L., Isita-Espejel, L., & Pick, S. (1999). Changing community response to wife abuse. American Psychologist, 54(1), 41– 49. Feagin, J. R., & Booher Feagin, C. (1999). Mexican Americans. In J. R. Feagin & C. Booher Feagin. Racial and ethnic relations (6th ed., pp. 291–335). Upper Saddle River, NJ: Prentice-Hall. Finkler, K. (1997). Gender, domestic violence and sickness in Mexico. Social Science and Medicine, 45(8), 1147–1160. Fischer, G. J. (1987). Hispanic and majority student attitudes toward forcible date rape as a function of different attitudes toward women. Sex Roles, 17(2), 93 –103. Flores-Ortiz, Y. (1993). La mujer y la violencia [The woman and the violence]: A culturally based model for the understanding and treatment of domestic violence in Chicana/Latina communities. In N. Alarcon, R. Castro, E. Perez, B. Pesquera, A. Sosa-Riddell, & P. Zavella (Eds.), Chicana critical issues (pp. 169–182). Berkeley, CA: Third Woman Press.

orga_c06.qxd

176

2/5/07

2:08 PM

Page 176

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Flores-Ortiz, Y., Esteban, M., & Carrillo, R. A. (1994). La violencia en la familia: Un modelo contextual de terapia intergeneracional [Family violence: A contextual model of intergenerational therapy]. Revista Interamericana de Psicologia, 28(2), 235 –250. Frisbie, W. P., & Bean, F. D. (1995). The Latino family in comparative perspective: Trends and current conditions. In C. K. Jacobson (Ed.), American families: Issues in race and ethnicity (pp. 29–71). New York: Garland Press. Gallagher-Thompson, D., Coon, D. W., Solano, N., Ambler, C., Rabinowitz, Y., & Thompson, L. W. (2003). Changes in indices of distress among Latino and Anglo female caregivers of elderly relatives with dementia: Site-specific results from the REACH National Collaborative Study. Gerontologist, 43(3), 580–591. Garcia-Preto, N. (1996). Latino families: An overview. In M. McGoldrick, J. Giordano, & J. K. Pearce (Eds.), Ethnicity and family therapy (2nd ed., pp. 141–154). New York: Guilford Press. Gomel, J. N., Tinsley, B. J., Parke, R. D., & Clark, K. M. (1998). The effects of economic hardship on family relationships among African American, Latino, and Euro-American families. Journal of Family Issues, 19(4), 436 – 467. Gondolf, E. W., Fisher, E., & McFerron, R. (1988). Racial differences among shelter residents: A comparison of Anglo, Black, and Hispanic battered women. Journal of Family Violence, 3(1), 39–51. Guendelman, S. (1987). The incorporation of Mexican women in seasonal migration: A study of gender differences. Hispanic Journal of Behavioral Sciences, 9, 245 –264. Haan, M. N., Mungas, D. M., Gonzalez, H. M., Ortiz, T. A., Acharya, A., & Jagust, W. J. (2003). Prevalence of dementia in older Latinos: The influence of Type 2 diabetes mellitus, stroke and genetic factors. Journal of the American Geriatrics Society, 51(2), 169–177. Harvey, M. (1985). Exemplary rape crisis programs: A cross site analysis and case studies. Bethesda, MD: National Institute of Mental Health. Henderson, J. N., & Gutierrez-Mayka, M. (1992). Ethnocultural themes in caregiving to Alzheimer’s disease patients in Hispanic families. Clinical Gerontologist, 11, 59–74. Henderson, J. N., Gutierrez-Mayka, M., Garcia, J., & Boyd, S. (1993). A model for Alzheimer’s disease support group development in African American and Hispanic populations. Gerontologist, 33(3), 409– 414. Iglehart, A. P., & Becerra, R. M. (1995a). Ethnic services, precedents, perspectives, and parameters. In A. P. Iglehart & R. M. Becerra (Eds.), Social services and the ethnic community (pp. 152–203). Boston: Allyn & Bacon. Iglehart, A. P., & Becerra, R. M. (1995b). Service delivery to diverse communities: Agency-focused obstacles and pathways. In A. P. Iglehart & R. M. Becerra (Eds.), Social services and the ethnic community (pp. 205 –239). Boston: Allyn & Bacon. Johnson, R. A., Schwiebert, V., Alvarado-Rosemann, P., Pecka, G., & Shirk, N. (1997). Residential preferences and eldercare views of Hispanic elders. Journal of Cross-Cultural Gerontology, 12, 91–107.

orga_c06.qxd

2/5/07

2:08 PM

Page 177

The Latino Family

177

Kaufman Kantor, G., Jasinski, J. L., & Aldarondo, E. (1994). Sociocultural status and incidence of marital violence in Hispanic families. Violence and Victims, 9(3), 207–222. Koss, M. P., Gidycz, C. A., & Wisniewski, N. (1987). The scope of rape: Incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. Journal of Consulting and Clinical Psychology, 55, 162–170. Lefley, H., Scott, C., Liabre, M., & Hicks, D. (1993). Cultural beliefs about rape and victim’s response in three ethnic groups. American Journal of Orthopsychiatry, 63, 623 –631. Low, G., & Organista, K. C. (2000). Latinas and sexual assault: Toward culturally sensitive assessment and intervention. Journal of Multicultural Social Work, 8(2), 131–157. Maciak, B. J., Guzman, R. G., Santiago, A., Villalobos, G., & Israel, B. A. (1999). Establishing LA VIDA: A community-based partnership to prevent intimate violence against Latina women. Health Education and Behavior, 26(6), 821–840. Montoya, V. (1997). Understanding and combating elder abuse in the Hispanic communities. Journal of Elder Abuse and Neglect, 9(2), 5 –17. National Center on Elder Abuse. (1998). National elder abuse incidence study: Final report. Washington, DC: American Public Human Services Association in collaboration with Westat. Organista, K. C., & Valdes Dwyer, E. (1996). Clinical case management and cognitive behavioral therapy: Integrated psychosocial services for depressed Latino primary care patients. In P. G. Manoleas (Ed.), The cross-cultural practice of clinical case management in mental health (p. 119–143). New York: Haworth Press. Ortiz, F., & Fitten, L. J. (2000). Barriers to health care access for cognitively impaired older Hispanics. Alzheimer Disease and Associated Disorders, 14(3), 141–150. Otiniano, M. E., Herrera, C. R., & Hardman-Muye, M. (1997). Abuse of Hispanic elders: A case study. Clinical Gerontologist, 18(1), 39– 43. Panel Study of Income Dynamics, 1990. Perez, W., & Padilla, A. M. (2000). Cultural orientation across three generations of Hispanic adolescents. Hispanic Journal of Behavioral Sciences, 22(3), 390–398. Perilla, J. L. (1999). Domestic violence as a human rights issue: The case of immigrant Latinos. Hispanic Journal of Behavioral Sciences, 21(2), 107–133. Perilla, J. L., Bakeman, R., & Norris, F. H. (1994). Culture and domestic violence: The ecology of abused Latinas. Violence and Victims, 9(4), 325 –339. Ramirez, O., & Arce, C. H. (1981). The contemporary Chicano family: An empirically based review. In A. Barron (Ed.), Explorations in Chicano psychology (pp. 3 –28). New York: Praeger. Rodriguez, M. A., Bauer, H. M., & Flores-Ortiz, Y. (2001). Domestic violence in the Latino population. In A. G. Lopez & E. Carrillo (Eds.), The Latino psychiatric patient: Assessment and treatment (pp. 163 –180). Washington, DC: American Psychiatric Publishing.

orga_c06.qxd

178

2/5/07

2:08 PM

Page 178

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Roll, S., Millen, L., & Martinez, R. (1980). Common errors in psychotherapy with Chicanos: Extrapolations from research and clinical experience. Psychotherapy: Theory, Research and Practice, 17(2), 158–168. Sabogal, F., Marin, G., Otero-Sabogal, R., Marin, B. V., & Perez-Stable, E. J. (1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9(4), 397– 412. Shartrand, A. (1996). Supporting Latino families: Lessons from exemplary programs (Summaries in Spanish): Vol. II. In-depth profiles. Cambridge, MA: Harvard Family Research Project. Sorensen, S. B. (1996). Violence against women: Examining ethnic differences and commonalities. Evaluation Review, 20(2), 123 –145. Sorenson, S., & Siegel, J. (1992). Gender, ethnicity and sexual assault: Findings from a Los Angeles study. Journal of Social Issues, 48, 93 –104. Sorensen, S. B., & Telles, C. A. (1991). Self-reports of spousal violence in a MexicanAmerican and non-Hispanic White population. Violence and Victims, 6(1), 3 –15. Sorensen, S. B., Upchurch, D. M., & Shen, H. (1996). Violence and injury in marital arguments. American Journal of Public Health, 86, 35 – 40. Starrett, R. A., Todd, A. M., Decker, J. T., & Walters, G. (1989). The use of formal helping networks to meet the psychological needs of the Hispanic elderly. Hispanic Journal of Behavioral Sciences, 11(3), 259–273. Straus, M. A., & Smith, C. (1990). Violence in Hispanic families in the United States: Incidence rates and structural interpretations. In M. A. Strauss & R. J. Gelles (Eds.), Physical violence in American families: Risk factors and adaptations to violence in 8,145 families (pp. 341–367). New Brunswick, NJ: Transaction. Szapocznik, J., Kurtines, W., Santisteban, D. A., Pantin, H., Scopetta, M., Mancilla, Y., et al. (1997). The evolution of a structural ecosystemic theory for working with Latino families. In J. G. Garcia & M. C. Zea (Eds.), Psychological interventions and research with Latino populations (pp. 166 –190). Boston: Allyn & Bacon. Therrien, M., & Ramirez, R. R. (2000). The Hispanic population in the United States: March, 2000 (Current Population Reports, pp. 20–535). Washington, DC: U.S. Census Bureau. Tran, T. V., & Williams, L. F. (1998). Poverty and impairment in activities of living among elderly Hispanics. Social Work and Health Care, 26(4), 59–78. Ullman, S. (1996). Social reactions, coping strategies, and self-blame attributions in adjustment to sexual assault. Psychology of Women Quarterly, 20, 505 –525. U.S. Bureau of the Census. (1994). Hispanic population in the United States, 1993 (Current Population Reports, pp. 20– 475). Washington, DC: U.S. Government Printing Office. Valle, R., & Vega, W. (1980). Hispanic natural support systems: Mental health promotion perspectives. Sacramento: State of California Department of Mental Health (No. 80-620047). Vasquez, C. I., & Dinelia, R. (1999). An understanding of abuse in the Hispanic older person: Assessment, treatment, and prevention. Journal of Social Distress and the Homeless, 8(3), 193 –206.

orga_c06.qxd

2/5/07

2:08 PM

Page 179

The Latino Family

179

Vega, W. A. (1990, November). Hispanic families in the 1980s: A decade of research. Journal of Marriage and the Family, 52, 1015 –1024. Weinbaum, Z., Stratton, T. L., Chavez, G., Motylewski-Link, C., Barrera, N., & Courtney, J. G. (2001). Female victims of intimate partner physical domestic violence (IPP-DV), California, 1998. American Journal of Preventive Medicine, 21(4), 313 –319. Weinbaum, Z., & Thorfinnson, T. (Eds.). (2006). Women’s health: Findings from the California Women’s Survey, 1997–2003. Sacramento, CA: California Department of Health Services, Office of Women’s Health. Weiss, S. J., Goebel, P., Page, A., Wilson, P., & Warda, M. (1999). The impact of cultural and familial context on behavioral and emotional problems of preschool Latino children. Child Psychiatry and Human Development, 29(4), 287–301. Williams, J. E. (1985). Mexican American and Anglo attitudes about sex role and rape. Free Inquiry in Creative Sociology, 13(1), 15 –20. Williams, J. E., & Holmes, K. A. (1981). The second assault: Rape and public attitudes. Westport, CT: Greenwood Press. Williams, J. E., & Holmes, K. A. (1982). In judgment of victims: The social context of rape. Journal of Sociology and Social Welfare, 9, 154 –169. Ybarra, L. (1982, February). When wives work: The impact on the Chicano family. Journal of Marriage and the Family, 169–178. Zambrana, M. M. (1985). Mejor sola que mal acompanada: Para la mujer golpeada [For the Latina in an abusive relationship] (Edicion bilingue). Seattle, WA: Seal Press. Zsembik, B. A. (1992). Determinants of living alone among older Hispanics. Research on Aging, 15(4), 449– 464. Zsembik, B. A. (1996). Preference for co-residence among older Latinos. Journal of Aging Studies, 10(1), 69–81. Zsembik, B. A., Drevenstedt, G. L., & McLane, C. P. (1997). Economic well-being among older Latinos. International Journal of Sociology and Social Policy, 17(9/10), 34 –54.

orga_c06.qxd

2/5/07

2:08 PM

Page 180

orga_c07.qxd

2/5/07

10:53 AM

Page 181

CHAPTER 7

Latino Youth

THE PSYCHOSOCIAL AND health problems of most Latino youth generally result from unmet developmental needs due to the breakdown of conventional social and cultural supports and resources within the family, ethnic community, and greater society. As such, risk in Latino youth is evident in a cluster of inter-related problems, especially in the poorest of barrio-dwelling youth, that need to be assessed and remedied as comprehensively as possible. Burt, Resnick, and Novick (1998, p. 38; see Table 7.1) articulate an ecologically comprehensive approach to understanding adolescent risk that is highly applicable to Latinos: The presence of harmful existing conditions (antecedents) in the absence of sufficient protective factors create vulnerabilities. These vulnerabilities, combined with the presence of specific early signs of difficulties (system markers), institutional inabilities to help children and youth who evidence such markers, and the absence of positive behaviors or competencies, may lead in time to problem behavior that will have more serious long-term consequences (negative outcomes).

For many Latino youth, antecedents include excessive poverty, family dysfunction, deficient community institutions (e.g., schools), and problems linked to minority status and the process of acculturation. Risk in Latino adolescents is generally higher in more acculturated youth experiencing family breakdown and disconnections from traditionally stabilizing social institutions such as school, church, prosocial peer groups and activities, and work. Psychosocial and health problems are most evident for Mexican American (i.e., Chicano) and Puerto Rican youth, from the 181

182 Positive interactions with family Participation in community and religious institutions Social, problemsolving, and peer skills High self-esteem and achievement motivation

Postponing sexual behavior

Good school attendance, attachment to school, good per formance

Positive Behaviors

Homelessness Physical abuse, battering Prostitution Sexual abuse, rape, incest Death or permanent injury from guns, knives, and other violent behavior; automobile accidents; other accidents Other morbidity/mortality outcomes (e.g., hepatitis, tuberculosis, pneumonia, AIDS complications) Depression, suicide Criminal convictions

Abuse of or addiction to alcohol or other drugs, and associated health problems

Pregnancy, too-early parenthood, poor pregnancy outcomes Sexually transmitted diseases, including chlamydia and AIDS

Dropping out of school, poor credentials for economic self-sufficiency

Negative Outcomes

Source: Building Supportive Communities for At-risk Adolescents: It Takes More Than Services, by M. R. Burt, G. Resnick, and E. R. Novick, 1998, Washington, DC: American Psychological Association.

Running away from home, foster home Associating with delinquent peers

Other adults Neighborhood resources Effective schools and other institutions with responsibility for children and youth

Early sexual behavior

Neighborhood and local institutions

Child protection/ out-of-home placement

Parental competencies/ resources

School-related problem behaviors (truancy, absenteeism, violence)

Problem Behaviors

10:53 AM

Use of tobacco, alcohol, other drugs

Poor school per formance

System Markers

Individual competencies/abilities

Protective Factors

2/5/07

Poverty

Family dysfunction

Antecedents

Table 7.1 Risk Antecedents, Markers, Behaviors, and Outcomes: A Conceptual Framework for Thinking about Youth

orga_c07.qxd Page 182

orga_c07.qxd

2/5/07

10:53 AM

Page 183

Latino Youth

183

oldest and largest of U.S. Latino groups whose histories reveal significant tension with mainstream society and consequent acculturative stress (e.g., segregation, poverty). Although the literature is scarce, there appear to be parallel problem patterns for Central American and Dominican youth, who usually live alongside predominantly urban-based Mexican American and Puerto Rican youth. And although Cuban American youth are hardly immune to psychosocial problems, the literature reveals generally better levels of adjustment given their unique history and generally better socioeconomic status (SES). For example, a study by Gil and Vega (1996) showed greater acculturative stress in Nicaraguan as compared to Cuban adolescents in Miami, given the latter’s integration into the highly successful Cuban enclave. Protective factors include individual, family, and community strengths; however, as noted in Burt et al.’s (1998) framework, such protective factors are frequently undermined by the very risk factors listed in that framework. As a result, early system markers (e.g., records of school failure, police records) are disproportionately high for Latino youth, as are more serious and long-term problem behaviors. The most prominent cluster of problem behaviors affecting Latino youth includes depression and suicidality, substance abuse, delinquency and gang involvement, school failure, and risky sexual behavior. To address such a cluster of problems, O. Rodriguez and Zayas (1990) argue for family therapy and family preservation efforts for adolescent status offenders, community-based groups for adolescents, and school-based interventions that emphasize family and ethnic pride. Certainly the overlapping nature of Latino youth problems and needed multilevel intervention strategies warrant addressing several problem areas simultaneously through comprehensive familycentered and community-based approaches. C L U S T E R O F P S YC H O S O C I A L A N D H E A LT H PRO B L E M S A F F E C T I N G L AT I NO YO U T H THE CENTRALITY OF SCHOOL FAILURE The historically entrenched problem of school failure for significant numbers of Mexican American and Puerto Rican youth, and more recently for Central American and Dominican youth, merits special attention for its central role in the development and exacerbation of related psychosocial and health problems, and for the potential role of the school as an optimal location for intervention. In a review of the literature by Rumberger (1998), data covey the following scholastic profile for Latino youth: (a) 17% of Latino students have dropped out by ninth grade; ( b) fewer than 50% of Latinos at ninth grade

orga_c07.qxd

184

2/5/07

10:53 AM

Page 184

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

have earned enough credits to be on track for graduation; and (c) by the end of the 10th grade, 31% of Latino students have dropped out and fewer than 21% have earned enough credits to be on track to graduate. Such data are particularly pronounced for Puerto Rican youth, who have the highest rates of dropout among Latino youth. A. Rodriguez (1992) highlighted the following factors in his brief review of the literature on dropout in Puerto Rican youth: (a) dropout rates between 45% and 65% in most cities, and a staggering 70% in New York; ( b) those who came to the mainland as adolescents are twice as likely to dropout as those born on the mainland; (c) two-thirds are from single-parent households; (d) youth with limited English proficiency youth are at higher risk than Englishproficient youth if not provided with appropriate bilingual education programs; and (e) students placed in special education programs are at higher risk of dropping out than those not in special education programs. Rumberger and Larson (1994) assert that Mexican American high school dropouts are like non-Latino dropouts in many respects (i.e., dislike for school, low educational aspiration, discipline problems), but they are more likely to drop out before high school and to receive a generally inferior education up to that point. In Solórzano and Solórzano’s (1995) review of the literature, they found that at both elementary and secondary school levels, Mexican American youth are more likely to attend segregated schools with low-quality curricula, less qualified teachers, greater teacher turnover, overemphasis on remedial studies, rigid ability placements and tracking into non-college-preparatory courses, low-quality programs for students with limited English proficiency, and curricula with little relevancy to the Chicano experience. Thus, theories of Chicano and Latino school failure in general need to focus on the role of school structure, resources, and processes as opposed to the traditional bias of looking for cultural defects within the Latino student, family, and community (Rumberger & Larson, 1994). It is still a fairly common misconception that poor Latino parents don’t place a high value on education, as if any group could do without such an essential need. What research does show is that Latino students and parents are similar to their Anglo counterparts in their educational values and aspirations, but the former have less instrumental knowledge regarding scholastic requirements for college and what type of education is needed to prepare for desired professional careers and are less aware of where to obtain such information (Behnke, Piercy, & Diversi, 2004; Garcia, 2001). Further, poor Latino parents are less able than their Anglo counterparts to provide direct guidance to help their children with homework and vocational aspirations (Azmitia, Cooper, Garcia, & Dunbar, 1996). Lack of English proficiency plays a major role in this problem area.

orga_c07.qxd

2/5/07

10:53 AM

Page 185

Latino Youth

185

As with other families, the more Latino parents are involved in school activities (Qian & Blair, 1999), as well as homework and monitoring their children (Plunkett & Bamaca-Gomez, 2003), the higher their children’s school motivation. Thus, it is imperative that schools step up their ability to help Latino students and their parents realize their healthy educational values and aspirations through competency-building strategies. Without the knowledge, resources, and skills to realize educational dreams, it is no surprise that so many young Latinos disconnect from school, as reflected in apathy and even resistant, anti-authority and antischool postures (Matute-Bianci, 1986). DEPRESSION AND SUICIDALITY The bulk of mental health research on Latino youth centers on Mexican Americans and shows that these youth, who constitute the majority of Latino youth, are at greater risk for depression and suicidality than Anglo and African American youth. Roberts, Roberts, and Chen (1997) assessed diagnosable Major Depression and related impairment in a survey of 5,423 students from five middle schools in Houston, Texas. They found rates of Major Depression that ranged from under 2% for Chinese American students to over 6% for Mexican American students, with Anglo students in the middle (3.9%). African American students also had higher rates of depression than Anglos, but only Mexican Americans had higher rates of Major Depression with impairment (i.e., problems functioning at home, school, and with peers), even after controlling for the effects of SES, sex, and age. A national survey of adolescents (Roberts & Sobhan, 1992), a household area probability sample of Los Angeles County (Siegel, Aneshensel, Taub, Cantwell, & Driscoll, 1998), a survey of high school students (Emslie, Weinberg, Rush, Adams, & Rintelmann, 1990; Weinberg & Emslie, 1987), and a comparison of Chicano and Anglo middle school students (Roberts & Chen, 1995) all found consistently higher rates of depression symptoms in Mexican American adolescents compared to Anglo-Americans and African Americans. With the exception of the Roberts and Chen study, Chicano youth rates remained highest even after controlling for SES, sex, and age. Thus, factors in addition to poverty influence depression in Chicano youth and need to be understood. The breakdown of traditional stabilizing forces, and not poverty per se, leaves Latino adolescents vulnerable to depression and related problems. Swanson, Linskey, Quintero-Salinas, Pumariega, and Holzer (1992) found higher rates of depression, suicidality, and drug use in 1,775 Chicano high school students compared to 2,383 poorer high school students from

orga_c07.qxd

186

2/5/07

10:53 AM

Page 186

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Mexico. Research suggests that the breakdown of the Latino family is central in the relation between acculturative stress and mental health problems. Hovey and King (1996) studied the relation between acculturative stress and depression in poor Latino high school students and found that depression and suicidality were predicted by high acculturative stress and low family cohesion (i.e., low support, tension). In turn, acculturative stress was predicted by low family cohesion and adolescent pessimism about the future. Further, suicidality was predicted by depression and low expectations of the future. Research on Latino families in Miami found greater acculturative stress in Nicaraguan adolescents compared to their Cuban counterparts, given the latter’s easier integration into the maturing Cuban enclave versus the recent refugee status of Nicaraguan youth (Gil & Vega, 1996). Nicaraguan adolescents had the highest rates of suicide attempts in Miami (Vega, Gil, Warheit, Apospori, & Zimmerman, 1993), and their early tobacco and alcohol use was related to language conflicts and suicide attempts (Vega, Gil, Zimmerman, & Warheit, 1993). Deterioration of family cohesion was evident in both of these Latino groups, but only for Nicaraguan adolescents was acculturative stress related to parent-child conflict, injured self-esteem, and perceptions of teacher derogation (Gil & Vega, 1996). Indeed, family breakdown can impair the ability of parents to guide their children safely through the risk-filled environments encountered by most Latino youth. For instance, in their sample of 121 low-income Chicana mothers of fourth-grade children, Dumka, Roosa, and Jackson (1997) found that maternal support and discipline (protective factors) mediated the impact of poverty and family conflict (risk factors) on child symptoms of depression and Conduct Disorder. That is, when support and discipline were high, there was no relation between risk factors and symptoms in children, and vice versa. Unfortunately, the risk factors contributed to inconsistent maternal discipline and low support for children or undermined protective factors. Seidman, Chesir-Teran, and Friedman (1999) assessed multiple risk and protective factors in both family and peer micro systems and their relation to depression and antisocial behavior in poor, urban adolescents of color. Results revealed a variety of ways in which poverty and family and peer systems are related to depression and acting out: (a) The most depressed and antisocial adolescents came from family relationships characterized by dysfunction (i.e., high conflict, low support, and medium parentchild involvement), enmeshment (medium-high conflict, medium-low support, and high parent-child involvement), and conflict (high conflict, medium support and involvement); ( b) the most depressed students also came from peer relationships characterized by rejection; and (c) the most

orga_c07.qxd

2/5/07

10:53 AM

Page 187

Latino Youth

187

antisocial adolescents had peer relationships with engaging but antisocial friends. Such results underscore the need for intervention programs that include prosocial peers and strategies to improve family functioning. ALCOHOL AND SUBSTANCE ABUSE As with depression, risk for substance abuse also increases with acculturation, family breakdown, school failure, and overinvolvement with risky peers, and varies by Latino groups based on their varied acculturation histories and SES profiles, as discussed in Chapters 1 and 2. Systematic attention to such variables helps us to unravel the sometimes confusing and contradictory findings in the literature. For example, major national surveys such as the Youth Risk Behavior Surveillance Study (Centers for Disease Control, 1996) and the 1998 National Household Survey on Drug Abuse (U.S. Department of Health and Human Services, 2000) tell us that adolescent substance use is generally greater in Latinos than in Anglo- and African Americans. However, by lumping all Latino groups together, important group differences are obscured under the label “Hispanic.” We can assume, however, that Puerto Rican and Chicano youth account for the higher rates of Latino substance use reported in these surveys given the SES profiles of these groups. SokolKatz and Ulbrich (1992) compared alcohol and substance use in a sample of Chicano (n = 794), Puerto Rican (n = 299), and Cuban (n = 144) adolescents and found that Chicano and Puerto Rican rates of drug use were twice as high (30% and 28%, respectively) as among Cubans adolescents (15%), although the three groups did not differ in alcohol use (15%, 12%, and 16%, respectively). Interestingly, Sokol-Katz and Ulbrich also found that although being from a single-parent home predicted alcohol and substance use for both Chicano and Puerto Rican adolescents, it failed to predict for Cubans. These researchers concluded that Cubans from single-parent homes are most likely protected by their higher SES advantages (e.g., better support networks). While national surveys suggests greater substance use in Latino youth, reviews of the literature have concluded that Chicanos have lower lifetime prevalence of illicit substance use than Anglo-Americans (Booth, Castro, & Anglin, 1990; De La Rosa, Khalsa, & Rouse, 1990). However, contradictory findings have also begun to emerge in large survey research. For instance, results from the National American Drug and Alcohol Survey showed greater current and lifetime substance use in Anglo (n = 2,243) than in Chicano (n = 1,837) 12th-grade students; however, rates for Chicano eighth-grade students (n = 2,530) were higher than for their Anglo counterparts (n = 1,547) in both current and lifetime substance use, as well as related risk behaviors such as using substances alone, using two

orga_c07.qxd

188

2/5/07

10:53 AM

Page 188

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

drugs at same time, and sharing needles (Chavez, Randall, & Swaim, 1992). Sampling high school seniors misses dropouts, who are overrepresented among Latino drug users. On a related note, results from the California Substance Use Survey (Boles, Casas, Furlong, Gonzales, & Morison, 1994) found equal rates of alcohol and drug use in Chicano and Anglo high school students, and within-group analysis showed greater substance use in U.S.-born versus Mexico-born Chicanos. Such studies underscore the need for more careful research that disaggregates Latinos, considers acculturation effects, and does not bias surveys toward high school completers. Family and Peer Factors In addition to the factors already noted, it is well-known in the literature that peer and family factors greatly influence youth substance use. But how do risk and protective factors within these two major domains of adolescence play out for Latinos? With regard to the role of peers, Flannery, Vazsonyi, Torquati, and Fridrich (1994) found that peer variables were more powerful than parent variables in predicting substance use in a sample of 1,170 middle school children in Tucson, Arizona (24% Chicano and 64% Anglo). That is, peer substance use and pressure to engage in antisocial behaviors were the strongest predictors of lifetime alcohol and drug use, compared to parent-child closeness, involvement in activities, and parental monitoring. Poorer adjustment to school also predicted substance use for Chicanos. Coombs, Paulson, and Richardson (1991) similarly reported that peer marijuana use was the most consistent predictor of substance use in a sample of 230 Chicano and 216 White students, ages 9 to 17. However, a closer look at their findings reveals a pattern in which substance use in Chicanos was predicted by both peer and parent factors, whereas use among Anglo students was predicted almost entirely by peer variables. That is, Chicano students were more likely than Anglo students to choose parents over peers when asked whose ideas they respected more and to whom they would turn during times of trouble. Chicano students also reported that they were more likely to obey their parents in the event of parent requests to keep away from peers whom their parents perceived as a bad influence. Another study of Chicano middle school children found that only low family cohesion predicted substance use in male adolescents, as compared to peer substance use, peer relations, adjustment to school, family substance use, and level of acculturation (Brooks, Stuewig, & LeCroy, 1998). In this study, family cohesion was defined as low conflict, high parental monitoring, intact family, and spending time together. Interest-

orga_c07.qxd

2/5/07

10:53 AM

Page 189

Latino Youth

189

ingly, family cohesion did not predict substance use in female students, consistent with the findings of Flannery et al. (1994), who found that substance abuse in Chicanas was predicted by poor adjustment to school but not by family variables. Taken together, these results appear to reflect greater familism in Latino youth, although more research is needed on sex differences. Risk and Protective Factors In one of the most comprehensive studies of substance use in Latino youth, Felix-Ortiz and Newcomb (1999) studied the separate and combined impact of risk and protective factors across multiple adolescent domains in a sample of 516 predominantly Chicano high school students from Los Angeles. Risk and protective factor indices were constructed from a wide variety of well-substantiated correlates of adolescent substance abuse: family variables (e.g., parental support and substance use), peer and community variables (e.g., peer substance use, availability of substances, tolerance for substances in the community), educational adjustment (e.g., grades, aspirations), conventionality (i.e., obeying the law, religiosity), emotional health (i.e., psychological distress, history of physical/sexual abuse and suicidality), and beliefs about self and drugs (e.g., self-acceptance, perceived harmfulness of substances). Dependent variables assessed were frequency of cocaine/crack, PCP, marijuana, inhalants, beer/wine/liquor, and cigarette use during the prior 6 months. A pattern of results emerged that are very important for sharpening our understanding of the complexity of substance use in Latino youth in general and high-risk youth in general: It was found that risk factors predicted substance use more strongly than did protective factors, but that protective factors mediated the relation between risk and substance use for both boys and girls. That is, at high levels of risk, protective factors predicted less substance use, whereas at low levels of risk they did not. Thus, protective factors protect Chicano youth from substance abuse when risk factors are substantial. Frauenglass, Routh, Pantin, and Mason (1997) found a similar pattern of results with regard to tobacco use in poor Latino adolescents in Miami: When peer tobacco use was high, family support predicted lower tobacco use in participants, but at low levels of peer use family support did not predict use. Thus, developing and reinforcing individual, family, peer, and community protective factors is likely to help adolescents coping with high-risk environments. More attention to Latina youth is also warranted in view of findings by Felix-Ortiz and Newcomb (1999) that alcohol and inhalants were the most commonly used substances among girls as well as boys, and that rates of alcohol use were actually higher for girls. Because two of the studies just

orga_c07.qxd

190

2/5/07

10:53 AM

Page 190

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

reviewed found that poor school adjustment but not family factors predicted substance use for Chicanas (Brooks et al., 1998; Flannery et al., 1994), it certainly makes sense to enhance academic and extracurricular school adjustment as a way of preventing substance use in Latinas. LATINO YOUTH GANGS Latino-Sensitive Gang Theory Most of what we know about Latino gangs comes from literature on Mexican American juvenile street gangs that date back to at least the 1930s. Puerto Rican youth gangs also have a long and notorious history in the United States, but major texts such as Youth Gangs in American Society (Shelden, Tracy, & Brown, 2004) and Gangs in America (Huff, 1996) contain almost no information on this important population. Even less information is available on those newer Latino youth (i.e., Central Americans and Dominicans) who fall into gang membership patterns. Although only a minority of Chicano youth become cholos, or gang members, this historically entrenched phenomenon has been a painful and destructive part of the Chicano experience throughout most of the twentieth century, sometimes occurring in multigenerations of the same, barrio-dwelling families. Goldstein and Soriano (1994) note that gang data are imprecise because no national-level agency has assumed responsibility for their systematic collection and dissemination. Using mostly local police and other criminal justice agency records, Goldstein and Soriano estimate the existence of 2,000 gangs in the United States with about 20,000 members. They note that the age range for membership has expanded from 12–21 to 9–30, and that the ratio of boy gangs to girl gangs has decreased from 201 to 151, with increasing autonomy in the latter. There are an estimated 600 Black and Chicano gangs in Los Angeles and 100,000 gang members, and there were 770 gang-related murders in 1991 (Harris, 1994). Yablonsky (1997) notes that four recent trends have made gangs in America more violent and problematic than ever before: (1) access to more lethal weapons; (2) greater availability of drugs; (3) increasing interracial violence; and (4) an increase in the multipurposes and sophistication of gang organization and structure. The foundations for a social and culturally sensitive understanding of Latino gangs were developed in the pioneering works of Vigil (1988) and Morales (1992), who conceptualized gang membership as an extreme response to the extreme failure of family, community, and traditional social systems to meet the developmental needs of Latino adolescents struggling with poverty-related risks and minority status in the United States. Such “multiple marginalities” were viewed as resulting in compromised

orga_c07.qxd

2/5/07

10:53 AM

Page 191

Latino Youth

191

development and struggles with distorted cognitive maps of the self, family, culture, social systems, and society. Belitz and Valdez (1994, 1997) build on these classic works by focusing on the context of family dysfunction and the psychological crisis of adolescent and ethnic identity development as responses to family marginality and adolescent alienation from family and society. These authors note that in immigrant families, parent and child role reversals (e.g., negotiating in English) and the low-prestige jobs of parents can create images of parents as weak in contrast to neighborhood gang members who appear powerful, confident, defiant, and aware of what’s going on. In multigenerational Latino families, the long-term effects of poverty can erode healthy family functioning needed to guide adolescents through the developmental task of healthy identity development, including issues of Latino ethnic identity. Family dysfunction pushes youth outside of the family to struggle with exceedingly complex issues of identity, purpose, role, and power on the streets. The pull of urban gang culture, with its rigidly defined hierarchy, prescribed member roles and activities, and symbols of group and cultural identity, can be particularly alluring for vulnerable youth. Chicano gang members invariably refer to their gang as their familia, to gang members as carnales, or blood brothers, and to the respeto and protection they are accorded as members. They also adopt or are given gang names (e.g., Payaso [clown], Sleepy) as well as roles (e.g., fighter, artist, leader) and use a mix of gang and Mexican symbols and images to express and project their individual and collective identities (e.g., tattoos, graffiti, hand signs). Thus, the use of gangs to achieve personal and social goals is considerable for these otherwise marginalized outsiders and suggests interventions that redirect such basic human motivations. But while gang members claim their “homies” as family, their distorted maps of familism and friendship limit healthy relationships. For example, in a rare empirical study of incarcerated Chicano and Anglo gang members, Lyon, Henggeler, and Hall (1992) found that members’ peer relationships were characterized by more aggressiveness and social immaturity than the relationships of nongang incarcerated youth. Chicano gang members also had more extensive criminal records and reported greater hard drug use than nongang incarcerated Chicanos. Belitz and Valdez (1997) note that the following family dysfunction factors are typically related to gang membership: substance abuse, domestic violence, and physical or sexual abuse of children and adolescents. The pent-up rage and violence frequently manifested (and valued) by gang members has many roots, including modeling and identifying with an aggressive and abusive parent or street models such as veterano (veteran)

orga_c07.qxd

192

2/5/07

10:53 AM

Page 192

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

gang members. The fact that Latino gang member violence is mostly directed at rival Latino gang members, who mirror each other in almost all respects, reflects a deep-seated self-hate linked to negative images of self and ethnic culture. Violence is also a way of creating real consequences to the gang realities that members construct from their limited environments and resources. For example, although the job of protecting one’s turf or barrio is at odds with lacking any property ownership, the price to be paid for crossing the imaginary line is quite real. To illustrate their theorizing, Belitz and Valdez (1994, pp. 67–69) offer the illustrative case study of 17-year-old Benito from an urban, barriodwelling, three-generation Chicano gang-involved family. Benito’s father was dominating, aggressive, and physically abusive toward his wife and children. Growing up, Benito avoided, helplessly tolerated, and eventually imitated his father’s violence. Benito loved his mother but saw her as weak and unable to protect him. School failure and disciplinary action at school resulted in hanging out with gang members and eventually joining a local gang of similar others. Benito took on the role of an extremely crazy or locote gang member with regard to alcohol and drug use, run-ins with the law, fighting, and so on. Multiple legal and mental health contacts followed with frequent incarceration where Benito would be victimized by stronger, and would himself victimize weaker, incarcerated youth. Despite the costs, Benito considered his gang his real family and professed his lifelong loyalty and willingness to die for it. ¡Mi barrio primero! [My barrio-gang above all!] is a frequent claim of gang members professing their loyalty to their gang above all. For Benito, the gang was also a location in which he could claim his Chicano identity, albeit a distorted one characterized by a crazy, violent, defiant, high risktaking male macho image. Unfortunately, schools generally exacerbate the Chicano gang problem by responding only with disciplinary actions such as detention and suspensions, as well as academic tracking, remedial courses, and alternative continuation schools, which all serve to further stigmatize and alienate gang members from school and positive peers (Vigil, 1999). Outside of school, the simple criminalizing of gangs and suppression activities by police further push gangs to the margins of society. Latina Gangs Females have always been active in Latino gangs, but primarily as girlfriends of male gang members. However, tough and autonomous Latina gangs have begun to form with potential for destructive acts similar to male gangs. Interviews with cholas from southern California (Felkenes & Becker, 1995; Harris, 1994) found them to be very similar to cholos in terms of why they join gangs, involvement in substance use, violence (e.g.,

orga_c07.qxd

2/5/07

10:53 AM

Page 193

Latino Youth

193

feuds with rival gangs), and other prized loca behavior. These girls had weak ties to family, school, and society, and many had experienced abuse in their family. Felkenes and Becker found that 41.2% of the 40 Los Angelesbased cholas interviewed had dropped out of school and that fewer than 25% were employed either full time or part time. Detention centers for these girls were often viewed more as safe havens than a deterrent to gang involvement. A qualitative study of female Puerto Rican gang members in New York concluded that their gang identity was almost a default identity resulting from the rejection of major aspects of their social and ethnic roles as poor Puerto Rican women (Campbell, 1987). Although they identified as Puerto Rican, they considered themselves more American and modern than old-fashioned Puerto Ricans but without much integration into mainstream society. Similarly, although they were aware of themselves as female and poor, they rejected both passive and promiscuous female roles and placed a high value on wearing designer clothes.

RISKY SEXUAL BEHAVIORS Teen Pregnancy Adolescent sexual behavior has been a long-standing public health priority for its connection to teen pregnancy and sexually transmitted diseases (STDs). National surveys indicate a continual rise in teen pregnancies, live births, and consequent problems, including greater health risks for mother and child, less education and fewer career choices for teen mothers, higher poverty and divorce rates for teen parents, and the potential for interpersonal violence and child abuse (Berry, Shillington, Peak, & Hohman, 2000; Franklin & Corcoran, 2000). The live birth rate for Latina adolescents (100 per 1,000 pregnancies) is quickly approaching that of African Americans (109 per 1,000), both of which are more than double the rate of Anglo-American adolescents (43 per 1,000). The majority of research on Latino adolescent teen pregnancy has been conducted among Mexican Americans and shows two consistent patterns: (1) Those higher in acculturation are at greater risk for sexual activity and single motherhood than those lower in acculturation (Becerra & de Anda, 1984; Darabi & Ortiz, 1986; Reynoso, Felice, & Shragg, 1993); and (2) Mexican American adolescents have higher live birth rates than Anglo-American teenage girls despite similar rates of pregnancy and lower rates of sexual intercourse (Aneshensel, Becerra, Fielder, & Schuler, 1990; Aneshensel, Fielder, & Becerra, 1989). The latter finding is most likely due to the Mexican American girls’ lack of knowledge about sex and contraceptives, less contraceptive use, and less communication with

orga_c07.qxd

194

2/5/07

10:53 AM

Page 194

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

parents about sexual matters (Baumeister, Flores, & VanOss Marin, 1995; Holck, Warren, Morris, & Rochat, 1982), factors also prominent in other Latino groups (DuRant, Pendergrast, & Seymore, 1990). Sexually Transmitted Diseases and HIV/AIDS In Los Angeles County, rates of gonorrhea and syphilis are low for both Latino and Anglo adolescents, but rates of chlamydia were twice as high for Latinos (483.2 versus 234 per 100,000, respectively; Nuno, Dorrington, & Alvarez, 1998). More alarming, although adolescent AIDS cases are only 1% of L.A. County cases, Latinos constituted almost half of these cases, as compared to 27.2% for African Americans and 21.9% for Anglos. A rare survey of HIV risk in just under 600 mostly Puerto Rican adolescents in New England found that over 40% were at high or moderate risk for HIV because of frequent unprotected sex with multiple partners during the prior 6 months (Smith, McGraw, Crawford, Costa, & McKinlay, 1993). Interestingly, girls were at considerably higher risk than boys in the study. Risky sexual behavior in Latino adolescents increases with acculturation to the United States because ties to traditionally stabilizing forces such as the family and traditional community institutions break down. Research on teenage Latinas shows that avoiding sexual activity is predicted by remaining in school, frequent church activity, and family stability (DuRant et al., 1990), and that not being pregnant is predicted by intact family, positive school attitudes, and getting information about sexual matters directly from parents (Baumeister et al., 1995). Felice, Shragg, James, and Hollingsworth (1987) found that dropping out of school was a greater precipitant of pregnancy for Mexican American than for Anglo or African American girls. So where are the Latino adolescent boys in all of this? Citing the work of Perez and Duany (1992), Kiselica (1995) reports the following percentages of sexual activity, by the age of 19, on the part of Latino (81%), Anglo (76%), and African American (96%) male adolescents: Latino adolescent males were found to have lower rates of effective contraceptive use (50%) compared to Anglos and African Americans (60% each). Preventing Risky Sexual Behavior A review of teen pregnancy programs serving mostly Latino and African American youth found that programs that provided contraceptive knowledge and access were superior in increasing contraceptive use and decreasing rates of pregnancy, even though they had no effect on sexual activity (Franklin & Corcoran, 2000). Despite such results, only one in five of 32 programs reviewed provided contraceptives to adolescents. Fur-

orga_c07.qxd

2/5/07

10:53 AM

Page 195

Latino Youth

195

ther, programs designed to delay sexual activity were effective but only for young adolescents. This point is important if we want to avoid the common mistake of advocating one-size-fits-all, abstinence-only approaches to diverse adolescents, as currently advocated by the Bush administration. Risky sex prevention programs for Latinos need to be integrated into schools, churches, and families, given that research showing that stability in these domains is related to less sexual activity (DuRant et al., 1990) and lower rates of pregnancy (Baumeister et al., 1995) in teenage Latinas. Mounting such programs will be difficult in view of the Catholic Church’s hard line on premarital sex and contraceptives and the traditional tendency for Latino parents and children not to discuss sexual matters. Such conservative systems need to better understand the current reality of risky sex in Latino youth and creative ways to address it. For example, churches could advocate delaying sexual activity in younger adolescents and more traditional immigrant adolescents, but need to be more realistic about the social experiences of older and more acculturated Latino adolescents if they wish to be effective. Further, given that research shows that Mexican American girls who discuss sexual matters with their parents are less likely to become pregnant, interventions that help parents with this challenging task are needed, especially considering the discomfort that such parents express about this task and their tendency to not discuss contraceptives (Baumeister et al., 1995). A DDR E S S I N G T H E C L U S T E R O F PRO B L E M S C U R R E N T LY A F F E C T I N G L AT I NO YO U T H SCHOOL- AND COMMUNITY-BASED INTERVENTION STRATEGIES Comprehensive, family-centered, and community-based strategies at multiple ecological levels are badly needed to address the cluster of psychosocial and health problems endangering the lives of Latino youth, families, and communities. Fortunately, trends in this direction have been pursued, complete with models, demonstration projects, and occasional outcome data on which to build (e.g., Burt et al., 1998; Dryfoos, 1994b; Flaherty, Weist, & Warner, 1996). An excellent example is the Houston Communities in School (CIS) project, which coordinates a broad range of child and family services in 21 schools with the ambitious goal of curbing dropout, improving academic skills, decreasing delinquency, and preparing students for adult work roles (Burt et al., 1998). The CIS service configurations are tailored to the needs of different schools but generally include personal and preemployment counseling for students and comprehensive social services for families. High-risk students are identified and referred to the CIS caseload; lower risk

orga_c07.qxd

196

2/5/07

10:53 AM

Page 196

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

students are invited to participate in school enrichment activities as a way of decreasing program stigma and promoting more needed interaction between risky and positive peers. The program functions as a broker for local county and community-based services that seek partnership on behalf of students. Continuity is enhanced by vertical teams that follow students through school feeder programs from elementary through high school. A complex set of public and private sources provide funding for CIS; because sources shift with political administrations and corporate mergers, funding requires ample administrative infrastructure to manage. As of 1996, more than 18,000 students had been served by CIS, with school retention rates remarkably between 89% and 100%. There is a CIS program at Edison Middle School in a community known as “Little Mexico,” where a club approach was used to attract Mexican American students to modeling, mariachi (traditional popular Mexican string and brass band), and English-as-a-second-language clubs (Burt et al., 1998). These clubs were particularly attractive to Chicana gang members. The CIS program employs 40 tutors from the University of Houston, two caseworkers, a drug counselor, and a community youth service crisis worker. Padres con Poder (Parents with Power) is a program for parents that teaches them parenting skills with special attention to Latino family themes, as well as substance use and violence prevention. Burt et al. also described a collaboration between CIS and county juvenile probation in which staff from both provide intensive student and family services to adjudicated youth. Greenberg Garrison, Roy, and Azar (1999) describe a community-based program in Washington, DC, designed to enhance the personal, social, and school functioning of Central American youth with dual attention to family adjustment to the United States. Program development began with a needs assessment via meetings with youth and families, community leaders, service providers, school administrators, and county government personnel. Student referrals were based on input from parents, teachers, principals, and school councils; student assessment included observation in school and unstructured settings and meetings with parents. Family assessment included a full evaluation of psychosocial needs. A comprehensive array of innovative programs was developed for Latino students and their families: in-home and crisis intervention services; individual, group, and family therapy; case management to address subsistence needs and community-based parent education and support (with child care as needed); consultation to school personnel regarding student behavior; and interagency collaboration to address family psychosocial needs. Examples of program innovations include a newcomer program for immigrant students, with a buddy system to facilitate adjust-

orga_c07.qxd

2/5/07

10:53 AM

Page 197

Latino Youth

197

ment to new schools, and group therapy focusing on refugee-related themes of loss and grief. A preliminary evaluation of the program found that 90% of parents’ and about 66% of teachers’ ratings indicated improvement in general student functioning. One-third of students improved in reading, and twothirds either improved or remained at appropriate grade-level math and study skills. With regard to school attendance, 90% of students attended 80% of the time, and 70% attended 90% of the time during the prior year. Both of these broad school programs bear a resemblance to what are called “full-service schools,” which are designed to address local children and families in their communities by consolidating multiple services within the school setting. FULL-SERVICE SCHOOLS

IN

LATINO COMMUNITIES

In her book Full-Service Schools: A Revolution in Health and Social Services for Children, Youth, and Families, Dryfoos (1994a) defines full-service schools as school centers where physical health, mental health, and social and family services are located, depending on local school and community needs. Dryfoos (1994b) describes an impressive pair of full-service schools in very different Latino communities that exemplify just what is possible to do on behalf of Latino students, families, and communities. A Full-Service School for the Dominican American Community Dryfoos (1994b) describes IS 218, a predominantly Dominican middle school in New York City’s Washington Heights, as a “settlement house” in a school, given this full-service school’s unique development and spectrum of school-based services tailored to the Dominican community. The development of IS 218 began with an extraordinary collaboration between New York City schools and the Children’s Aid Society (CAS), one of the city’s oldest and largest nonprofit social services, whose budget of over $30 million was being used to operate 26 social service agencies (e.g., community centers, adoption services and foster care, housing for the homeless, medical and dental care, job programs). In the late 1980s, CAS began to address the social service needs of Washington Heights. During consultations with local school officials, the idea of school-based community services arose. The timing was auspicious because the city was planning to replace outdated school buildings and the new collaboration worked on an architectural plan to create a full-service school that would be open 7 days a week, from early morning to late evening, as well as during the summer. The Children’s Aid Society simultaneously partnered with the community organization Alianza

orga_c07.qxd

198

2/5/07

10:53 AM

Page 198

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Dominicana (Dominican Alliance) by securing grants to train staff to work in afterschool programs in the new “beacon school” (schools linked with community agencies). Grants were also obtained to address a number of issues articulated by staff and community members (e.g., mobile medical and dental care, program for disabled). After 4 years of planning, IS 218 opened in 1992 complete with a family resource center, medical suite, and security guards. Social workers and community volunteers at the family center help with public assistance and housing, immigration and citizenship needs, crisis intervention, drug prevention, and adult education; for example, parents can earn certificates in dental assistance. The school was named after a Latino poet, Salome Urena Middle Academies, and houses 1,200 students who are enrolled in one of four academic academies: math, science, and technology; business; expressive arts; or community service. Each academy consists of five classes and five team teachers who meet frequently with advisory groups of 15 students to discuss career plans, school, and family problems and issues. Afterschool programs build on the academies (e.g., business students develop and operate a school store that can involve family members and family business plans). There’s even a Spanish class for local police taught by students and family members! Regular meetings between the school principal, the CAS director, and the superintendent of schools are essential in the administrative management of such a complex and ambitious venture. Interestingly, Dryfoos (1994b) noted that the school cost about $800,000 a year to run, and that the annual cost per student of $7,500 was actually below what is spent on suburban school students. A Full-Service School for the Mexican American Community In Modesto, California, the predominantly Chicano Hanshaw Middle School is managed by the Interagency Children’s Service Coordination Council, which is composed of representatives from the city school district, several county government child agencies, and major nonprofit organizations. The council’s mission is to build community-responsive schools in poor neighborhoods. Hanshaw provides on-site medical and dental screenings, mental health care, substance use prevention and treatment, and family support and education. Students are divided into seven “communities,” each tied to local California state universities (e.g., California State Stanislaus, Fresno, Sacramento, etc.) that provide tutoring (as well as university T-shirts!). Team teaching and cooperative learning are practiced throughout the curriculum and local businesses assist with employment preparation activities. The 1991 Healthy Start Support Services for Children Act provides funding for interagency case management services to minimize fragmented services to students and families. Al-

orga_c07.qxd

2/5/07

10:53 AM

Page 199

Latino Youth

199

though more program evaluation is needed, school attendance is 98%, and test scores are reported to be rising (Dryfoos, 1994b). F O C U S E D S C H O O L - BA S E D I N T E RV E N T I O N S PREVENTING SCHOOL FAILURE Although it is optimal to address Latino school failure as part of the comprehensive programs described earlier, there are specific programs worth mentioning given their creative, culturally competent approaches. Achieving Latinos through Academic Success (ALAS) was designed for high-risk Chicano middle school students with disciplinary problems, poor grades, and chronic truancy (Rumberger & Larson, 1994). Alas means “wings” in Spanish. The program interrupts school failure by implementing empirically based strategies at multiple ecological levels: (a) increasing student problem-solving skills in academics and family matters; ( b) providing continuous feedback to students and parents (i.e., daily, weekly) regarding school performance and behavior; (c) “hot seat attendance monitoring” of students on a period-by-period basis, expectation to make up truancies, and quick notification of parents about students’ problems; (d) extracurricular school activities with positive peers and adults at school; and (e) parent training regarding parenting issues as well as how to best interact with the school on students’ behalf. A report by Rumberger and Larson (1994) based on 2 years of program implementation with 2,000 predominantly Chicano students found that ALAS students had better school attendance, higher grades, and lower dropout rates by the end of eighth grade, as compared to no-program control students. Only 5% of ALAS students were chronically truant during the program’s 2-year period, as compared to 21% of control students. Students in ALAS also demonstrated lower failure rates than control students in English (29% and 45%, respectively) and math (37% and 59%, respectively). By the end of ninth grade, ALAS students continued to outperform controls (e.g., 80% on track to graduate versus fewer than 50%; Rumberger, 1998). The Theme Project is another school failure prevention program for Chicano middle school children that involved a collaboration between teachers and university researchers. The program offered intensive teacher training and enhancement of student learning through collaborative learning groups in which basic school subjects were integrated and taught through themes of relevance and high interest to Chicano students (e.g., the Olympics, ethnic identity, cultural differences, crime and nonviolence; Garcia, 2001). Findings showed that student involvement in the Theme Project improved school attendance, academic preparation, and

orga_c07.qxd

200

2/5/07

10:53 AM

Page 200

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

achievement compared to a matched control group. The superiority of the Theme Program over the school’s regular curriculum was also apparent on standard achievement tests (e.g., reading, writing, and language subtests), and bilingual as well as English-only students performed equally well in the program. Unfortunately, the overrepresentation of Latino youth in resource-poor schools means that innovative schools and programs are still the rare exception and not the rule. This will continue to be the case until Latino communities achieve enough power to effectively assert their basic need for quality education and family support services. PREVENTING SUBSTANCE ABUSE A meta-analysis of 143 adolescence drug prevention programs found that (a) the majority of programs are school-based and delivered to White middle-class youth; ( b) only 12.6% of programs were delivered to at-risk youth, defined as ethnic minority or substance-using or maladjusted to school; (c) peer programs (i.e., positive peer influence plus drug refusal skills training) were far superior in decreasing drug use than drug knowledge programs, affective programs (that increase self-esteem, communication, decision-making skills, etc.), and combinations of knowledge and affective programs; and (d) at-risk youth benefited most from alternative programs that included remedial tutoring, job skills training, community volunteering, and one-to-one relationships with positive role models (Tobler, 1986). Implications of this important review for Latino youth include the need to provide culturally competent peer and alternative programs to prevent and limit substance use. A study by Forgey, Schinke, and Cole (1997) comes close to implementing these suggestions with auspicious results in a sample of more than 600 seventh graders from six New York City schools. Half of the sample was African American and just under 40% were Latino. These researchers involved students in their Culturally Tailored Intervention (CTI) program, a psychosocial program that includes culturally sensitive approaches to teaching skills and involves prosocial peer leaders to deliver parts of the curriculum. Rap videos and cultural stories based on historical and contemporary African American and Latino heroes are used to teach ways of coping with poverty and discrimination. Forgey et al. compared their CTI to a psychosocial program called Life Skills Training (LST) and found that at posttest, both CTI and LST were effective, and superior to a no-treatment control condition, in decreasing intention to drink and use drugs in the future. Further, at 2-year followup, students in both the CTI and LST conditions maintained gains, but

orga_c07.qxd

2/5/07

10:53 AM

Page 201

Latino Youth

201

only CTI students actually drank less often and intended to drink less in the future. INTERVENTIONS

WITH

GANGS

For years, Vigil (1999) has recommended use of the school as a base of prevention and intervention work with Chicano youth at risk for gang membership and their families. Branch (1997) adds that gang interventions should consider the results of a meta-analysis of interventions for juvenile offenders which found that tightly structured, skills-oriented behavioral programs are the most successful at decreasing delinquent behavior. School-based gang programs are scarce and rarely based on the literature; however, a couple of noteworthy programs exist. Gang Mediation Program RESPECT (Respect Encourages Student Participation in Empowering Communication Techniques) is a school-based mediation program for preventing and decreasing violence among inner-city, barrio-dwelling, multigenerational gang members (Tabish & Orell, 1996). Gang members are contacted by school staff and gang interventionists, who develop personalized relationships that are based on mutual respect, recognition of dignity, and understanding. The school was the scene of many long-standing turf battles between members of three rival gangs with a history of multigenerational animosity. A gang leadership council, consisting of representatives from each gang, was formed to monitor conflicts on a bimonthly basis. Formal mediation includes explanation of the process by staff and selection of one representative and an alternate from each gang. A formal and neutral setting is selected with clearly posted ground rules (e.g., honesty, mutual respect, confidentiality, and no name calling, insults, interruptions, threats, or weapons). The objectives of RESPECT are to take adolescent realities seriously, respecting adolescents but not gang behavior, and modeling mature conflict resolution. The program lasts 1 to 3 hours a day for 3 to 5 days. Mediation begins by reviewing purpose and process and defining the problem. As feelings escalate, mediators rephrase and redirect communication. Subsequent meetings include review, calling witnesses to clarify disagreements and to redefine problems if necessary, and eventually brainstorming to generate solutions. The feasibility of solutions is tested and discussed until consensus is achieved. Agreements are typed up and signed by each gang representative, who meet the following week to review plan implementation. Although RESPECT lacks evaluation, it

orga_c07.qxd

202

2/5/07

10:53 AM

Page 202

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

conveys the need to conduct outreach to gang members and to involve them in a school-based violence prevention program that emphasizes Latino values and models appropriate alternatives to violent behavior. Experimental School for Gang Members In a fascinating book titled Peace in the Streets, Hernandez (1998) describes his evolution from a truant officer in Los Angeles to a teacher, guidance counselor, and founder of two experimental schools for Chicano gang members. The schools created badly needed spaces for chronically truant gang members who spent their days hanging out in abandoned homes and condemned buildings, doing drugs, and frequently exploiting and abusing each other (i.e., fighting, rapes of female members). At these schools, volunteer teachers, counselors, and clinicians provided needed tutoring, vocational counseling, and individual and group therapy. Lessons were embedded in Chicano stories and taught in group formats in which even the slightest participation was rewarded. Neglectful and abusive life histories were common in these youth, and the book sensitively reaffirms the child developmental needs of Chicano gang youth coping with immense problems with few, if any, supports. With regard to macro-level factors, the creation of more jobs for Chicano youth is likely to be an effective way of reducing the gang problem. For example, Gertz, Bedard, and Persons (1995) surveyed 702 Mexican American adults about gangs and heard the following solutions to preventing gangs: more jobs (46%), youth centers (23%), stiffer sentences (18%), improved security (8%), and other (5%). A full 75% of the sample considered Latino youth gangs a serious problem. The high endorsement of jobs and youth centers by two-thirds of the sample is worth considering in the creation of community-based gang prevention strategies.

FA M I LY- F O C U S E D I N T E RV E N T I O N S Given the central role of familismo in Latino culture, as well as family dysfunction in the psychosocial adjustment problems of Latino youth, family therapy represents a logical treatment option, whether alone or in conjunction with other interventions (e.g., individual and/or group therapy for youth, family case management). As mentioned in Chapter 6, Latino family therapists emphasize an ecosystems approach with the overriding goal of restoring family stability and adaptive functioning by addressing the needs of different family members and promoting bicultural flexibility with regard to understanding and responding to youth and family mental health problems.

orga_c07.qxd

2/5/07

10:53 AM

Page 203

Latino Youth

203

FAMILY THERAPY Falicov (1998) views the family therapist as an intermediary of family conflict whose role is to reframe troubled youth as “nervous” instead of bad, and family problems as “cultural transitions” in need of better understanding. Uneven levels of acculturation between parents and children, Latino migration histories, and the process of acculturation form a context for youth and family problems that can be remedied through greater mutual understanding and appreciation and improving communication skills. Falicov (1998) describes a Mexican immigrant family in which a U.S.born 15-year-old daughter makes a suicide attempt precipitated by her overprotective father’s refusal to let her take a cross-town bus to visit a friend who has moved. Therapy focused on helping the parents to understand their daughter’s struggle for greater autonomy in the United States while trying to be a good Latina daughter, and negative consequences that can be prevented. Simultaneously, the daughter was helped to see the positive intentions behind her father’s strictness (i.e., protection from their high-crime urban environment). Father and daughter were guided through a series of increasingly larger negotiations and compromises, such as permission to stay out a little later providing that the daughter call home to check in and permission for the daughter to express her disagreement provided she does so in a respectful manner. Falicov’s (1998) approach to family therapy is consistent with that of the Spanish Family Guidance Center in Miami, where Szapocznik and colleagues (1997) have developed acculturation-sensitive models of family therapy with Cuban and other Latino immigrant families, with an emphasis on drug-abusing and delinquent adolescents. Like Falicov, Szapocznik attributes adolescent problems to the “acculturation gap” that often exacerbates the normal generation gap between parents and adolescents. For example, in their Bicultural Effectiveness Training, Szapocznik, Santisteban, Kurtines, Perez-Vidal, and Hervis (1984) emphasize the goal of aligning family members to work together against acculturation gaps that threaten family stability (see Figure 7.1). By fostering cross-generational alliances within families, parents are connected to the positive aspects of modern American values and youth are connected to the positive aspects of more traditional Latino values. Falicov (1998) also argues for therapists to take on the role of “culture brokers” to help families obtain needed social services and natural support systems. The East Little Havana Parent Leadership Program (Szapocznik et al., 1997) is designed for the families of Latino children at risk for joining gangs. Parents are convened and taught leadership and resource-seeking

orga_c07.qxd

2/5/07

10:53 AM

Page 204

Hispanic Values-Parents

Youth/Acculturated Values

1) Detouring (a) Creating an IP: value conflict placed in IP role, blamed for the familyís ailment. The intergenerational conflict is reframed by attributing all negative consequences to the cultural conflict.

Parents

Youth

Hispanic Values

Acculturated Values

(b) Reframing: intergenerational relationship is attributed positive consequences (enrichment available from differences), and the family is encouraged to perceive culture conflict as a common foe. Intergenerational cultural conflict between generations are detoured through culture conflict.

Parents

Youth

Culture Conflict 2) Establishing crossed alliances (a) Family boundaries are made more permeable at this time to foment crossed alliances and encourage Parent/Acculturated Value and Youth/Hispanic Value relationships. Crossed alliances are expected to further weaken existing generational cultural alliances.

Parents

Hispanic Values

Youth

Acculturated Values

(b) By viewing culture conflict as a common foe and by weakening existing generational-cultural alliances new crossed alliances are fostered, the overall level of biculturalism in families is enhanced, and parents and youth strengthen their relationship vis-a-vis cultural alliances.

Parents

Hispanic Values

Youth

Acculturated Values

Legend Conflict Communication Direction of communication

Permeable boundaries Firm boundaries around alliances or relationships

Figure 7.1 The Bicultural Effectiveness Training Approach to Latino Family Therapy. (Source: “Bicultural Effectiveness Training (BET): A Treatment Intervention for Enhancing Intercultural Adjustment in Cuban American Families,” by J. Szapocznik, D. Santisteban, W. Kurtines, A. Perez-Vidal, and O. Hervis, 1984, Hispanic Journal of Behavioral Sciences, 6(4), pp. 317–344. Reprinted with permission.)

204

orga_c07.qxd

2/5/07

10:53 AM

Page 205

Latino Youth

205

skills, which are then used to implement supervised activities for their children and their children’s friends (e.g., field trips, team sports). With regard to evaluation, Szapocznik et al.’s summary of their research shows that their ecosystemic, culture-based family therapies are as effective as more generic forms of family therapy (e.g., structural family therapy) in reducing symptoms but are superior at engaging and retaining Latino families and preserving family cohesiveness. Consistent with Szapocznik et al.’s (1997) model, Belitz and Valdez (1997) begin family therapy for Chicano gang members by reviewing each family member’s unmet needs and trauma history. The goal is to decrease blaming and increase understanding of each family member’s behaviors. Culture brokering by the therapist attempts to meet the family’s social service needs, including out-of-home placement for gang youth as needed. Family therapy with immigrant families emphasizes disempowered yet overprotective parents and overempowered youth by virtue of their greater acculturation and premature autonomy.

PRIMARY PREVENTION

WITH

LATINO FAMILIES

Johnson and Walker (1987) conducted a rare empirical and longitudinal study on the primary prevention of behavior problems in young Mexican American children from low-SES backgrounds in Texas. When their children were between the ages of 1 and 3, parents were provided with inhome and clinic-based parenting and family decision-making skills and education about basic child development. Mother and child interactions were also observed, and services were provided in Spanish as needed. Comparisons of experimental and control families over a 5- through 8year period showed dramatic differences in parenting skills and child development, intelligence, and adjustment. Mothers in the experimental condition used less criticism and restrictive control and more encouragement and praise; experimental children scored higher on standard tests of development and intelligence; and experimental boys were less destructive, overactive, negative attention seeking, and emotionally sensitive, as compared to control boys ages 4 to 7. G RO U P T R E AT M E N T Whether in combination with individual or family therapy or schoolbased mental health services, group therapy is a promising way of addressing Latino youth problems, especially given the overimportance of peers and urban street culture in response to family breakdown and dysfunction and loss of other prosocial controls. De Las Fuentes (2000)

orga_c07.qxd

206

2/5/07

10:53 AM

Page 206

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

describes school-based groups she has conducted with urban immigrant Latino adolescents that address acculturation challenges faced by older adolescent immigrants who frequently experience lengthy separations from parents and other family members prior to migration. Baca and Koss-Chioino (1997) describe a group treatment for Chicano adolescents experiencing behavioral problems, substance abuse, and gang involvement. Group therapy is offered as a “fourth space” away from home, school, and the street, where participants can look at lives in a setting that re-creates positive features of the home (e.g., living room furniture, snacks). Treatment goals include promoting adjustment by improving the expression of feelings, clarifying and affirming healthy ethnic identity, and expanding life choices. Participants are asked to lead relevant discussions stimulated by clips from Chicano/Latino movies (e.g., El Norte, Mi Familia), documentaries, art, or poetry. Gang involvement is discussed by decreasing its glorification and focusing on alternative ways of meeting the real need for familia, belonging, respeto, and a visible and viable role in the world. Preliminary results reveal improvement in educational problems and family interactions and in decreasing symptoms of depression, Conduct Disorder, and Oppositional Defiant Disorder. Belitz and Valdez (1997) also recommend group treatment for Chicano gang members, usually in combination with family therapy. The goal is to reduce the gang member component of identity by teaching group members about ethnic identity development within the Chicano experience. For example, members learn that alienation from both Mexican and American cultures can push individuals toward gangs as a way of addressing their legitimate need for family and belonging and ethnic identity. In addition to examining the personal and social consequences of gang membership, members are also involved in healthy activities and affiliations designed to replace the positive functions of gangs (e.g., pro-community organizations, education programs at school, probation plans). Belitz and Valdez (1994) discuss a case study in which 2 years of group, family, and individual therapy were used to help a Chicano gang member named Chris, who joined a gang at 12 years of age following years of neglect by a substance-abusing mother, sexual abuse by a stepfather, and being shuffled between the homes of mother and grandparents. At 15 years of age, Chris attempted suicide after threatening to kill his pregnant girlfriend for breaking up with him. Individual therapy focused on processing childhood traumas, related vulnerability and rage, and behavioral consequences (substance abuse, gang involvement, suicidal and homicidal impulses). Group therapy with other gang members focused on exploring adolescent, “gang banger,” and Chicano identities. Members

orga_c07.qxd

2/5/07

10:53 AM

Page 207

Latino Youth

207

were helped to critically examine how their cholo identities, vato loco (crazy guy) role models, and gang activities were used to cope with inadequate families, roles, and identities, as well as venting pent-up rage. Consistent with an ecological model, members were helped to distinguish the positive and negative aspects of gang membership and to move into more adaptive roles and identities outside of the gang (e.g., acquiring a job, being a responsible father, helping the community). Chris did not quit the gang for some time but increasingly felt permission to move into other fulfilling roles. Family therapy included helping Chris to express his highly ambivalent feelings toward his mother (resentment for lack of protection yet fantasy of being properly mothered by her), helping his mother to apologize while expressing appropriate concern about Chris’s gang involvement, and involving extended family in treatment to construct a more cohesive and traditional Chicano family. Belitz and Valdez (1997) note that individual therapy with a gang member involves tolerating the youth’s strong impulse to test limits and act out, as well as monitoring the therapist’s countertransference (e.g., seeing gang members as criminal, not treatable). Knowledge about Chicano gangs (local as well as general) is a basic requirement for sensitive treatment. The role of therapist blends micro and macro levels by assuming an advocacy and brokering role with respect to accessing resources from educational, vocational, court, and probation-related agencies and supports from the community’s natural support systems, including healthy extended family relations. I N DI V I DUA L T H E R A PY In a rare comparison of individual cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) in the treatment of 71 clinically depressed Island Puerto Rican adolescents, Rossello and Bernal (1999) found that both therapies reduced symptoms better than a waiting-list control condition, and that IPT was also superior to the control condition in increasing self-esteem and social adaptation. Interestingly, the authors concluded that though both culturally adapted treatments are efficacious for Puerto Rican youth, IPT may be especially congruent with Latino cultural values. Treatment manuals for both therapies included values such as respeto and familismo, but IPT may have more directly emphasized such values, as well as personalismo, given its main objective of reducing symptoms in interpersonal relations and contexts. Though only preliminary, these results support IPT, as well as several writings on the appropriateness of CBT, for Latinos and other people of color, given this treatment’s emphasis on particular client circumstances,

orga_c07.qxd

208

2/5/07

10:53 AM

Page 208

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

using self-change skills to empower, attention to specific behaviors and conscious process, emphasis on action versus just verbal expression, and a didactic approach (Hays, 1995; Organista & Muñoz, 1996).

CONCLUSION The pernicious cluster of problems affecting large numbers of Latino youth is unlikely to abate soon considering the persistent parallel clusters of risk factors and undermined protective factors, which have their roots in historical legacies of racism and subordination, poverty and segregation. Emerging trends toward ecosystemically comprehensive, community- and school-based, child- and family-centered prevention and intervention programs represent a viable way of beginning to address formidable challenges. Comprehensive community-based approaches are a partial solution to traditionally fragmented social and human services for adolescents, each with their different rules, requirements, administrative procedures, and lack of coordination. Indeed, the term “categorical” program reflects the ways that most grant programs fund single agencies or coalitions to address narrowly defined adolescent problems such as dropout, teen pregnancy, and juvenile delinquency. Integrating services at federal, state, and local levels can be facilitated by changing the focus of funding sources toward collaborative efforts. This is beginning to happen (e.g., Healthy Families Act). Human service providers must continue to inform themselves about relevant funding mechanisms and social policies for pursuing integrated service projects. Burt et al. (1998) refer to comprehensive, integrated youth and family services as “an idea whose time has come” and make several recommendations based on their study of actual programs. At the individual program level, the best programs were those that worked with community stakeholders to identify gaps in the local service delivery network. These agencies also evolved to broker services, often by working in the gray areas between service boundaries that defined catchment areas, clients served, and problems addressed. Burt et al. note that key players in this arena were successful coalition builders who often mirrored the ethnic and racial characteristics of the communities they represented. At the local system level, service collaborators must develop a common set of long-term goals and exercise flexibility in their roles. Commitment and longevity can be promoted by pooling a portion of each agency’s funding to support integrative activities and by establishing interagency advisory group chaired by someone from a different agency each year. At the policy system level, evidence supporting the treatment outcome and

orga_c07.qxd

2/5/07

10:53 AM

Page 209

Latino Youth

209

cost effectiveness of integrated services must be generated to persuade policymakers to fund such efforts. R EFER ENCE S Aneshensel, C. S., Becerra, R. M., Fielder, E. P., & Schuler, R. H. (1990). Onset of fertility-related events during adolescence: A prospective comparison of Mexican American and non-Hispanic White females. American Journal of Public Health, 80(8), 959–963. Aneshensel, C. S., Fielder, E. P., & Becerra, R. M. (1989, March). Fertility and fertility-related behavior among Mexican-American and non-Hispanic White females. Journal of Health and Social Behavior, 30, 56 –76. Azmitia, M., Cooper, C. R., Garcia, E. E., & Dunbar, N. D. (1996). The ecology of family guidance in low-income Mexican-American and European-American families. Social Development, 5(1), 1–23. Baca, L. M., & Koss-Chioino, J. D. (1997). Development of a culturally responsive group counseling model for Mexican American adolescents. Journal of Multicultural Counseling and Development, 25(2), 130–141. Baumeister, L. M., Flores, E., & VanOss Marin, B. (1995). Sex information given to Latina adolescents by parents. Health Education Research: Theory and Practice, 10(2), 233 –239. Becerra, R. M., & de Anda, D. (1984). Pregnancy and motherhood among Mexican American adolescents. Health and Social Work, 9(2), 106 –123. Behnke, A. O., Piercy, K. W., & Diversi, M. (2004). Educational and occupational aspirations of Latino youth and their parents. Hispanic Journal of Behavioral Sciences, 26(1), 16 –35. Belitz, J., & Valdez, D. (1994). Clinical issues in the treatment of Chicano male gang youth. Hispanic Journal of Behavioral Sciences, 16(1), 57–74. Belitz, J., & Valdez, D. (1997). A sociocultural context for understanding gang involvement among Mexican-American male youth. In J. G. Garcia & M. C. Zea (Eds.), Psychological interventions and research with Latino populations (pp. 56 –72). Boston: Allyn & Bacon. Berry, E. H., Shillington, A. M., Peak, T., & Hohman, M. M. (2000). Multiethnic comparison of risk and protective factors for adolescent pregnancy. Child and Adolescent Social Work Journal, 17(2), 79–96. Boles, S., Casas, M. J., Furlong, M., Gonzales, G., & Morison, G. (1994). Alcohol and other drug use patterns among Mexican-American, Mexican, and Caucasian adolescents: New directions for assessment and research. Journal of Clinical Child Psychology, 23(1), 39– 46. Booth, M. W., Castro, F. G., & Anglin, M. D. (1990). What do we know about Hispanic substance use? A review of the literature. In R. Glick & J. Moore (Eds.), Drugs in Hispanic communities (pp. 21– 43). New Brunswick, NJ: Rutgers University Press. Branch, C. W. (1997). Race and ethnicity. In C. W. Branch (Ed.), Clinical interventions with gang adolescents and their families (pp. 44 –63). Boulder, CO: Westview Press.

orga_c07.qxd

210

2/5/07

10:53 AM

Page 210

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Brooks, A. J., Stuewig, J., & LeCroy, C. W. (1998). A family based model of Hispanic adolescent substance use. Journal of Drug Education, 28(1), 65 –86. Burt, M. R., Resnick, G., & Novick, E. R. (1998). Building supportive communities for at-risk adolescents: It takes more than services. Washington, DC: American Psychological Association. Campbell, A. (1987). Self-definition by rejection: The case of girl gangs. Social Problems, 34(5), 451– 466. Centers for Disease Control. (1996). Youth risk behavior surveillance, United States, 1995. Mortality and Morbidity Weekly Review 45. Atlanta, GA: Author. Chavez, E. L., Randall, C., & Swaim, R. C. (1992). An epidemiological comparison of Mexican-American and White non-Hispanic 8th- and 12th-grade students’ substance use. American Journal of Public Health, 82(3), 445 – 447. Coombs, R. H., Paulson, M. J., & Richardson, M. A. (1991). Peer versus parental influence in substance use among Hispanic and Anglo children and adolescents. Journal of Youth and Adolescence, 20(1), 73 –88. Darabi, K. F., & Ortiz, V. (1986). Childbearing among young Latino women in the United States. American Journal of Public Health, 77, 25 –28. De La Rosa, M., Khalsa, J. H., & Rouse, B. A. (1990). Hispanics and illicit drug use: A review of recent findings. International Journal of Addictions, 26, 665 –691. de las Fuentes, C. (2000). Group psychotherapy: Adolescent Latinos. In M. C. Flores & G. Carey (Eds.), Family therapy with Hispanics (pp. 151–163). Boston: Allyn & Bacon. Dryfoos, J. (1994a). Full-service schools: A revolution in health and social services for children, youth, and families. San Francisco: Jossey-Bass. Dryfoos, J. (1994b). Realizing the vision: Two full-service schools. In J. Dryfoos (Ed.), Full-service schools: A revolution in health and social services for children, youth, and families (pp. 99–122). San Francisco: Jossey-Bass. Dumka, L. E., Roosa, M. W., & Jackson, K. M. (1997, May). Risk, conflict, mother’s parenting, and children’s adjustment in low-income Mexican immigrant, and Mexican American families. Journal of Marriage and the Family, 59, 309–323. DuRant, R. H., Pendergrast, R. E., & Seymore, C. (1990). Sexual behavior among Hispanic female adolescents in the United States. Pediatrics, 85(6), 1051–1058. Emslie, G. J., Weinberg, W. A., Rush, A. J., Adams, R. M., & Rintelmann, J. W. (1990). Depression symptoms by self-report in adolescence: Phase I of the development of a questionnaire for depression by self-report. Journal of Child Neurology, 5, 114 –121. Falicov, C. J. (1998). Latino families in therapy: A guide to multicultural practice. New York: Guilford Press. Felice, M. E., Shragg, G. P., James, M., & Hollingsworth, D. R. (1987). Psychosocial aspects of Mexican-American, White, and Black teenage pregnancy. Journal of Adolescent Health Care, 3, 330–335. Felix-Ortiz, M., & Newcomb, M. D. (1999). Vulnerability for drug use among Latino adolescents. Journal of Community Psychology, 27(3), 257–280.

orga_c07.qxd

2/5/07

10:53 AM

Page 211

Latino Youth

211

Felkenes, G. T., & Becker, H. K. (1995). Female gang members: A growing issue for policymakers. Journal of Gang Research, 2(4), 1–10. Flaherty, L. T., Weist, M. D., & Warner, B. S. (1996). School-based mental health services in the United States: History, current models, and needs. Community Mental Health Journal, 32(4), 341–352. Flannery, D. J., Vazsonyi, A. T., Torquati, J., & Fridrich, A. (1994). Ethnic and gender differences in risk for early adolescent substance use. Journal of Youth and Adolescence, 23(2), 195 –213. Forgey, M. A., Schinke, S., & Cole, K. (1997). School-based interventions to prevent substance use among inner-city minority adolescents: Health-promoting and health compromising behaviors among minority adolescents (pp. 251–267). Washington, DC: American Psychological Association. Franklin, C., & Corcoran, J. (2000). Preventing adolescent pregnancy: A review of programs and practices. Social Work, 45(1), 40–52. Frauenglass, S., Routh, D. K., Pantin, H. M., & Mason, C. A. (1997). Family support decreases influence of deviant peers on Hispanic adolescents’ substance use. Journal of Clinical Child Psychology, 26(1), 12–23. Garcia, E. E. (2001). The education of Hispanics in the United States: Raices y Alas. Boulder, CO: Rowen and Littlefield. Gertz, M., Bedard, L., & Persons, W. (1995). Hispanic perceptions of youth gangs: A descriptive exploration. Journal of Gang Research, 2(3), 37– 49. Gil, A. G., & Vega, W. A. (1996). Two different worlds: Acculturative stress and adaptation among Cuban and Nicaraguan families. Journal of Social and Personal Relationships, 13(3), 435 – 456. Greenberg Garrison, E., Roy, I. S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based service. Clinical Psychology Review, 19(2), 199–219. Harris, M. G. (1994). Cholas, Mexican American girls, and gangs. Sex Roles, 30(3/4), 289–301. Hays, P. A. (1995). Multicultural applications of cognitive-behavior therapy. Professional Psychology: Research and Practice, 26, 309–315. Hernandez, A. (1998). Peace in the streets: Breaking the cycle of gang violence. Washington, DC: Child Welfare League of America. Holck, S. E., Warren, C. W., Morris, L., & Rochat, R. W. (1982). Need for family planning services among Anglo and Hispanic women in the U.S. counties bordering Mexico. Family Planning Perspectives, 14(30), 155 –159. Hovey, J. D., & King, C. A. (1996). Acculturation stress, depression, and suicidal ideation among immigrant and second generation Latino adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 35(9), 1183 –1192. Huff, C. R. (Ed.). (1996). Gangs in America (2nd ed.). Thousand Oaks, CA: Sage. Johnson, D. L., & Walker, T. (1987). Primary prevention of behavior problems in Mexican American children. American Journal of Community Psychology, 15(4), 375 –385. Kiselica, M. S. (1995). Hispanic American teenage fathers. In M. S. Kiselica (Ed.), Multicultural counseling with teenage fathers: A practical guide (pp. 238–268). Thousand Oaks, CA: Sage.

orga_c07.qxd

212

2/5/07

10:53 AM

Page 212

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Lyon, J. M., Henggeler, S., & Hall, J. A. (1992). The family relations, peer relations, and criminal activities of Caucasian and Hispanic-American gang members. Journal of Abnormal Child Psychology, 20(5), 439– 449. Matute-Bianci, M. E. (1986, November). Ethnic identities and patterns of school success and failure among Mexican-descent and Japanese-American students in a California high school: An ethnographic analysis. American Journal of Education, 233 –255. Morales, A. T. (1992). Therapy with Latino gang members. In L. A. Vargas & J. D. Koss-Chioino (Eds.), Working with culture: Psychotherapeutic interventions with ethnic minority children and adolescents (pp. 129–154). San Francisco: JosseyBass. Nuno, T., Dorrington, C., & Alvarez, I. (1998). Los Angeles County Hispanic youth health assessment report. Los Angeles: Multicultural Area Health Education Center. Organista, K. C., & Muñoz, R. F. (1996). Cognitive-behavioral therapy and Latinos. Cognitive and Behavioral Practice, 3, 255 –270. Perez, S. M., & Duany, L. A. (1992). Reducing Hispanic teenage pregnancy and family poverty: A replication guide. Washington, DC: National Council of La Raza. Plunkett, S. W., & Bamaca-Gomez, M. Y. (2003). The relationship between parenting, acculturation, and adolescent academics in Mexican-origin immigrant families in Los Angeles. Hispanic Journal of Behavioral Sciences, 25, 222–239. Qian, Z., & Blair, S. L. (1999). Racial/ethnic differences in educational aspirations of high school seniors. Sociological Perspectives, 42, 605 –625. Reynoso, T. C., Felice, M. E., & Shragg, G. P. (1993). Does American acculturation affect outcome of Mexican-American teenage pregnancy? Journal of Adolescent Health, 14, 257–261. Roberts, R. E., & Chen, Y. C. (1995). Depression symptoms and suicidal ideation among Mexican origin and Anglo adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 81–90. Roberts, R. E., Roberts, C. R., & Chen, Y. R. (1997). Ethnocultural differences in prevalence of adolescent depression. American Journal of Community Psychology, 25, 95 –110. Roberts, R. E., & Sobhan, M. (1992). Symptoms of depression in adolescents: A comparison of Anglos, African, and Hispanic Americans. Journal of Youth and Adolescence, 21(6), 639–651. Rodriguez, A., Jr. (1992). On to college: Dropout prevention is possible. In A. N. Ambert & M. D. Alvarez (Eds.), Puerto Rican children on the mainland: Interdisciplinary perspectives (pp. 193 –216). New York: Garland Press. Rodriguez, O., & Zayas, L. H. (1990). Hispanic adolescent and antisocial behavior: Sociocultural factors and treatment implications. In A. Rubin Stiffman and L. E. Davis (Eds.), Ethnic issues in adolescent mental health (pp. 147–171). Newbury Park, CA: Sage. Rossello, J., & Bernal, G. (1999). The efficacy of cognitive-behavioral and interpersonal treatment for depression in Puerto Rican adolescents. Journal of Consulting and Clinical Psychology, 67(5), 734 –745.

orga_c07.qxd

2/5/07

10:53 AM

Page 213

Latino Youth

213

Rumberger, R. W. (1998). Achievement for Latinos through academic success. In P. Gandara, K. Larson, R. Rumbereger, & H. Mehan (Eds.), Capturing Latino students in the academic pipeline (pp. 3 –120). Berkeley: California Policy Seminar. Rumberger, R. W., & Larson, K. A. (1994). Keeping high risk Chicano students in school. In R. J. Rossi (Ed.), Schools and students at risk (pp. 141–162). New York: Teacher’s College Press. Seidman, E., Chesir-Teran, D., & Friedman, J. C. (1999). The risk and protective functions of perceived family and peer microsystems among urban adolescents in poverty. American Journal of Community Psychology, 27, 211–237. Shelden, R. G., Tracy, S. K., & Brown, W. B. (2004). Youth gangs in American society (3rd ed.). Belmont, CA: Thomas/Wadsworth. Siegel, J. M., Aneshensel, C. S., Taub, B., Cantwell, D. P., & Driscoll, A. K. (1998). Adolescent depressed mood in a multiethnic sample. Journal of Youth and Adolescence, 27(4), 413 – 427. Smith, K. W., McGraw, S. A., Crawford, S. L., Costa, L. A., & McKinlay, J. B. (1993). HIV risk among Latino adolescents in two New England cities. American Journal of Public Health, 83(10), 1395 –1399. Sokol-Katz, J. S., & Ulbrich, P. M. (1992). Family structure and adolescent risktaking behavior: A comparison of Mexican, Cuban, and Puerto Rican adolescents. International Journal of the Addictions, 27(10), 1197–1209. Solórzano, D. G., & Solórzano, R. W. (1995). The Chicano educational experience: A framework for effective schools in Chicano communities. Educational Policy, 9(3), 293 –314. Swanson, J. W., Linskey, A. O., Quintero-Salinas, R., Pumariega, A. J., & Holzer, C. E., III. (1992). A binational school survey of depression symptoms, drug use, and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 31(4), 669–678. Szapocznik, J., Kurtines, W., Santisteban, D. A., Pantin, H., Scopetta, M., Mancilla, Y., et al. (1997). The evolution of a structural ecosystemic theory for working with Latino families. In J. G. Garcia & M. C. Zea (Eds.), Psychological interventions and research with Latino populations (pp. 166 –190). Boston: Allyn & Bacon. Szapocznik, J., Santisteban, D., Kurtines, W., Perez-Vidal, A., & Hervis, O. (1984). Bicultural Effectiveness Training (BET): A treatment intervention for enhancing intercultural adjustment in Cuban American families. Hispanic Journal of Behavioral Sciences, 6(4), 317–344. Tabish, K. R., & Orell, L. H. (1996). Respect: Gang mediation at Albuquerque, New Mexico’s Washington Middle School. School Counselor, 44, 65 –70. Tobler, N. S. (1986). Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control or comparison group. Journal of Drug Issues, 16(4), 537–567. U.S. Department of Health and Human Services. (2000). Cultural issues in substance abuse and treatment (DHHS Publication No. SMA 99-3278, Substance Abuse and Mental Health Services Administration). Rockville, MD: Author. Vega, W. A., Gil, A. G., Warheit, J. G., Apospori, E., & Zimmerman, R. S. (1993). The relationship of drug use to suicide ideation and attempts among African

orga_c07.qxd

214

2/5/07

10:53 AM

Page 214

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

American, Hispanic, and White non-Hispanic male adolescents. Suicide and Life Threatening Behavior, 23, 110–120. Vega, W. A., Gil, A. G., Zimmerman, R. S., & Warheit, J. G. (1993). Risk factors for suicidal behavior among Hispanic, African American, and non-Hispanic White boys in early adolescence. Ethnicity and Disease, 3, 229–241. Vigil, J. D. (1988). Barrio gangs: Street life and identity in southern California. Austin: University of Texas Press. Vigil, J. D. (1999). Streets and schools: How educators can help Chicano marginalized gang youth. Harvard Educational Review, 69(3), 270–288. Weinberg, W. A., & Emslie, G. J. (1987). Depression and suicide in adolescents. International Pediatrics, 2, 154 –159. Yablonsky, L. (1997). Black and Chicano gangs: In and out of prison. In L. Yablonsky (Ed.), Gangsters: Fifty years of madness, drugs, and death on the streets of America. New York: New York University Press.

orga_c08.qxd

2/5/07

10:53 AM

Page 215

CHAPTER 8

Latino Mental Health SO WHAT DO we know about Latino mental health in America? Until recently, the answer to this question used to be “Nothing conclusive” because research consisted mainly of local community studies conducted on different subgroups of Latinos, focusing on different mental health problems, and employing different research methods. Fortunately, U.S. Latinos have become increasingly included in large psychiatric prevalence studies during the past 25 years and informative patterns of mental health problems are beginning to emerge. But even before reviewing these data, we should make a couple of educated guesses about Latino mental health in America based on the theoretical frameworks presented in Chapters 1 through 4. For example, we could expect to find a relation between acculturation and mental health such that the more stressful the acculturation experience for a Latino group, the more distress and consequent mental health problems. That is, we should expect to find important differences between major Latino groups as well as within them. On a related note, the well-substantiated link between poverty and mental health problems should be in evidence for Latinos overaffected by poverty. AC C U LT U R AT I V E S T R E S S , P OV E R T Y, A N D R I S K With regard to adjustment to acculturation, Puerto Ricans are the poorest and most segregated Latinos in America, and Cuban Americans have attained SES levels approaching their non-Hispanic White counter parts. Mexican Americans are midway between Puerto Ricans and Cubans with respect to SES, and less segregated than Puerto Ricans. Like Cubans, Central Americans are largely recent refugees but largely without the official sanction and support of the U.S. government. They also lack the predominant professional background of Cuban Americans. As a result, Central Americans live mostly in poor, segregated, and working-class urban communities, an experience resembling that of Mexican Americans. Given 215

orga_c08.qxd

216

2/5/07

10:53 AM

Page 216

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

these general conditions regarding acculturation, it is fairly easy to rank the major Latino populations with respect to level of acculturative stress, as in Chapter 1, and consequent risk for stress and mental health problems. So, what does the literature say? Rogler, Cortes, and Malgady (1991) published the seminal review of the literature on acculturation and Latino mental health based on 30 empirical studies published between 1967 and 1989. Not surprisingly, Rogler et al. discovered that they could not integrate the studies because of a general lack of methodological uniformity. That is, this group of studies utilized different measures of acculturation (from scales to single items) and mental health (from diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders [DSM] to psychological symptoms) and studied different groups of Latinos, thereby disallowing meaningful comparisons. Indeed, 12 of the studies demonstrated a positive relation between acculturation and mental health, but 13 studies demonstrated a negative relation. Of the remaining five studies, three reported curvilinear relations, and two reported mixed findings on different dependent variables.

THE SOCIAL STRESS HYPOTHESIS Rogler et al. (1991) concluded that future research must be conducted with greater methodological uniformity; this has begun to happen. In addition, they noted that while acculturation can be stressful in an external sense (i.e., migration, loss of supports, adaptation to new country), there are also internal perceptions of acculturation to consider. For example, although new immigrants and refugees experience migration-related stress, they may also feel safe, hopeful, and better off than they were in their country of origin. However, Rogler et al. further note that although new immigrants may make positive social comparisons to their countryof-origin counterparts, second- and later generation Latinos may soon come to make negative social comparisons to mainstream American society given the different ways that prejudice, discrimination, and devalued ethnic minority status limit their once optimistic aspirations. Better designed studies are needed to test the social stress hypothesis of mental health problems in Latinos; this also has begun to happen.

T H E PR E VA L E N C E O F M E N TA L DI S OR DE R S I N U. S . L AT I NO S There is a small but growing number of epidemiological, populationbased prevalence studies of Latino mental health. Consistent with recom-

orga_c08.qxd

2/5/07

10:53 AM

Page 217

Latino Mental Health

217

mendations by Rogler et al. (1991), this collection of surveys is more methodologically uniform with respect to epidemiological survey methods, DSM-based diagnoses, use of large representative samples of Latinos, careful translations and adaptations of assessment instruments, and the inclusion of acculturation measures. THE HISPANIC HEALTH AND NUTRITION EXAMINATION SURVEY The Hispanic Health and Nutrition Examination Survey (HHANES) was the first major prevalence study of Latino health in America; it was conducted between 1982 and 1984 and included the following large samples of Latinos: 7,462 Mexican Americans in the five southwestern states; 2,834 Puerto Ricans in the New York Area; and 1,357 Cubans in Miami, Florida. The HHANES primarily consisted of a medical history examination, but it also included a DSM-III-based measure of Major Depression and the well-known Center for Epidemiologic Studies Depression (CESD) scale to measure recent symptoms of depression (Radloff, 1977). Assessment instruments were fully translated and administered in Spanish and English as needed. Consistent with earlier predictions, results form the HHANES do indeed show the highest rates of Major Depression in Puerto Ricans and the lowest in Cuban Americans, but Mexican Americans’ rates are similarly low (Moscicki, Rae, Regier, & Locke, 1987). As can be seen in Table 8.1, current, 6-month, and lifetime prevalence of Major Depression rates for Puerto Ricans are all more than double the rates of Cuban and Mexican Americans’. The fact that rates for Mexican and Cuban Americans do not differ can be explained by acculturation differences within Mexican Americans that must be taken into account. Table 8.1 Mental Health Comparisons of the Three Major U.S. Latino Groups on HHANES* Mainland Puerto Rican

Mexican American

Prevalence of Major Depression Disorder (%) Lifetime 8.9 4.2 Six months 5.8 2.3 One month 4.8 1.8 Rates of Past Heavy Drinking (%) Male 35.0 Female 17.0

36.0 15.0

*Hispanic Health and Nutrition Examination Survey

Cuban American 3.9 2.4 1.4 17.0 05.0

orga_c08.qxd

218

2/5/07

10:53 AM

Page 218

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

A follow-up study on the Mexican American sample found that “caseness” of depression, based on CES-D cutoff scores of 16 or higher, was predicted by an “Anglo orientation,” as assessed by being born in the United States, preference for English versus Spanish, and self-identification as Mexican American or Anglo versus Chicano or Mexicano, even after controlling for SES (Moscicki, Locke, Rae, & Boyd, 1989). Kaplan and Marks (1990) similarly found a positive relation between acculturation and depression in the Mexican American sample but only for younger (20 to 30 years of age) and not older participants, even after controlling for SES. They concluded that younger Latinos are more actively acculturating than their elders. Thus, more acculturated Mexican Americans appear to have rates of depression closer to those Puerto Ricans. But then why don’t we see acculturation differences among Puerto Ricans? This question was addressed by Vera et al. (1991), who compared the HHANES U.S. Puerto Rican sample to a probability sample of Island Puerto Ricans and found comparable rates of CES-D caseness or cutoff scores above 16 (28.1% and 28.6%). Although an acculturation perspective might predict higher distress for more acculturated mainland Puerto Ricans, it is important to understand that the distinction between mainland and Island Puerto Ricans has been blurred by decades of unrestricted circular migration and the fact that all Puerto Ricans are U.S. citizens. Moreover, as a U.S. colony, Puerto Rico has undergone dramatic Americanization during the twentieth century, including transition from a rural agrarian society to a more urban and industrial one. In fact, the only Puerto Rico islandwide prevalence study, conducted in 1984, showed overall prevalence rates of mental disorders comparable to those in the U.S. general population (G. J. Canino et al., 1987). However, it is worth noting that when Vera et al. compared U.S. and Island Puerto Ricans at the lowest income level (i.e., less than $15,000 annual income), U.S. Puerto Ricans did indeed have higher levels of depression symptoms than Island Puerto Ricans. The relation between depression and self-reported health in the HHANES was investigated by Angel and Guarnaccia (1989), who found an inverse relation for both Puerto Ricans and Mexican Americans. However, self-reported health and depression were worse in Puerto Ricans, and medical doctors rated Puerto Ricans less healthy than they rated Mexican Americans. Other reports comparing Mexican Americans to Island Puerto Ricans show higher rates of somatic symptoms (I. A. Canino, Rubio-Stipec, Canino, & Escobar, 1992) and Somatization Disorder (Shrout et al., 1992) in Puerto Ricans. The latter study also found higher rates of alcohol abuse/dependence and affective disorders in Mexican Americans, but again this was true only for U.S.-born and not immigrant Mexican Americans.

orga_c08.qxd

2/5/07

10:53 AM

Page 219

Latino Mental Health

219

More recently, Lee, Markides, and Ray (1997) used the HHANES to compare patterns of heavy drinking (i.e., in excess of guidelines for safe alcohol consumption). Not surprisingly, they found greater prevalence of past heavy drinking in Mexican American (36%) and Puerto Rican (35%) males compared to Cuban American males (17%); the same pattern, albeit lesser rates, was found for women (15%, 17%, and 5%, respectively; See Table 8.1). Puerto Rican men and women had the longest periods of past heavy drinking (Ms = 6.2 and 4.4 years, respectively) as compared to Mexican American men and women (Ms = 4.6 and 2.8 years, respectively) and Cuban American men (M = 4.4 years; there were not enough Cuban women to calculate years). Further, past heavy drinking was related to current heavy drinking and various health risk factors and chronic medical conditions. For example, Mexican American females who were past heavy drinkers had higher rates of smoking, depression symptoms, and chronic medical conditions compared to Mexican American women with no history of heavy drinking. This same pattern was found for Puerto Rican men for smoking and chronic medical conditions, and for Mexican American men for smoking. In sum, the HHANES survey allows for rare comparisons between the three major Latino groups in America. These comparisons form a pattern of mental health problems that is consistent with the different acculturation histories of these three groups: Puerto Ricans appear to be at highest risk and Cubans lowest, with Mexican Americans’ risk closer to Puerto Ricans but also evidencing a clear positive relation between acculturation and mental health problems. THE EPIDEMIOLOGIC CATCHMENT AREAS STUDY Also during the 1980s, the National Institute of Mental Health sponsored the largest psychiatric prevalence study in America (L. N. Robins & Regier, 1991). The Epidemiologic Catchment Areas (ECA) study was conducted with population-based probability sampling, stratified by catchment areas, in five major Americans cities, and conducted DSM-III-based diagnoses. The ECA included a large sample of Mexican Americans from Los Angeles (n = 1,244), but Puerto Ricans composed only 2% of the New Haven ECA site. No other Latino groups were included. Reports comparing Mexican American and non-Latino White mental health are based on the Los Angeles ECA (LA-ECA) study that was conducted in 1983 to 1984. Although LA-ECA reports reveal comparable lifetime (Karno et al., 1987) and 6-month (Burnam, Hough, Escobar, et al., 1987) prevalence of mental disorder in Mexican Americans and their White counterparts, an examination of these rates reveals important acculturation differences within the Mexican American sample. Immigrant

orga_c08.qxd

220

2/5/07

10:53 AM

Page 220

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Mexican Americans have lower overall lifetime prevalence than nonLatino Whites (i.e., less Major Depression, Obsessive-Compulsive Disorder, and drug abuse/dependence), but U.S.-born Mexican Americans have higher lifetime prevalence (i.e., more alcohol abuse/dependence, dysthymia, and phobia; Burnam, Hough, Karno, Escobar, & Telles, 1987). Burnam, Hough, Karno, et al. (1987) utilized a multidimensional scale of acculturation and found that acculturation was positively associated with higher lifetime prevalence of several mental disorders (i.e., alcohol abuse and dependence, substance abuse and dependence, and phobia), even after controlling for age, sex, and marital status. More specifically U.S.-born Mexican Americans (who had higher acculturation scores) had higher rates of all of these disorders, with the addition of Major Depressive Disorder and dysthymia. THE SELECTIVE MIGRATION HYPOTHESIS The fact that immigrant Mexican Americans have far lower prevalence rates of mental disorder than their U.S.-born counterparts is intriguing given their generally lower SES and supposed stress from migration. One popular explanation for this finding is the “selective migration hypothesis,” which holds that perhaps those Mexicans who immigrate to America are especially healthy compared to those who do not immigrate. The selective migration hypothesis is the opposite of the social stress hypothesis, which holds that the lower mental health of native-born Mexican Americans has to do with their stressful experience in America as a devalued and discriminated ethnic minority group. This latter hypothesis is more consistent with earlier predictions and is supported by a study by Vega et al. (1998), reviewed shortly in the chapter. NATIONAL COMORBIDITY SURVEY Not as large as the ECA, the National Comorbidity Survey (NCS) is the first mental health prevalence study based on a national probability sample of adults (N = 8,098), including representative percentages of Latinos (9.7%) and African Americans (11.5%) in addition to non-Latino Whites (75.3%; other = 3.5%), and DSM-III-R-based diagnoses. Results published by Kessler et al. (1994) reveal generally comparable mental health profiles across ethnic groups, although Latinos have higher levels of current affective disorders and comorbidity, which refers to simultaneous diagnoses of three or more mental disorders. Thus the NCS is helpful in indicating higher risk in Latinos for comorbidity and affective disorders such as depression. Unfortunately, the NCS represents a step backward with regard to understanding Latino mental health and its relation to acculturation. That

orga_c08.qxd

2/5/07

10:53 AM

Page 221

Latino Mental Health

221

is, the NCS lumped together Latinos of various national-origin backgrounds and interviewed only English-speaking Latinos. The fact that about half of Latinos participating in prevalence studies elect to do interviews in Spanish underscores the enormity of this omission. Employing such culturally insensitive research methods in view of the ECA findings is difficult to understand. Fortunately, a recent prevalence study on Mexican American mental health has greatly advanced our understanding of the relation between acculturation and Latino mental health. THE MEXICAN AMERICAN PREVALENCE AND SERVICES SURVEY Vega et al. (1998) surveyed a stratified random sample of 3,012 noninstitutionalized adults of Mexican background in Fresno County, California. As in the NCS, DSM-III-R-based diagnoses were made. But to better understand the relation between acculturation and mental health, Vega et al. compared U.S.-born Mexican Americans to short-term (less than 13 years in the United States) and long-term (13 years or more in the United States) immigrants. Further, findings from the Mexican American Prevalence and Services Survey (MAPSS) were compared to those of the NCS as well as a Mexico City prevalence study. Thus, this study is extremely helpful in expanding on the prevalence studies reviewed earlier. Like the NCS and ECA, initial findings from the MAPSS reveal comparable prevalence rates between Mexican Americans and the general U.S. population (i.e., a lifetime prevalence rate of nearly 50% for any disorder assessed). However, further analyses of MAPSS data reveal that these comparable prevalence rates are found only for U.S.-born Mexican Americans. In contrast, rates among immigrant Mexican Americans are only half those of the general prevalence of U.S.-born Mexican Americans, comparable to rates of mental disorder found in the Mexico City survey. Table 8.2 reveals the dramatic positive relation between acculturation and mental illness by comparing short- and long-term immigrants and U.S.-born Mexican Americans across virtually all major mental disorders assessed. Super Mexicans or Stressed Mexicans? With regard to understanding the relation between acculturation and Mexican American mental health, Vega et al. (1998) conclude that their findings do not support the selective migration hypothesis, given the comparable prevalence rates for immigrants in the MAPSS and their counterparts in the Mexico City survey. Instead, these researchers conclude, “Mexican immigrants share the lower risk status of their national origin, but acculturation has deleterious effects on many aspects of their health at the population level” (p. 777). In other words, acculturation may be hazardous to Latino mental health!

222 7.9 1.6 1.6 10.8 2.6 7.5 5.7 7.9 0.0 17.1 2.2 10.4 1.8 5.3 14.3 32.3

14.4 2.7 5.2 18.5 1.8 11.8 11.8 12.0 0.0 24.1 5.2 18.0 3.4 13.8 29.3 48.7

7.8 1.3 1.5 9.0 0.4 3.8 2.2 3.0 1.1 8.3 3.1 8.2 0.3 0.8 11.8 23.4

(n = 1,733) (%)

Mexico City

18.3 0.5 8.6 20.4 1.8 6.8 19.0 16.4 6.2 28.0 6.6 14.2 3.3 7.0 24.7 51.4

17.2 0.4 6.8 19.5 3.5 5.0 13.4 11.1 5.4 25.0 9.9 15.1 4.7 7.9 28.2 48.6

NCS Latinos Total (n = 305) (N = 5,384) (%) (%)

Note: MAPSS = Mexican American Prevalence and Services Survey; NCS = National Comorbidity Survey. Source: “Lifetime Prevalence of DSM-III-R Psychiatric Disorders among Urban and Rural Mexican Americans in California,” by W. A. Vega et al., 1998, Archives of General Psychiatry, 55, pp. 771–782. Reprinted with permission.

3.2 1.3 1.6 5.9 1.0 3.0 3.8 2.6 0.0 7.6 0.5 8.6 0.0 3.0 9.7 18.4

U.S. Born (n = 1,145) (%)

10:53 AM

Major Depression Manic Depression Dysthymia Any affective disorder Panic Disorder Agoraphobia without history of panic Social phobia Simple phobia Generalized Anxiety Disorder Any anxiety disorder Alcohol abuse Alcohol dependency Substance abuse Substance dependency Any abuse/dependency Any mental disorder

Immigrants >13 years (n = 851) (%)

2/5/07

Immigrants <13 years (n = 884) (%)

MAPSS

Table 8.2 Lifetime Prevalence of Mental Disorders in MAPSS, Mexico City, and NCS Surveys

orga_c08.qxd Page 222

orga_c08.qxd

2/5/07

10:53 AM

Page 223

Latino Mental Health

223

Vega et al. (1998) end their report with a series of questions, including two that are entertained here. The first question is “Why does socialization into American culture and society increase susceptibility to psychiatric disorders so markedly, what are the risk factors, and is this process generalizable to other ethnic groups?” (p. 777). Obviously this is a complex question requiring long and qualified answers based on new and improved research. However, the short answer is that the acculturation histories of different U.S. Latino groups predispose them to varying degrees of exclusion and poverty, which are related to above-average stress, below-average resources, and thus risk for mental disorders. This application of an acculturation framework appears to be supported by the studies reviewed, which reveal highest risk in Puerto Ricans and lowest risk in Cuban Americans for disorders such as Major Depression, Somatization Disorder, alcohol abuse/dependence, and related chronic medical conditions. Further, the literature on Mexican Americans clearly shows a positive relation between acculturation and mental disorder due mostly to the stress of being Mexican American in America as opposed to the selective migration of “Super Mexicans” from Mexico. With regard to the second question, “What components of Mexican culture are protective against mental health problems, and can these be conserved?” (Vega et al., 1998, p. 777), much has been written about healthy and protective aspects of traditional Mexican culture, such as close and supportive extended family systems. As a core characteristic of Latino culture, familismo is likely to be an important buffer of acculturative stress and the effects of poverty but is also probably weakened by such challenges. Interestingly, the idea of slowly diminishing protective cultural factors may help to explain why U.S.-born Mexican Americans and Island Puerto Ricans do not have overall prevalence rates that greatly exceed those in the general U.S. population. That is, considering the much higher poverty rates of Island Puerto Ricans (60%) and Mexican Americans (31%) compared to non-Latino Whites (8.6%), it’s nothing short of amazing that their mental health profiles are roughly comparable to Anglo-Americans with regard to prevalence at the population level. A NOTE

ON

CENTRAL AND SOUTH AMERICAN MENTAL HEALTH

As mentioned in Chapter 1, most Central Americans report fleeing their country of origin under war-related duress (Cordova, 1998), but their adaptation to the United States has been hampered by a general denial of refugee status (including entitlements to social services) due to limited ability to prove direct evidence of political persecution (Ferris, 1987). The

orga_c08.qxd

224

2/5/07

10:53 AM

Page 224

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

denial of political asylum leads to inhibited social and community life, mistrust, and perceptions of the U.S. government as supporting repressive governments in Latin America (Farias, 1991). This Central American predicament is unfortunate because studies of community samples report elevated symptom levels of depression, anxiety, somatization, and interpersonal sensitivity compared to American norms (Plante, Manuel, Menendez, & Marcotte, 1995). In addition, rates for Central Americans are higher than for Mexican immigrants in symptoms of depression and migration-related stress (Salgado de Snyder, Cervantes, & Padilla, 1990) and in Posttraumatic Stress Disorder (PTSD; Cervantes, Salgado de Snyder, & Padilla, 1989). With regard to South Americans, mental health studies are almost nonexistent. The main reasons for immigration are similar for South American groups as for other Latinos, namely, economic hardships and, at times, internal armed conflicts that place people in danger of torture or death (Gonsalves, 1990). As such, themes of loss and trauma are likely in this population, as well as the stress of acculturation and poverty. An additional stress is the greater geographical distance from their country of origin, which makes periodic contact with their families much less likely than most other Latinos. Having fewer neighbors from their country of origin results in fewer chances to share meaningful memories and customs, such as national celebrations (e.g., Independence Day), and national songs, foods, and folk knowledge. Much more research on Central and South Americans is needed to better understand their experience in the United States and related mental health profiles. I N C R E A S I N G AC C E S S T O M E N TA L H E A LT H S E RV I C E S It is now well-known that Latinos underutilize mental health services despite mental health needs that are at least equivalent to those of the general U.S. population. It is also well-known that underutilization is due mostly to external structural obstacles, reviewed briefly in Chapter 5, as opposed to internal cultural obstacles (e.g., culture-related attitudes and practices). Excessive emphasis in the past has been placed on the latter, but it is worth exploring and understanding any such obstacles from a culturally sensitive perspective. UNDERUTILIZATION For more than 25 years, reviews of the literature have repeatedly documented that members of ethnic minority groups underutilize mental

orga_c08.qxd

2/5/07

10:53 AM

Page 225

Latino Mental Health

225

Table 8.3 Mental Health Service Utilization Patterns for Los Angeles County by Major Ethnic/Racial Groups Group

Percentage of Los Angeles County

Percent of County Patient Population

Latino Americans (n = 3,000) Asian Americans (n = 3,000) Anglo Americans (n = 3,000) African Americans (n = 3,000)

34 9 43 13

26 3 44 21

Source: “Community Mental Health Services for Ethnic Minority Groups: A Test of the Cultural Responsiveness Hypothesis,” by S. Sue, D. C. Fujino, L. Hu, D. T. Takeuchi, and N. W. S. Zane, 1991, Journal of Consulting and Clinical Psychology, 59, pp. 533–540. Reprinted with permission.

health services despite their considerable needs (Atkinson & Lowe, 1995; Sue, 1977; Sue & Zane, 1987). Underutilization appears to be especially true for language minority groups such as Latinos and Asian Americans. For example, Sue, Fujino, Hu, Takeuchi, and Zane (1991) conducted a major study of the Los Angeles County Mental Health System and found that Latinos and Asians were underrepresented in proportion to their population sizes, Whites were proportionately represented, and Blacks were overrepresented (see Table 8.3). The same pattern of results was found in an earlier study of L.A. County (Flaskerud, 1986), as well as a study of nearly 14,000 mental health charts from 17 community mental health centers in King County, Seattle (Sue, 1977). The latter study also found that when ethnic minorities did use county mental health services, about half dropped out of treatment after one session of therapy, as compared to 30% of Anglo-American clients. STRUCTURAL OBSTACLES: DOES ETHNIC AND LINGUISTIC MATCHING MAKE A DIFFERENCE? In addition to low service availability and accessibility, the low number of bilingual/bicultural mental health professionals continues to be a major problem, especially in view of research showing that they do make a difference for language minorities such as Latinos. For example, Sue et al. (1991) studied the impact of linguistic and ethnic matching of therapists and clients by reviewing the mental health charts of 12,000 L.A. County mental health patients. More specifically, these researchers examined the charts of 3,000 Latino, 3,000 Asian, 3,000 African American, and 3,000 Anglo-American mental health patients. Results revealed that linguistic and/or ethnic matching improved treatment outcome, decreased dropout

orga_c08.qxd

226

2/5/07

10:53 AM

Page 226

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

from therapy, and increased the total number of therapy sessions but only for Latinos and Asians who were low in acculturation (i.e., recent immigrants, less likely to speak English, and less familiar with the mental health system). Thus, the presence of bilingual and/or bicultural mental health professionals is imperative for the huge numbers of Latinos low in acculturation who need such matching the most as they confront increasing mental health problems during the acculturation process.

CULTURAL OBSTACLES Somatization There is empirical support for the widespread belief that Latinos and other traditionally oriented groups tend to express emotional problems through their bodies (i.e., somatization) and thus seek help from medical rather than mental health providers (Padilla, Carlos, & Keefe, 1976). The tendency for Latinos to somaticize is especially true for those lower in acculturation and for females. Escobar et al. (1987) used the Los Angeles ECA data to compare Somatization Disorder in Mexican Americans (n = 1,242) and non-Hispanic Whites (n = 1,309) and found that whereas men’s prevalence did not differ, the rate among Mexican American women over 40 years of age was higher than for their non-Latino White counter-parts. Somatization in Mexican American women was also found to be positively correlated with age and negatively correlated with level of acculturation. Further, looking just at women who met criteria for depression or dysthymia, Escobar et al. found that about 50% of Mexican American women also met criteria for Somatization Disorder, as compared to 20% of non-Latino White women. Thus, medical staff need to be actively involved in mental health outreach and referral to better serve Latino patients. It should also be noted that the diagnosis of Somatization Disorder is extremely rare (e.g., prevalence of 0.1% in the ECA study), partly because of the complex criteria required in the DSM. Thus, to better capture somatic symptoms in community and clinical settings, Escobar et al. (1987) developed an abridged index of the most common somatic symptoms, requiring only six or more symptoms for women and four or more for men. Using the abridged index, they found a prevalence of 4.4% in the LAECA data in addition to the results just enumerated on Mexican American women. It is worth mentioning the historically negative bias against somatization. It has been conceptualized by Freudians as a primitive defense mechanism used by those who are not psychologically minded and thus not amenable to psychotherapy. Here’s where cultural sensitivity in mental

orga_c08.qxd

2/5/07

10:53 AM

Page 227

Latino Mental Health

227

health should compel us to be critical of any perspective that pathologizes what may be a cultural difference. For example, some researchers have forwarded the idea that somatization can also be viewed as a culturally adaptive idiom of distress, of which the culture-bound syndromes nervios (nerves) and ataque de nervios (nerves attack) are examples among Latinos (Hulme, 1996). As idioms of distress, somatic symptoms communicate emotional distress in a cultural context, rather than defend against it, but such meanings are lost on and even devalued by insensitive practitioners. In my mental health work with somatic Latino patients, I emphasize that pain is pain and that the distinction between mental and physical distress is a convention of the modern Western world that insists on dividing physical, mental, and even spiritual domains within people for the sake of specialization. As such, it may be just as (un)fair to accuse modern U.S. and European culture of “psychologizing” physical pain as it is to accuse less modern cultures of “somaticizing” mental pain. Folk Healer Utilization: Fact or Fiction? The Latino mental health literature is very insistent that we consider the supposed importance of folk healers and practices such as Curanderismo in the case of Mexican people and Santería in the case of Puerto Ricans and other Caribbean peoples. Although more research is needed, that which has been conducted largely fails to support any widespread use of folk healers among Latinos and clearly does not support its use to the exclusion of much needed conventional health services. For example, in the MAPPS survey, Vega, Kolody, Aguilar-Gaxiola, and Catalano (1998) assessed mental health service utilization in their epidemiological survey of 3,012 Mexican Americans in Fresno County, California, and found that only 3% of the 508 participants who met criteria for one or more psychiatric diagnoses during the prior year had used “informal help,” including curanderos (Mexican folk healers). Similarly, Higginbotham, Treviño, and Ray (1990) found that only 4.2% of 3,623 southwestern Chicanos reported consulting a curandero, herbalist, or other folk practitioner during the prior year. Folk doctor use by this small percentage was predicted by low income and dissatisfaction with modern medical services recently received, indicating use of curanderos as a last resort. Finally, an early survey of 666 Chicanos from Los Angeles found that only 2% had consulted a folk healer or curandero for emotional problems during the prior year, and that only 8% had ever done so in their entire life (Padilla et al., 1976). When these participants were asked who is the first person they would recommend to someone with an emotional problem, 0% indicated a curandero as opposed to doctor (25%), relative or compadre (20%), priest (17%), friend (14%), mental health clinic (14%), or psychiatrist or counselor (9%).

orga_c08.qxd

228

2/5/07

10:53 AM

Page 228

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Despite such data, the Latino mental health literature continues to push the idea of pervasive folk healer use in Latinos as a valid culturebased alternative to conventional medicine, without any evidence or critical examination of such culture-based practices (e.g., Harris, Velasquez, White, & Renteria, 2004). It just may be that folk healer use in Latinos is similar to the utilization of astrologists, fortune tellers, and witchcraft on the part of a few Anglo-Americans: a real yet small and insignificant endeavor. If so, Latinos would be much better served if we concentrated our efforts on promoting accessible, affordable, and culturally acceptable modern health and mental health services. Hopefully more scholarly research will continue to clarify this popular area of discussion in the Latino mental health literature. For example, Becerra and Iglehart (1995) conducted a fascinating study of folk medicine and home remedy use in an urban Los Angeles sample of nearly 500 participants from public housing projects and the Chinatown area. The sample was almost evenly divided among Mexican, African, Anglo-, and Chinese Americans. Results revealed that (a) all racial/ethnic groups used such practices; ( b) such practices were used in addition to, and not in place of, conventional health care; and (c) folk medicine remedies were used primarily for minor illnesses or to prevent major illnesses, but not to treat chronic illnesses. Further, compared to nonusers, folk medicine users were found to use more self-care strategies in general, suggesting that rather than viewing folk medicine as something exotic, it may simply reflect part of a larger picture of better health behaviors. Unfortunately, comparable survey data on Puerto Rican and Cuban use of Caribbean folk doctors do not appear to exist, although we should expect low use of Santeros (Caribbean folk healers practicing Santería) in Cuban Americans whose higher SES affords them rapid acculturation and high levels of health insurance and access to professional medical services. With regard to Puerto Ricans, much descriptive literature has been written on their use of Santería, but with little critical inquiry.

A S E L E C T I V E R E V I E W O F C U LT U R A L LY C OM PE T E N T M E N TA L H E A LT H I N T E RV E N T I O N S W I T H L AT I NO S The preceding review of the prevalence of mental disorders in Latinos makes clear the rather compelling link between historical acculturative stress, poverty, risk for mental disorders, and the need for culturally competent mental health services. Unfortunately, there continues to be extremely little empirical research on best intervention approaches for Latinos. The few studies that do exist are not methodologically uniform

orga_c08.qxd

2/5/07

10:53 AM

Page 229

Latino Mental Health

229

enough to suggest which treatments are best for specific mental health problems and Latino subgroups. Thus, we need to strive for conceptually sound approaches based on the working practice model presented in Chapter 5, with sufficient attention to ecosystemic levels that blend macro, meso, and micro practice approaches. The services and other interventions reviewed in this section range from comprehensive communitybased approaches to individual therapy. Family therapy was covered in Chapter 6 and thus is not covered here. COMMUNITY MENTAL HEALTH APPROACHES Aponte and Morrow (1995) assert that community mental health approaches are ideal for ethnic minority groups such as Latinos because of their focus on decreasing stress in the community versus individuals through the provision of services that are community-based and comprehensive, that emphasize continuity between services as well as disease prevention and health promotion, that strive to be innovative in response to community needs, that tap natural resources and supports such as paraprofessionals, and that attempt to empower communities by sharing control over services through active community board leadership. All of this sounds great, but it is a radical departure from institutionalized mental health business as usual, with its predominant top-down medical model of practice, “power over versus power with” clients, categorical funding streams for specific problems or populations, and the recent industrialization of services emphasizing cost savings (Manning, 1999). Thus, “alternative community delivery systems” and “ethnic agencies” are in the best position to deliver progressive services to Latinos. Iglehart and Becerra (1995) describe ethnic-focused agencies as consisting primarily of ethnic staff serving predominantly ethnic clients, resulting from local community initiatives (e.g., grassroots, bottom-up), committed to social change on behalf of special populations, frequently small and resource-poor but not always. According to Aponte and Morrow (1995), the major elements of alternative community service delivery systems include the following: • Ecological validity: This term refers to congruence between services and the community ecosystem and between how community members experience their environment and how it is perceived by service providers. Thus, services are less prepackaged and more tailored to community needs. • Multiproblem approach to services: Mental health services need to address a broad range of community needs through multiple service provider roles (e.g., advocate, teacher, consultant, therapist, case

orga_c08.qxd

2/5/07

230

•

•

•

•

•

•

10:53 AM

Page 230

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

manager, organizer). With the exception of clinical social work, this is a significant departure from professional mental health training. Commitment to interagency collaboration and coordination: The quality of mental health care is enhanced by activities ranging from regular staff in-services between as well as within agencies to informal links with community institutions such as churches, groups, and leaders. Employment of bilingual/ bicultural staff: The importance of this factor has already been stressed for promoting rapport and the cultural acceptability of mental health services. Utilization of paraprofessionals: This involves the utilization of informal community helpers, some of whom are former mental health clients, in the provision of community mental health services. In a study of 54 agencies serving ethnic minority communities, Jenkins (1981) noted quite a few years ago a large trend toward utilizing paraprofessionals (i.e., 43% of 574 workers had less than a BA degree). Development of community competence with social services: This factor emphasizes the need to increase the ability of community members to negotiate formal mainstream services via information, modeling, organizing, and political participation. Strengthening social support networks: From extended family to the community and beyond, alternative community service delivery systems promote existing social networks. Prevention and consultation strategies: Here the emphasis is on prevention of mental health problems and provision of technical assistance and resources needed to address mental health and other community problems.

The literature frequently describes projects, agencies, and centers that address many of these goals in a wide variety of settings, ranging from community-based multiservice centers to special ethnic-focused units within traditional mental health institutions. Unfortunately, outcome evaluations of such community interventions are almost always lacking given their lack of research arms. The following are illustrations of communitybased mental health interventions with Latinos with an emphasis on outcome studies when possible and adherence to the elements of alternative community delivery systems just outlined. Proyecto Bienestar and the Prevention of Depression in the Latino Community Proyecto Bienestar (Wellness Project) appears to be the only large randomized, controlled, clinical mental health trial conducted in the Latino community (Vega, Valle, & Kolody, 1994). The goal of Proyecto was to prevent depression symptoms in low-SES immigrant Mexican women in San

orga_c08.qxd

2/5/07

10:53 AM

Page 231

Latino Mental Health

231

Diego County by identifying, training, and supervising natural female helpers in the community, known as servidoras (servants). In addition to a no-treatment control condition, 655 women were randomized into two other experimental conditions, each of which involved weekly 90-minute meetings for 12 weeks: a servidora-facilitated merienda (afternoon get-together) group and a link-person condition in which servidoras met individually with participants. In both experimental conditions, the intervention consisted of teaching participants how to modify unsupportive environments, increase effectiveness in interpersonal relationships, and improve coping with expected and unexpected life stressors. One-year posttreatment results comparing experimental and control conditions revealed that the project was successful in preventing depression symptoms in those women with the fewest pretreatment symptoms of depression, and this was especially true for those women who completed more than half of the 12 intervention sessions. However, for women with moderate symptoms at baseline or higher, there was no intervention effect. The authors concluded that Proyecto Bienestar was successful in its goal of preventing depression in a high-risk group not yet evidencing symptoms, but was least helpful to those already evidencing symptoms. They recommend adapting these types of prevention programs to Latino communities, but it is evident that more intensive treatment programs are needed for Latinas evidencing serious symptoms of depression. One such program is described in the “Group Treatment” section that follows. GROUP INTERVENTIONS There has been consensus for some time in the psychotherapy literature that group treatment is an especially viable modality for Latino patients (e.g., Delgado & Humm-Delgado, 1984). Though descriptive, these reports discuss how group therapy is particularly well suited to Latino patients struggling with migration- and acculturation-related stress and isolation, the breakdown of the extended family, the difficulty of not speaking English, and the experience of discrimination. Following are some brief illustrations of Latino group therapy that are consistent with the components of culturally responsive community interventions outlined earlier, as well as with the working model of practice with Latinos presented in Chapter 5. Group Therapy with Puerto Ricans Lilian Comas-Diaz and associates have generated much helpful literature on group work with Puerto Ricans that emphasizes the creative incorporation of what they call “drama” by way of Puerto Rican music, poetry, literature, and Espiritismo (Spiritism, Caribbean-based folk healing beliefs

orga_c08.qxd

232

2/5/07

10:53 AM

Page 232

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

and practices) as a more effective alternative to conventional forms of group therapy such as gestalt and rational emotive therapy. For example, Comas-Diaz (1986) designed a grupo de mujeres (women’s group) specifically for alcoholic Puerto Rican women; she describes initial aggressive outreach to emergency rooms, police, schools, and churches, followed by group therapy that addresses alcoholism in the context of cultural adaptation and conflicts created by shifting gender roles. The cultural stigma and protection attached to female alcoholics are addressed, and older women are used to communicate their experiences to younger group participants. In a rare (and too short) note on the utilization of folk healers, Comas-Diaz mentions a psychologically charged session led by espiritistas (Spiritualists, or folk healers) who relay messages to group members while supposedly being inhabited by spirits. Puerto Rican salsa and bolero music conveying emotions and struggles similar to those of group members are carefully selected and played as a way of facilitating the group process. Because so many Latinas follow novelas (soap operas) on Spanish television, Puerto Rican plays that mirror the struggles of the people are also used to facilitate self-examination. Such media were also found to be helpful in getting Puerto Rican male group members to discuss their problems and issues. With regard to more conventional approaches, Comas-Diaz (1981) also documented the equal effectiveness of cognitive therapy and behavioral therapy over a no-treatment control condition in the treatment of depression in Puerto Rican women. Cognitive and behavioral therapies do appear consistent with the expectations of traditional clients that include immediate symptom relief, guidance and advice, and a problem-centered approach (M. R. Miranda, 1976). Such short-term, directive, problemsolving therapies are also more consistent with the expectations of lowincome groups, whose pressing life circumstances frequently demand immediate attention and interfere with long-term treatment (TorresMatrullo, 1982). Treating Major Depression in Latinos The Cognitive-Behavioral Depression Clinic (CBDC) at the San Francisco General Hospital is an example of a needed service for Latinos located within a traditional mental health system. Obstacles to services are minimized by providing free or low-fee (affordable) hospital-based (available, accessible) services by linguistically and ethnically matched therapists (acceptability). In terms of outreach, medical staff have been trained to recognize and refer patients presenting with sad affect and/or multiple somatic complaints. Patients are offered an evaluation for depression based on their physician’s recommendation that facilitates the acceptance

orga_c08.qxd

2/5/07

10:53 AM

Page 233

Latino Mental Health

233

of mental health services. The clinic receives about 300 referrals a year, and about half of these are Spanish-speaking Latino primary care patients, predominantly first-generation immigrants from Mexico and Central American refugees. Outpatient group CBT is offered to patients who meet criteria for Major Depression without psychotic features. Persons with active substance abuse, cognitive disorders, or other Axis I psychiatric diagnoses are referred out for appropriate services. However, patients with concomitant anxiety disorders (e.g., Generalized Anxiety Disorder, Panic Disorder, PTSD) or Somatization Disorder are not excluded. Also, persons currently in treatment for their substance abuse problems are allowed to enter group CBT. Patients are offered 16 weeks of standardized, manualdriven, group CBT provided by bilingual, bicultural Latino therapists. Groups meet weekly for 2 hours for 16 weeks, and the treatment protocol addresses three major areas (Muñoz, Ghost Ippen, Rao, Le, & Valdes Dwyer, 2000): (1) activity schedules designed to break the vicious cycle of depression leading to low activities and vice versa; (2) assertiveness training to increase interpersonal effectiveness; and (3) cognitive restructuring designed to identify and change depression-related thinking and core beliefs. The psychoeducational style of CBT quickly orients patients to treatment by educating them about the diagnosis of Major Depression and how CBT is used to conceptualize and treat their problems. The use of therapy manuals, homework assignments, and chalkboard-aided teaching results in patients referring to therapy as la clase de depresión, which further helps to alleviate stigma attached to therapy. Each participant is given a copy of the manual, which includes outlines of each of the sessions and weekly homework assignments consisting primarily of daily mood monitoring in relation to activities, interpersonal contacts, and thoughts. Homework is reviewed at each session to teach patients the relations between thoughts, behaviors, and mood. Pretreatment Preparation. To reduce the incidence of dropout, patients are invited to a pretreatment orientation session in which they meet bilingual, bicultural Latino staff and therapists and learn about the structure and process of group therapy over coffee and cookies. This type of role preparation is highly recommended for decreasing dropout in low-income (Orlinsky & Howard, 1986), ethnic minority (Acosta, Yamamoto, & Evans, 1983), and Latino (Delgado, 1983) patients. Personalized Engagement. Engagement is further enhanced during the first group therapy session by incorporating the salient Latino value of

orga_c08.qxd

234

2/5/07

10:53 AM

Page 234

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

personalismo into a culturally sensitive relationship protocol. Hence, during the first session, time is allotted for presentaciones in which therapists and patients share personal background information about where they are from, their families, work that they have done, personal interests, and so on. The similarities among patients in terms of countries of origin, types of work, and interests naturally elicit questions and small talk, or plática. Following the presentations, therapists educate patients about the diagnosis of Major Depression and the CBT model. As a preliminary assessment of depressed thinking, patients are asked to speculate about the causes of their depression. For example, a middleaged Central American woman attributed her depression to the death of her son, who had been killed years earlier in El Salvador, where young men were frequently the targets of either government or guerrilla forces during that country’s civil war. The woman recalled the trauma of having to identify her son’s bullet-riddled body in the city morgue. After ample empathy was expressed, the woman was asked what about her son’s death had made her so depressed. Interestingly, she blamed herself because the two of them had an argument on the morning of his death and he stormed out of the house, never to return (“If I had not argued with him, he would not have been killed”). This case illustrates the difference between normal bereavement and guilt-ridden self-blame that can result in Major Depression. It also illustrates the kinds of traumas that Central American refugees often bring into therapy. Cognitive Restructuring. In the preceding case, it was imperative to eventually challenge the woman’s belief that she was responsible for forces outside of her control. She eventually learned to think, “Yes, it’s true that my son and I argued and that he left the house in anger on the day of his death, but that doesn’t mean that his death was my fault.” The woman was also reminded that her son’s life included more than his tragic death, and she was asked to recall some pleasant memories of him. She was eventually able to share that her son had been quite a joker and recalled a few of his pranks, which made her laugh for the first time in a long time. This is an example of a streamlined approach to cognitive restructuring by teaching clients what I refer to as the “Yes, but . . . technique,” in which clients are taught that much problematic thinking amounts to “half-truths” about problems that need to be made into “whole truths.” Rather than provoking defensiveness by labeling patient beliefs as irrational, à la Albert Ellis (Ellis & Grieger, 1977), or distorted, à la Aaron Beck (Beck, Rush, Shaw, & Emery, 1979), patients feel understood when therapists communicate that their thoughts are understandable in view of their circumstances. This approach is also helpful in addressing another

orga_c08.qxd

2/5/07

10:53 AM

Page 235

Latino Mental Health

235

common problem in middle-aged Latinas, who frequently have to stop working because of chronic medical problems, disabilities, and depression; for example, in a sample of 176 CBDC patients, 52% had chronic medical conditions (Organista, Muñoz, & Gonzalez, 1994). A common conclusion among these women was “¡No sirvo para nada!” (I’m good for nothing!) because self-worth is frequently overinvested in providing tangible support to their family. Again, we teach cognitive restructuring by asking patients to complete such statements as “Yes, my health problems do limit what I can do, but . . . ,” to which patients respond with something like “but that doesn’t mean I’m worthless” or “but there are still some things I can do for my family.” Restructuring Prayer? Because the majority of Latino patients are Catholics, religion is regarded as a relevant domain in which practitioners need to work. For example, churchgoing and prayer are reinforced as behavioral and cognitive activities, respectively, that help patients cope with negative mood states. However, it is often necessary to assess and even challenge forms of prayer that may lessen active problem solving. For example, when patients report that they “just prayed” as a way of coping, they are asked to share their prayers during group. They often reply that they simply asked god to alleviate their suffering or to solve their problems. In such cases, patients are helped to shift prayers in a more active direction by discussing relevant Latino dichos, or sayings, such as “Ayudate, que Dios te ayudará” (God helps those who help themselves). Therapists also model for patients, asking them to recite prayers in which god is asked for support in trying out new behaviors (e.g., “God, please give me the strength to increase my daily activities” or “learn how to be more assertive”). Activity Schedules. Activity schedules and behavioral contracts to increase reinforcing activities are used to break the vicious cycle of depression and loss of interest in things, leading to low activity levels that in turn maintain depression. Activity schedules are also helpful in countering Agoraphobia related to Panic Disorder affecting some patients (Organista, 1995). When applying cognitive-behavioral techniques, it is important to be aware of underlying mainstream American cultural assumptions. For example, an implicit assumption underlying activity schedules emphasizes the need to take time out for oneself, based on the value that one must take care of oneself before others. Although such an assumption is undoubtedly adaptive in our individually oriented society, it can run counter to the emphasis in Latino culture, especially for women, to put

orga_c08.qxd

236

2/5/07

10:53 AM

Page 236

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

the needs of family members ahead of one’s own. This cultural contradiction is further complicated by the fact that although traditional Latino female gender-role expectations may be more realistic within intact extended families and community systems (with their many compensating resources), such expectations become unrealistic in the United States, where Latino families have become more nuclear, with fewer traditional resources. Consider, for example, the excessiveness of one of our female clients who had the bulk of homemaker and parenting responsibilities in her family, in addition to working full time outside of the home. For this client it was important to balance her responsibilities with some time for pleasant relaxation, but how? It was also important to teach her how to set limits with her husband and other family members regarding excessive housework and child care. Naturally, Latino patients can be persuaded to do pleasant activities with family members. The woman in this example began increasing pleasant activities by taking her children to the park after work and by visiting a coworker who also had children. The two women talked about work over coffee while their children played together. Interestingly, depression clinic patients frequently express a willing to increase pleasurable activities in order to distraerse or distract themselves from problems. This view of pleasant activities as a way of temporarily escaping problems provides practitioners with an opening for encouraging this effective intervention strategy. In addition, because Latino patients are disproportionately poor, lists of local activities costing little or no money (e.g., free admission to museums and the zoo on the first Wednesday of the month, crocheting, preparing favorite meals) can be generated by group members. Next, obstacles to doing such activities are addressed (e.g., falta de ganas [loss of desire] due to depression). Because Latino patients are so fond of dichos, we discuss sayings such as “You can lead a horse to water but you can’t make him drink” as a way of increasing motivation. Finally, teaching patients to assertively set limits on excessive demands from family members is another helpful way of decreasing obstacles to doing activities. For instance, the woman in the current example practiced how to ask her husband to spend more time with the children after school while she shopped. Getting a traditionally oriented Latina to make such assertive requests requires a culturally sensitive approach to assertiveness training. Assertiveness Training. In traditional Latino culture, communication is strongly governed by traditional institutions such as the extended family, the community, and the church, as well as by values such as deference to

orga_c08.qxd

2/5/07

10:53 AM

Page 237

Latino Mental Health

237

those of higher status based on age, sex, and social position. As such, assertive communication can run contrary to the culture’s emphasis on communication that is polite, nonconfrontational, deferential, and even intentionally indirect (e.g., asking one relative to speak to another on one’s behalf). Such communication is especially true for women, who are taught to defer to and obey men and to subordinate their needs to those of the family (Comas-Diaz, 1985). Unfortunately, such a traditional system of communication is subject to breakdown in modern society, where the mediating functions of traditional institutions are rapidly deteriorating. As such, the need for members of our society to assertively convey their needs and desires is imperative for optimal adaptation. Despite the dilemma of teaching a modern, Western, and particularly American style of communication to traditionally oriented individuals (Rakos, 1991), the argument to do so with Latino patients is compelling. For example, Soto and Shaver (1982) studied a sample of nearly 300 Puerto Rican women and found that those rating highest in gender-role traditionalism were the least assertive and the most psychologically distressed. But how can practitioners conduct assertiveness training in a culturally sensitive manner? Encouraging descriptions of assertiveness training with Latinos have been reported (e.g., Torres-Matrullo, 1982), as well as culturally sensitive training guidelines for ethnic minorities in general (Wood & Mallinckrodt, 1990) and with Latinas in particular (Comas-Diaz & Duncan, 1985). Such guidelines de-emphasize the concept of “personal rights” as a way of motivating assertiveness because it can seem foreign to the nondemocratic, nonegalitarian family and friendship systems of traditional Latinos. The trick is to sensitively deviate from traditional Latino culture by encouraging patients to expand their bicultural capabilities by adding assertive communication skills to their traditional communication style. That is, we biculturate patients by describing assertiveness as an effective communication skill in mainstream American society. The emphasis on biculturation is based on an additive model of therapy, in which the task is to add mainstream communication skills to the patient’s current repertoire rather than devaluing and attempting to subtract traditional communication styles. Care is taken to stress culturally compatible aspects of assertiveness such as the emphasis on communication that is not only direct but also honest, respectful, a way of cultivating family relationships, and a good way of teaching one’s children how to be socially competent in mainstream society. Based on Comas-Diaz and Duncan’s (1985) guidelines, Latino cultural factors that mitigate against developing assertiveness are discussed during group as well as strategies for dealing with predictable negative reactions from spouses and other high-status individuals. For

orga_c08.qxd

238

2/5/07

10:53 AM

Page 238

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

example, Comas-Diaz and Duncan taught Puerto Rican women to preface assertive expressions with phrases like “Con todo respeto” (With all due respect) and “¿Me permite expresar mis sentimientos?” (Would you permit me to express my feelings?). In addition, patients are taught to respond to negative reactions to their assertiveness with explanations such as “Expressing my feelings makes me less upset and better able to handle things.” One seemingly passive woman in our group learned how to respond more assertively toward her overly critical mother. On one occasion, the patient was hurt because when she had shared with her mother the possibility of starting a job, her mother responded by saying, “And just how do you expect to work a job when you can’t even speak English!” When the patient was asked why she did not express her hurt feelings to her mother, she said that she did not want to be disrespectful. This point is noteworthy because, although Latinos are as likely as anybody else to be passive, the patient’s reason for enduring her mother’s insensitivity stemmed from her culture-based practice of respectful behavior toward one’s parents and not passivity per se. With the help of modeling by therapists and role-play, the woman was finally able to say to her mother, “With all due respect, Mamá, could you please be more supportive in my efforts to get a job? It hurts my feelings when you are so critical and discouraging.” Both surprised and angered, the patient’s mother quickly accused her daughter of “talking back” and called her a mal criada, or “badly raised” child without manners. But roleplaying and group discussion had prepared our patient for this assertionmitigating response, to which she replied, “Would you permit me to say something about that?” Her mother could hardly say no, and the patient continued, “If you don’t let me express my feelings to you I’m going to feel bad and resentful toward you, which I really don’t want to do.” In this case, group discussion was extremely helpful in differentiating an honest and respectful assertive communication from the rude, disrespectful, and aggressive expressions of a mal criada. Another way of motivating Latino patients to consider assertiveness is to ask them what happens when they hold in negative feelings. Almost without exception, patients describe the exacerbation of existing physical illness such as high blood pressure, diabetes, heart disease, and gastrointestinal symptoms. This approach is important because Latino patients commonly report a tendency to aguantar (tolerate) or guardar (hold in) anger rather than express it to those with whom they are upset. The tendency to guardar can be viewed as part of a larger culture-based style known as controlarse, which refers to the disciplined self-control of negative thoughts and feelings leading to either resignation or efforts to overcome hardship (Cohen, 1985).

orga_c08.qxd

2/5/07

10:53 AM

Page 239

Latino Mental Health

239

Evaluation. A randomized clinical trial comparing group CBT with and without social work case management was conducted at the CBDC ( J. Miranda, Azocar, Organista, Valdes Dwyer, & Areán, 2003). Clinical case management (CCM) was employed to enhance treatment by addressing the multiple needs of depression clinic patients. Case managers also cofacilitated CBT groups and reinforced clinical work during individual case management sessions. Participants in this study were 199 patients (77 Spanish-speaking Latinos, 112 mostly non-Latino Whites, and a few African American clients). Results showed less dropout in the CBT + CCM condition than in CBT alone for all patients. The combined condition was also more effective in decreasing depression and improving functioning but only for Spanish-speaking Latino clients. This latter finding is consistent with the aforementioned work by Sue et al. (1991), which showed that linguistic and ethnic matching in therapy improved retention and outcome but only for Latinos and Asians low in acculturation and not for their higher acculturated counterparts nor for Anglo- or African Americans. J. Miranda et al. concluded that Latino clients were most responsive to group CBT + CCM because of their special linguistic- and acculturation-related needs, which were directly addressed in treatment. INDIVIDUAL APPROACHES Hays (1995) argues that CBT is well suited for people of color for many reasons, including its emphasis on tailoring treatment to the client’s particular circumstances, the way it empowers clients through self-change skills, and its attention to conscious process and specific behaviors. On the same topic, Casas (1988) notes that CBT emphasizes action, not just verbal expression, and can be used to change environmental factors causing psychological distress, and that explanations of problems are more plausible and less abstract than in other therapies. Although these are sound arguments, others have argued that psychodynamic therapy can also be adapted to ethnic minority clients (Wohl, 1995). In Martinez’s (1994) review of the treatment outcome literature on Latinos, nothing definitive could be concluded about individual therapy. Thus, at this point in time, nothing conclusive can be said about individual treatment with Latinos other than that service should be consistent with the new practice model presented in this book as well as with lessons learned from the literature discussed earlier. CONCLUSION The purpose of this chapter was to review Latino mental health and its links to acculturative stress and poverty, and to apply the book’s working model of culturally and socially competent practice with Latinos to a review of noteworthy mental health interventions. Generalist practice

orga_c08.qxd

240

2/5/07

10:53 AM

Page 240

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

issues were spelled out and followed up with domain-specific illustrations (e.g., prevention and treatment of depression). In the illustrations, examples were provided on how practitioners can work both within as well as outside of traditional Latino culture in a culturally sensitive and competent manner. Although outcome evaluations are scarce, those that exist are informative and should encourage us to pursue better research in this important area for Latinos. R EFER ENCE S Acosta, F. X., Yamamoto, J., & Evans, L. A. (1983). Effective psychotherapy for lowincome and minority patients. New York: Plenum Press. Angel, R., & Guarnaccia, P. J. (1989). Mind, body, and culture: Somatization among Hispanics. Social Science Medicine, 28, 1229–1238. Aponte, J. F., & Morrow, C. A. (1995). Community approaches with ethnic minorities. In J. F. Aponte, R. Young Rivers, & J. Wohl (Eds.), Psychological interventions and cultural diversity (pp. 128–144). Boston: Allyn & Bacon. Atkinson, D. R., & Lowe, S. M. (1995). The role of ethnicity, cultural knowledge, and conventional techniques in counseling and psychology. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 387– 456). Thousand Oaks, CA: Sage. Becerra, R. M., & Iglehart, A. P. (1995). Folk medicine use: Diverse populations in a metropolitan area. Social Work in Health Care, 21(4), 37–53. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press. Burnam, M. A., Hough, R. L., Escobar, J. I., Karno, M., Timbers, D. M., Telles, C. A., et al. (1987). Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic Whites in Los Angeles. Archives of General Psychiatry, 44, 687–694. Burnam, M. A., Hough, R. L., Karno, M., Escobar, J. I., & Telles, C. A. (1987). Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. Journal of Health and Social Behavior, 28, 89–102. Canino, G. J., Bird, H. R., Shrout, P. E., Rubio-Stipec, M., Bravo, M., Martinez, R., et al. (1987). Prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44, 727–735. Canino, I. A., Rubio-Stipec, M., Canino, G., & Escobar, J. I. (1992). Functional somatic symptoms: A cross-ethnic comparison. American Journal of Orthopsychiatry, 629(4), 605 –612. Casas, J. M. (1988). Cognitive-behavioral approaches: A minority perspective. Counseling Psychologist, 16(1), 106 –110. Cervantes, R. C., Salgado de Snyder, V. N., & Padilla, A. M. (1989). Post traumatic stress disorder among immigrants from Central America and Mexico. Hospital and Community Psychiatry, 40, 615 –619. Cohen, L. M. (1985). Controlarse and the problems of life among Latino immigrants. In W. A. Vega & M. R. Miranda (Eds.), Stress and Hispanic mental

orga_c08.qxd

2/5/07

10:53 AM

Page 241

Latino Mental Health

241

health: Relating research to service delivery (DHHS Pub. No. ADM 85-1410, pp. 202–218). Rockville, MD: U.S. Department of Health and Human Services. Comas-Diaz, L. (1981). Effects of cognitive and behavioral group treatment on the depressive symptomatology of Puerto Rican women. Journal of Consulting and Clinical Psychology, 49, 627–632. Comas-Diaz, L. (1985). Cognitive and behavioral group therapy with Puerto Rican women: A comparison of content themes. Hispanic Journal of Behavioral Sciences, 7(3), 273 –283. Comas-Diaz, L. (1986). Puerto Rican alcoholic women: Treatment considerations. Alcoholism Treatment Quarterly, 3(1), 47–57. Comas-Diaz, L., & Duncan, J. W. (1985). The cultural context: A factor in assertiveness training with mainland Puerto Rican women. Psychology of Women Quarterly, 9, 463 – 476. Cordova, C. B. (1998). Living in the United States: Central American immigrant communities in the United States. In F. G. Rivera & J. L. Erlich (Eds.), Community organizing in a diverse society (3rd ed., pp. 180–200). Boston: Allyn & Bacon. Delgado, M. (1983). Hispanics and psychotherapeutic groups. International Journal of Group Psychotherapy, 33, 507–520. Delgado, M., & Humm-Delgado, D. (1984). Hispanics and group work: A review of the literature. Ethnicity in Group Work Practice, 85 –96. Ellis, A., & Grieger, R. (1977). Handbook of rational emotive therapy. New York: Holt, Rinehart & Winston. Escobar, J. I., Golding, J. M., Hough, R. L., Karno, M., Burnam, M. A., & Wells, K. B. (1987). Somatization in the community: Relationship to disability and use of services. American Journal of Public Health, 77, 837–840. Farias, P. J. (1991). Emotional distress and its sociopolitical correlates in Salvadoran refugees: Analysis of a clinical sample. Culture, Medicine, and Psychiatry, 15, 167–192. Ferris, E. G. (1987). The Central American refugees. New York: Praeger. Flaskerud, J. H. (1986). The effects of culture-compatible intervention on the utilization of mental health services by minority clients. Community Mental Health Journal, 22, 127–141. Gonsalves, C. J. (1990). The psychological effects of political repression on Chilean exiles in the United States. American Journal of Orthopsychiatry, 60, 143 –153. Harris, M., Velasquez, R. J., White, J., & Renteria, T. (2004). Folk healing and curanderismo within the contemporary Chicana/o community: Current status. In R. J. Velasquez, L. M. Arellano, & B. W. McNeill (Eds.), The handbook of Chicana/o psychology and mental health (pp. 111–125). Mahwah, NJ: Erlbaum. Hays, P. A. (1995). Multicultural applications of cognitive-behavior therapy. Professional Psychology: Research and Practice, 26, 309–315. Higginbotham, J. C., Trevino, F. M., & Ray, L. A. (1990). Utilization of curanderos by Mexican Americans: Prevalence and predictors: Findings from HHANES 1982–1984. American Journal of Public Health, 80(Suppl.), 32–35.

orga_c08.qxd

242

2/5/07

10:53 AM

Page 242

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Hulme, P. A. (1996). Somatization in Hispanics. Journal of Psychosocial Nursing, 34, 33 –36. Iglehart, A. P., & Becerra, R. M. (1995). Ethnic services: Precedents, perspectives, and parameter. In A. P. Iglehart & R. M. Becerra (Eds.), Social services and the ethnic community (pp. 149–203). Boston: Allyn & Bacon. Jenkins, S. (1981). The ethnic dilemma in social services. New York: Free Press. Kaplan, M. S., & Marks, G. (1990). Adverse effects of acculturation: Psychological distress among Mexican American young adults. Social Science Medicine, 31(12), 1313 –1319. Karno, M., Hough, R. L., Burnam, M. A., Escobar, J. I., Timbers, D. M., Santana, F., et al. (1987). Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic Whites in Los Angeles. Archives of General Psychiatry, 44, 695 –701. Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Archives of General Psychiatry, 51, 8–19. Lee, D. J., Markides, K. S., & Ray, L. A. (1997). Epidemiology of self-reported past heavy drinking in Hispanic adults. Ethnicity and Health, 2(1/2), 77–88. Manning, S. S. (1999). Empowerment in mental health programs: Listening to the voices. In L. M. Gutierrez, R. J. Parsons, & E. O. Cox (Eds.), Empowerment in social work practice: A sourcebook (pp. 89–109). Pacific Grove, CA: Brooks/Cole. Martinez, C. (1994). Psychiatric treatment of Mexican Americans: A review. In C. Telles & M. Karno (Eds.), Latino mental health: Current and policy perspectives (pp. 227–239). Los Angeles: Neuropsychiatric Institute of the University of California. Miranda, J., Azocar, F., Organista, K. C., Valdes Dwyer, E., & Areán, P. (2003). Treatment of depression in disadvantaged medical patients. Psychiatric Services, 54(2), 219–225. Miranda, M. R. (Ed.). (1976). Psychotherapy with the Spanish-speaking: Issues in research and service delivery (Monograph No. 3). Los Angeles: Spanish-Speaking Mental Health Research Center, University of California. Moscicki, E. K., Locke, B. Z., Rae, D. S., & Boyd, J. H. (1989). Depressive symptoms among Mexican Americans: The Hispanic Health and Nutrition Survey. American Journal of Epidemiology, 130, 348. Moscicki, E. K., Rae, D. S., Regier, D. A., & Locke, B. Z. (1987). The Hispanic Health and Nutrition Survey: Depression among Mexican Americans, Cuban Americans, and Puerto Ricans. In M. Garcia & J. Arana (Eds.), Research agenda for Hispanics (pp. 145 –159). Chicago: University of Chicago Press. Muñoz, R. F., Ghost Ippen, C., Rao, S., Le, H., & Valdes Dwyer, E. (2000). Manual for group cognitive-behavioral therapy for major depression: A reality management approach. San Francisco: Cognitive-Behavioral Depression Clinic, Division of Psychosocial Medicine, San Francisco General Hospital, University of California. Organista, K. C. (1995). Cognitive-behavioral treatment of depression and panic disorder in a Latina patient: Culturally sensitive case formulation. In Session: Psychotherapy in Practice, 1, 53 –64.

orga_c08.qxd

2/5/07

10:53 AM

Page 243

Latino Mental Health

243

Organista, K. C., Muñoz, R. F., & Gonsalez, G. (1994). Cognitive behavioral therapy for depression in low-income and minority medical outpatients: Description of a program and exploratory analyses. Cognitive Therapy and Research, 18, 241–259. Orlinsky, D. E., & Howard, K. I. (1986). Process and outcome in psychotherapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (3rd ed., pp. 311–381). New York: Wiley. Padilla, A. M., Carlos, M. L., & Keefe, S. E. (1976). Mental health service utilization by Mexican Americans. In M. R. Miranda (Ed.), Psychotherapy with the Spanish-speaking: Issues in research and service delivery. (Monograph No. 3, pp. 9–20). Los Angeles: Spanish-Speaking Mental Health Research Center, University of California. Plante, T. G., Manuel, G. M., Menendez, A. V., & Marcotte, D. (1995). Coping with stress among Salvadoran immigrants. Hispanic Journal of Behavioral Sciences, 17(4), 471– 479. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385. Rakos, R. F. (1991). Assertive behavior: Theory, research, and training. New York: Routledge. Robins, L. N., & Regier, D. A. (Eds.). (1991). Psychiatric disorders in America: The Epidemiologic Catchment Areas Study. New York: Free Press. Rogler, L. H., Cortes, D. E., & Malgady, R. G. (1991). Acculturation and mental health status among Hispanics: Convergence and new directions for research. American Psychologist, 46(6), 585 –597. Salgado de Snyder, V. N., Cervantes, R. C., & Padilla, A. M. (1990). Gender and ethnic differences in psychosocial stress and genalized distress among Hispanics. Sex Roles: A Journal of Research, 22(7/8), 441– 453. Shrout, P. E., Canino, G. J., Bird, H. R., Rubio-Stipec, M., Bravo, M., & Burnam, M. A. (1992). Mental health status among Puerto Ricans, Mexican Americans, and non-Hispanic Whites. American Journal of Community Psychology, 20(6), 729–752. Soto, E., & Shaver, P. (1982). Sex-role traditionalism, assertiveness, and symptoms of Puerto Rican women living in the United States. Hispanic Journal of Behavioral Sciences, 4, 1–19. Sue, S. (1977). Community mental health services to minority groups: Some optimism, some pessimism. American Psychologist, 32, 616 –624. Sue, S., Fujino, D. C., Hu, L., Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533 –540. Sue, S., & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy. American Psychologist, 42, 37– 45. Torres-Matrullo, C. (1982). Cognitive therapy of depressive disorders in the Puerto Rican female. In R. M. Becerra, M. Karno, & J. I. Escobar (Eds.), Mental health and Hispanic Americans (pp. 101–113). New York: Grune & Stratton. Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E., Catalano, R., & Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSM-III-R psychiatric

orga_c08.qxd

244

2/5/07

10:53 AM

Page 244

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771–782. Vega, W. A., Valle, R., & Kolody, B. (1994). Preventing depression in the Hispanic community: An outcome evaluation of Proyecto Bienestar. In C. Telles & M. Karno (Eds.), Latino mental health: Current research and policy perspectives (pp. 201–225). Los Angeles: Neuropsychiatric Institute, University of California. Vera, M., Alegria, M., Freeman, D., Robles, R. R., Rios, R., & Rios, C. (1991). Depressive symptoms among Puerto Ricans: Island poor compared with residents of the New York City area. American Journal of Epidemiology, 134(5), 502–510. Wohl, J. (1995). Traditional individual psychotherapy and ethnic minorities. In J. F. Aponte, R. Young Rivers, & J. Wohl (Eds.), Psychological interventions and cultural diversity (pp. 74 –91). Boston: Allyn & Bacon. Wood, P. S., & Mallinckrodt, B. (1990). Culturally sensitive assertiveness training for ethnic minority clients. Professional Psychology: Research and Practice, 21, 5 –11.

orga_c09.qxd

2/5/07

10:54 AM

Page 245

CHAPTER 9

Latino Health AFTER YEARS OF neglect, and a glaring lack of baseline data, the study of Latino health in the United States is beginning to pick up considerable speed with the production of numerous research publications, including major book compilations (e.g., Aguirre-Molina, Molina, & Zambrana, 2001) and inclusion of Latinos in large surveys just in time to address the growing and complex health needs of the diverse Latino population. Reviews of the literature in this area (e.g., Carter-Porkas & Zambrana, 2001; Vega & Amaro, 1994) concur that, though much more research is needed, Latino health is sometimes characterized as a paradox in that U.S. Latinos often manifest surprisingly good health on a variety of indicators in spite of being overly affected by poverty and legacies of exclusion and discrimination. This chapter provides an overview of Latino health in the United States, followed by a selective review of major health problems and issues across different Latino groups and disease states in order to situate this immense topic within the context of culturally and socially competent health care.

OV E RV I E W O F L AT I NO H E A LT H I N T H E U N I T E D S TAT E S : MOR TA L I T Y A N D MOR B I DI T Y Despite the consistent inverse relation between health and SES all over the world, Latinos appear to be as healthy, and sometimes even healthier, than their non-Latino White counterparts on some major indicators. A review of overall mortality rates reveals equivalent rates in children between the ages of 1 and 14 (about 30 deaths per 100,000 for both) and lower death rates for middle-aged (45 to 65) and older (65 and over) Latinos (609 and 790 per 100,000, respectively; Vega & Amaro, 1994). However, mortality rates are higher for Latinos than Whites between the active ages of 15 and 44, and an examination of the leading causes of death for Latinos helps us begin to understand why. 245

orga_c09.qxd

246

2/5/07

10:54 AM

Page 246

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Table 9.1 lists the top 10 leading causes of death for Latinos, Whites, and African Americans (Carter-Pokras & Zambrana, 2001). As can be seen, many of these causes of death overaffect Latinos between the ages of 15 and 44 (e.g., homicide, accidents). It should also be noted that although heart disease and cancer are the top two leading causes of death for all major U.S. groups listed, age-adjusted rates show lower overall risk in Latinos. However, Latinos are at greater risk for certain types of cancer (i.e., cervical, stomach), as well as for diabetes, homicide, chronic liver disease, hypertension, and HIV/AIDS. Comparisons between Whites and different Latino groups further help to clarify health disparities, contextual factors, and needs. For example, although Latinos have lower overall cancer rates than Whites (i.e., lung, prostate, breast), Mexican Americans and Puerto Ricans have higher rates of stomach cancer (Cubans’ rates are lower than Whites’) and 2 to 3 times more cervical cancer (Carter-Pokras & Zambrana, 2001; Vega & Amaro, 1994). Further, tuberculosis, long associated with poverty, is twice as high in Latinos compared to Whites and is concentrated primarily among Puerto Ricans in New York City and Mexicans in the Southwest. Rates of sexually transmitted diseases (STDs) are also generally higher in Latinos than Whites, and the rate of HIV/AIDS is 3 times greater in Latinos, concentrated mostly among Puerto Ricans, where it is an alarming 7 times greater than for Whites. The AIDS problem also translates to an overrepresentation of Latinos, especially Puerto Ricans, among pediatric cases (23%) and among women (20%). Not surprisingly, Puerto Ricans have higher all-cause mortality (406 per 100,000) compared to Cubans (300 per 100,000) and Mexican Americans (348 per 100,000; Carter-Pokras & Zambrana, 2001). MATERNAL-INFANT HEALTH With regard to maternal-infant reproductive health outcomes, Latinos and Whites differ little in terms of infant mortality (5.6 and 6 per 100,000 births, respectively), with the exception of Puerto Ricans (8.6 per 100,000 births). This same pattern holds for low birth weight (6.4, 6.6, and 9.7 per 100,000 births, respectively; Carter-Pokras & Zambrana, 2001). Latinos’ rates are slightly higher than Whites’ on preterm births (11.4 and 10.2 per 100,000, respectively), as well as maternal mortality rates (5.2 and 4 per 100,000, respectively). A Mexican Health Paradox? Guendelman and associates (Guendelman, Chavez, & Christianson, 1994; Guendelman & English, 1995; Guendelman, English, & Chavez, 1995)

64,751 30,575 26,182 25,192 — — — —

Diabetes

Suicide

Kidney disease

Chronic liver disease

Alzheimer ’s disease

Homicide

HIV/AIDS

Perinatal conditions

—

—

—

—

10

9

8

7

6

5

4

3

2

1,987

—

2,978

—

2,845

—

—

4,741

3,277

8,248

2,528

5,587

19,528

24,596

98,406

Number

10

—

7

—

8

—

—

5

6

3

9

4

2

1

—

Rank

—

—

—

20,834

—

20,372

25,846

46,884

78,174

73,669

101,274

131,039

449,785

609,256

1,912,802

Number

—

—

—

9

—

10

8

7

5

6

4

3

2

1

—

Rank

4,674

7,055

8,282

—

—

—

—

11,278

8,246

12,617

7,131

18,067

60,642

77,434

275,264

Number

10

9

6

—

—

—

—

5

7

4

8

3

2

1

—

Rank

African Americans

From “Latino Health Status” (pp. 23–54), by O. Carter-Pokras and E. Zambrana, Health Issues in the Latino Community, in M. Aguirre-Molina, C. W. Molina, and R. E. Zambrana (Eds.), 2001, San Francisco: Jossey-Bass. Adapted with permission.

91,871

112,584

Chronic obstructive pulmonary disease

Pneumonia and influenza

158,448

Stroke

97,835

541,532

Cancer

1

—

Rank

Whites

10:54 AM

Accidents

724,859

2,337,256

All causes (age adjusted)

Heart disease

Number

Latinos

2/5/07

Cause of Death

Total Population

Table 9.1 The 10 Leading Causes of Death in the United States among Latinos, Whites, and African Americans, Both Sexes, All Ages (1998)

orga_c09.qxd Page 247

247

orga_c09.qxd

2/5/07

248

10:54 AM

Page 248

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

have documented surprisingly healthy birth outcomes for Mexican immigrant women in California, comparable to their non-Hispanic White counterparts (i.e., low rates of fetal death and low birth weight). However, these researchers also report a decline in good birth outcomes with increasing acculturation. For example, Guendelman and English found that, compared to newcomers, Mexican immigrants living in the United States for as little as 5 years were more likely to deliver preterm and low birth weight infants, had more pregnancy complications and fewer planned pregnancies, and were more likely to smoke. Infant health also appears to deteriorate with acculturation, as indicated by a study of more than 700 healthy infants of Mexican immigrants born in San Diego County. Guendelman et al. (1995) found that a quarter of these infants succumbed to serious infectious disease due to negative social conditions such as large households, barriers to care, and mothers who smoked. Comparisons of the health behaviors of Mexican American women and their White counterparts show that Mexican American women report lower consumption of tobacco, alcohol, diet soda, and caffeine, especially during pregnancy and lactation (Guendelman & Abrams, 1995a). Unfortunately, Guendelman and Abrams (1995b) also found that second-generation Mexican Americans have diets that resemble their White counterparts. Thus, acculturation to the United States appears to have a negative impact on the maternal-infant health of Mexican Americans because of negative social conditions and a decline in healthy immigrant behavior. O B S TAC L E S T O L AT I NO DI S E A S E PR E V E N T I O N A N D H E A LT H PROMO T I O N There appear to be two overriding tasks in promoting health and preventing disease in Latino communities. The first involves studying possible culture-based protective factors (e.g., healthy diet, low rates of smoking and drinking) to better understand and reinforce such behaviors. The second task is to promote culturally and socially competent health care for Latinos that involves micro- through macro-level systemic changes, beginning with improving basic access to health care.

THE PERVASIVE PROBLEM

OF

LOW HEALTH CARE ACCESS

FOR

LATINOS

The fact that many Latinos are likely to lack health insurance clearly has a major impact on their overall health outcomes. It is difficult to imagine how a patient without insurance can get the necessary battery of preventive examinations such as mammography, pap smears, and screening for diabetes

orga_c09.qxd

2/5/07

10:54 AM

Page 249

Latino Health

249

and colon and prostate cancer, among others; or how a patient with hypertension can be examined and treated regularly to prevent any cardiovascular complications that result from this condition. (Carillo, Treviño, Betancourt, & Coustasse, 2001, p. 65)

Carter-Pokras and Zambrana (2001) report the following percentages of uninsured Americans: 14% of Whites, 20% of African Americans, and 33% of Latinos. Among Latinos, the percentages are 19% for Puerto Ricans, 21% for Cubans, and an alarming 39% for Mexican Americans. With regard to health consequences, Carillo et al. (2001) report that half of uninsured Latinos (a) had not seen a doctor when last sick; ( b) had gone without a prescription for needed medication; and (c) had gone without recommended medical tests and treatments; two-thirds reported having trouble paying bills or being contacted by collection agencies for medical expenses. Reasons for lack of insurance center on a pervasive lack of health coverage through employment because of high concentrations in non-white-collar occupations such as construction, small firms, agriculture, and mining. Lack of citizenship is also a significant reason. It is a cruel irony that the United States employs a predominantly Mexican farmworker labor force that is mostly undocumented and that generally lacks any form of health care in spite of working in what many consider to be the most dangerous occupation in America in terms of annual number of injuries and deaths (Organista, 2004). Primary Barriers Carillo et al. (2001) describe various macro-level or primary barriers to health care faced by Latinos in the United States that threaten to worsen an already unhealthy situation. For example, the Balanced Budget Act of 1997, which called for decreasing Medicare expenditures by $116 billion over a 5-year period, may succeed by balancing the budget on the backs of the poor given that “safety net” providers, such as community health centers, are the hardest hit because of the types of clients they serve: 41% uninsured, 33% Medicare, 31% Latino, 65% below the poverty level, 20% at the poverty level or just above it, and 25% nonreimbursable. The same is true for academic medical centers, which tend to serve poor communities of color, often in general hospital type settings. Carillo et al. (2001) note that recent welfare reform, the Personal Responsibility and Work Reconciliation and Opportunity Act of 1996, severed the link between public assistance and Medicaid and prepares welfare recipients for work in sectors without health insurance. Many who remain eligible for Medicaid may not even be aware of it. Similarly,

orga_c09.qxd

250

2/5/07

10:54 AM

Page 250

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Latino families 200% below the poverty line that are documented but not Medicaid eligible may be unaware of safety net programs for which their children are eligible, such as the recent State Children’s Health Insurance Program. Secondary and Tertiary Barriers Secondary barriers to health care include lack of Latino and Spanishspeaking medical staff and interpreters and excessively complex HMOrelated intake procedures, all of which ultimately translate into poor health for Latino patients. Carillo et al. (2001) note that although Latino physicians are more likely than their White counterparts to provide services to Medicaid patients and the uninsured, they constitute only 2% of medical doctors. Tertiary barriers include low-quality communication between patients and their doctors and other medical staff and relations that compromise Latino health. For example, Giacomini (1996) reports that Latino patients with health care equivalent to that of Whites undergo fewer of the following medical procedures: coronary artery bypass graft, angioplasty, and kidney transplants. Even among ischemic heart disease patients in L.A. County, Latinos’ rates of coronary artery bypass graft and angiography were lower compared to Whites. Thus, culturally and socially competent health care for Latinos is dependent on multiple levels of reform needed to connect eligible Latinos to the services for which they are entitled, maintain and improve safety net services for poverty-stricken Latinos who are ineligible for Medicaid, and provide accessible health care for undocumented Latinos who continue to live and work in the United States. What follows are illustrations of ways to conceptualize and respond to major health problems and issues that continue to compromise the health of U.S. Latinos.

A S E L E C T I V E R E V I E W O F C U LT U R A L LY C OM PE T E N T A P PROAC H E S T O L AT I NO H E A LT H Given the immensity of Latino health problems and issues in the United States, the remainder of this chapter illustrates needed approaches to Latino health promotion and disease prevention by selectively reviewing published reports of various campaigns and programs that are conceptually tight, involve multiple intervention levels, and present auspicious results. Priority is granted to some of the most grave and pervasive health problems currently affecting U.S. Latinos.

orga_c09.qxd

2/5/07

10:54 AM

Page 251

Latino Health

251

DIABETES AND HEART DISEASE Adult-onset Type II diabetes (90% to 95% of all cases of diabetes) increasingly exacts a major toll on the American public. This is especially true for Mexican Americans and Puerto Ricans, whose rates of this disease are twice that of Whites and Cuban Americans. Over the past 50 years, diagnoses of diabetes in the United States have increased 10-fold, from 1.5 million in 1958 to 10.5 million in 1998, and it is now the seventh leading cause of death (sixth leading cause for Latino men and fourth leading for Latinas; Luchsinger, 2001). Latinos also evidence greater complications from diabetes than Whites, including amputations, retinitis, dementia associated with stroke, end-stage renal failure, and even tuberculosis. Such complications appear to be related to documented late detection of diabetes and lack of health care that can help to prevent and minimize complications. Because rates of diabetes are lowest among Euro-Americans and highest among American Indians, with intermediate rates for Mexican Americans and Puerto Ricans, there is much conjecture about genetic loading given that these Latino groups come from an admixture of indigenous and European genetic backgrounds, as well as African ancestry in the case of Puerto Ricans. Although more genetic research is needed, the role of weight, diet, and exercise in the risk for diabetes is clear, as are implications for Latino-focused interventions. National data show a strong and clear positive relation between diabetes and weight, with risk ranging from 2 times greater prevalence in overweight Americans to 6.5 times greater risk in obese Americans. Unfortunately, Americans show a steady trend in weight gain and decline in physical activity; this is especially pronounced for Mexican Americans (for whom we have the most Latino data). Survey data from the Hispanic Health and Nutrition Examination Survey (HHANES, collected in 1982 to 1984) and the National Hispanic Health and Nutrition Examination Survey (NHANES; collected in 1988 to 1992) show that the rate of overweight Mexican American men went from 31% to 40%, and from 41% to 48% for Mexican American women (Luchsinger, 2001). Further, rates of overweight and obese children ages 2 months to 5 years are also higher for Mexican Americans than for Whites. With regard to diet and exercise, data from the HHANES III show that 15.6% of men and 27% of women in the United States report no leisure time physical activity; these rates are 29% and 43.8% for Mexican American men and women, respectively. Among 4-year-old children, Mexican Americans are reported to have less home- and school-related physical activity. Various investigations of diet in Mexican American children

orga_c09.qxd

252

2/5/07

10:54 AM

Page 252

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

show excessive meat and milk, too few servings of fruits and vegetables (HHANES), and greater general intake of fat among Mexican Americans than among Cubans and Puerto Ricans (HHANES and HHANES II). These diet and exercise data are also highly relevant to heart disease. Clearly, diabetes prevention depends on early detection, improving diet and physical exercise, and testing high-risk groups: Mexican Americans and Puerto Ricans, those over 45 years of age, those with diabetic first-degree relatives, women with past and current diagnosis of gestational diabetes (i.e., during pregnancy), and babies heavier than 9 pounds at birth (Luchsinger, 2001). Such interventions are few, but promising community-based and family-focused efforts have documented success in the Latino community. Work in related areas such as prevention of coronary vascular disease (CVD) and cancer prevention and control also offer comprehensive models of macro-level public health campaigns through micro-level education and problem solving. PREVENTING DIABETES AND HEART DISEASE Holcomb and associates (1998) reported on a rare, school-based, diabetes prevention program aimed at poor fifth-grade Mexican American students residing in the U.S.-Mexico border region. Thirty teachers at 13 schools received a day of training regarding diabetes and how to deliver the Jump into Action curriculum to their students. A comparison group of nine teachers from six schools also volunteered to use the curriculum, but without training. Jump into Action was designed to teach children about the causes of diabetes and the role of diet and exercise and to build self-efficacy regarding prevention. More than 800 students completed pre- and postintervention assessment, as well as a 1-month follow-up. Promising results showed that, regardless of teacher condition, significant gains were made on all areas assessed and that the majority of these gains were maintained at follow-up. Teachers overwhelmingly rated the program effective and clear and said that they would recommend it to other teachers. Holcomb et al. (1998) did note that there was less improvement in the dietary-related behaviors of students compared to gains in knowledge and self-efficacy, and that interventions need to better impact the home environment. Clearly elementary school children are limited in their power to influence family dietary habits, making the involvement of parents, especially mothers, key to making diabetes prevention-related changes in diet. Communitywide campaigns are also needed to pave the way for familyfocused interventions. A pair of studies designed to prevent CVD in Lati-

orga_c09.qxd

2/5/07

10:54 AM

Page 253

Latino Health

253

nos are very instructive with regard to how Latino families and communities can be engaged in such disease prevention efforts. Foreyt, Ramirez, and Cousins (1991) compared a family-oriented approach to long-term weight loss to a group intervention for individuals, as well as to an information-only control condition. The project was called Cuidando el Corazón (Taking Care of the Heart) and was aimed at lowincome, married Mexican American women who were 20% above ideal body weight and who had one or more children between the ages of 3 and 6. Women in the control group were provided with a manual on preventing CVD through behavior change, nutrition, exercise, and modifying the fat content of traditional Mexican recipes. Women in the group condition received the same manual but also attended 24 90-minute, weekly meetings throughout the course of a year. The groups also included extended behavioral education, food demonstrations, and six monthly maintenance classes designed to enhance compliance by teaching problem-solving strategies aimed at slips and high-risk situations such as holidays and socials. It is important to note that child care was made available for the women attending the groups. Corazón’s family-oriented condition was the same as the group condition except that groups were composed of married couples and included techniques for supporting the efforts of spouses, as well as for promoting healthy habits in children (for whom separate groups were held). Culturally appropriate weight reduction strategies began with brisk couple and/or family walks and framing mother’s weight loss as beneficial to la familia rather than just to her individually. Participants were assessed every 3 months throughout a 1-year period for weight loss and other measures. A little more than half of the 168 Latinas who participated completed the multiple assessments. Results showed that participants in both the family and the group condition lost significantly more weight than those in the information-only control group. Cuidando el Corazón is impressive for facilitating actual weight loss in overweight Latina mothers, and one could imagine combining elements of its family-focused condition with the child-focused efforts of Holcomb et al. (1998), as well as with more communitywide efforts to raise awareness about major preventable diseases overaffecting Latinos. At the community level, Alcalay, Alvarado, Balcazar, Newman, and Huerta (1999) reported on the development, implementation, and evaluation of Salud para Su Corazón (Health for Your Heart), which was successful in increasing awareness of CVD risk factors and ways to prevent them in a sample of 344 adult Latinos in Washington, DC. When the vast majority of these individuals were assessed at six different locations results showed that although only 50% could name three or more ways to

orga_c09.qxd

254

2/5/07

10:54 AM

Page 254

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

prevent CVD at pretest, 70% could do so at posttest. Although no changes in behaviors were found (and this should be explored), this study is noteworthy for its methodical and comprehensive attention to building a Latino community-based alliance of key players, ranging from health care providers and community leaders to business and media professionals, who used a consensus-building approach to develop, test, revise, implement, and evaluate multiple CVD prevention efforts. Such efforts included a needs assessment via generation of a community profile and conducting six focus groups with community residents at high risk for CVD, followed by developing and testing Spanish TV and radio media campaigns and sorely missing Spanishlanguage materials and conducting charlas (informal talks) on the topic with participants. Through the involvement of media professionals, a 21-part, 5-minute series, called A Month of Prevention against Heart Disease, was created and aired three times daily on Radio Borinquen (Puerto Rican Radio). Also two 24-minute telenovelas (novellas for television) entitled For the Love of Your Heart and Cooking with Your Heart in Mind were created and were aired 2,000 times by Univisión, the national Latino television network. Such efforts support the overarching goals of this program: to maximize reach into the Latino community and to promote program sustainability and transferability (e.g., Spanishlanguage materials have been packaged and are frequently disseminated throughout the country). Addressing Latino Diet Because diet and eating habits can be central to social, cultural, and developmental experiences, they can be resistant to change even if the goal is to prevent and control numerous chronic diseases. Thus, a deeper understanding of how to address problems in bicultural Latino diets is warranted, and there is some insightful research to assist with this task. Buena Alimentación, Buena Salud (Good Nutrition, Good Health) is the name of an auspicious program that was successful in improving the diet of overweight Latino diabetics (Vasquez, Millen, Bissett, Levenson, & Chipkin, 1998). At 3-months postintervention, the 18 participants in the experimental condition had reduced total and saturated fats and increased fiber and carbohydrates. Each of the 12 intervention sessions contained three components: active discussion to clarify health information, behavioral skills acquisition, and demonstrations of how to shop for and prepare healthier meals (e.g., in-session cooking and tasting, trips to supermarket, how to read food labels). The overall intervention framework used a social learning theory analysis of the antecedents and conse-

orga_c09.qxd

2/5/07

10:54 AM

Page 255

Latino Health

255

quences of food/eating behavior, with emphasis on identifying high-risk situations (e.g., holidays, eating out) and healthy alternative behaviors, sustaining healthy behaviors, and how to problem-solve around relapses. Table 9.2 lists the program contents, skill objectives, and methods of Buena Alimentación, Buena Salud, which were carefully developed from three phases of background research: (1) assembling a local consultative multidisciplinary team; (2) developing and implementing a patient population survey to assess knowledge and attitudes related to diabetes management; and (3) conducting focus groups to discuss major obstacles encountered when attempting to manage diabetes. This background research revealed widespread lack of compliance with diabetes management, high rates of poverty, the belief in nearly half of participants that they were not overweight, and high daily consumption of traditional foods. At the same time, over 90% of participants surveyed agreed that complications of diabetes could be avoided. Not discussed explicitly in the report are the specific kinds of beliefs and attitudes among diabetics in general, and Latino diabetics in particular, that compete with diabetes management. For example, Hunt, Pugh, and Valenzuela (1998) conducted lengthy qualitative interviews with 51 Mexican American diabetics which showed that although all participants practiced self-care and expressed concerned about their diabetes, none fully complied with recommended management because of the following competing beliefs and behaviors:

• Overestimation of the power of medications to compensate for poor diet: Half of participants reported using their diabetes medications in place of exercise and improved diet; some viewed medications as a safety valve to be used when eating poorly. • Strong desire to feel normal: Almost 80% of participants found it hard to accept “never eating/drinking normally again.” Men found it distressing to give up favorite fatty dishes such as tamales and enchiladas and claimed that low-fat foods were too light and not filling. Men also generally continued to drink alcohol, discounting it as a problem. Women said it was difficult to both diet and prepare meals for the family, and that taking care of family members left no time for exercise. Some women tried to eat smaller portions of normal family foods, but then found it difficult to resist eating more. • Problems dieting during social events: Participants either ignored their diet during social events or avoided such events. • Misconceptions about blood glucose levels and desire to avoid side effects of medication: Medication side effects (e.g., acute dizziness, disorientation, sweating, palpitations) sometimes scared patients and

256

Diabetes and complications

Dietary fat and cholesterol

The role of portion control in diabetes management

Label reading

Inexpensive and healthy low-fat foods at the market

Review label reading and supermarket idea

Role of weight reduction in NIDDM

Psychological lesson—relationship between food, emotions, thoughts, and behaviors

Psychological lesson—stress management

Importance of exercise for weight management

Planning for holidays and vacations

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Develop and implement coping strategies.

Develop realistic exercise plan.

Examine sources of stress. Develop coping strategies for dealing with stress.

Analyze impact of stress on food choices and eating habits.

Identify problem eating behavior. Problem-solve in situations of high risk for inappropriate eating.

Examine food labels.

Identify barriers to low-fat food selection.

Analyze food labels for fat and calorie content.

Work on problem-solving situations during holidays.

Practice exercising. Monitor glucose before and af ter activity.

Practice relaxation techniques.

Prepare and taste low-fat recipe.*

Prepare and taste low-fat recipe.*

Prepare and taste low-fat recipe.*

Attend supermarket tour.

Practice reading labels.

Practice measuring portions in a variety of foods.

Analyze low-fat menu.

Prepare and taste low-fat recipe.*

Prepare and taste low-fat recipe.*

Demonstration

10:54 AM

Describe appropriate portion sizes of different foods.

Examine the amount and type of fat in traditional foods.

Identify factors that contribute to diabetes complications. Evaluate food records for fat content.

Identify realistic outcomes from program participation.

Skills

2/5/07

* A traditional low-fat recipe was prepared and taste-tested in every class. From “ Buena Alimentaciøón, Buena Salud [Good Nutrition, Good Health]: A Preventive Nutrition Intervention in Caribbean Latinos with Type 2 Diabetes,” by I. M. Vazquez, B. Millen, L. Bisset t, S. M. Levenson, and S. R. Chipkin, 1998, American Journal of Health Promotion, 13 (2), pp. 116–119. Adapted with permission.

Program goals, diabetes risk in Latinos

Content

1.

Week

Table 9.2 Diabetes Prevention Program Objectives

orga_c09.qxd Page 256

orga_c09.qxd

2/5/07

10:54 AM

Page 257

Latino Health

257

caused them to discontinue medications and to eat sweet and heavy foods. Some patients actually expressed fear of low blood glucose. • Limited economic resources: Many low-SES participants said that recommended diet and exercise are expensive (i.e., price of blood glucose strips, syringes; preparing separate meals for self and family; needing to eat what’s available when finances are low). • Poor recognition of the relation between glucose control and the previous factors: None of the above beliefs and behaviors were seen as impacting control of blood glucose levels! Related studies by Hunt and colleagues also found that some Mexican American diabetic patients lost motivation to comply with diabetes management when inconsistencies arose between their efforts and health outcomes (Hunt, Valenzuela, & Pugh, 1998), that is, when careful diabetes management did not result in controlled glucose levels and vice versa. Such patients need to be taught about the process of chronic disease management, including the need for consistent diabetes management despite occasional counterintuitive outcomes. One final note on work by Hunt and colleagues (Hunt, Hamdi Arar, & Akana, 2000): These researchers examined the use of culture-based alternative treatments (e.g., herbs, prayer, fatalistic religious beliefs) as possible competitors to the biomedical management of diabetes in 43 low-income Mexican Americans with Type 2 diabetes. They found that use of such alternatives was infrequent and did not interfere with standard medical care. None of the participants used curanderos (Mexican folk healers) for diabetes, use of herbs was infrequent and only supplemental to medical treatments, and prayer was viewed as enhancing medicines but not as a substitute. Regarding the last point, I recall one Latino diabetic patient with whom I worked who stopped his diabetes management and, when asked about it, replied that if it was god’s will for him to die, then he would. I challenged the patient’s fatalistic thinking by asking him if he felt that it was his right to challenge god. When the patient expressed confusion at the question, I explained that it was as if he were putting a single bullet into a pistol, holding the gun to his head, and saying, “Let’s see if god wants me to live or die.” It remains unclear how beliefs about the management of diabetes differ between Latinos and non-Latinos (given the lack of a comparison group in the studies just reviewed); still, these beliefs and related behaviors are noteworthy for the kinds of culturally related phenomena that need to be specifically targeted in interventions designed to enhance healthy disease management. The growing focus on cancer prevention and control with Latinos offers further illustrations of increasingly culturally and socially

orga_c09.qxd

258

2/5/07

10:54 AM

Page 258

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

competent primary and secondary prevention strategies and multiple levels of intervention. CANCER Reviews of the literature on cancer among Latinos point out that although national surveillance data are improving, there continue to be limitations (Gutierrez-Ramirez & Carter-Pokras, 1994; Ramirez & Suarez, 2001). Nevertheless, such reviews conclude that Latinos have lower overall rates of cancer compared to non-Latino Whites (e.g., less lung, colorectal, breast, and prostate cancer). Cancer disparities favoring Latinos are attributed to healthy diets that are high in fiber and low in fat, as compared to the diets of Anglos and African Americans. Nevertheless, Latinos do have higher rates of certain types of cancer (i.e., stomach, cervical, gallbladder, esophagus, and liver). Recognizing lower cancer risk in Latinos, Gutierrez-Ramirez and Carter-Pokras caution that “there are indications that this situation could change” (p. 230). For example, they note trends in the literature that the following cancers may be increasing among Latinos: leukemia and cancers of the breast, colon and rectum, lung, prostate, bladder, kidney, and brain. The most common forms of cancer for both Latino and White men are prostate, colon, and lung; the most common for both Latinas and White women are breast and colon cancer. The third most common cancer for Latinas is cancer of the cervix, whereas for white women it is lung cancer. Despite the primal fear evoked in Latinos and Whites alike by the diagnosis of cáncer, Gutierrez-Ramirez and Carter-Pokras (1994) are quick to note that there is substantial room for primary and secondary prevention given the significant roles of diet, lifestyle, and access to preventive care. The most obvious example is lung cancer, 80% of which could be prevented by avoiding smoking. The authors note that although Latinas smoke less than their White counterparts, smoking rates continue to increase for Latinos living in the United States. In fact, rates of smoking in Latino and White men is now about the same at around 30%, and the rate is even higher for Puerto Rican men, at 37%. Gutierrez-Ramirez and Carter-Pokras cite the many documented associations between being overweight and eating a Western diet rich in animal products and fats and a variety of cancers, including colon and rectal, prostate, ovary, uterus, breast, and testicular; links between alcohol consumption and liver cancer; and links between exposure to pesticides among farmworkers and malignant lymphoma, GI tract cancer, cancer of testes, and clusters of childhood cancers found in farmworker-filled towns such as Delano and McFarland in California. Thus, there is considerable work to be done in the area of Latino cancer prevention and control. In addition to the usual disease-related recommendations (i.e., more research, more funding, more Latino participation), the First North

orga_c09.qxd

2/5/07

10:54 AM

Page 259

Latino Health

259

American Conference on Cancer in Hispanics (Modiano, 1992) asserted that the process and development of “culturally tailored” interventions need to be adequately explained. Hopefully this important recommendation can be addressed here by reviewing some auspicious cancer prevention interventions. CANCER PREVENTION EN ACCIÓN One of the most impressive efforts at rigorous, comprehensive, culturally and socially appropriate, and communitywide cancer prevention with Latinos has been conducted through En Acción: the National Hispanic Leadership Initiative on Cancer (NHLIC). The NHLIC is a program for both research and action to prevent and control cancer in major U.S. Latino groups (i.e., Mexican, Puerto Rican, Cuban, Central American) in eight major Latino urban centers: San Francisco, San Diego, Houston, San Antonio, Laredo, Brownsville, Brooklyn, and Miami. The three major components of En Acción are (1) conducting a large-scale survey to assess cancer screening behaviors and related background and risk factors; (2) promoting cancer prevention and control at the community level by connecting national and regional experts with grassroots groups to mount media campaigns and peer network support efforts; and (3) evaluating prevention intervention efforts (Ramirez et al., 1998). A series of published reports by the NHLIC research team documents ethnoregional differences in cancer risk and correlates, as well as evaluations of NHLIC’s culturally and socially appropriate prevention intervention model. These three components are highlighted next. The Cancer Risk Survey To generate cancer risk data, the NHLIC survey was conducted in the early 1990s and consisted of 1,200 completed telephone interviews in each of the eight city sites, stratified by sex and age groups (under and over 40; Ramirez et al., 1999). Areas assessed included level of health care, consumption of fruit and vegetables, smoking, various forms of cancer screening for women (i.e., history of pap smears and mammograms) and men (i.e., digital rectal exams for screening prostate cancer), and other background variables related to risk. Reports from this database provide insights into many of the dynamics of cancer risk in Latino communities across the country, and also provide the basis for implementing NHLIC’s prevention intervention model. The Cancer Prevention Model Education and advocacy are based on a social modeling approach in which behavioral journalism is used to create local “role model” stories of

orga_c09.qxd

260

2/5/07

10:54 AM

Page 260

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

real Latinos preventing and controlling cancer. These are disseminated through mass media (i.e., television news, radio, newspapers) and small local media (e.g., print material distributed by grassroots volunteers). Stories relate how the role models acquired information, changed attitudes, and picked up the skills needed for optimal cancer prevention or control. Following the media campaign, local peer networks of natural helpers, composed primarily of volunteer housewives and in some places promotores (nonprofessional community health promoters), are identified and trained to reinforce media messages with friends, neighbors, and others in the community. PREVENTING CERVICAL AND BREAST CANCER

IN

LATINAS

It has been documented that Latinas have twice the rate of invasive cervical cancer as non-Latino White women (16.2 and 7.9 per 100,000, respectively) yet are less likely than all other groups of women in the United States to receive pap smear screening (Gutierrez-Ramirez & CarterPokras, 1994). This means that Latinas are dying needlessly: Cervical cancer screening can save the lives of women of childbearing age who get regular pap smears so that precancerous lesions can be quickly treated (Ramirez & Suarez, 2001). Breast cancer screening rates are also lower for Latinas than for White and African American women, and this is even the case for Latinas without financial barriers to health care (Ramirez, Suarez, et al., 2000). Although Latinas’ rate of breast cancer is about 40% lower than the rate for White women, presumably because of Latinas’ greater number of earlier and multiple births, breast cancer continues to be the most common form of cancer among Latinas in the United States (Ramirez & Suarez, 2001). Ethnoregional Differences in Latina Cancer Screening Data from the NHLIC show considerable ethnoregional differences in Latina cancer screening. Screening for cervical (Ramirez, Talavera, et al., 2000) and breast (Ramirez, Suarez, et al., 2000) cancer was found to be consistently lower for Mexican American women in Texas (especially in the South Texas border region) and was highest among Central Americans in San Francisco and Cuban Americans in Miami. For Latinas over the age of 40, pap smear screening during the past 3 years was lowest in Texas (from about 48% in Laredo to 60% in Houston), as compared to between 63% (Puerto Ricans in New York) and 74% (Central Americans in San Francisco) for all other Latina groups. The same pattern was found for mammogram screening during the past 2 years for Latinas over 40: lowest in Texas (from approximately 42% in Laredo to 59% in San Anto-

orga_c09.qxd

2/5/07

10:54 AM

Page 261

Latino Health

261

nio) compared to between 60% (Mexican American women in San Diego) and 83% (Central American women in San Francisco) for all other Latina groups. Armed with these data, the NHLIC conducted analysis to better understand the social and cultural contexts of cancer prevention screening in Latino communities and to test their conceptually tight prevention intervention model. Social Integration and Cancer Screening The NHLIC team investigated the relation between cancer screening and social integration for Latinas over the age of 40 (Suarez et al., 2000) and found that Latinas with higher numbers of friends and relatives, higher frequency of social contacts, and higher church membership and attendance were almost twice as likely to have had a recent pap smear than Latinas low in these markers of social integration. Church involvement emerged as the strongest predictor of cervical cancer screening. Social networks were generally large and active for these middle-aged and older Latinas. The impressive link between social integration and cancer screening was strongest for Mexican American and weakest for Puerto Rican women. In fact, there was no relation between social integration and screening for Puerto Ricans, whose social networks were smallest, indicating greater isolation in these women. The results support the NHLIC’s prevention intervention model that is designed to mobilize naturally occurring peer support networks in Latino communities to prevent disease. Using the Model to Prevent Cervical Cancer Given the data on cervical cancer screening, the NHLIC team decided to promote cervical cancer screening where it was needed most by implementing their prevention intervention model in the U.S.-Mexico border region of South Texas (Ramirez et al., 1999). Salud en Acción (Health in Action) is the name of the Brownsville-based intervention, which consisted of a predominantly Spanish-speaking media blitz that included more than 80 TV segments, more than 60 newspaper stories, and nearly 50 radio programs featuring local role model stories. Embedded in these personalized accounts of cervical cancer prevention were the knowledge, attitudes, and skills involved with acquiring pap smears, as well as ways that spouses and family members can be instrumental in supporting such behavior for the sake of the entire family. Following the media blitz, natural peer networks were mobilized by identifying and training 175 predominantly homemaker volunteers to incorporate cancer prevention into their communications with community residents. To evaluate Salud en Acción, a panel of just over a 100 Brownsville women who had participated in the NHLIC baseline survey were reinterviewed

orga_c09.qxd

262

2/5/07

10:54 AM

Page 262

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

following several months of the intervention. Their data were compared to the baseline Brownsville data, as well as to data of a comparison panel of more than 100 women from Laredo, where no Salud en Acción intervention was implemented (i.e., control site). As can be seen in Table 9.3, impressive intervention effects were reported only in Brownsville, where the percentage of women in the highest pap smear adherence condition increased from a little over half at baseline to nearly two-thirds. Further, the percentage of Brownsville women in the lowest adherence condition decreased from almost a quarter at baseline to 13%. In contrast, no such positive changes in cancer screening rates were evident at the Laredo site. Using the Model to Prevent Smoking McAlister et al. (1992) also used the NHLIC model to prevent smoking in a Texas-Mexico border community, with auspicious results. Over a period of 5 years, these researchers implemented four smoking cessation campaigns, advertised as Programa a Su Salud (Program for Your Health), in the South Texas city of Eagle Pass. The nearby town of Del Rio was selected as the no-intervention comparison town. To evaluate Programa, a panel of 135 participants from Del Rio was compared to a panel of 160 residents from Eagle Pass. The Eagle Pass panel also included a subsample of 70 residents who received intensive counseling for smoking cessation in addition to the communitywide intervention. That is, 70 Eagle Pass residents accepted an additional offer of more individualized counseling for quitting smoking, which ranged from telephone consultations to face-toface meetings with outreach workers, as well as enrollment in the Ameri-

Table 9.3 Percentages of Mexican American Women in Highest and Lowest Pap Smear Adherence Levels by Intervention (Brownsville) and Control (Laredo) Sites Site

Adherence

Baseline (1994)

Follow-Up (1996)

Brownsville (Program) Laredo (Campaign)

Highesta Lowestb Highesta Lowestb

54.2 23.4 46.8 27.6

60.7 13.1 47.1 25.0

a

Within past year or 2 years (at baseline) and strong intentions (at follow-up). Never or more than 3 years ago and no intentions (at follow-up). Source: “Cervical Cancer Screening in Regional Hispanic Populations,” by A. G. Ramirez et al., 2000, American Journal of Health Behavior, 24(3), pp. 181–192. Reprinted with permission. b

orga_c09.qxd

2/5/07

10:54 AM

Page 263

Latino Health

263

can Cancer Society’s Latino-focused telephone-based smoking prevention intervention. With regard to results, self-reported rates of smoking cessation for Eagle Pass were 17%; 8% were verified though breath samples into a portable carbon monoxide analyzer. In comparison, only 8% of the Del Rio panel self-reported cessation and only 1.5% were verified through carbon monoxide analysis. Interestingly, no differences were found between Eagle Pass participants who received intensive counseling and those exposed only to the campaign. Thus, use of the NHLIC model to prevent smoking appears to result in moderate reductions in smoking for border-area Mexican Americans and appears to be as effective as more intensive counseling to prevent smoking.

L AT I NO S AT R I S K F OR H I V/A I D S HIV/AIDS has been called a disease that knows no borders (geographical or human), and that exploits human vulnerability on a global scale. For these reasons, it should not be surprising that rates of HIV/AIDS are disproportionately high for U.S. Latinos, and highest among the poorest of Latinos (i.e., Puerto Ricans) and the most stigmatized sexual minorities within both U.S. and Latino cultures (i.e., men who have sex with men). My own research also shows that HIV/AIDS poses a significant threat to Mexican/Latino migrant workers whose immense poverty pushes them across the U.S.-Mexico border to work in a country that depends on their labor yet marginalizes them. Given the very different realities for each of these Latino groups, similar as well as different factors need to be considered for effective HIV/AIDS prevention. Before reviewing viable prevention interventions, a brief overview of HIV/AIDS and U.S. Latinos is provided.

U.S. LATINOS AND HIV/AIDS The most recent government data show that although Latinos make up about 14% of the U.S. population, they compose 18% of cumulative AIDS cases and 19% of both new AIDS and HIV cases reported in 2001 and 2002, respectively (S. Ruiz, Kates, & Pontius, 2003). Latinos currently make up 20% of those living with AIDS, as compared to 37% for Whites and 42% for African Americans. A breakdown of data shows interesting patterns of HIV/AIDS by sex, exposure category, and geographic location. Newly reported AIDS cases among Latinos are primarily in men (77%) but include a sizable number of Latinas (23%). In fact, Latinas compose a growing

orga_c09.qxd

264

2/5/07

10:54 AM

Page 264

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

proportion of AIDS cases, which increased from 15% in 1991 to 23% of all female AIDS cases in 2001. On a related note, while pediatric AIDS cases have declined dramatically during the 1990s due to treatments that can prevent HIV transmission from mother to infant, Latinos still made up 15% of pediatric AIDS cases in 2001. HIV exposure categories for Latino and White men reveal considerable differences: sex between men (48% and 73%, respectively), injection drug use (29% and 13%, respectively), and heterosexual contact (16% and 5%, respectively). Analyses of Latino AIDS cases by place of birth and exposure categories are depicted in Figure 9.1. As can be seen, sex between men is a major exposure category yet varies between 14% for mainland Puerto Ricans to 47% for Latinos born in Mexico. Conversely, 43% of mainland Puerto Ricans were infected through injection drugs, as compared to 17% of other U.S.-born Latinos and less than 10% of Latinos born in Mexico, Cuba, and Central/South America. The percentage of risk “not reported” is lowest for Puerto Ricans but remarkably high for all other groups. Although the AIDS case rate is 31.4 per 100,000 for U.S. Latinos in general, case rates are much higher in the northeastern states, where Puerto Ricans predominate: Massachusetts (103.8 per 100,000), Washington, DC (102.6), Connecticut (98.7), New York (92.7), Pennsylvania (77.6 per 100,000), and Delaware (64.6). An analysis of all registered Latino AIDS cases in Chicago showed that Puerto Ricans had the highest annual AIDS cases in the city since 1987, and that the major mode of transmission for men was injection drug use (Murphy, Mueller, & Whitman, 1996). For all Latinas in the Chicago study, heterosexual contact was the predominant mode of transmission, with the largest proportion being sex partners of injection drug users. Thus, national and regional data show considerable variability between and within national-origin Latino groups. However, Puerto Ricans clearly stand out as the highest risk group among U.S. Latinos. THE PUERTO RICAN HIV/AIDS CRISIS HIV/AIDS thrives in groups most impacted by poverty and social marginality given the frequently lethal combination of high social problems and low resources that plays a central role in the transmission of HIV through injection drug use, prostitution, and sex with high-risk partners. In 2000, the Latino Commission on AIDS in New York held a press conference to declare a state of emergency regarding HIV/AIDS in the Latino community (http://www.latinosaids.org). Among many important points raised, the commission noted the following: (a) While New York Latinos

orga_c09.qxd

2/5/07

10:54 AM

Page 265

Latino Health

265 0%

U.S. - 50 states and DC

25%

17%

42%

11%

3%

0%

U.S. - Puerto Rico

14%

43%

29%

10%

4% 0%

Mexico

47%

6%

16%

29%

2% 1%

Central/South America

35%

5%

19%

39%

2%

1%

Cuba

34%

7% 10%

46%

0%

MSM IDU

Heterosexual Contact

3% 100%

Risk Not Reported

Hemophilia/ Transfusion

IDU/ MSM

Figure 9.1 Percentage of AIDS cases reported among Latinos by place of birth and risk behavior, 2001. (Note: Includes reported cases among those 13 years of age and older. May not total 100% due to rounding. Source: Key Facts: Latinos and HIV/AIDS (#6088), The Henry J. Kaiser Foundation, July 2003, Menlo Park, CA: Author. Reprinted with permission.)

represent only 9% of U.S. Latinos, they make up 30% of all Latino AIDS cases in the United States; ( b) over half of all Puerto Rican AIDS cases can be traced directly to intravenous drug use, 40% of Puerto Rican women became infected through sex with male injection drug users, and virtually all pediatric cases are attributable to the direct or indirect IV drug use of parents; and (c) gay, bisexual, and transgender men make up 30% of male Latino AIDS cases. The commission went on to point out that few services are available to New York Latinos, and even fewer services

orga_c09.qxd

266

2/5/07

10:54 AM

Page 266

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

are geared toward women and stigmatized groups such as IV drug users and gay, bisexual, and transgender individuals. In fact, they note that New York has the highest rate of HIV infection and AIDS cases of any prison population in the United States because over 90% of those incarcerated for drug-related offenses are Latino and African American. Kottiri, Friedman, Neaigus, Curtis, and Des Jarlais (2002) note that the higher rates of HIV/AIDS in Puerto Ricans and Blacks in New York City were established early in the epidemic, during the late 1970s and early 1980s. In their study of 662 intravenous drug users (IDUs) from New York City, these researchers found that almost half of Puerto Rican and Black IDUs were HIV positive, as compared to a third of White IDUs. They also found that sexual- and drug-related risk taking was highest in Puerto Ricans, and that risk taking in these IDU groups generally occurred within their own racial/ethnic social networks. Thus, community-based collaborative efforts are urgently needed to study and respond to the racially and ethnically linked mixture of poverty and culture that contribute to IV drug and HIV/AIDS risk in the Puerto Rican community. PREVENTING HIV/AIDS

IN THE

PUERTO RICAN COMMUNITY

Colon, Sahai, Robles, and Matos (1995) describe an HIV prevention effort aimed straight at the heart of the Puerto Rican AIDS crisis. Ex-addicts were trained to conduct extensive HIV prevention outreach education to more than 1,100 IDUs in San Juan, Puerto Rico. These individuals were actively injecting drugs and not enrolled in drug treatment programs. They were approached at shooting galleries, “copping areas” where drugs are scored, and on the street corners of 10 different neighborhoods; 80% were male, almost half were HIV positive, and they had been injecting drugs for an average of 13 years. Outreach included education about sex and IV-related transmission and demonstrations of proper condom use and how to clean needles with bleach. Outreach workers spent an average of 12 weeks in the community and successfully posttested almost 90% of participants. Results revealed significant decreases in sharing cookers and increased needle cleaning with bleach. There were no effects on needle sharing, which was low to begin with and which probably requires needle exchange programs to reduce further. There was also a lack of impact on risky sexual behaviors. The authors note that specialized interventions need to be designed for female partners who do not inject drugs and who make up the majority of the sex partners of IV-drug-using men. The authors also report non-intervention-related reductions in IDU risk behav-

orga_c09.qxd

2/5/07

10:54 AM

Page 267

Latino Health

267

iors such as less injecting in galleries, borrowing or renting needles, and sharing cookers, which could be a promising reflection of IDUs receiving risk reduction messages in their environment. LATINO GAY MEN Sex between men remains the highest risk factor for acquiring HIV in the United States generally, for both U.S.-born and immigrant Latinos, and this is true in many Latino countries of origin such as Mexico and Puerto Rico. For this reason, it is important to focus prevention efforts on Latino men who have sex with men, whether gay-identified or other, and to promote detailed prevention efforts that consider the environmental, social, cultural, and sexual contexts of HIV risk. Rafael Diaz’s HIV prevention work with Latino gay men stands out for its careful attention to theory, research, and practice. Oppression versus Self-Regulation Diaz (1998) believes that while Latino gay men neither wish nor intend to engage in unsafe sex, underdeveloped self-regulatory processes are vulnerable to breakdown during sex, where they become undermined by the internalization of oppressive social factors such as homophobia, racism, and poverty, as well as cultural factors such as familismo and machismo, which contain elements oppressive to nonheterosexual family members. For example, while familism is generally considered to be the central cultural strength among Latinos, it may actually work to put Latino gay males at greater risk for HIV because it is generally rejecting of deviations from the traditional heterosexual norm. Gay Latino men are too often faced with the dilemma of having to choose between la familia and living their life openly. For those who remain in the family by concealing their sexual orientation, Diaz believes that their sexuality can become confined to a forbidden domain of secrecy and shame. Thus there can be a splitting off or dissociation from their sexuality that can leave many Latino gay males with too little opportunity during their early psychosocial development to have the kinds of normative experiences that are needed to develop a healthy and meaningful sense of self, especially with respect to sexual and gender roles. An unfortunate consequence of this cultural predicament is seeking release of sexual impulses and feelings in limited, secretive, and unpredictable ways that render Latino gay males vulnerable to risk (e.g., being vulnerable to sexual manipulation and abuse, cruising for anonymous sex). This is not to say that traditional family members can’t be supportive of sexually different family members. Indeed, such support frequently

orga_c09.qxd

268

2/5/07

10:54 AM

Page 268

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

happens among various members (e.g., a mother or sister), but because it isn’t normative at the traditional end of the family continuum, it’s not probable. This is unfortunate given the potentially powerful role of family acceptance to help sexually different family members deal with potential societywide rejection and discrimination. Latino family support probably increases with acculturation, modernization, and a loosening of traditional gender and sexual norms and expectations. Machismo is another traditional cultural value that gay Latino men often internalize early in maladaptive ways. Diaz (1998) notes that because Latino culture has traditionally confused gender with sexuality, gay men are popularly likened to women in men’s bodies. Thus, some gay men who internalize this stereotype may be prone to think of themselves as inadequate or “failed men,” resulting in either submissive or overly macho gay men with something to prove in the bedroom (e.g., prioritizing sexual prowess over affection and communication and over safer sex strategies such as condom use). Racism and poverty can also overinfluence the sexual and interpersonal lives of gay Latino men in the United States, who are frequently stereotyped as sexually exotic in the predominantly White gay community, and because Latino gay men are frequently at a vulnerable economic disadvantage relative to Whites. Rather than risk rejection, some gay Latino men may feel the pressure to live up to sexual stereotypes, or not to disappoint partners on whom they are economically dependent. The bottom line in Diaz’s (1998) psychocultural theoretical framework is that healthy self-regulation becomes undermined in challenging sexual situations where scripted and automatized behaviors, stemming from oppressive social and cultural variables, take over in unconscious and emotionally charged ways. Repeated experiences of failure to implement intentions to practice safe sex can lead to hopelessness and even fatalism about contracting el premio gordo (the grand prize), as some gay men refer to HIV/AIDS. Thus, oppressive social and cultural regulators of interpersonal behavior become internalized psychological regulators of sexual behavior that is experienced not simply as risky and unsafe but as socially and culturally meaningful scripts. Such a bold theory is not without its critics (e.g., pathologizing gay Latino men), but it is a well-thought-out attempt to tie public oppressive conditions to the personal experiences and lives of individuals who frequently lack the kinds of supports needed to develop a healthy sense of self under dehumanizing conditions. Service providers hoping to respond to the special needs of Latino gay men need to be able to think on these two levels of psychosocial analysis.

orga_c09.qxd

2/5/07

10:54 AM

Page 269

Latino Health

269

Evidence-Based Practice Diaz (1998) has conducted research to support his theory by connecting HIV risk in a large and diverse urban sample of gay Latino men to their personal experiences of homophobia (operationalized as verbal and physical harassment during childhood for being homosexual), racism (i.e., rude treatment and police harassment linked to race/ethnicity), and poverty (i.e., running out of money for basic necessities, having to borrow money, having to look for work). Based on a probability sample of 912 gay Latino men recruited from Latino and gay-identified bars, clubs, and social events in Los Angeles (n = 301), New York (n = 309), and Miami (n = 302), Diaz and Ayala (2000) found that men with high levels of HIV risk (i.e., reporting unprotected sex with a recent nonmonogamous partner) reported more oppressive experiences than their counterparts with lower sexual risk taking. Such research and theorizing have led to a well-conceived HIV prevention program for Latino gay men, based in San Francisco, that has received national attention; the Centers for Disease Control recognizes this program and provides technical assistance and financial support for its implementation for gay Latino men in community service agencies across the country. PREVENTING HIV

IN

LATINO GAY MEN

The Hermanos de Luna y del Sol (HLS; Brothers of the Moon and Sun) program was designed by Diaz (1998) and Latino gay health educators in San Francisco’s Latino Mission District based on Diaz’s adaptation of Bandura’s (1994) theory of self-regulation and Freire’s (1993) principles of empowerment education. Developers of HLS believe that HIV prevention programs for gay Latino men can be effective if they can (a) break the sexual silence by providing safe venues for serious communication about sex; ( b) provide an experience of commonality and pride in which men can feel part of a larger supportive gay Latino community; (c) provide opportunities for critical self-reflection and self-observation about factors that regulate sexual and other behaviors; (d) collaborate in the construction of group, dyadic, and individual strategies to address perceived barriers to safer sex; and (e) create opportunities for social activism. Outreach Participants are recruited into HLS groups by outreach workers who visit Latino and gay-identified social venues and distribute attractive calling cards advertising encuentros de comunicación y amistad (friendship and communication encounters) para hombres Latinos de ambiente. The latter

orga_c09.qxd

270

2/5/07

10:54 AM

Page 270

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

term literally means “for Latino men of the ambience,” which, according to Diaz (1998, p. 162), “is a popular Latino expression referring collectively to all those who are homosexually active or self-identify as homosexual, even though perhaps only privately so.” He goes on to say, “De Ambiente is thus a code phrase that denotes (in-group) knowledge about sexual orientation and behavior, but does so in a private, self-referenced way, without the implications of being out publicly within a viable gay community” (p. 162). The carefully designed calling cards also feature an attractive logo composed of the HLS name around a composite drawing of a Latino man’s face, partially eclipsed by a crescent moon on one side, both of which are encircled by the corona of the sun. On the card’s backside is a carefully worded description of the program above a photo of smiling Latino men, with contact information and a list of incentives ($10 and dinner per meeting, a T-shirt). Consistent with personalismo, the invitation is direct yet warm; phrases include “La cena ya esta servida” (Dinner is already served) and “Solo faltas tu!” (The only thing that’s missing is you!). HIV Prevention Groups Interested participants are invited to four group sessions with the following goals: (a) to facilitate communication resulting in self-observation and critical self-reflection; ( b) to create a sense of community and gay pride; and (c) to facilitate the co-construction of strategies to combat social and cultural oppressors and to promote safer sex behaviors. Methods to achieve these goals include discussions guided by the following key questions: “What’s the most difficult thing about being a Latino Gay man?”; “How have you been affected by the HIV/AIDS epidemic?”; and “What makes safe sex difficult for you?” Ensuing discussions help participants to connect social and cultural factors with psychosocial problems that interfere with self-care (e.g., low self-esteem, low sex regulation, social isolation, fatalism regarding HIV). Participants also keep a safe sex journal guided by questions they are asked to answer within 24 hours of a sexual episode. For example, participants are asked to rate how positive or negative the sexual encounter was and why. Answers are discussed in group to help participants understand the personal and situational factors that hinder or facilitate safer sex, how personal self-regulation is enhanced by sex journal discourse, and how having a healthy sex life is a heroic struggle against oppression. A preliminary evaluation of 78 HLS participants revealed promising findings: Most of the men felt better about themselves and more connected to the Latino gay community, better able to understand their sexu-

orga_c09.qxd

2/5/07

10:54 AM

Page 271

Latino Health

271

ality and risk for HIV, and more capable of practicing safer sex and of avoiding situations that make it difficult to practice safer sex (Diaz, 1998). MEXICAN/LATINO MIGRANT LABORERS

IN THE

UNITED STATES

I have dedicated more than 15 years to studying the problem of HIV risk in predominantly Mexican migrant laborers who live and work in the United States for extended periods of time providing essential labor to lucrative American businesses and industry sectors such as construction, the pervasive service sector, domestic labor, agricultural labor, meat packing and poultry preparation. HIV prevalence and prevention research on this unique population of Latinos consists mainly of a number of small studies in different regions of the country, but reviews of the literature (Organista & Balls Organista, 1997; Organista, Carrillo, & Ayala, 2004) indicate considerable HIV risk warranting prompt attention. Migratory labor systems all over the world are involved with the geographical spread of HIV because they are composed primarily of young male migrants away from home for extended periods of time, resulting in family breakdown, increased number of sex partners (including sex with commercial sex workers and sex between men), and the consequent risks to wives and other sex partners of such migrant men. Documented risk factors for Mexican migrant laborers are high numbers of sex partners, including sex between men and between men and female sex workers, high rates of STDs, needle sharing following injections of illegal drugs and “therapeutic” injections of vitamins and antibiotics, sex with IDUs on the part of female migrants (Organista & Balls Organista, 1997), and a high prevalence of alcohol and substance dependency and depression (Alderete, Vega, Kolody, and Aguilar-Gaxiola, 2000). A screening of 151 drug-using farmworkers in the DelMarVa Peninsula of Delaware revealed six men who were HIV positive (Inciardi, Surratt, Colon, Chitwood, & Rivers, 1999), four of whom were Mexican who each had a history of trading sex for money or drugs. It has also been documented that Mexican farmworkers report lower perceived risk than Black and Anglo farmworkers (McBride, Weatherby, Inciardi, & Gillespie, 1999). All of the risk factors just enumerated are exacerbated by the nature of migratory labor in the United States, which is typically difficult, dangerous, inconsistent, low-paying, exploitive, lonely, and disruptive of social, familial, romantic, and sexual relations in one’s country of origin. Background characteristics of Latino migrants that also influence risk include low formal education and literacy, limited English, high rates of undocumented status, low access to health and social services, and traditional gender roles.

orga_c09.qxd

272

2/5/07

10:54 AM

Page 272

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Sex between Men Because sex between men remains the highest risk factor for acquiring HIV in both the United States and Mexico, it is an imperative exposure category to assess. Yet, self-reported rates of sex between men in surveys of Mexican/Latino migrant laborers are unexpectedly low, between 2% and 4%. These rates probably reflect difficulty detecting actual prevalence with the survey method, even if done anonymously. Thus, qualitative research methods, such as private, anonymous interviews with key informants, are needed to render more visible this sensitive and important HIV exposure category (Organista, 2004; Parker, Herdt, & Carballo, 1991). Women at Risk Organista, Balls Organista, Garcia de Alba, Castillo Moran, and Ureta Carrillo (1997) found that married migrant men were just as likely as single migrants to have sex with female prostitutes while in the United States, yet were less likely to use condoms. It has also been documented that married Mexican migrant men, unaccompanied by their wives while working in the United States, report more lifetime sexual partners, more partners in the previous 2 years, more extramarital affairs, and more sex with prostitutes, as compared to men accompanied by their wives (Viadro & Earp, 2000). The fact that guest-worker contracts typically contain provisions preventing wives from joining their migrant husbands during seasonal work (Chang, 2000) is an example of how structural factors in the form of labor policies can create risky environments for migrant laborers. Cultural factors that place the female sex partners of migrant men at risk for HIV include traditional Latino gender roles in which sex with husbands is rarely discussed, let alone negotiated, resulting in low levels of safer sex. For example, in a study of 100 rural women in Mexico who were the wives of Mexican migrants working in the United States, Salgado de Snyder, Diaz Perez, and Maldonado (1996) found that two-thirds did not practice safer sex when having sex with their husband during his visits to Mexico, despite being knowledgeable about HIV transmission and despite suspecting the husband’s infidelity. This latter point is not surprising in view of research showing that such women believe it is promiscuous to carry and suggest use of condoms, and thus rely primarily on nonbarrier contraceptive methods such as the pill and IUD for family planning and not disease prevention (Balls Organista, Organista, & Soloff, 1998; Organista et al., 1997; Salgado de Snyder et al., 1996). Interestingly, a follow-up study by Salgado de Snyder, Acevedo, DiazPerez, and Saldivar-Garduno (2000) compared the sample of 100 rural wives of migrant laborers left behind in Mexico to 100 wives currently

orga_c09.qxd

2/5/07

10:54 AM

Page 273

Latino Health

273

living with their husbands in rural Mexico, and to 100 wives of migrant men currently living with their migrant husbands in Los Angeles. The results of this study indicate a clear acculturation trend in that the L.A.based wives reported more lifetime sex partners, experience with a wider variety of sexual behaviors, greater condom use during sexual episodes with husbands, and a higher frequency of asking husbands to use condoms. Such findings suggest that Latina-focused interventions promoting sexual negotiation and safer sex may be viable, especially for more acculturated Latinas.

HIV PREVENTION INTERVENTIONS

WITH

MIGRANT LABORERS

In a review of 187 community-based agencies providing HIV prevention services to Latinos in the state of California, Castañeda and Collins (1997) found that community based organizations (CBOs) were considerably more effective in reaching Latinos than federal and state agencies because of their greater number of bilingual staff and volunteers and their culturally sensitive approaches to service delivery. Further, although the Latino-focused CBOs in the study were fewer and smaller than non-Latino-focused agencies, they had more bilingual/bicultural staff and less staff turnover, made greater use of education videos and Spanish media, provided more one-on-one services, stressed outreach more often, and provided more services to sex workers. Despite the dedicated effort of these Latino CBOs, they typically lack the capacity to evaluate services or to take their services beyond basics such as teaching about HIV transmission, promoting safer sex (e.g., condom use), and providing HIV testing and related counseling for those testing positive. Collaborative Approaches There are two major ways of expediting HIV prevention with Latinos in general and Mexican migrants in particular. The first is through topdown governmental and bottom-up community collaborations that combine governmental financial resources and technical assistance with community-based agency and resident knowledge of local problems and high-risk groups and how to access them. The second way is through university-community collaborations that combine research expertise with community-level service expertise. Both of these collaborative strategies have resulted in a few promising HIV prevention approaches with Mexican migrant laborers and related groups (e.g., Mexican immigrants). A review of the literature by Organista et al. (2004) revealed only a handful of published studies on HIV prevention interventions with

orga_c09.qxd

274

2/5/07

10:54 AM

Page 274

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Mexican/Latino migrant laborers, or closely related groups (see Table 9.4). Though only a beginning, this small set of studies is instructive for the inclusion of culturally competent approaches at either a basic (e.g., bilingual and bicultural personnel, outreach) or more advanced level that creatively incorporate Mexican culture-based elements into interventions that address local realities. These studies also demonstrate the tremendous advantages of community-based collaborative approaches. Increasing HIV/AIDS Knowledge in Farmworkers On behalf of the California State Office of AIDS, Ruiz and Molitor (1997) conducted a community-based intervention designed to improve knowledge of HIV transmission in 142 predominantly Mexican, Spanish-speaking migrant farmworkers in northern California. The intervention relied primarily on local outreach workers who conducted one-to-one contacts in which they educated participants about HIV/AIDS and promoted and distributed condoms. HIV/AIDS information was also disseminated through community festivals and on local Spanish-language radio and TV programs. The results of pre- and postintervention assessments showed significantly improved knowledge of HIV transmission. Yet although this study validates the effectiveness of “HIV 101” educational approaches, the mainstay of Latino AIDS service organizations, it addresses few of the complex issues raised in the literature review just discussed. Though theirs is not a migrant-focused study, Maxwell, Bastani, and Warda (2002) conducted a noteworthy single-session HIV prevention intervention with young Spanish-speaking Latinos recruited at an HIV testing clinic in Los Angeles that primarily serves Latino immigrants. The idea was to enforce behavior changes advocated during HIV testing and counseling sessions by offering a single follow-up weekend session. The intervention went beyond the usual HIV 101 information to include proper condom use demonstration and practice, discussion and role-plays of negotiating condom use with a partner, and the distribution of a Mexican style fotonovela entitled Flirting with Danger. As mentioned in Chapter 6, fotonovelas are comic-book-like forms of Mexican/Latino entertainment that contain actual photos instead of illustrations, bubble dialogue, and storylines that blend comedy and drama. Of the 106 participants recruited for the baseline pretest, about half agreed to participate in the workshop; 81% of workshop participants were available for a 4-week posttest, as were 54% of the nonintervention participants. Interestingly, participants were almost evenly divided between Mexican and Central American and between male and female, and the intervention session was designed for both men and women to

193 Mexican male migrant farmworkers

Condom promotion via fotonovelas and radionovelas depicting scenarios with female prostitutes

More rigorous replication of Mishra & Conner (1992)

Community-based HIV prevention groups for predominantly Mexican migrant day laborers

90-minute single-session AIDS prevention workshop

Mishra & Conner (1996)

Sanudo (1999)

Organista, Alvarado, Balbutin-Burnham, Worby, & Martinez (2006)

Maxwell, Bastani, & Warda (2002)

Two-thirds of the sample received 4-week posttest that showed increase in “always” carrying condoms, in male workshop participants, from 18% pretest to 42%.

Preliminary results indicate pre- to postintervention increases in condom use with female sex partners, carrying condoms, and knowledge of correct condom use.

From “HIV Prevention with Mexican Migrants: Review, Critique, and Recommendations,” by K. C. Organista, H. Carrillo, and G. Ayala, 2004, Journal of Acquired Immune Deficiency Syndrome, 37(Suppl. 4), pp. S227–S239. Adapted with permission.

106 Latino immigrants (55 male and 43 female) recruited and pretested at an AIDS testing clinic; 54 attended workshop and 81% posttested; 54% of nonworkshop participants were posttested

23 predominantly Mexican male migrant day laborers

Same pattern of results as Mishra & Conner (1996)

10:54 AM

Increased condom use with prostitutes

Improved pre- to postintervention HIV knowledge

Major Findings

2/5/07

175 Mexican male farmworkers (85 in experimental and 90 in control conditions)

142 Mexican migrant farmworkers

Community-based HIV education; mostly one-on-one contacts by outreach workers plus educational talks and activities at community venues

J. Ruiz & Molitor (1997)

Sample Description

Intervention Description

Authors of Study

Table 9.4 Summary of HIV Prevention Outcome Evaluations with Mexican Migrant Laborers and Related Groups

orga_c09.qxd Page 275

275

orga_c09.qxd

276

2/5/07

10:54 AM

Page 276

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

enhance discussions of condom negotiation. With regard to results, the proportion of participants who “always” carrying condoms increased from 18% to 42% among those who responded to this item at both baseline and posttest, and this was true only for those who attended the workshop and for male participants. These are meaningful results given the importance of carrying condoms as a predictor of actual condom use with both occasional and regular sex partners in Mexican migrants (Organista et al., 2000). However, these results also support past research showing that most Mexican migrant women do not carry condoms because doing so is associated with promiscuity. Increasing Condom Use by Male Farmworkers A collaboration between researchers at the University of California, Irvine, and a health clinic in northern San Diego County with experience serving farmworkers resulted in an intervention designed to increase condom use with female sex workers by 193 Mexican male farmworkers (Mishra & Conner, 1996). HIV prevention information was provided to participants in the culture-friendly form of fotonovelas and radionovelas (radio broadcast novellas), with the latter broadcast daily on a local Spanish-language station (participants were given radios and program times and encouraged to tune in). Like much of Mexican entertainment, the Tres hombres sin fronteras (Three Men without Borders) novelas were both funny and dramatic and depicted three scenarios in which a male farmworker either (a) decides to use a condom with a prostitute; (b) abstains from sex with the prostitute; or (c) infects his wife with HIV, who gives birth to an HIV-positive baby, as a result of unprotected sex with the prostitute. All participants were pre- and posttested and results showed significant gains in HIV/AIDS knowledge and related attitudes, and in reported condom use with prostitutes. Of those men who used prostitutes during the course of the study, 20 of 37 reported condom use after participation in the study, compared to 1 of 32 prior to participation. This study demonstrates the promising use of an intervention that is sensitive to both Mexican culture and the migrant farmworker to target a particular subgroup (adult men), risk factor (unprotected sex), and situation (sex with female prostitute). A more rigorous replication of this study was conducted by Sanudo (1999) with the same pattern of promising results: 20 of 85 male farmworkers reported sex with prostitutes at baseline, and only 4 of the 20 reported having used condoms. At postintervention, 24 reported sex with prostitutes and 16 of them reported condom use. Further, in the nonintervention control group, 22 of 90 male farmworkers reported sex with prostitutes at baseline, 26 of 90 reported using prostitutes at postinter-

orga_c09.qxd

2/5/07

10:54 AM

Page 277

Latino Health

277

vention, and none of these men reported any condom use. Further replications of the intervention are highly warranted and could be expanded to address more situational factors common to migrants, such as the role of excessive drinking in unprotected sex, sex between men, and sex with transgender individuals. HIV Prevention with Migrant Day Laborers A collaboration by the author at the University of California, Berkeley, and the city of Berkeley HIV/AIDS Program, which conducts outreach to migrant day laborers (MDLs), resulted in a convenience sample survey of risk in 102 predominantly Mexican migrant day laborers (Organista & Kubo, 2005), followed by the development, implementation, and evaluation of a pilot HIV prevention group (Organista, Alvardo, Balbutin-Burnham, Worby, & Martinez, 2006). Survey results indicated many of the usual risk factors in Mexican migrant men (e.g., unprotected sex with prostitutes, excessive drinking), and a follow-up focus group explored the context of risk for these day laborers, which included sexual risk taking while intoxicated and when feeling what the men called desesperación (desperation) due to lack of work and money, boredom, and missing family. Sex between men was discussed by an openly gay MDL in the focus group, as well as by heterosexual-identified men, one of whom reported being propositioned while performing day labor work for an informal employer. The pilot intervention group was conducted twice with a total of 23 MDLs, all of whom were pretested and 12 of whom were located for a 1month postintervention evaluation. The intervention focused primarily on (a) asking participants to share their personal goals in seeking work in the United States, including obstacles that interfere with such goals; ( b) asking participants to discuss HIV risk for MDLs in general, and for each participant personally, following a review of HIV/STD transmission and a hands-on condom use demonstration and exercise with phallic replicas; and (c) facilitating a discussion of various risk reduction strategies. Group process was meant to facilitate participatory learning health circles, as described by Magaña, Ferreira-Pinto, Blair, and Mata (1992), who advocate the use of círculos de salud (health circles) for HIV prevention with Latinos based on the empowering and progressive work of Brazilian educator Paulo Freire. Such health circles provide participants with basic information about HIV transmission and prevention, but aim at involving participants in active problem-solving discussion after posing risky situations and questions directly relevant to their lives. HIV-related discussion with the MDLs was facilitated by the creation of poster-size Mexican lottery game cards depicting relevant aspects of the MDL experience. Lotería is a Mexican card game like Bingo, but the

orga_c09.qxd

278

2/5/07

10:54 AM

Page 278

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

numbered cards also contain funny and dramatic Mexican images. For example, the card for El Borracho (the drunk) depicts a hunched-over intoxicated Mexican man, the card for La Muerte (death) depicts the Grim Reaper, and the card for La Escalera (the ladder) depicts a ladder symbolizing progress. The research team copied these images from actual barajas de lotería (lottery cards) but also created their own to depict HIV/AIDS issues commonly raised by Mexican migrants: La Prostituta (the prostitute), La Amante (the lover), and Sexo entre Hombres (sex between men). As with fotonovelas, the use of Mexican lottery cards is meant to facilitate HIV/AIDS-related discussion and self-reflection in ways consistent with expectations of the nature of Mexican social life and the spontaneity and humor that characterize social interactions (Carrillo, 2002). While preliminary results must be interpreted with caution given the very small sample of convenience and the loss of approximately half of the sample by follow-up evaluation, results are auspicious in that they indicate higher knowledge of correct condom use, increased levels of carrying condoms, and increased condom use with female sex partners. Such findings pave the way for taking this intervention beyond the pilot phase to a sufficiently funded, broader, and more rigorous application of culturally competent methods that evolved over the course of a rewarding, albeit challenging, 2-year collaboration between university and community. CONCLUSION In 1994, Vega and Amaro reported a mixed health prognosis for U.S. Latinos, noting various health issues and disease states for which Latinos were at higher and lower risk. Many of these major health problems and issues were reviewed in the current chapter with an eye toward situating them within the historical and current experiences of U.S. Latinos. This chapter also sought to illustrate many creative, promising, and effective approaches to socially and culturally competent health care with Latinos. Pervasive poverty for too many Latinos alongside a far too pervasive lack of health care insurance will continue to depress the negative side of the Latino health paradox, while a growing body of research will hopefully illuminate and build on the positive side in instructive ways. R EFER ENCE S Aguirre-Molina, M., Molina, C. W., & Zambrana, R. E. (2001). Health issues in the Latino community. San Francisco: Jossey-Bass. Alcalay, R., Alvarado, M., Balcazar, H., Newman, E., & Huerta, E. (1999). Salud para Su Corazón: A community-based Latino cardiovascular prevention and outreach model. Journal of Community Health, 24(5), 359–379.

orga_c09.qxd

2/5/07

10:54 AM

Page 279

Latino Health

279

Alderete, E., Vega, W. A., Kolody, B., & Aguilar-Gaxiola, S. (2000). Lifetime prevalence of risk factors for psychiatric disorders among Mexican migrant farmworkers in California. American Journal of Public Health, 90(4), 608–614. Balls Organista, P., Organista, K. C., & Soloff, P. R. (1998). Exploring AIDSrelated knowledge, attitudes, and behaviors of female Mexican migrant workers. Health and Social Work, 23(2), 81–160. Bandura, A. (1994). Social cognitive theory and the exercise of control over HIV infection. In R. J. DiClemente & J. L Peterson (Eds.), Preventing AIDS: Theories and methods of behavioral interventions (pp. 25 –59). New York: Plenum Press. Carillo, J. E., Treviño, F. M., Betancourt, J. R., & Coustasse, A. (2001). Latino access to health care: The role of insurance, managed care, and institutional barriers. In M. Aguirre-Molina, C. W. Molina, & R. E. Zambrana (Eds.), Health issues in the Latino community (pp. 55 –73). San Francisco: Jossey-Bass. Carrillo, H. (2002). The night is young: Sexuality in Mexico in the time of AIDS. Chicago: University of Chicago Press. Carter-Pokras, O., & Zambrana, E. (2001). Latino health status. In M. AguirreMolina, C. W. Molina, & R. E. Zambrana (Eds.), Health issues in the Latino community (pp. 23 –54). San Francisco: Jossey-Bass. Castañeda, D., & Collins, B. E. (1997). Structure and activities of agencies providing HIV and AIDS education and prevention to Latino/a communities. AIDS Education and Prevention, 9(6), 533 –550. Chang, G. (2000). Disposable domestics: Immigrant women workers in the global economy. Cambridge, MA: South End Press. Colon, H. M., Sahai, H., Robles, R. R., & Matos, T. D. (1995). Effects of a community outreach program in HIV risk behaviors among injection drug users in San Juan, Puerto Rico: An analysis of trends. AIDS Education and Prevention, 7(3), 195 –209. Diaz, R. M. (1998). Latino gay men and HIV: Culture, sexuality, and risk behavior. London: Routledge. Diaz, R. M., & Ayala, G. (2000). Social discrimination and health: The case of Latino gay men and HIV risk. Washington, DC: Policy Institute of the National Gay and Lesbian Task Force. Foreyt, J. P., Ramirez, A. G., & Cousins, J. H. (1991). Cuidando el Corazon: A weight-reduction intervention with Mexican Americans. American Journal of Clinical Nutrition, 53, S1639–S1641. Freire, P. (1993). Education for critical consciousness. New York: Seabury. Giacomini, M. K. (1996). Gender and ethnic differences in hospital-based procedure utilization in California. Archives of Internal Medicine, 156, 1217–1224. Guendelman, S., & Abrams, B. (1995a). Dietary, alcohol, and tobacco intake among Mexican-American women of childbearing age: Results from HHANES data. American Journal of Health Promotion, 8(5), 363 –372. Guendelman, S., & Abrams, B. (1995b). Dietary intake among Mexican-American women: Generational differences and a comparison with White non-Hispanic women. American Journal of Public Health, 85(1), 20–25.

orga_c09.qxd

280

2/5/07

10:54 AM

Page 280

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Guendelman, S., Chavez, G., & Christianson, R. (1994). Fetal death in MexicanAmerican, Black, and non-Hispanic women seeking government-funded prenatal care. Journal of Community Health, 33(5), 319–330. Guendelman, S., & English, P. B. (1995). Effects of United States residence on birth outcomes among Mexican immigrants: An exploratory study. American Journal of Epidemiology, 142(9, Suppl.), S30–S38. Guendelman, S., English, P., & Chavez, G. (1995). Infants of Mexican immigrants: Health status of an emerging population. Medical Care, 33(1), 41–52. Gutierrez-Ramirez, A., & Carter-Pokras, O. (1994). Cáncer. In C. W. Molina & M. Aguirre-Molina (Eds.), Latino health in the United States: A growing challenge (pp. 211–246). Washington, DC: American Public Health Association. Henry J. Kaiser Foundation. (2003, July). Key facts: Latinos and HIV/AIDS (#6088). Menlo Park, CA: Henry J. Kaiser Family Foundation. Holcomb, J. D., Lira, J., Kingery, P. M., Smith, D. W., Lane, D., & Goodway, J. (1998). Evaluation of Jump into Action: A program to reduce the risk of noninsulin dependent diabetes mellitus in school children on the Texas-Mexico border. Journal of School Health, 68(7), 282–288. Hunt, L. M., Hamdi Arar, N., & Akana, L. L. (2000). Herbs, prayer, and insulin: Use of medical and alternative treatments by a group of Mexican American diabetes patients. Journal of Family Practice, 49(3), 217–223. Hunt, L. M., Pugh, J., & Valenzuela, M. (1998). How patients adapt diabetes selfcare recommendations in everyday life. Journal of Family Practice, 46(3), 207–215. Hunt, L. M. Valenzuela, M., & Pugh, J. (1998). Porque me tocó a mi? Mexican American diabetes patients’ causal stories and their relationship to treatment behaviors. Social Science and Medicine, 46(8), 959–969. Inciardi, J. A., Surratt, H. L., Colon, H. M., Chitwood, D. D., & Rivers, J. E. (1999). Drug use and HIV risk among migrant workers on the DelMarVa Peninsula. Substance Use and Misuse, 34(4/5), 653 –666. Kottiri, B. J., Friedman, S. R., Neaigus, A., Curtis, R., & Des Jarlais, D. C. (2002). Risk networks and racial/ethnic differences in the prevalence of HIV infection among injection drug users. Journal of Acquired Immune Deficiency Syndromes, 30, 95 –104. Luchsinger, J. A. (2001). Diabetes. In M. Aguirre-Molina, C. W. Molina, & R. E. Zambrana (Eds.), Health issues in the Latino community (pp. 227–300). San Francisco: Jossey-Bass. Magaña, J. R., Ferreira-Pinto, J. B., Blair, M., & Mata, A., Jr. (1992). Una pedagogia de concientización para la prevención del VIH/SIDA [A pedagogy of conscientization for the prevention of HIV/AIDS]. Revista Latino Americana De Psicología, 24(1/2), 97–108. Maxwell, A. E., Bastani, R., & Warda, U. S. (2002). Pilot test of a single-session AIDS workshop for young Hispanic U.S. immigrants. Journal of Immigrant Health, 4(2), 73 –79. McAlister, A. L., Ramirez, A. G., Amezcua, C., Pulley, L., Stern, M. P., & Mercado, S. (1992). Smoking cessation in Texas-Mexico border communities: A quasiexperimental panel study. American Journal of Health Promotion, 6(4), 274 –279.

orga_c09.qxd

2/5/07

10:54 AM

Page 281

Latino Health

281

McBride, D. C., Weatherby, N. L., Inciardi, J. A., & Gillespie, S. A. (1999). AIDS susceptibility in a migrant population: Perception and behavior. Substance Use and Misuse, 34(4/5), 633 –652. Mishra, S. I., & Conner, R. F. (1996). Evaluation of an HIV prevention program among Latino farmworkers. In S. I. Mishra, R. F. Conner, & J. R. Magana (Eds.), AIDS crossing borders: The spread of HIV among migrant Latinos (pp. 157–181). Boulder, CO: Westview Press. Modiano, M. R. (1992). North American conference on cancer in Hispanics. Journal of National Cancer Institute, 84, 644. Murphy, J., Mueller, G., & Whitman, S. (1996). Epidemiology of AIDS among Hispanics in Chicago. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 11(1), 83 –87. Murphy, S. L. (2000). Deaths: Final data for 1998: National Vital Statistics Reports, 48, 11. Hyattsville, MD: National Center for Health Statistics. National Center for Health Statistics. (2000). Health, United States, 2000, with Adolescent Health Chartbook. Hyattsville, MD: Author. Organista, K. C. (2004). HIV prevention models with Mexican farmworkers. In R. J. Mancoske & J. D. Smith (Eds.), Practice issues in HIV/AIDS services: Empowerment-based models and program applications (pp. 127–160). Binghamton, NY: Haworth Press. Organista, K. C., Alvarado, N. J., Balbutin-Burnham, A., Worby, P., & Martinez, S. R. (2006). An exploratory study of HIV prevention with Mexican/Latino migrant day laborers. Journal of HIV/AIDS and Social Services, 5(2), 89–114. Organista, K. C., & Balls Organista, P. (1997). Migrant laborers and AIDS in the United States: A review of the literature. AIDS Education and Prevention, 9, 83 –93. Organista, K. C., Balls Organista, P., Bola, J. R., Garcia de Alba, J. E., & Castillo Moran, M. A. (2000). Predictors of condom use in Mexican migrant laborers. American Journal of Community Psychology, 28(2), 245 –265. Organista, K. C., Balls Organista, P., Garcia de Alba, G. J. E., Castillo Moran, M. A., & Ureta Carrillo, L. E. (1997). Survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers. Journal of Community Health, 22(3), 185 –198. Organista, K. C., Carrillo, H., & Ayala, G. (2004). HIV prevention with Mexican migrants: Review, critique, and recommendations. Journal of Acquired Immune Deficiency Syndromes, 37(Suppl. 4), S227–S239. Organista, K. C., & Kubo, A. (2005). Pilot survey of HIV risk and contextual problems and issues in Mexican/Latino migrant day laborers. Journal of Immigrant Health, 7(4), 269–281. Parker, R. G., Herdt, G., & Carballo, M. (1991). Sexual culture, HIV transmission, and AIDS research. Journal of Sex Research, 28(1), 77–98. Ramirez, A. G., & Suarez, L. (2001). The impact of cancer on Latino populations. In M. Aguirre-Molina, C. W. Molina, & R. E. Zambrana (Eds.), Health issues in the Latino community (pp. 211–244). San Francisco: Jossey-Bass.

orga_c09.qxd

282

2/5/07

10:54 AM

Page 282

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Ramirez, A. G., McAlister, A. L., Villarreal, R., Suarez, L., Talavera, G., PérezStable, E. J., et al. (1998). Prevention and control in diverse Hispanic populations: A national initiative for research and action. Cancer, 83(8), 1825 –1829. Ramirez, A. G., Suarez, L., McAlister, A., Villarreal, R., Trapido, E., Talavera, G. A., et al. (2000). Cervical cancer screening in regional Hispanic populations. American Journal of Health Behavior, 24(3), 181–192. Ramirez, A. G., Talavera, G. A., Villarreal, R., Suarez, L., McAlister, A., Trapido, E., et al. (2000). Breast cancer screening in regional Hispanic populations. Health Education Research, 15(5), 559–568. Ramirez, A. G., Villarreal, R., McAlister, A., Gallion, K. J., Suarez, L., & Gomez, P. (1999). Advancing the role of participatory communication in the diffusion of cáncer screening among Hispanics. Journal of Health Communication, 4, 31–36. Ruiz, J. D., & Molitor, F. (1998). Community-based HIV/STD prevention interventions among a community of migrant farm workers in California. California HIV/AIDS Update, 11(2), 21–25. Salgado de Snyder, V. N., Acevedo, A., Diaz-Perez, M. J., & Saldivar-Garduno, A. (2000). Understanding the sexuality of Mexican-born women and their risk for HIV/AIDS. Psychology of Women’s Quarterly, 24, 100–109. Salgado de Snyder, V. N., Diaz Perez, M. J., & Maldonado, M. (1996). AIDS: Risk behaviors among rural Mexican women married to migrant workers in the United States. AIDS Education and Prevention, 8(2), 134 –142. Sanudo, F. (1999). The effects of a culturally appropriate HIV intervention on Mexican farmworkers’ knowledge, attitudes, and condom use behavior. Unpublished master’s thesis, San Diego State University, Department of Public Health. Suarez, L., Ramirez, A. G., Villarreal, R., Marti, J., McAlister, A., Talavera, G. A., et al. (2000). Social networks and cáncer screening in four U.S. Hispanic groups. American Journal of Preventive Medicine, 19(1), 47–52. Vazquez, I. M., Millen, B., Bissett, L., Levenson, S. M., & Chipkin, S. R. (1998). Buena Alimentación, Buena Salud [Good nutrition, good health]: A preventive nutrition intervention in Caribbean Latinos with Type 2 diabetes. American Journal of Health Promotion, 13(2), 116 –119. Vega, W. A., & Amaro, H. (1994). Latino outlook: Good health, uncertain prognosis. Annual Review of Public Health, 15, 39–67. Viadro, C. I., & Earp, J. L. (2000). The sexual behavior of married Mexican immigrant men in North Carolina. Social Science and Medicine, 50, 723 –735.

orga_c10.qxd

2/5/07

10:54 AM

Page 283

C H A P T E R 10

Latino Power Political Participation, Policy Benefit, and the Role of Service Providers

THE OVERRIDING PREMISE of this book is that huge percentages of U.S. Latinos suffer disproportionately low rates of SES and compromised social welfare as a result of historical and current experiences of oppression on the basis of race, ethnicity, culture, immigration status, and other factors. In Chapter 1, the analysis of Latino acculturation histories showed that those groups with the most stressful acculturation experiences (e.g., Mexican Americans and Puerto Ricans), as reflected in protracted historical conflict with mainstream society and consequent oversegregation, poverty, and social marginality, continue to live out legacies of vulnerability to psychosocial and health problems. In Chapter 2, the analysis of social stratification of Latino ethnicity and power in the United States described how Latino inequality has been historically institutionalized by macro-social arrangements and standard ways of operating, frequently codified in laws and social policies and justified by dominant national narratives, ideologies, values, and cherished myths. The review of core SES data for Latinos (i.e., educational and occupational indicators) clearly shows an unacceptably slow rate of progress for those Latinos overly affected by poverty and low levels of political power. Yet, mainstream media and politicians insist on emphasizing the spectacular growth rate of Latinos and some sort of imminent rise to power and equality à la European immigrants. But such optimism is based on a half-truth, the false side of which requires macro-level economic, political, and cultural solutions to advance Latino social welfare. 283

orga_c10.qxd

284

2/5/07

10:54 AM

Page 284

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Chapter 3 described ways in which living under circumstances of stressful acculturation and social stratification can negatively affect the racial/cultural identity development of Latinos, as well as distort the race-related perceptions of Anglo-Americans. One of the pernicious consequences of socialization within a democratic social matrix tainted by oppression is to overattribute Latino social welfare to individual-level factors such as intelligence, ability, effort, merit, values, and culture. Such mainstream attributions serve to justify and stabilize Latino inequality and suggest minimal interventions designed mostly to fix Latinos. But with greater awareness of historical and current social forces, we can more accurately see Latino inequality as powerfully shaped by the uneven Latino experience in America. As such, implications for practice should expand to include working at various macro levels to change Latino welfare compromising social structures and environments, social policies and laws, and unfair business as usual standard ways of operating. These suggestions may at times sound abstract to the academic and professional training of social workers, educators, and medical and mental health professionals, but some basic grounding in Latino politics helps to demystify a social justice approach to service delivery and paves the way for political arena involvement and macro-level changes. Hopefully some of the meso- and macro-level interventions reviewed in Chapters 6 through 9 (e.g., full-service schools in Dominican and Chicano communities, communitywide cancer prevention and control on the Texas-Mexico border by the National Hispanic Leadership Initiative in Cancer) illustrate urgently needed, policy-relevant ways to promote Latino well-being that depart from inadequate, institutionalized care or lack thereof. This chapter emphasizes Latino-relevant policy issues and ways that service providers can be more involved at this level. L AT I NO P OW E R ? W E L L , Y E S A N D NO In her seemingly mistitled book, Out of the Barrio: Toward a New Politics of Hispanic Assimilation, Linda Chavez (1991) claims diminished discrimination aimed at Latinos, criticizes Latino leaders’ civil rights agenda, and overfocuses on positive indicators of Latino upward mobility in America. Latinos have indeed progressed in many of the ways described in Chavez’s selective review of the literature, but it is the unacceptably slow pace of progress for America’s most oppressed Latinos that continues to exact massive tolls on Latino youth, families, and communities, as carefully documented in Chapters 6 through 9. Chavez’s lack of sufficient problem emphasis (or politically savvy omission?) was undoubtedly instrumental in her presidential cabinet nomination by George W. Bush to

orga_c10.qxd

2/5/07

10:54 AM

Page 285

Latino Power

285

head the U.S. Department of Labor in 2000. But like her writings, her appointment was strongly attacked by Latino and labor leadership, who publicized enough incriminating evidence to have the nomination overturned (e.g., like many middle-class Americans, she had a history of hiring undocumented Latino laborers to help out at home). Such actions reflect how almost unbearable it is for those that truly represent impoverished Latinos to listen to Chavez’s (1989) rhetoric about Latinos rising to the top of society like a “Tequila Sunrise”! Perhaps a more fitting title for her book would be Out of (Touch with) the Barrio. In addition to the trite remedies offered by Chavez (i.e., learn English, get an education, apply for citizenship, and vote), socially and culturally informed macro-level policy analysis and interventions are imperative for advancing Latino SES, political and cultural power, social capital, and even national image in truly significant ways. HUMAN SERVICE PROVIDERS AND

THE

POLITICAL ARENA

A basic understanding of Latino political participation and incorporation, and how service providers can play important political roles, is key to promoting Latino social welfare on a broad scale. Yet the idea of political support, advocacy, and activism on behalf of a client group is too infrequently a part of academic, professional, and research training. Indeed, political involvement might even be discouraged and looked down upon at the agency level, leaving most service providers to experience a disconnect between political involvement and their seemingly “neutral” professional roles. This doesn’t mean that national professional organizations, such as the National Association of Social Workers (NASW) or the American Psychological Association (APA), don’t weigh in on important political matters relevant to the profession; it means that the average practitioner has but a vague sense of how to become involved at the local level on behalf of client groups such as Latinos. In their book Affecting Change: Social Workers in the Political Arena, sixth edition, Haynes and Mickelson (2006a) remind social and human service professionals that though they may lack background training in politics, they do possess a variety of skills and talents for operating in the political arena on behalf of clients. At a minimum, such skills include acquired expertise on specific client and community problems, knowledge about service gaps, and which service elements constitute best practices. Service providers also possess access to agency records and data that can be very relevant to policy development and advocacy. Mindful of vague legal restrictions on the political activities of human service professionals, Haynes and Mickelson (2006b) summarize what’s

orga_c10.qxd

286

2/5/07

10:54 AM

Page 286

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

allowed while on the job and what isn’t according to the Hatch Act, which was enacted in 1939 and updated in 1993 to limit the partisan political activities of government employees (i.e., those employed by the federal executive branch and state and local executive agencies). Table 10.1 specifies these restrictions. Haynes and Mickelson (2006b) admit that exactly whom the Hatch Act covers is not always clear and that service providers should seek out such information (e.g., from their professional organizations, agency administrators). For example, service providers working for a nonprofit, taxexempt organization are still subject to the restrictions, given their agency’s government-related funding streams (Thompson, 1994). Of course, as citizens, service providers have the same rights as others to involve themselves in partisan politics while off duty.

Table 10.1 Limits on Partisan Political Participation of Federal Government Employees Allowable

Not Allowable

Register people to vote

Register voters for only one party

Assist in voter registration drives

Campaign for/against candidates in partisan elections

Express opinions about candidates and issues

Collect contributions, sell tickets for political fund raising

Contribute funds to political organizations

Join campaign activities to elect partisan candidates

Sign nomination petitions

Distribute campaign materials in partisan election

Wear political buttons and political messages while off duty; support nonpartisan organizations

Organize or manage political rallies

Campaign on referenda, constitutional amendments, and municipal petitions

Circulate nomination petitions

Be a candidate for nonpartisan elections (e.g., independent party candidate), or local offices such as school board or city council, which do not involve fund raising

Be a candidate in partisan elections

From “ The Practitioners Influence on Policy ” (pp. 82– 95), by K. S. Haynes and J. S. Mickelson, in Af fecting Change: Social Workers in the Political Arena, sixth edition, K. S. Haynes and J. S. Mickelson (Eds.), 2006, New York: Longman.

orga_c10.qxd

2/5/07

10:54 AM

Page 287

Latino Power THE DYNAMICS

OF

287

LATINO POLITICAL POWER

Determinants of Political Participation Political involvement in Latino-relevant social issues depends on a basic understanding of central historical and ongoing issues. In J. A. Garcia’s (2003a) analysis of Latino politics in America, he notes that political participation, or actions to influence the policy-making process, depends heavily on a group’s resources and recruitment into the political process. Not surprisingly, SES and related resources (e.g., time, money, and skills that transfer to the political arena) are the most powerful determinants of political participation. Other determinants include socialization into the political process (e.g., parental role models) and a positive psychological disposition toward politics. With regard to recruitment, elected officials and their representatives engage in efforts to mobilize different groups in society and must consider issues such as timing and degree of nonparticipation in a group (e.g., youth voting age, ineligible noncitizens and felons, those uninterested in politics). These disadvantages translate into the problematic political profile that was sketched out in Chapter 2 (Table 2.6), where it was noted that Latino political participation and representation continue to be very low in America, with the exception of Cuban Americans, and that the majority of Latinos are ineligible to vote either because they are too young or are noncitizens. It should also be noted that far too many eligible Latinos are not registered to vote. The net effect of such background characteristics is a Latino electorate that is only a fraction of what it could be based on the population size of U.S. Latinos. Such a pervasive lack of political participation means little to no role in social policy development and benefit. Public Policy Done to Latinos Consistent with the theme of Latino subordination running throughout this book, Hero (1992) has developed a model of Latinos in the U.S. political system that he refers to as “two-tiered pluralism.” This model describes the condition of Latino citizens as characterized by equal legal rights to participate in the political process, coupled with lower social and political status due to social structural and historical subordination. Thus, whereas conventional pluralism presumes relative equal opportunity for different groups in society to compete for resources and power (i.e., to become politically active in a variety of ways), two-tiered pluralism acknowledges historical conditions of racism and discrimination that have marginalized certain groups and set into motion entrenched legacies of unequal power and opportunity and limited political clout.

orga_c10.qxd

288

2/5/07

10:54 AM

Page 288

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

In Figure 10.1, the first diamond-shaped tier, which actually contains the second tier, illustrates the healthy distribution of wealth for AngloAmericans; most are in the middle, with smaller proportions at the top and bottom. In sharp contrast, Latinos are concentrated predominantly in the less powerful second tier due to historical constraints on equality and continuing informal and institutionalized discrimination. The unhealthy triangular-shaped distribution of Latino (and African American) wealth conveys that relatively few have achieved even middle-class status. The position of Latinos as predominantly in the second tier underscores the well-known connection between low SES and low political clout.

Policy Arena

Stage of Policy Process

Developmental

Agenda Setting

Anglo (white) Allocational Policy Formulation

Policy Legitimation

First Tier Redistributive

Blacks

Second Tier

Policy Implementation Threshold (minorities as recipients of policies)

Latinos

ìFloor” of Individual Rights

Figure 10.1 Two-tiered political participation for Latinos. (Source: “Latinos and the Political System: Two-Tiered Pluralism” (pp. 189–206), by R. Hero, in Latinos and the U.S. Political System: Two-Tiered Pluralism, R. Hero (Ed.), 1992, Philadelphia: Temple University Press. Reprinted with permission.)

orga_c10.qxd

2/5/07

10:54 AM

Page 289

Latino Power

289

One of the results of the political predicament of Latinos is that their political demands have historically been those of a disadvantaged ethnic minority group striving for increased equality, primarily responded to by mediating institutions such as meager government assistance programs, welfare bureaucracies, nonprofit organizations, and political task forces charged with studying the status of minority groups. From a conventional pluralist perspective, the demands of ethnic minorities tend to be viewed as undeserving complaints because it is widely presumed that equality already exists, which of course is technically but not actually true (Hero, 1992). In contrast, the demands of first-tier occupants are rarely viewed as complaints because the politically powerful can more easily meet their needs through direct access to the political system and have little need for overt political activity to demand equality. It should also be noted in Figure 10.1 that being concentrated in the second tier means that Latinos have little power to set agenda, formulate and legitimate policy, or exercise political power in any broad sense. As a result, top-down public policy is generally done to Latinos because they are rarely its creators, despite being in the best position to understand and solve their own social problems. Only through increased political participation and representation can Latinos become more centrally involved with agenda setting and policy formation, legitimation and implementation, as depicted in Figure 10.1. Understanding the links between the dynamics of Latino voting and political representation, capable of influencing social policy, can help service providers to more clearly imagine different places in the political incorporation process in which they can participate to advance Latino social welfare. T OWA R D P O L I C Y B E N E F I T F OR U. S . L AT I NO S Using the state of California as a major example of Latino political incorporation, Fraga and Ramirez (2003) provide a framework and a decade’s worth of data to illuminate the complex dynamics of growing political power and remaining problems and issues. They begin by noting that between 1992 and 2000, Latinos doubled their percentage of the California electorate, from 7% to 14% of state voters, and that this increase significantly affected state politics: From 1990 to 2000, 11 elections were held [in California] for governor, U.S. senator, and president. Democrats have won nine of these races. In seven of these nine (78%) Latino voters were significant contributors to the winning Democratic candidates. Three of these nine successful Democratic candidates (i.e., one third) would not have won without the Latino vote. . . . Latino

orga_c10.qxd

2/5/07

290

10:54 AM

Page 290

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

voters utilized their growing percentage of the California electorate to vote consistently as a majority block in favor of Democratic candidates. (p. 316)

But Fraga and Ramirez (2003) also note that influencing the policy benefit for Latinos is not simply a function of the increasing Latino electorate or voters, but also the degree to which Latinos become elected to office— that is, Latino representation—and the degree to which such Latino representation can influence policy making by playing key roles in local government and state legislature. Such policy influence ranges from seats on local city councils and school boards to becoming partisan leaders, committee chairs, and assembly speakers at the state level. Thus all three dimensions—voting, representation, and policy making—are critical for service providers and others to understand in order to enhance Latino political incorporation, which Fraga and Ramirez define as “the extent to which self-identified group interests are articulated, represented, and met in public policymaking” (p. 304). ENHANCING

THE

LATINO ELECTORATE

Of course, growing Latino numbers all around the country eventually translate into an increase in voting power. However, service providers and others can significantly expedite this process by doing four basic, yet essential things: 1. Assist unregistered eligible Latinos with registration. For example, although the number of eligible Latinos registered to vote in California increased from 52% in 1990 to 62% in 1996, recent data show that of the more than 4.5 million eligible Latino citizens, only about half are registered (Fraga & Ramirez, 2003)! Thus, making Latino clients and community groups aware of such sobering numbers and of their potential influence on local, state, and national issues pertinent to Latino welfare represents one of the most viable direct strategies to enhance Latino political power. Service providers can push for same-day registration opportunities at voting sites. Piven and Cloward (1988, p. 13) made the strong case for public agency-based voter registration years ago, arguing that “if people could register in the course of using services in agencies as diverse as welfare, Social Security, nutrition, employment, agriculture, education, and day care, the United Sates would have universalized access to the electoral system.” They also reported on the success of an organization called Human SERVE that implemented agency-based voter registration in 16 states and 15 major cities.

orga_c10.qxd

2/5/07

10:54 AM

Page 291

Latino Power

291

2. Involve Latino youth in the political process, with their huge numbers and potential imminent political power. Alvarez and Butterfield (1998) studied Latino population growth in California from 1990 to 1995 and found that nearly 90% of the state’s net increase in Latinos (1,414,112) was due, not to migration, as popularly believed, but to a natural increase from U.S. births. Thus, well over a million Latino youth could possess significant voter influence by the time they reach 18, somewhere around 2015, but this will depend on how well we involve them in the political process. History and government classes represent viable school-based sites for integrating such a relevant lesson into the general curriculum. Service providers working with delinquent and gang-involved Latinos could integrate prosocial political involvement as a way of redirecting youths’ misspent time and energy to relevant youth and community issues. 3. Assist immigrant Latinos with applications for naturalization and consequent voting privileges. Even legal immigrants cannot vote unless they apply for citizenship through the process known as naturalization. J. A. Garcia (2003b) reports that fewer than half of all permanent residents in the United States have been naturalized, and that rates for Latinos have been the lowest of all immigrant groups, especially for Mexicans. Results from the National Latino Immigrant Survey found that while between 82% and 95% of respondents planned to apply for citizenship, only between 38% and 51% had only begun the process (DeSipio, 1997). Thus, service providers should be familiar with the criteria for naturalization in order to motivate eligible Latino immigrants to apply. Applicants must be 18 years of age or older; living as a legal permanent resident in the United States for at least 5 years; able to read, write, speak, and understand commonly used words in the English language; and able to demonstrate a basic knowledge of U.S. history and government. Fraga and Ramirez (2003) suggest that adult education and English classes are ideal sites for teaching immigrants about the naturalization process and its link to voting, citizenship, and civic duty. Mexicans, who constitute the majority of all U.S. immigrants, should also be informed that naturalization no longer means losing Mexican citizenship, now that Mexico honors dual citizenship. And though there will always be a few immigrants unwilling to pursue citizenship, data from the National Latino Immigrant Survey indicate that between 82% and 95% intend to do so. 4. Assist undocumented Latinos with citizenship applications. This is tricky business, given that failed applications can mean deportation, yet undocumented migrants with several years and investments in the United States, as well as with noneconomic hardships, may qualify

orga_c10.qxd

292

2/5/07

10:54 AM

Page 292

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

(L. R. Chavez, 1998). As mentioned in Chapter 4, such hardship refers to a compelling need to remain in the United States other than losing one’s job or not being able to attain comparable earnings in Mexico. Examples include family members with pressing problems (e.g., children or elderly with disabilities or chronic illnesses requiring services) who would suffer in Mexico due to inadequate services. Undocumented Central Americans can be urged to request sponsorship from employers to whom they are close (e.g., as in the case of domestic workers). However, requests for political asylum still rest on providing proof of political persecution, which is difficult for most. ENHANCING LATINO REPRESENTATION All of these recommendations will enhance the Latino electorate in America, but it remains necessary to have social policies in place designed to empower Latino voters by reducing institutionalized barriers to political representation. In their study of Latino incorporation in California, Fraga and Ramirez (2003) note small but impressive trends in the election of Latino state officials that are directly attributable to attaining Latino registration percentages at 40% and above in Latino-majority districts, which were created by the legislature to help Latinos elect candidates of their choice. Despite the controversial nature of creating majority-minority voting districts, the method clearly advances minority representation. In California, for example, Fraga and Ramirez note that all nine such Latino-majority districts elected Latino state officials in 1998. Further, between 1990 and 1998, the number of Latino state assemblypersons increased from 4 to 17, and Latino senators increased from 3 to 7. Fraga and Ramirez further note that the majority of these Latino state officials have been Democrats, thereby concentrating partisan political power, and that a large proportion have been women (e.g., almost a third of Latinos in the assembly and over half in the senate in 2000). The Endangered Voting Rights Act Latino-majority districts guarantee not only the election of Latinos, but also the long-term institutionalization of Latino political leadership. As such, the bipartisan practice of using census data to create such districts, allowable under the Voting Rights Act (VRA), needs to be defended. The VRA was enacted in 1965 to enhance the voting power of African Americans, who, like other ethnic minorities, have been historically unable to elect local officials in White-majority districts. Indeed, where Blacks and Latinos have been historically numerous (e.g., the South and Southwest, respectively), voting districts were purposefully created to disallow

orga_c10.qxd

2/5/07

10:54 AM

Page 293

Latino Power

293

racial and ethnic minority voting blocks in what is known as gerrymandering (this odd term derives from eighteenth-century Massachusetts Governor Elbridge Gerry, who created a salamander-shaped voting district). The VRA was amended in the early 1970s to include language minorities and has had a significant impact on Latino representation ever since. For example, J. A. Garcia (2003c) notes that there were only 5 Latinos elected to the U.S. Congress before the VRA amendments and that the number grew to 21 by the 1990s. He also notes that the VRA’s largest impact on Latino representation has been at the local level, where more than 10,000 such officials have been elected to school boards, city councils, and county boards of supervisors. But even with these gains, it is important to keep in mind that Latinos still compose only about 1% of all elected officials in America. Even in California, Whites still make up 75% of voters, which, if united, can easily overwhelm Latino voters, as was evident in the White block votes that passed anti-immigrant, antibilingual, and anti-affirmative action statewide referenda during the past 20 years (outlined in Table 10.2). Table 10.2 Anti-immigrant, Antibilingual, and Anti-Affirmative Action Referenda in California Latino-Relevant Referenda in California

Purpose and Outcome

Proposition 187

The so-called Save Our State proposition passed in 1994. Denied undocumented people access to publicly funded health, education, and social services, and even denied permanent resident aliens access to social welfare programs. Proposition 187 was immediately ruled unconstitutional for its multiple violations of federal and state laws governing basic human rights.

Proposition 227

The “English Language Initiative for Immigrant Children,” passed in 1998, replaced bilingual education programs in public schools (K–12) with one-year English-immersion programs.

Proposition 209

Removed state affirmative action provisions for both employment and higher education.

Proposition 54

The so-called Racial Privacy Act, defeated in 2003, would have prohibited state and local government from collecting information that includes reference to race and ethnicity.

orga_c10.qxd

294

2/5/07

10:54 AM

Page 294

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Interestingly, the combined agenda of these backlash referenda can be viewed as seeking to disempower Latinos by rolling back previous political gains won in areas central to Latino social welfare in the United States. However, it should also be noted that one of the great ironies of such polarizing propositions is that they resulted in the greatest surge of Latino voter registration and turnout, including immigrant applications for naturalization, in the history of California ( J. A. Garcia, 2003c; Fraga & Ramirez, 2003). To some degree, propositions have also alerted racial and ethnic minorities in California and progressive Whites of their common agenda, which probably helped to defeat Proposition 54 in 2003, the so-called Racial Privacy Initiative, which was designed to amend the California constitution by restricting state and local governments from collecting and using race and ethnic identifiers in public heath, schools, crime prevention, and civil rights enforcement. The author of Proposition 54 (and of Proposition 209), University of California Regent Ward Connerly, viewed it as a step toward a color-blind California; however, such a proposition would make it nearly impossible to address the deep and numerous health and racial disparities in California and the rest of society. Such superficial fixes to entrenched racial problems in America are naively premature at best and downright regressive at worse. In spite of continuing minority political disadvantage, there has been a predictable backlash against the VRA in states such as Texas, Louisiana, Georgia, North Carolina, New York, Illinois, and Florida, where it is frequently disparaged as “reverse gerrymandering.” Such a backlash ignores the racist institutional barriers that made the VRA necessary in the first place, and it generally comes from those with enough political power to render minority gains short-lived anyway. For example, in the North Carolina case of Shaw v. Reno in 1993, the constitutionality of using race to draw voting district boundaries to enhance the representation of ethnic and racial minority interests was strongly questioned by the U.S. Supreme Court, which outlawed the use of race as the predominant factor in drawing such districts. Thus, other factors such as poverty and community cohesiveness need to be considered. Fraga and Ramirez (2003) proactively urge elected Latinos to practice more inclusive politics by building coalitions and addressing issues that may include but go beyond Latino benefits. For example, California’s 1998 Healthy Families Initiative extends the availability of low-cost health insurance to the state’s 7 million uninsured, 50% of whom are Latino. Although this health policy does not cover a third of Latino children because of various eligibility criteria (e.g., restricted to citizens, documented residents in California before August 1996), it is an example of a

orga_c10.qxd

2/5/07

10:54 AM

Page 295

Latino Power

295

policy beneficial to the poor in general and Latinos in particular (Burciaga Valdez, 2003). Interestingly, in California, where Latinos have finally established a foothold in representative state politics, Governor Arnold Schwarzenegger launched a vigorous campaign in the fall of 2005 to redraw voting districts, complaining about their odd shapes (remember the salamander?), rather than simply awaiting the official voting district review period that happens with each new census. Not only would the governor’s off-cycle proposal have cost millions of unnecessary dollars, but it also appeared aimed at disempowering heavily minority and Democratic voting districts. Fortunately for Latinos, the measure was defeated at the polls, but it will predictably resurface throughout the United States. ENHANCING LATINO POLICY BENEFIT To what degree does increasing Latino representation result in the elusive prize of social welfare-enhancing policy benefit? Is influence at this macro level, especially in the priority areas of poverty, employment, health, education, and immigration reform, beginning to occur in ways that would be predicted by the political gains outlined earlier? Unfortunately, Fraga and Ramirez (2003) note that there is no existing research on the policy accomplishments of Latino legislators, whether in terms of policy interest articulation, agenda setting, or legislative enactment. However, these researchers conclude that the small but unprecedented growth of Latino representation in California can be influential. For example, in 1998, Latino Democrats constituted 54% of the majority in both the assembly and senate necessary to elect party leaders, including Antonio Villaraigosa as the second Latino speaker of the assembly, the first being Cruz Bustamante, who subsequently was elected to lieutenant governor, the first Latino statewide elected official in over 100 years! Though unsuccessful, Villaraigosa’s strong bid for mayor of Los Angeles in 2002 and Bustamante’s bid for governor of California in 2004 symbolize the growing confidence of Latino representatives to directly influence policy on city- and statewide levels. As noted in Chapter 2, such confidence and accruing political savvy resulted in the historic election in 2006 of Villaraigosa as the first Latino mayor of Los Angeles in 133 years! To the degree that policy development is advanced by Latino or Latinointerested officials, service providers can help by keeping abreast of the issues (local, statewide, national) and by offering their direct assistance to the process. Haynes and Mickelson (1997b) recommend that social workers volunteer to provide testimony, either alone or with clients, which is an essential and influential part of legislative deliberation on

orga_c10.qxd

2/5/07

296

10:54 AM

Page 296

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

senate bills. Such testimony can include presentations of case studies and relevant agency data, as well as speculation on policy implementation scenarios. These actions can be taken by individual service providers locally and by their professional organizations (e.g., NASW, APA) at regional, statewide, and national levels. Other potential areas of involvement are grassroots movements and formal Latino political organizations.

R E V I S I T I N G T H E L AT I NO P O L I C Y AG E N DA : T H E PE R S I S T E N C E O F S O C I O E C O NOM I C V U L N E R AB I L I T Y ECONOMIC DEVELOPMENT AND REFORM In a more functional model, social welfare policy would provide support for the tangible survival and instrumental needs of the populations whose participation in the market system has been most limited by societal factors, including Hispanics and their families. It would also be organized to support their socioemotional needs, intervene in crises, and deliver longterm support. There would be validation of the membership and capability of the Hispanic community to build upon its own strengths. There would be participation by those community members, creation or expansion of neighborhood-based services, and increasing control by the community itself. (McDonough & Korte, 2002, p. 245)

The functional model of social welfare suggested in this excerpt could be better supported by the slowly growing political power of Latinos, if not for powerful and well-orchestrated backlashes that frequently unravel the hard-won victories of Latino movements. For instance, although significant gains in Latino political power began to happen in the 1970s, the simultaneous disappearance of community based organizations (CBOs) in the Latino community undermined such gains, as well as advances made by Latino movements and the War on Poverty during the 1960s. In their economic analysis of Chicano communities in southern California, Moore and Vigil (1993) conclude that despite massive federal spending on CBOs, which spearheaded significant improvements in Latino education, medical and mental health care, and relations with the police, the criminal justice system, and the INS, funding rapidly dried up during the 1970s and 1980s due principally to the growing political momentum to shrink the welfare state, economic recession, and a few scandals in young and inexperienced Latino CBOs. The loss of Latino-focused CBOs left hundreds of thousands of community members without adequate safety nets for coping with the continued disappearance of core sector jobs in unionized industrial plants (i.e., eco-

orga_c10.qxd

2/5/07

10:54 AM

Page 297

Latino Power

297

nomic restructuring). Since then, there have been few alternatives but to join the ranks of the working poor as part of the dramatic rise in service sector work, or what Moore and Vigil (1993, p. 33) refer to as “low wage reindustrialization.” Thus, while lower and working-class Americans have generally been hurt by economic restructuring during the second half of the twentieth century (e.g., downsizing industry, corporate outsourcing of jobs abroad, sharp increase in dead-end service sector work), Latinos have been especially vulnerable given the short half-life of their meager policy benefits. President Reagan’s Blueprint for Today’s Ultraconservativism The election of President Reagan during the 1980s and his administration’s New Federalism legislative agenda drastically slashed federal government spending on social welfare programs for the poor, forming the blueprint for today’s hyperconservative ideology toward poverty, or the belief that poverty is a moral failure not to be subsidized by government. Yet by the end of Reagan’s second term as president, instead of the “trickle-down economics” promised, the national debt had doubled, the stock market had crashed, and homelessness in America had surged. As noted by De La Rosa (2000), Reaganomics was further solidified in the 1990s with huge Republican wins in the 1994 congressional elections and their Contract with America legislative agenda, which was codified into law with the passage of the 1996 Personal Responsibility and Work Opportunity Act. The fact that less than 25% of poor Americans can actually escape poverty (Rothman, 2002), and that little “work opportunity” or living wages exist beyond the service sector jobs of the working poor, somehow seems to elude self-proclaimed “compassionate conservatives” in their mission to shrink big government (and its safety nets for the poor) while expanding the corporate sector through corporate welfare, or the use of taxpayer money to supplement the expenses and losses of big business. The result has been a continuously widening gap between rich and poor, paid for by the working and middle classes. If the average American was more aware of how relatively little tax money goes to the poor and to basic public facilities (i.e., public schools, parks and recreation, waterworks), and how many billions in taxes subsidize rich corporations that return almost nothing to the people (e.g., jobs, cheaper products and services) or to the government (tax revenue), there would be a renewed commitment toward lifting Americans out of poverty while stemming corporate greed. In-depth discussion of this topic is beyond the scope of this book; awareness of corporate welfare is detailed by

orga_c10.qxd

298

2/5/07

10:54 AM

Page 298

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

writers and organizations such as Barlett and Steele (1998), Citizens for Tax Justice (2002), and Nader (2000), which are briefly outlined next to put welfare for the poor into proper perspective. CORPORATE RECIPIENTS

OF

WELFARE

Under the guise of misnomers such as “public-private partnership” and even “economic development,” corporate welfare costs taxpayers billions annually in higher prices and lost revenue. Rothman (2002) writes that such welfare for the rich and corporate business class has been estimated at $60 billion in industry-specific tax breaks annually, and another $75 billion in government spending that directly benefits business. He notes that the government contributes about $100 million every year to help major U.S. corporations advertise their products abroad. Corporate welfare recipients such as McDonald’s, Mars candy, Campbell’s soup, Miller beer, and Gallo wine defend government subsidies on the basis of remaining competitive in the global economy and thus better able to provide cheap products and job opportunities. But how likely is it that Mexican farmworkers picking grapes for Gallo will experience any benefit from their tax contribution to this form of corporate welfare? No average American taxpayer, or small business for that matter, has the economic and political clout to directly influence politicians and economic policies or to coerce state and local governments to provide millions of dollars in tax exemptions or building project grants simply for deciding to start or expand a business or for merely threatening to move a business out of state. Yet entitled corporations routinely pit states against each other in giant welfare package bidding wars for precisely such reasons. For example, Marriot of Maryland claimed that its offices had grown too small for its 3,800 employees and threatened to move these jobs out of state. When the state of Virginia offered a multimillion-dollar welfare package to lure Marriot, Maryland counteroffered with a package estimated at between $31 and $47 million and won the bid (Nader, 2000). It was later revealed that Marriot had decided not to move before Maryland’s offer! Similarly, when the Stock Exchange threatened to leave New York a few years ago if tax breaks were not granted, Mayor Giuliani came up with an estimated $900 million in tax relief (which worked out to about $200,000 for each job retained). There is a long list of such uses of taxpayer money resulting in little if any real job gain for states, and in many cases actual job losses. For example, after the relatively poor city of Toledo, Ohio, came up with a $300 million welfare package to keep Chrysler’s Jeep plant in the city, the cor-

orga_c10.qxd

2/5/07

10:54 AM

Page 299

Latino Power

299

poration announced that it would decrease its workforce from 5,600 to 4,900 and would try not to go below 4,200 (Nader, 2000). In addition to a lack of jobs, most U.S. citizens are also having their tax money diverted from the major domains of public life, which continue to deteriorate and undermine the quality of life for most Americans. According to Nader (2000): • A third of schools are in need of extensive repair or replacement ($113 billion needed over 3 years to remedy). For example, a quarter of schools in Cleveland need replacement. Yet the city phased out athletic programs to save money, while $300 million in taxpayer money was used to build basketball and baseball arenas for multimillionaire team owners who do little to make tickets affordable to the city residents whose tax dollars built the stadiums. • About $9 billion in services are needed to restore and upgrade public parks in the United States. • The U.S. Department of Transportation estimates that just under $10 billion is needed to maintain public transportation at its current mediocre level. Another $4 billion would result in an upgrade of the public transportation system to “good.” • The Centers for Disease Control estimates that $140 billion over the next 20 years are needed to prevent 900 deaths and 1 million people from getting sick each year from bad public water. In an eight-part series on corporate welfare, Time magazine (Barlett & Steele, 1998) profiled Evansville, Arkansas, a town unable to secure a mere $750,000 from the state to remedy the problem of undrinkable water (due to sulfur, natural gas, and other petroleum products and E. coli contamination). Yet, Arkansas spent $7 million for a water and sewage treatment plant in nearby Jonesboro to lure Frito-Lay to the state. And this was only a small part of the total corporate welfare package of over $100 million in tax credits, industrial development grants, a 140-acre plant site, and a 20% discount on sewer bills for 15 years. As a subsidiary of Pepsi-Cola, which generates profits of over $20 billion annually, why would Frito-Lay need Arkansas taxpayer money, especially in return for a little over 150 new jobs?

Given what appear to be some obviously bad investments of taxpayer money, why do such forms of corporate welfare persist and even flourish? The answers are many but center around the tremendous political clout of large corporations, characterized by national organizations, millions of dollars in annual campaign contributions, and powerful lobbyists advocating for the maintenance and expansion of corporate welfare-related tax codes and various business and economic policies. Thus, the definition of corporate welfare is fairly straightforward. According to Nader (2000, p. 31):

orga_c10.qxd

2/5/07

300

10:54 AM

Page 300

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

If a program involves the government giving more to private companies than it gets back—that is, where it is engaging in a transaction that cannot be justified as a fair market value exchange—then it should be considered corporate welfare.

According to Nader, the welfare double standard for the rich and poor in America is characterized by an absence of public campaigns against corporate “welfare kings” versus imaginary “welfare queens” (the latter term popularized by President Reagan), no time limits on or regular reporting of corporate welfare versus the current 5-year time limits on welfare for the poor, and no welfare restrictions on foreign corporations like those repeatedly imposed on immigrants. All the conservative rhetoric about success through merit and rugged individualism simply does not apply to the most powerful of American businesses, while it is consistently used to portray the poor as unworthy of government investment. Perhaps corporate welfare would be worthwhile if corporations generating billions of dollars in profits annually simply paid their fair share of taxes. Imagine if they paid the 25% to 30% tax rate typically paid by the average middle-class American. Yet one of the greatest ironies of corporate welfare is that corporate recipients have made an art form out of paying back little to nothing in taxes into the very government that subsidizes them. For example: • The Citizens for Tax Justice (CTJ; 2002) report that current surges in corporate welfare, including those enacted by the Bush administration’s so-called Stimulus Bill, will cost ordinary Americans over $170 billion while driving corporate income tax down to a mere 1.3% of the gross domestic product by 2004, or the second lowest level in the past 6 decades. The CTJ goes on to profile 10 large profitable corporations (e.g., Microsoft, General Electric, Ford, IBM, GM, Worldcom), noting that while they received $29 billion in corporate welfare over the 2-year period from 2002 to 2003, they paid only 5.9% of their profits (approximately $135 billion) in federal income tax. During the 5-year period studied by CTJ prior to their report, it was found that during some years, many corporations paid less than 2% in taxes (e.g., Microsoft, WorldCom) and some paid no taxes at all (e.g., Enron, Colgate-Palmolive), despite profits in the billions. • In a 2003 Frontline television story, “Catch Us If You Can,” the Fortune 500 corporation Union Bank was featured for its clever tax break scheme, in which it would use client money to lease the entire rail transportation system of a small German town for billions of dol-

orga_c10.qxd

2/5/07

10:54 AM

Page 301

Latino Power

301

lars only to cancel the lease the very next day, so that it could be listed as a tax-deductible business venture (the German town received a few million for cooperating). It took years for the underfunded and understaffed IRS to bring Union Bank to a congressional hearing and to close the tax loophole. But once the IRS had succeeded, Union Bank went back to the same German town and leased its sewer system, canceling the transaction the next day. • In his book Perfectly Legal, Johnston (2003) describes a variety of complex ways that the superrich pay little to nothing in taxes, frequently consulting elite law firms and banks that have become experts at creatively manipulating tax codes and shelters (e.g., tax-exempt offshore business addresses). That billion-dollar corporations can wind up with a tax rate of less than 6%, thereby shifting the disproportionately unfair tax burden onto American workers and taxpayers while receiving billions in corporate welfare and returning nothing to taxpayers in the way of good jobs with living wages and benefits, is the real welfare problem in America—not the pittance begrudgingly meted out to the working poor trapped in the deadend service sector because American big business would rather maximize profits by outsourcing jobs abroad rather than pay working-class Americans a decent living wage and basic benefits. UNDERSTANDING LATINO POVERTY The socioeconomic vulnerability of most U.S. Latinos will continue to require multiple strategies, ranging from enhancing the Latino policy benefit to continued grassroots movements at the local level and the ongoing efforts of various formal Latino organizations. Without Latino input, policies designed to combat poverty will continue to miss their targets in the Latino community. The Urban Institute (1995) asserts that antipoverty policies aimed at the dislocated, unemployed, and “underclass” (e.g., poor African Americans) continue to miss the fact that most Latinos are working poor, and that even pro-immigrant policies miss the twothirds of Latinos who are U.S.-born. In their book In the Barrios: Latinos and the Underclass Debate, Moore and Pinderhughes (1993) present a series of reports demonstrating how Latino poverty is different from African American poverty (with the exception of Puerto Ricans): Among Latinos, both work participation and marriage rates are higher than the national average ( because of continuous immigration), there has been less of an exodus of middle-class Latinos ( because of family ties to the barrios), and the sale of illegal drugs has occurred on a much smaller scale. Thus,

orga_c10.qxd

302

2/5/07

10:54 AM

Page 302

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

viable solutions to Latino poverty need to be based on the characteristics of Latino economic vulnerability. In De La Rosa’s (2000) plan of action to combat Latino poverty, he advocates a pair of ideas to stimulate economic development in the barrio and to subsidize working poor Latinos. First, the federal government should implement the 1992 Enterprise Zone Act in all Latino barrios where the poverty rate exceeds 20% (not 45%, as currently prescribed). This Act provides tax breaks in exchange for businesses locating within impoverished communities and agreeing to hire at least 30% of their workforce locally. De La Rosa’s adjustment to the Act would broaden its application beyond underclass to working poor communities. The second recommendation is to provide monthly cash transfer payments to all working poor persons equal to 150% (not 100%) of the poverty threshold established annually by the government. For example, based on the 1998 poverty threshold of $16,450 for a family of four in which parents are not currently working, annual cash assistance would amount to $24,675 or 150% of $16,450. In the case where working parents earn $12,000 annually, then the federal government would subsidize the difference of $12,675 to achieve 150% of the poverty threshold of $16,450. Americans have been conditioned to recoil at the idea of cash incentives for the taxpaying working poor; however, such incentives should be viewed in contrast to corporate recipients of welfare, as discussed earlier. Lifting taxpaying citizens out of poverty is a good investment for the country. De La Rosa imagines reaching this lofty goal through the development of a political action committee or coalition of professional and political Latino organizations (such as those outlined later in the chapter), including professional service organizations, that can prioritize and publicize Latino poverty (e.g., raise money, conduct a major rally in DC, lobby the White House to appointment poverty-focused officials). IMMIGRATION AND WELFARE POLICY REFORM With over half of all U.S. immigrants coming from Mexico, including significant numbers of undocumented, immigration-related policy making during the 1990s concentrated on decreasing annual numbers, curtailing the use of public and social services, and making illegal immigration more difficult (DeSipio, 1997). The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) denies Social Security and food stamps to immigrants, including legal permanent residents; requires the sponsors of immigrants to be legally responsible for those unable to support themselves; mandates the INS to verify the eligibility of immigrants applying for public benefits; and authorizes deportation for

orga_c10.qxd

2/5/07

10:54 AM

Page 303

Latino Power

303

ineligible applicants. Criticism of PRWORA has influenced how the Balanced Budget Act of 1997 restored Social Security and Medicaid benefits to pre-PRWORA-eligible immigrants whose benefits had been terminated, and how eligibility was extended to those in the country as of 1996 who had become disabled. The Agricultural Research Act of 1998 restored food stamp benefits to pre-PRWORA-qualified immigrant children, those that were receiving disability assistance, and the elderly (Kilty & Vidal de Haymes, 2000). Thus, criticism of policies that deny the most basic help to the most vulnerable members of society (e.g., children, elderly, disabled) can temper extreme and insensitive measures. Militarization of the U.S.-Mexico Border With the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, increased militarization of the U.S.-Mexico border continued to be a high policy priority to curb illegal immigration. The Act built on 1994s “Operation Gatekeeper” by erecting a 14-milelong steel wall, increasing the number of border patrol agents and providing them with paramilitary training, and authorizing 5,000 soldiers for border patrol duty in 1989 (Kilty & Vidal de Haymes, 2000). A tragic outcome of these policies has been the continuously mounting deaths— more than 2,000 so far—of Mexicans who attempted to cross in less guarded but more dangerous border areas (e.g., precarious mountainous and desert areas beyond the fence). U.S. dependence on essential Mexican labor makes such lethal immigration policies a cruel contradiction in urgent need of reform (e.g., some form of regulating the crossing of laborers to meet worker and corporate needs). Instead, Congress drafted an inflammatory bill in spring 2006 advocating not just the criminalization of an estimated 11 million undocumented migrants, composing 5% of the U.S. workforce, but making the crime a felony, sealing the U.S.-Mexico border, and deporting massive numbers of immigrants (as was done to Mexican immigrants in 1929 when the economy collapsed and they made handy scapegoats with very little power). A far more immigrant-friendly counterbill soon emerged in addition to an unprecedented grassroots movement of Latinos across the country expressing moral outrage at the first bill as well as galvanized political voice and power. The absurdity of Mexico-related immigration policies, or perhaps the cold logic in allowing U.S. corporations and capitalists to manipulate a huge, cheap, and exploitable workforce, partly through the historical legal production of illegal workers (De Genova, 2004), has been discussed by various immigration scholars who study the uniqueness of the Mexican case. For example, Sassen (1990, pp. 382–383) concludes:

orga_c10.qxd

2/5/07

304

10:54 AM

Page 304

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

The implications for the Mexican case are clear. Migrations are produced. The mere fact of a shared border and inequality in wages between the two countries is not sufficient in itself to account for immigration. The construction of railroads in the 1800s, the development of commercial agriculture, and now the development of the Border Industrialization Program are all processes that created a labor market. The fact that this labor market was eventually divided by a patrolled border led to contradictions in the legislation covering both halves. Secondly, if the United States through its economic activities, has incorporated Mexican workers and Mexican areas into a broader international organization of production, and if, furthermore, these activities promote the formation of migrations, then the United States must assume some responsibility for immigration of Mexicans into North America.

LANGUAGE AND EDUCATION POLICY REFORM For a brief moment in the 1960s and 1970s, it seemed as though the educational crisis of Latinos, as well as their anemic political participation, would be partially remedied when the U.S. Congress adopted the Bilingual Education Act of 1968 and when the VRA was extended to language minorities in the 1970s, eliminating linguistic barriers to voting (e.g., bilingual ballots). But as early as 1981, backlash campaigns to make English the official language were introduced into Congress every year. They finally began to succeed in as many as 17 states by 1990, either through initiative or legislative action. According to Schmidt (1997), proponents of English-only movements not only viewed English as essential to social mobility, but also feared national disunity based on a perception of Latinos as more interested in maintaining their culture of origin. Linda Chavez, former executive director of U.S. English, went as far as attributing the bilingual movement to selfish Latino leaders, whom she views as motivated by political self-interest, and insisting that Latinos should be free to embrace individualism through English rather than from government-imposed homogenization through culture maintenance. This is why, for example, critics of bilingual education advocate rapid transition to English programs over maintenance programs designed to support Spanish language and Latino culture while promoting English acquisition. Maintenance programs represent a pluralistic approach to bilingual education based not on a rejection of English and its obvious advantages, but on the right to linguistic nondiscrimination and cultural maintenance. While the assimilationist position of Linda Chavez imagines liberal individualism without barriers, pluralists recognize the historical role of English as the language of power and oppression in the United States. Thus they value cultural maintenance partly as protection against the marginality that results

orga_c10.qxd

2/5/07

10:54 AM

Page 305

Latino Power

305

when people of color are forced to assimilate without being provided with equal access, opportunity, and power (i.e., marginality). Results of the National Latino Political Survey (NLPS) strongly support a pluralist approach that places value on both English/American culture and Spanish/Latino culture. For example, NLPS results reveal that over 90% of U.S. Latinos agree that English should be learned, over 80% support bilingual education, over 70% favor bilingual education in which both languages are learned, and over 50% of Latinos disagree that English should be the official language, as compared to 80% of Anglos who also participated in the NLPS (Schmidt, 1997). Thus, politically powerful opponents of bilingual education are dismantling such programs against the will of Latinos on the basis of inaccurate perceptions of Latinos. For example, fears of Latino nationalism are hardly supported by the results form the National Latino Immigrant Survey, which tells us that over 95% of Latino immigrants intend to stay in the United States, that between 82% and 95% plan to become citizens, and that the majority either strongly or very strongly love the United States (DeSipio, 1997)! Service providers genuinely interested in empowering Latinos should find ways to promote bilingual education and other forms of linguistic access, freedom, and equality in democratic America. Not relinquishing the ideal of bilingual education is consistent with the recommendations of both researchers and government reports that have addressed the educational crisis of Latinos for decades. In his summary of this literature, Eugene E. Garcia (2003), dean of education at Arizona State University and former dean of education at U.C. Berkeley, concludes that there is simply no substitute for quality teaching, sensitive to Latino culture and linguistic needs, in addition to adequate school resources. Citing the 1998 U.S. Department of Education Report No More Excuses: Final Report of U.S. Hispanic Dropout Project, Garcia reiterates documented factors that reliably predict school success for Latinos and all children: preschool attendance, small class size in the early grades, more money spent per child, lower teacher turnover, and higher teacher satisfaction with school resources. Garcia is understandably critical of the current era of so-called educational reform, in which school accountability is mistakenly equated with high-stakes state testing, which results in the closing of poorly performing public schools or the reconstitution of such schools with new leadership, staff, and plans. Garcia concludes: Beyond the lack of evidence that supports the belief that these remedies will solve the problem of failing schools, the trouble with all of them is that they focus on changing governance and structure, rather than on improving teaching and learning in schools. For 30 years, research has shown what makes an

orga_c10.qxd

2/5/07

306

10:54 AM

Page 306

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

effective school where teaching and learning takes place; high expectations and standards for all students, curricula that mirror the standards, appropriate methods of standards-based assessment, strong principals, a safe and orderly environment, a high degree of parental involvement, teachers who are well-prepared in content and pedagogy, ongoing professional development for all teachers, and accountability throughout the school. As E. E. Garcia (1999) discusses in Student Cultural Diversity: Understanding and Meeting the Challenge, these characteristics can be found in the best schools, be they public, private, religious, charter, or reconstituted. (p. 81)

Thus, at the heart of the issue is the continuing inferior education of poor Latino children in the public schools. As an example, E. E. Garcia (2003) states that the 2000 case of Williams et al. v. The State of California et al., which charged that poor Latino and African American children are being given a public education far inferior to that provided their more privileged White counterparts throughout the state. The Mexican American Legal Defense Fund (MALDEF), which joined in the filing of this suit, was pleased with the state’s settlement of the case in summer 2004 because it agreed to abolish shorter school calendars that disproportionately affected poor students of color. One could easily imagine school social worker actions to support cases like Williams, such as providing testimony at hearings or local school data on structural and resource-related school deficiencies. Other sites for social worker advocacy exist all along the educational pipeline, where ruptures at each major junction decrease academic achievement. This is vividly illustrated in Figure 10.2 using the work of Solórzano and associates (Yosso & Solórzano, 2006), who analyzed data from the 2000 U.S. census, the National Center for Educational Statistics, and the National Survey on Earned Doctorates to show just how dramatically schools are failing Latino youth. Policy recommendations by these researchers include the following: (a) Make basic college entrance requirements the default curriculum for all students; ( b) increase access to academic enrichment programs such as elementary school gifted and talented education programs and high school advanced placement courses that underenroll Latinos; (c) make Latino parents aware of their right to opt out of vocational programs and inappropriate standardized testing and to opt in to Englishlanguage learner support and academic enrichment programs; and (d) decrease reliance on high-stakes and inappropriate testing and assessment. HEALTH CARE POLICY REFORM All of the Latino policy areas under discussion constitute different dimensions of the same old problem: SES vulnerability. Policy advances in the

orga_c10.qxd

2/5/07

10:54 AM

Page 307

100 Elementary School Students

46 Graduate from High School

17 Go to a Community College

26 Enroll in College

9 Go to a 4-Year College

1 Transfers to a 4-Year College 8 Graduate with a B.A. Degree

2 Earn a Graduate or Professional Degree

0.2 Graduate with a Doctoral Degree

Figure 10.2 Mexican Americans attain low academic outcomes at each point along the educational pipeline (2000). (Source: “Leaks in the Chicana and Chicano Educational Pipeline,” by T. J. Yosso and D. G. Solórzano, 2006, Latino Policy and Issues Brief, 13, pp. 1–3. Reprinted with permission.)

307

orga_c10.qxd

2/5/07

308

10:54 AM

Page 308

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

educational achievement of Latinos will also improve health, given the strong association between SES and health. But because educational reform and educating a population are long-term goals, policy makers need to extend and not limit health care benefits to Latinos as a way of saving the country massive expenses that will eventually result from neglecting the health of millions of U.S. Latinos and other poor populations. In her summary of the recommendations of Latino health professionals and researchers, Suarez (2002) highlights the following: (a) federal legislation to appropriate funds for the development and evaluation of health promotion and disease prevention programs for Latinos; ( b) such programs should integrate Latino community lay leaders and promotoras in development, implementation, and evaluation; (c) educational campaigns to raise Latino awareness through large and small local media and community networks; and (d) mass media marketing targeting Spanish-speaking Latinos regarding issues of health access and eligibility. Hayes-Bautista (2003) adds to this list the urgent need to increase the number of Latino medical doctors, noting that in California, for example, Latinos make up over 30% of the state population yet less than 5% of physicians. This amounts to a Latino-patient-to-Latino-physician ratio of 2,8931, as compared to a nonLatino-patient-to-non-Latino-physician ratio of 3351. De La Rosa (2000) concludes that we must revisit President Clinton’s ideas of universal health care for all Americans. This is consistent with Cornelius (2000), who advocates promoting health care as a human right and not a class privilege. At the least, De La Rosa suggests extending Medicaid programs to those at 150% (not 100%) above the current poverty threshold to better meet the health needs of working poor Americans. Burciaga Valdez (2003) recommends federal subsidies to enable small businesses to provide health insurance, given that they do not have the clout to extract corporate welfare from the government. This suggestion is based on the fact that about a third of Latinos are employed by small firms with fewer than 25 workers that can’t afford to provide health care benefits. In fact, three-quarters of all firms employ fewer than 10 employees and are thus in the same position. But government subsidies could easily make health care insurance available by dividing the cost among government, employer, and employee (i.e., small business welfare that enables both small businesses and workers). Health Policy for the Undocumented With regard to the health of the undocumented in America, Kullgren (2003, p. 1630) concludes: Intended to serve as a tool for reducing illegal immigration and protecting public resources, federal restrictions [PRWORA] on undocumented immi-

orga_c10.qxd

2/5/07

10:54 AM

Page 309

Latino Power

309

grants’ access to publicly financed health services unduly burden health care providers and threaten the public’s health. These deleterious effects warrant the public health community’s support of strategies to both repeal these restrictions and sustain the provision of health services irrespective of immigration status.

Although PRWORA does make a few exceptions in the case of emergency treatment, immunization, and health care for the children of undocumented born in United States, confusion about such minor exceptions inhibits undocumented parents from seeking family health care. Other compelling reasons for serving the undocumented include controlling communicable diseases in the general population, reducing the ethical dilemma of health professionals who are being told not to deliver the needed heath services that they were trained to provide, and the lack of cost effectiveness in using taxpayers’ money to provide emergency treatment but not the preventive services that would decrease such emergency care. But how can health care providers circumvent the PRWORA while avoiding legal challenge? Kullgren (2003) recommends that we introduce congressional bills at the state level to amend PRWORA to include primary and preventive care among the list of health services exempted from restriction, as was done by Texas representatives in the 107th congress. Until Latino political power can sufficiently marshal policy benefit to begin to remedy the long-standing policy agenda of U.S. Latinos, the work of grassroots political organizing and movements, in concert with the various types of formal Latino organizations, will need to continue the struggle to lift Latino social welfare.

G R A S S RO O T S P O L I T I C S A S A BA S E O F L AT I NO E M P OW E R M E N T While the Latino policy agenda struggles forward in fits and starts, spurts and setbacks, those who experience firsthand and on a daily basis the consequences that compromise social welfare will also continue to struggle, sometimes succumbing to vulnerabilities and sometimes surmounting them through personal and community agency. In spite of formal political underinvolvement, there has been a long, rich, and persistent history of Latino activism, primarily at the local level aimed at specific issues. Examples of past and ongoing Latino social justice movements provide insight into Latino initiative, agency, and resilience. Latino political activism, largely neglected by mainstream historians, is increasingly documented by Latino-interested scholars. The sample

orga_c10.qxd

310

2/5/07

10:54 AM

Page 310

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

offered in this section exemplifies what is still possible, and indeed necessary, in U.S. Latino communities, as Latino needs continue to be overlooked by mainstream social policy and politics. THE MOTHERS

OF

EAST LOS ANGELES

Pardo (1998) has documented the community activism of the Mothers of East Los Angeles (MELA), formed in the mid-1980s to defeat the first state prison planned for an urban setting. The prison proposal infuriated Gloria Molina, the first Latina assemblywoman, because 75% of L.A. County prisons were already located in her East Los Angeles district. But when her objections were dismissed by the California Department of Corrections and Governor Dukmejian, Molina, a seasoned Chicana feminist, took the fight to the grassroots level, where 8 years of marches, rallies, and litigation by the MELA eventually defeated the state. It is worth noting that Molina later became the first Latina elected to the Los Angeles City Council (1987–1991) and the first woman and first Mexican American elected to the Los Angeles Board of Supervisors, which oversees an annual budget of $13 billion (Pardo, 1998). Molina’s vacated assembly seat was won in 1986 by fellow Latina community activist Lucille RoybalAllard, who also worked to defeat the prison plan and was elected to Congress in 1992 ( J. A. Garcia, 2003d). Subsequent MELA activism prevented the construction of a toxic waste incinerator, also planned for East Los Angeles. A branch of MELA incorporated in 1990 as a nonprofit organization that has promoted water conservation, lead poisoning abatement, immunization awareness, and scholarships for college. Pardo’s (1998) research helps to tell the larger story of emerging Latino power by focusing on local community mothers sparked to action by locally elected Latina representatives and supported by Catholic parish priests, who defeat powerful state officials and corporations to protect their community. The fact that the pioneering elections of Molina and Roybal-Allard resulted from Latino-majority voting districts created under the VRA, which was expanded to include Latinos as a result of litigation on the part of MALDEF, helps us to connect the many dots of Latino political power. One particularly amusing MELA story comes from its defeat of a proposal by oil companies to construct a shallow oil pipeline from offshore rigs in Santa Barbara to Long Beach through the heart of East Los Angeles. This route would bypass affluent and predominantly White coastal cities such as Pacific Palisades. At one meeting, community members asked oil representatives why they didn’t run the pipeline along the coast,

orga_c10.qxd

2/5/07

10:54 AM

Page 311

Latino Power

311

to which one official replied, “Oh no! If it burst, it would endanger the marine life!” (Pardo, 1998, p. 132). Gendered Latino Politics As Pardo (1998) underscores, MELA is also the story of ordinary women doing extraordinary political things because they view their activism not as a violation, but as an extension of the traditional Mexican gender role to protect their families. Given this perspective, and extra measures to meet family obligations (e.g., early cooking and cleaning to free up time for meetings and marches), husbands were generally supportive, often driving their wives to political activities and occasionally participating themselves. Pardo’s analysis thus eliminates the commonly presumed boundary between public political and private domestic work for Latinas and reinserts women back into the center of their long history in Latino politics. Two Latino Thumbs Up for Salt of the Earth The 1953 movie Salt of the Earth portrays a dramatic reenactment of the Empire Zinc mining strike in New Mexico during the 1950s, in which the wives of Mexican miners replaced their husbands on the picket line when legal harassment and intimidation prevented the men from continuing their union-supported strike. Far ahead of its time, the film depicts how these strong Mexican women contested subordination by their husbands, who were initially unsupportive of their political involvement. The film includes leading Mexican actors in inspiring roles and was the only blacklisted film in America; director Herbert J. Biberman was sent to federal prison by the U.S. House Un-American Activities Committee as part of the red scare of the 1950s. This makes it a remarkable testament to the agency of those oppressed on the basis of social class, race, gender, and culture against powerfully oppressive corporate and legal systems. Such past and ongoing stories should inspire service providers and others not to underestimate the history and potential of Latinas to care for their families and communities by successfully blending political activism and Latino culture.

(CATHOLIC) CHURCH-BASED ACTIVISM The new role of the Catholic Church as a culture-based foundation for community activism continues to unfold in the aftermath of harsh criticism from Latino activists during the 1960s and 1970s for neglecting Latino social justice issues. Also, the fact that Latino immigration continues to revitalize and expand Catholic congregations throughout the United States has raised the Church’s accountability to the Latino community. Thus, service providers working with Latinos should make themselves aware of local Catholic Church community activism in order

orga_c10.qxd

312

2/5/07

10:54 AM

Page 312

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

to collaborate on ongoing campaigns and programs, involve clients where appropriate, and introduce new issues to Church coalitions. The Resurrection Project A particularly striking example of Catholic Church-driven community organizing and social justice work comes from the predominantly Mexican Latino community of Pilsen on Chicago’s Lower West Side. What is noteworthy about the Resurrection Project (TRP) is the Church’s leadership in empowering community residents to pursue central needs in nonpartisan ways. As reported by Grossman et al. (2000), TRP emerged in 1994, after years of coalition building among eight local Catholic churches, community organizations, and businesses, complete with by-laws requiring two-thirds community residents on the board of directors. With a budget of $25 million, four major programs are directed at some of the most pressing community needs: (a) community organizing to institutionalize local power by identifying and training indigenous community leaders to advocate for local issues (e.g., community policing, voter registration); ( b) family support services ranging from Head Start, day care, and parenting skills to housing programs for homeless women and children; (c) home ownership and financial services to develop low-income housing to replace inadequate housing and increase savings and loans options for residents; and (d) real estate and assets management to develop and renovate community-owned real estate to increase sustainability and affordability, increase tenant management of church-owned properties, and support a cooperative of minority-owned construction companies to participate. The Project’s United Power for Justice coalition of churches, residents, and nonprofit organizations aims to hold elected officials accountable to the needs of the Latino community. Further, general training classes offered to parishioners stress “the prophetic teachings of Jesus, the role of the church in seeking justice, and the importance of building people power for justice” (p. 141). F OR M A L L AT I NO P O L I T I CA L ORG A N I Z AT I O N S The history of the Latino political organization is as old as anti-Latino discrimination in the United States and Latino countermovements designed to promote survival and civil and human rights under often hostile conditions (outlined in Chapters 1 and 2). Many of the organizations profiled in Table 10.3 continue to prosper and enhance Latino social justice in America. They offer a wide variety of sites and specialties in which service providers and others can promote Latino social justice and welfare at the macro level by lending their professional skills,

orga_c10.qxd

2/5/07

10:54 AM

Page 313

Latino Power

313

Table 10.3 Latino Political Organizations Organization

History and Scope

La Alianza Hispano Americano (Hispanic American Alliance), Orden de Los Hijos de America (Order of the Children of America)

Nineteenth-century mutual aid societies that combated segregation and discrimination by providing basic, survivaloriented resources such as credit, burial insurance, and social services, especially to immigrants.

Mexican American Legal Defense Fund (MALDEF)

Los Angeles-based MALDEF, founded in San Antonio, Texas, in 1968, is a litigation organization with a $6.5 million annual budget, with additional offices in San Antonio, Atlanta, Chicago, Houston, Sacramento, and Washington, DC. Its staff of 75 employees includes 22 attorneys, 10 legislative and policy analysts, and outreach staff to promote community education and leadership. MALDEF focuses on the central Latino program areas of education, employment, immigrant rights, political participation, and public resource equity (fair share of government services) and access to justice. MALDEF was instrumental in litigation that expanded the VRA to include Latinos and other language minorities. In Tyler v. Phloe, MALDEF won free access to public education for undocumented children living in the United States.

League of United Latin American Citizens (LULAC)

Founded in Texas in 1927 as a nonpartisan organization of Latino citizens designed to promote assimilation, LULAC eventually fought the segregation of Mexican students in Texas and California. Now a DC-based, inclusive, Latino multi-issue membership organization.

Puerto Rican Legal Defense and Education Fund (PRLDEF)

Like MALDEF, a litigation organization founded in the 1970s that assisted with expansion of the VRA to language minorities. In Aspira v. New York, PRLDEF litigated for bilingual education and service rights for Puerto Rican and other languageminority students. (continued)

orga_c10.qxd

314

2/5/07

10:54 AM

Page 314

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Table 10.3

(Continued)

Organization

History and Scope

Cuban American National Foundation (CANF)

Founded in 1981 as an anti-Castro, anticommunist exile organization, CANF has been successful in winning asylum status for Cuban refugees and support for their adaptation and promoting foreign policy that isolates Cuba (e.g., trade blockade).

Southwest Voter Registration Project (SVRP), Midwestern Voter Registration Project (MVRP)

SVRP and MVRP have conducted campaigns to register eligible Latinos to vote for over 25 years, of ten timing their efforts to coincide with local elections.

Dominican American National Roundtable (DANR)

A recent civic organization, serving as an umbrella for over 60 local Dominican groups to promote adaptation in the United States.

Congressional Hispanic Caucus (CHC)

From 5 Latino Congress members in 1976 to currently over 20, the CHC is designed to promote collective Latino agendas at the federal level (e.g., developing a pool of Latino candidates for Supreme Court vacancies). CHC efforts are limited by its generally Mexican American membership and Democratic politics, avoided by the few Latino Republicans in Congress.

National Association of Latino Elected and Appointed Officials (NALEO)

Nonprofit, nonpartisan organization founded in 1976 to enhance the effectiveness of all Latino representatives through assistance and training, networking, research reports, assistance with policy matters, and establishing Latino-inclusive priorities (e.g., its major campaign beginning in 1985 was to promote naturalization of Latino immigrants in order to vote).

making financial donations, and involving Latino community members. The few profiled here come from the work of J. A. Garcia (1993d) and feature some of the major historical and current political organizations, now spanning three centuries. TOWARD PAN-LATINO POLITICAL POWER? In 2000, 6-year-old Elian Gonzales was rescued by the U.S. Coast Guard after his mother and her boyfriend drowned at sea while trying to escape Cuba by sailing to Florida on a small boat. His story provided a

orga_c10.qxd

2/5/07

10:54 AM

Page 315

Latino Power

315

glimpse into some of the impediments to pan-Latino political power in the United States. While the boy’s uncle in Miami sought political asylum for Elian, the fact that he was taken without the permission of his father in Cuba sparked a national debate and an international political incident involving no less than Fidel Castro, the INS and Department of Justice, the Cuban American community, and even the Office of the President. The event climaxed with an INS raid of the home at which Elian was living after the family, backed by the Cuban community, refused to surrender the boy for return to Cuba. The position of the Cuban exile community in Miami is understandable, given their anti-Castro politics, but most other Latino groups, and most of America for that matter, placed the importance of reuniting the boy with his family above local and international politics. As can be seen in Table 10.3, national Latino political organizations such as the National Association of Latino Elected and Appointed Officials work to promote networking among all elected Latino politicians and appointed representatives, with the objective of identifying Latinowide priorities (e.g., naturalizing immigrants as citizens, language rights), building coalitions and thus consolidating nationwide Latino political power and impact. Although the Congressional Hispanic Caucus aims to do the same at the U.S. congressional level, it’s telling that Republican Latino congresspersons currently refuse to participate in the predominantly Mexican American and Democratic organization. Huge differences of opinion on Castro and the Cuban blockade make the inclusion of Cuban Republican congresspersons on the caucus highly unlikely, again underscoring major differences between Latino nationalorigin groups. Indeed, J. A. Garcia (2003e) has advanced a number of pan-Latino political scenarios, one of which depicts Cuban Americans as an “outlier,” whose predominant Republican political agenda and higher SES have separated them from most other U.S. Latinos. But even among the remaining U.S. Latino groups, Garcia acknowledges that pan-Latino politics may take on merely a symbolic form, in which groups such as Mexican Americans, Puerto Ricans, and Central Americans continue to pursue their own group-specific issues while occasionally invoking the term Hispanic or Latino as a device to enhance the perception of such issues at the national level. Still, Garcia is sticking to his chief scenario of growing pan-Latino political power based on what he terms a “community of interests.” With commonalities in culture, language, and history (including minority status, discrimination, and negative public image) as a basis, pan-Latino politics can simultaneously address Latino subgroup concerns and crosscutting concerns such as those brought up in this chapter (i.e., language

orga_c10.qxd

316

2/5/07

10:54 AM

Page 316

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

needs versus English-only movement, immigration reform, political participation needs, affirmative action). Garcia reports findings from the Latino National Political Survey (LNPS, de la Garza, DeSipio, García, García, & Falcón, 1993) to support his vision. The data, however, seem to convey a mixed picture. INTER-LATINO GROUP PERCEPTIONS, INTERACTION, AND AFFINITY The LNPS (de la Garza et al., 1993) data used to analyze Latino intergroup perceptions and behaviors, essential to pan-ethnicity, reveal low panethnic identification (i.e., as Hispanic or Latino) versus high nationalorigin identification (i.e., as Mexican, Puerto Rican, or Cuban), and generally low contact between groups, yet fairly positive intergroup affinity. For example, when asked the degree to which participants have contact with members of the three major U.S. Latino groups, less than 10% of respondents indicate “a lot” of such contact. However, when asked to rate how warmly they felt about other group members, using a “feeling thermometer” with a neutral midpoint of 50, ratings ranged from 53 to 67, indicating moderate affinity. When asked about similarity in cultural practices across Latino groups, over 50% of respondents perceived them to be “somewhat similar,” 20% said “very similar,” and yet a full 25% perceived “none”! When asked about similarities in political and economic interests, less than 10% of respondents perceived such interests to be “very similar,” and between a 25% and 42% said they were “somewhat similar.” Based on these data, we should not expect Latino pan-ethnic political clout on a national level any time soon. At the same time, we should confidently expect and facilitate growing Latino political participation, representation, and, hopefully, policy benefit on a group-by-group, issue-by-issue basis, which may be able to focus on many of the social welfare-enhancing issues of paramount importance to most U.S. Latinos. Service providers should not underestimate their own past and potential contributions to Latino political power in America.

R EFER ENCE S Alvarez, M., & Butterfield, T. L. (1998). Citizenship and political representation in contemporary California. Social Science Working Paper 1041, California Institute of Technology, Pasadena. Barlett, D. L., & Steele, J. B. (1998). Special report: Pt. I. Corporate welfare. Time, 152(19), 36 –54. Burciaga Valdez, R. (2003). Access to illness care and health insurance. In D. Lopez & A. Jimenez (Eds.), Latinos and public policy in California: An agenda

orga_c10.qxd

2/5/07

10:54 AM

Page 317

Latino Power

317

for opportunity (pp. 189–215). Berkeley: Institute of Governmental Studies, University of California, Berkeley. Chavez, L. (1989, Spring). Tequila sunrise: The slow but steady progress of Hispanic immigrants (Policy review). Washington, DC: Heritage Foundation. Chavez, L. (1991). Out of the barrio: Toward a new politics of Hispanic assimilation. New York: Basic Books. Chavez, L. R. (1998). Shadowed lives: Undocumented immigrants in American Society (2nd ed.). Stamford, CT: Wadsworth/Thomson Learning. Citizens for Tax Justice. (2002). Surge in corporate tax welfare drives corporate tax payments down to near record low. Available from http://www.ctj.org/html /corp0402.htm. Cornelius, L. J. (2000). Financial barriers to health care for Latinos: Poverty and beyond. Journal of Poverty, 4(1/2), 62–83. De Genova, N. (2004). The legal production of Mexican/migrant “illegality.” Latino Studies, 2, 160–185. de la Garza, R., DeSipio, L., García, F. C., García, J. A., & Falcón, A. (1993). Latino voices: Mexican, Puerto Rican, and Cuban perspectives on American politics. Boulder, CO: Westview. De La Rosa, M. (2000). An analysis of Latino poverty and a plan of action. Journal of Poverty, 4(1/2), 27–62. DeSipio, L. (1997). The engine of Latino growth: Latin American immigration and settlement in the Untied Sates. In F. C. Garcia (Ed.), Pursuing power: Latinos and the political system (pp. 314 –342). Notre Dame, IN: University of Notre Dame Press. Fraga, L. R., & Ramirez, R. (2003). Latino political incorporation in California, 1990–2000. In D. Lopez & A. Jimenez (Eds.), Latinos and public policy in California: An agenda for opportunity (pp. 301–335). Berkeley: Institute of Governmental Studies, University of California. Garcia, E. (1999). Student cultural diversity: Understanding and meeting the challenge. Boston: Houghton Mifflin. Garcia, E. E. (2003). K-12 public education: Bedrock or barrier? In D. Lopez & A. Jimenez (Eds.), Latinos and public policy in California: An agenda for opportunity (pp. 65 –85). Berkeley: Institute of Governmental Studies, University of California. Garcia, J. A. (2003a). Culture and demographics. In J. A. Garcia (Ed.), Latino politics in America: Community, culture, and interests (pp. 31–51). New York: Rowan and Littlefield. Garcia, J. A. (2003b). Education and voting rights. In J. A. Garcia (Ed.), Latino politics in America: Community, culture, and interests (pp. 187–215). New York: Rowan and Littlefield. Garcia, J. A. (2003c). Immigration and Latino immigrants. In J. A. Garcia (Ed.), Latino politics in America: Community, culture, and interests (pp. 166 –186). New York: Rowan and Littlefield. Garcia, J. A. (2003d). Building political alliances. In J. A. Garcia (Ed.), Latino politics in America: Community, culture, and interests (pp. 216 –240). New York: Rowan and Littlefield.

orga_c10.qxd

318

2/5/07

10:54 AM

Page 318

SELECTIVE REVIEWS

OF

MAJOR PROBLEM AREAS

Garcia, J. A. (2003e). The Latino community: Beyond recognition politics. In J. A. Garcia (Ed.), Latino politics in America: Community, culture, and interests (pp. 241–257). New York: Rowan and Littlefield. Grossman, S. F., Cardoso, R. M., Belanger, G., Belski, J., Corethers, T. C., Pettinelli, M. E., et al. (2000). Pilsen and the Resurrection Project: Community organization in a Latino community. Journal of Poverty, 4(1/2), 131–149. Hayes-Bautista, D. (2003). Illness and wellness: The Latino paradox. In D. Lopez & A. Jimenez (Eds.), Latinos and public policy in California: An agenda for opportunity (pp. 155 –187). Berkeley: Institute of Governmental Studies, University of California. Haynes, K. S., & Mickelson, J. S. (2006a). Affecting change: Social workers in the political arena, (6th ed.). New York: Longman. Haynes, K. S., & Mickelson, J. S. (2006b). The practitioner’s influence on policy. In K. S. Haynes & J. S. Mickelson (Ed.), Affecting change: Social workers in the political arena (6th ed., pp. 82–95). New York: Longman. Hero, R. (1992). Latinos and the political system: Two-tiered pluralism. In R. Hero (Ed.), Latinos and the U.S. political system: Two-tiered pluralism (pp. 189–206). Philadelphia: Temple University Press. Johnston, D. C. (2003). Perfectly legal: The covert campaign to rig our tax system to benefit the super rich—And cheat everybody else. New York: Portfolio. Kilty, K., & Vidal de Haymes, M. (2000). Latino poverty in the new century: Challenges and barriers. Journal of Poverty, 4(1/2), 1–22. Kullgren, J. T. (2003). Restrictions on undocumented immigrants’ access to health services: The public health implications of welfare reform. American Journal of Public Health, 93(10), 1630–1633. McDonough, K., & Korte, A. (2002). Hispanics and the social welfare system. In P. San Juan Cafferty & D. W. Engstrom (Eds.), Hispanics in the United States: An agenda for the twenty-first century (pp. 237–275). New Brunswick, NJ: Transaction. Moore, J., & Pinderehughes, R. (Eds.). (1993). In the barrio: Latinos and the underclass debate. New York: Russell Sage Foundation. Moore, J., & Vigil, J. D. (1993). Barrios in transition. In J. Moore & R. Pinderhughes (Eds.), In the barrio: Latinos and the underclass debate (pp. 27– 49). New York: Russell Sage Foundation. Nader, R. (2000). Cutting corporate welfare. New York: Seven Stories Press. Pardo, M. S. (1998). Mexican American women activists: Identity and resistance in two Los Angeles communities. Philadelphia: Temple University Press. Piven, F. F., & Cloward, R. A. (1988). New prospects for voter registration reform. Social Policy, 18(3), 2–15. Rothman, R. A. (2002). The dynamics of economic inequality. In R. A. Rothman (Ed.), Inequality and stratification: Race, class, and gender (4th ed., pp. 92–113). Upper Saddle River, NJ: Prentice-Hall. Sassen, S. (1990). Immigration policy toward Mexico in a global economy. Journal of International Affairs, 42(2), 369–383.

orga_c10.qxd

2/5/07

10:54 AM

Page 319

Latino Power

319

Schmidt, R., Sr. (1997). Latinos and language policy: The politics of culture. In F. C. Garcia (Ed.), Pursuing power: Latinos and the political system (pp. 343 –367). Notre Dame, IN: University of Notre Dame Press. Suarez, Z. E. (2002). Hispanics and health care. In P. San Juan Cafferty & D. W. Engstrom (Eds.), Hispanics in the United States: An agenda for the twenty-first century (pp. 195 –235). New Brunswick, NJ: Transaction. Thompson, J. J. (1994). Social workers and politics: Beyond the Hatch Act. Social Work, 39(4), 457– 465. Urban Institute. (1995, Winter/Spring). Policy implications of Latino poverty. Policy and Research Report, 10–12. Yosso, T. J., & Solórzano, D. G. (2006). Leaks in the Chicana and Chicano educational pipeline. Latino Policy and Issues Brief, 13, 1–3.

orga_c10.qxd

2/5/07

10:54 AM

Page 320

orga_z01bepil.qxd

2/5/07

10:55 AM

Page 321

Epilogue Adelante—Proceeding Forward

THIS BOOK HAS been a challenging yet exciting opportunity to deepen our understanding of Latino psychosocial and health problems and to describe in sufficient detail a number of real-life best and promising practices aimed at solving some of the most important and difficult problems and issues affecting various Latino populations in the United States today. Because no single book can address all of the important problems affecting Latinos, a major objective was to demonstrate general principles of cultural competence by concentrating on a few very important specific areas, and hence teaching practice by example and illustration. Hopefully such general principles of culturally competent practice can be transferred to the reader’s local area of practice and expertise in the spirit of thinking globally and acting locally. The illustrations and critiques of best and promising practices were guided by a comprehensive yet pragmatic new practice model for working with Latinos that spells out the four major practice dimensions that need to be included if we are to continue addressing multiple problem levels and solutions, from micro individual to meso community to macro social institutional. The integrative approach used throughout this book, applied to different Latino populations, theoretical frameworks, and problem areas, was intended to address the kinds of nonrandom problem patterns that affect racial and ethnic minority groups given the links of such problems to historical and current issues of injustice, marginality, and social injustice. During its development, this book was extensively reviewed by a number of thoughtful experts in the social sciences whose commentary and recommendations were used to strengthen the book’s content. These reviewers also underscored the continuing dilemma of needing to include more coverage of other important Latino groups (e.g., Dominicans, South and Central Americans) and problem areas (e.g., juvenile justice 321

orga_z01bepil.qxd

322

2/5/07

10:55 AM

Page 322

EPILOGUE

and prison systems, child abuse) that increasingly demand our concern and attention. I hope to remain informed of the growing research and writing in such areas and to integrate such work into future editions of this book, an opportunity I would welcome con mucho gusto. Similarly, books such as this need to remain in tune with topical political and cultural issues, activities, and events directly affecting Latinos, such as the current bitter and divisive debate on undocumented immigration and the U.S.-Mexico border policies. Clearly such issues could benefit from an integrative social science approach that describes their complex history and broader context. A social constructivist perspective teaches us that there is little if any neutrality in the social sciences and that it can be occasionally refreshing to have writers and thinkers be more up front about their biases. Although I made great efforts to offer balanced perspectives in this work— as much as was humanly possible—I also had to make peace with what I needed to say. How could I not be biased from my own Chicano experience of being born and raised in East Lost Angeles during the eventful 1960s and 1970s? I believe we still need to hear from voices throughout the Latino experience in America, as well as from Latino interested scholars and practitioners, to better understand and help ourselves and each other. I sincerely hope this book serves to promote such understanding and action.

orga_z02bindauth.qxd

2/5/07

10:55 AM

Page 323

Author Index A Abrams, B., 248 Acevedo, A., 272 Acharya, A., 171 Acosta, F. X., 151, 233 Acuña, R., 14, 15, 18 Adams, R. M., 185 Aguilar-Gaxiola, S., 220, 221, 222, 223, 227, 271 Aguirre-Molina, M., 245 Akana, L. L., 257 Alcalay, R., 253 Aldarondo, E., 154 Alegria, M., 218 Alipuria, L., 78 Alvarado, M., 253 Alvarado, N. J., 275, 277 Alvarado-Rosemann, P., 169 Alvarez, I., 194 Alvarez, M., 291 Amaro, H., 144, 245, 246, 278 Ambler, C., 173 Amezcua, C., 262 Andrews, J. W., 167 Aneshensel, C. S., 185, 193 Angel, R., 218 Anglin, M. D., 187 Annis, R. C., 7 Aponte, J. F., 229 Apospori, E., 186 Aranda, M. P., 173 Arce, C. H., 112, 141 Areán, P., 239 Arnalde, M. A., 102, 103 Aronson, J., 84 Atkinson, D. R., 71, 129, 225 Ayala, G., 269, 271, 273, 275 Azar, V., 196

Azmitia, M., 184 Azocar, F., 239

B Baca, L. M., 206 Baca Zinn, M., 141 Bakeman, R., 155, 156 Balbutin-Burnham, A., 275, 277 Balcazar, H., 253 Balls Organista, P., 144, 271, 272, 276 Bamaca-Gomez, M. Y., 185 Bandura, A., 269 Baptiste, D., 114 Barlett, D. L., 298, 299 Barrera, N., 154 Bastani, R., 274, 275 Bauer, H. M., 155 Baumeister, L. M., 194, 195 Bean, F. D., 20, 27, 51, 54, 55, 56, 148 Becerra, R. M., 145, 146, 193, 228, 229 Beck, A. T., 234 Becker, H. K., 192 Bedard, L., 202 Behnke, A. O., 184 Belanger, G., 312 Belitz, J., 191, 192, 205, 206, 207 Bell, L. A., 97 Belski, J., 312 Berlin, J. A., 101 Bernal, G., 148, 207 Berry, E. H., 193 Berry, J. W., 5, 6, 7, 9 Betancourt, J. R., 249, 250 Bird, H. R., 218 Bissett, L., 254, 256 Blair, M., 277 Blair, S. L., 185

323

orga_z02bindauth.qxd

324

2/5/07

10:55 AM

Page 324

AUTHOR INDEX

Blumenthal, R., xiv, 135 Bola, J. R., 276 Boles, S., 188 Booher Feagin, C., 16, 17, 18, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 50, 57, 144 Booth, M. W., 187 Boswell, T. D., 54 Boyd, J. H., 218 Boyd, S., 172 Branch, C. W., 201 Bravo, M., 218 Bronfenbrenner, U., 120 Brooks, A. J., 188, 190 Brown, W. B., 190 Burciaga Valdez, R., 295, 308 Burnam, M. A., 128, 218, 219, 220, 226 Burt, M. R., 181, 182, 183, 195, 196, 208 Butterfield, T. L., 291

C Caetano, R., 156 Campbell, A., 193 Canino, G., 218 Canino, I. A., 218 Cantwell, D. P., 185 Caraveo-Anduaga, J., 220, 221, 222, 223, 227 Carballo, M., 272 Cardoso, R. M., 312 Carillo, J. E., 249, 250 Carlos, M. L., 226, 227 Carrillo, H., 271, 273, 275, 278 Carrillo, R. A., 161 Carter-Pokras, O., 245, 246, 247, 249, 258, 260 Casas, J. M., 239 Casas, M. J., 188 Cass, V. C., 108 Castañeda, A., 72 Castañeda, D., 273 Castillo Moran, M. A., 272, 276 Castro, F. G., 187

Catalano, R., 220, 221, 222, 223, 227 Cervantes, R. C., 35, 224 Chang, G., 272 Chavez, E. L., 188 Chavez, G., 154, 246, 248 Chavez, L., 18, 20, 105, 106, 107, 284, 285, 292, 304 Chavous, T. M., 82, 83, 84 Chelala, C. A., 34 Chen, Y. C., 185 Chen, Y. R., 185 Chesir-Teran, D., 186 Ching, A., 110 Chipkin, S. R., 254, 256 Chitwood, D. D., 271 Christianson, R., 246 Clark, C. L., 156 Clark, K. M., 144 Clements-Nolle, K., 110 Cloward, R. A., 290 Cohen, L. M., 238 Cole, K., 200 Collins, B. E., 273 Colon, H. M., 266, 271 Comas-Diaz, L., 114, 115, 151, 232, 237 Conner, R. F., 276 Cooke, D. Y., 82, 83, 84 Coombs, R. H., 188 Coon, D. W., 173 Cooper, C. R., 184 Corcoran, J., 193, 194 Cordova, C. B., 223 Cordova, R., 34, 40 Corethers, T. C., 312 Cornelius, L. J., 308 Cortes, D. E., 216, 217 Costa, L. A., 194 Costantino, G., xiv, 135 Courtney, J. G., 154 Cousins, J. H., 253 Coustasse, A., 249, 250 Cox, E. O., 131, 134 Crawford, S. L., 194 Cross, H. G., 53 Cross, W., 71

orga_z02bindauth.qxd

2/5/07

10:55 AM

Page 325

Author Index Cunardi, C. B., 156 Curtis, R., 266

D Darabi, K. F., 193 de Anda, D., 113, 193 Decker, J. T., 169 De Genova, N., 303 Deitz, T. L., 168 de la Garza, R., 316 De La Rosa, M., 187, 297, 302, 308 de las Fuentes, C., 205 De La Torre, A. C., 52, 54 del Castillo, R. G., 15 Delgado, M., 144, 151, 170, 231, 233 DeLois, K., 131, 132 Denton, N. A., 27 DeSipio, L., 291, 302, 305, 316 Des Jarlais, D. C., 266 Diaz, R. M., 107, 267, 268, 269, 270, 271 Diaz-Perez, M. J., 272 Dinelia, R., 170 Diversi, M., 184 Domhoff, W. D., 53 Domhoff, W., 112 Dorrington, C., 34, 35, 194 Drevenstedt, G. L., 168 Driscoll, A. K., 185 Dryfoos, J., 195, 197, 198, 199 Duany, L. A., 194 Dumka, L. E., 186 Dunbar, N. D., 184 Duncan, J. W., 237 DuRant, R. H., 194, 195

E Earp, J. L., 272 Ehrenberg, R., 52 Ellis, A., 234 Ellsberg, M., 160 Emery, G., 234 Emslie, G. J., 185

325

English, P., 248 English, P. B., 246 Escobar, J. I., 128, 218, 219, 220, 226 Eshleman, S., 220 Espín, O. M., 103, 108, 109 Esteban, M., 161 Evans, L. A., 233

F Falcón, A., 316 Falicov, C. J., 141, 144, 148, 149, 152, 167, 203 Farias, P. J., 34, 224 Fawcett, G. M., 158, 159 Feagin, J. R., 16, 17, 18, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 50, 57, 144 Felice, M. E., 193, 194 Felix-Ortiz, M., 189 Felkenes, G. T., 192 Ferreira-Pinto, J. B., 277 Ferris, E. G., 33, 34, 35, 40, 223 Fielder, E. P., 193 Figueroa, J. B., 48, 52 Finkler, K., 156 Fischer, G. J., 164 Fisher, E., 155, 157 Fitten, L. J., 172 Flaherty, L. T., 195 Flannery, D. J., 188, 189, 190 Flaskerud, J. H., 225 Flores, E., 194, 195 Flores-Ortiz, Y., 148, 154, 155, 157, 161 Foreyt, J. P., 253 Forgey, M. A., 200 Fraga, L. R., 289, 290, 291, 292, 294, 295 Frankenberg, R., 86 Franklin, C., 193, 194 Frauenglass, S., 189 Freeman, D., 218 Freire, P., 269 Fridrich, A., 188, 189, 190 Friedman, J. C., 186 Friedman, S. R., 266 Frisbie, W. P., 112, 148

orga_z02bindauth.qxd

326

2/5/07

10:55 AM

Page 326

AUTHOR INDEX

Fujino, D. C., 225, 239 Furlong, M., 188

G Gallagher-Thompson, D., 173 Gallion, K. J., 259, 261 Garcia, E., 184, 199, 305, 306 García, F. C., 316 Garcia, J., 172, 287, 291, 293, 294, 310, 314, 315 Garcia, J. A., 60, 61, 316 Garcia, M. C., 29, 30, 31, 32 Garcia, M. T., 20 Garcia, R. E., 35 Garcia de Alba, G. J. E., 272, 276 Garcia-Preto, N., 141 Garcia Vasquez, J. J., 34 Germain, C. B., 120 Gersh, B. J., 101 Gertz, M., 202 Ghost Ippen, C., 233 Giacomini, M. K., 250 Gidycz, C. A., 163 Gil, A. G., 183, 186 Gillespie, S. A., 271 Glenmaye, L., 131, 132 Goebel, P., 145 Golding, J. M., 226 Gomel, J. N., 144 Gomez, P., 259, 261 Gondolf, E. W., 155, 157 Gonsalez, G., 235 Gonsalves, C. J., 224 Gonzales, G., 188 Gonzales, J. L., Jr., 5, 33 Gonzalez, H. M., 171 Gonzalez Baker, S., 9, 12, 15, 17, 19, 20, 44 Goodway, J., 252, 253 Green, J., 109 Greenberg Garrison, E., 196 Greene, R. R., 121 Grieger, R., 234 Grossman, S. F., 312 Guarnaccia, P. J., 218

Guendelman, S., 103, 149, 246, 248 Guilamo-Ramos, V., 114 Gutierrez, L. M., 131, 132, 134 Gutierrez-Mayka, M., 172, 173 Gutierrez-Ramirez, A., 258, 260 Guzman, R., 110, 158

H Haan, M. N., 171 Hakuta, K., 57, 59 Hall, J. A., 191 Hamdi Arar, N., 257 Han, L., 111 Hardiman, R., 97 Hardman-Muye, M., 170 Harless, W., 101 Harris, M., 190, 192, 228 Harrison, B., 52 Harvey, M., 165 Hayes-Bautista, D., 308 Haynes, K. S., 285, 286, 295 Hays, P. A., 208, 239 Healey, J. H., 19 Heise, L. L., 158, 159 Helms, J., 71 Henderson, J. N., 172, 173 Henggeler, S., 191 Herdt, G., 272 Hernandez, A., 202 Hero, R., 287, 288, 289 Herrera, C. R., 170 Herskovits, M. J., 4 Hervis, O., 203, 204 Hicks, D., 163, 164 Higginbotham, J. C., 227 Hohman, M. M., 193 Holck, S. E., 194 Holcomb, J. D., 252, 253 Hollinger, D. A., 78 Hollingsworth, D. R., 194 Holmes, K. A., 164 Holzer, C. E., III, 185 Hondagneu-Sotelo, P., 103, 104 Hough, R. L., 128, 219, 220, 226 Hovey, J. D., 186

orga_z02bindauth.qxd

2/5/07

10:55 AM

Page 327

Author Index Howard, K. I., 233 Hu, L., 225, 239 Huerta, E., 253 Huff, C. R., 190 Hughes, M., 220 Hulme, P. A., 227 Humm-Delgado, D., 151, 231 Hunt, L. M., 255, 257 Hurtado, A., 101

I Iglehart, A. P., 145, 146, 228, 229 Inciardi, J. A., 271 Isita-Espejel, L., 158, 159 Israel, B. A., 158 Iwata, E., 73, 74

Kerner, J., 101 Kessler, R. C., 220 Khalsa, J. H., 187 Kilty, K., 303 King, C. A., 186 Kingery, P. M., 252, 253 Kiselica, M. S., 194 Kolody, B., 220, 221, 222, 223, 227, 230, 271 Korte, A., 296 Koss, M. P., 163 Koss-Chioino, J. D., 206 Kottiri, B. J., 266 Kubo, A., 277 Kullgren, J. T., 308, 309 Kurtines, W., 102, 103, 152, 153, 203, 204, 205

L J Jaccard, J., 114 Jackson, B. W., 97 Jackson, K. M., 186 Jacobs, P., 17 Jagust, W. J., 171 James, M., 194 Jasinski, J. L., 154 Jenkins, S., 230 John, R., 168 Johnson, A. G., 86 Johnson, D. L., 205 Johnson, R. A., 169 Johnston, D. C., 55, 301

K Kaplan, M. S., 218 Karno, M., 128, 219, 220, 226 Kates, J., 263 Katz, M., 110 Kaufman Kantor, G., 154 Keatley, J., 110, 111 Keefe, S. E., 79, 80, 81, 82, 226, 227

Landau, S., 17 Lane, D., 252, 253 Larson, K. A., 184, 199 Le, H., 233 LeCroy, C. W., 188, 190 Lee, D. J., 219 Lefley, H., 163, 164 Lenski, G., 41, 42, 43 Leslie, L. A., 34, 35 Levenson, S. M., 254, 256 Li, J., 52 Liabre, M., 163, 164 Lietch, M. L., 34, 35 Liljestrand, J., 160 Linskey, A. O., 185 Linton, R., 4 Lira, J., 252, 253 Locke, B. Z., 217, 218 Low, G., 163 Lowe, S. M., 129, 225 Luchsinger, J. A., 251, 252 Luke, D., 110 Lum, D., xiv, xix, 123, 125, 127, 130 Lyon, J. M., 191 Lyons, B., 167

327

orga_z02bindauth.qxd

328

2/5/07

10:55 AM

Page 328

AUTHOR INDEX

M Maciak, B. J., 158 Magaña, J. R., 277 Maldonado, M., 35, 272 Malgady, R. G., xiv, 135, 216, 217 Mallinckrodt, B., 237 Mamo, L., 110 Mancilla, Y., 152, 153, 203, 205 Manning, S. S., 229 Manoleas, P., 123 Manuel, G. M., 35, 224 Marcotte, D., 35, 224 Marger, N. N., 39, 41, 42, 48, 54, 59, 61, 94 Marin, B. V., 142 Marin, G., 142 Markides, K. S., 219 Marks, G., 218 Marti, J., 261 Martinez, C., 239 Martinez, R., 143, 218 Martinez, S. R., 275, 277 Mason, C. A., 189 Massey, D. S., 27 Mata, A., Jr., 277 Matos, T. D., 266 Matute-Bianci, M. E., 185 Maxwell, A. E., 274, 275 Mazon, M., 18 McAlister, A., 259, 260, 261, 262 McBride, D. C., 271 McDonough, K., 296 McFerron, R., 155, 157 McGonagle, K. A., 220 McGraw, S. A., 194 McGuire, L., 121 McIntosh, P., 46, 85, 86 McKinlay, J. B., 194 McLane, C. P., 168 McLemore, S. D., 9, 12, 15, 17, 19, 20, 44 McWilliams, C., 14, 15 Melendez, E., 48, 52 Mell, K. G., 53 Menendez, A. V., 35, 224

Mercado, S., 262 Mickelson, J. S., 285, 286, 295 Millen, B., 254, 256 Millen, L., 143 Miranda, J., 239 Miranda, M. R., 232 Mishra, S. I., 275, 276 Modiano, M. R., 259 Molina, C. W., 245 Molitor, F., 274, 275 Montejano, D., 20 Montes Mozo, S. M., 34 Montoya, V., 171 Moore, J., 296, 297, 301 Moquin, W., 16 Morales, A. T., 190 Moran, C. E., 57 Morison, G., 188 Morris, L., 194 Morrow, C. A., 229 Morten, G., 71 Moscicki, E. K., 217, 218 Motylewski-Link, C., 154 Mueller, G., 264 Mungas, D. M., 171 Muñoz, R. F., 208, 233, 235 Murguia, E., 53, 112 Murphy, H. B. M., 8 Murphy, J., 264 Murphy, S. L., 281

N Nader, R., 298, 299 Neaigus, A., 266 Nelson, C. B., 220 Nemoto, T., 110, 111 Newcomb, M. D., 189 Newman, E., 253 Norris, F. H., 155, 156 Novick, E. R., 181, 182, 183, 195, 196, 208 Nuno, T., 194

orga_z02bindauth.qxd

2/5/07

10:55 AM

Page 329

Author Index O Operario, D., 110, 111 Orell, L. H., 201 Orfield, G., 20 Organista, K. C., 144, 163, 166, 208, 235, 239, 249, 271, 272, 273, 275, 276, 277 Orlinsky, D. E., 233 Ortiz, F., 172 Ortiz, T. A., 171 Ortiz, V., 193 Otero-Sabogal, R., 142 Otiniano, M. E., 170

329

Plante, T. G., 35, 224 Plunkett, S. W., 185 Pontius, C. O., 263 Priest, R., 113 Pugh, J., 255, 257 Pulley, L., 262 Pumariega, A. J., 185

Q Qian, Z., 185 Quintero-Salinas, R., 185

P

R

Padilla, A., 35, 79, 80, 81, 82, 128, 142, 224, 226, 227 Page, A., 145 Pantin, H., 152, 153, 189, 203, 205 Pardo, M. S., 310, 311 Parham, T., 71 Parke, R. D., 144 Parker, R. G., 272 Parron, D. L., 129 Parsons, R. J., 131, 134 Patria, J., 110 Paulson, M. J., 188 Peak, T., 193 Pecka, G., 169 Pell, E., 17 Pendergrast, R. E., 194, 195 Perez, S. M., 194 Perez, W., 142 Pérez-Stable, E. J., 142, 259 Perez-Vidal, A., 203, 204 Perilla, J. L., 155, 156, 157 Persons, W., 202 Pettinelli, M. E., 312 Phinney, J. S., 65, 70, 78 Pick, S., 158, 159 Piercy, K. W., 184 Pinderehughes, R., 301 Piven, F. F., 290

Rabinowitz, Y., 173 Radloff, L. S., 217 Rae, D. S., 217, 218 Rakos, R. F., 237 Ramirez, A. G., 253, 258, 259, 260, 261, 262 Ramirez, M., III, 72 Ramirez, O., 141 Ramirez, R., 173, 290, 291, 292, 294, 295 Ramirez, R. R., 147 Ramos, B., 114 Randal Joseph, B. H., 131 Randall, C., 188 Ranney, M., 173 Rao, S., 233 Rapp, C., 126, 134 Ray, L. A., 219, 227 Redfield, R., 4 Regier, D. A., 217, 219 Renteria, T., 228 Resnick, G., 181, 182, 183, 195, 196, 208 Reynoso, T. C., 193 Richardson, M. A., 188 Riddel, V. A., 113 Rintelmann, J. W., 185 Rios, C., 218 Rios, R., 218

orga_z02bindauth.qxd

330

2/5/07

10:55 AM

Page 330

AUTHOR INDEX

Rivers, J. E., 271 Roberts, C. R., 185 Roberts, R. E., 185 Robins, L. N., 219 Robles, R. R., 218, 266 Rochat, R. W., 194 Rodriguez, A., Jr., 184 Rodriguez, C. E., 27, 48, 52 Rodriguez, M. A., 155 Rodriguez, N., 34 Rodriguez, O., 183 Rodriguez, R., 77, 78, 108 Rogler, L. H., xiv, 135, 216, 217 Roll, S., 143 Romo, H., 9, 12, 15, 17, 19, 20, 44 Ronstrom, A., 35 Roosa, M. W., 186 Rosenberg, M., 69, 72 Rosenberg, P., 52 Rossello, J., 207 Rothman, R. A., 40, 41, 51, 53, 298 Rouse, B. A., 187 Routh, D. K., 189 Rowland, D., 167 Roy, I. S., 196 Roy, L. C., 168 Rubio-Stipec, M., 218 Ruiz, J. D., 274, 275 Ruiz, S., 263 Rumberger, R. W., 183, 184, 199 Rush, A. J., 185, 234

S Sabogal, F., 142 Sahai, H., 266 Saldivar-Garduno, A., 272 Salgado de Snyder, V. N., 224, 272 Santana, F., 128, 219 Santiago, A., 158 Santisteban, D., 152, 153, 203, 204, 205 Sanudo, F., 275, 276 Sassen, S., 303 Schafer, J., 156

Schinke, S., 200 Schmidt, R., Sr., 304, 305 Schuler, R. H., 193 Schulman, K. A., 101 Schwiebert, V., 169 Scopetta, M., 102, 103, 152, 153, 203, 205 Scott, C., 163, 164 Seidman, E., 186 Sellers, R. M., 82, 83, 84 Seymore, C., 194, 195 Shartrand, A., 152 Shaver, P., 237 Shaw, B. F., 234 Shelden, R. G., 190 Shen, H., 153 Shillington, A. M., 193 Shirk, N., 169 Shragg, G. P., 193, 194 Shrout, P. E., 218 Siegel, J., 163, 165, 185 Sistrunk, S., 101 Smith, C., 153 Smith, D. W., 252, 253 Smith, K. W., 194 Sobhan, M., 185 Sokol-Katz, J. S., 187 Solano, N., 173 Soloff, P., 144, 272 Solórzano, D. G., 184, 306, 307 Solórzano, R. W., 184 Soma, T., 111 Sorensen, S. B., 153, 154, 155 Sorenson, S., 163, 165 Soto, E., 237 Stalvey, L. M., 88 Starrett, R. A., 169 Steele, C. M., 84 Steele, J. B., 298, 299 Stern, M. P., 262 Stratton, T. L., 154 Straus, M. A., 153 Stuewig, J., 188, 190 Suarez, L., 258, 259, 260, 261, 262 Suarez, Z. E., 308 Sue, D., 70, 71, 83, 87, 88

orga_z02bindauth.qxd

2/5/07

10:55 AM

Page 331

Author Index Sue, D. R., 71 Sue, D. W., 70, 71, 83, 87, 88 Sue, S., 225, 239 Surratt, H. L., 271 Swaim, R. C., 188 Swanson, J. W., 185 Szapocznik, J., 102, 103, 152, 153, 203, 204, 205

T Tabish, K. R., 201 Takeuchi, D. T., 225, 239 Talavera, G., 259, 260, 261, 262 Tatum, B. D., 46, 86, 87, 88, 89, 90 Taub, B., 185 Telles, C. A., 153, 154, 219, 220 Telles, E. R., 53 Thandeka, 99, 100, 101, 108 Therrien, M., 147 Thomas, P., 114 Thompson, J. J., 286 Thompson, L. W., 173 Thorfinnson, T., 154 Tienda, M., 20, 27, 51, 54, 55, 56 Timbers, D. M., 128, 219, 220 Tinsley, B. J., 144 Tobler, N. S., 200 Todd, A. M., 169 Torquati, J., 188, 189, 190 Torres, R. D., 52, 54 Torres-Matrullo, C., 232, 237 Tracy, S. K., 190 Tran, T. V., 167 Trapido, E., 260, 262 Trejo, L., 173 Treviño, F. M., 227, 249, 250

U Ulbrich, P. M., 187 Ullman, S., 164 Upchurch, D. M., 153 Ureta Carrillo, L. E., 272

331

V Valdes Dwyer, E., 166, 233, 239 Valdez, D., 191, 192, 205, 206, 207 Valenzuela, M., 255, 257 Valle, R., 144, 230 Van Doren, C., 16 VanOss Marin, B., 194, 195 Vasquez, C. I., 170 Vazquez, I. M., 254, 256 Vazsonyi, A. T., 188, 189, 190 Vega, W., 141, 144, 183, 186, 220, 221, 222, 223, 227, 230, 245, 246, 271, 278 Velasquez, R. J., 228 Vera, M., 218 Viadro, C. I., 272 Vidal de Haymes, M., 303 Vigil, J. D., 190, 192, 201, 296, 297 Villa, V. M., 173 Villalobos, G., 158 Villarreal, R., 259, 260, 261, 262 Villegas, D., 110, 111 Vlach, N., 35

W Wakefield, J. C., xv, 121 Walker, T., 205 Walters, G., 169 Warda, M., 145 Warda, U. S., 274, 275 Warheit, J. G., 186 Warner, B. S., 195 Warren, C. W., 194 Weatherby, N. L., 271 Weinbaum, Z., 154 Weinberg, W. A., 185 Weiss, S. J., 145 Weist, M. D., 195 Wells, K. B., 226 West, C., 75 White, J., 228 Whitman, S., 264

orga_z02bindauth.qxd

332

2/5/07

10:55 AM

Page 332

AUTHOR INDEX

Williams, J. E., 164 Williams, L. F., 167 Wilson, P., 145 Winkvist, A., 160 Winn, N. N., 113 Wintersteen, R., 134 Wisniewski, N., 163 Wohl, J., 239 Wood, P. S., 237 Worby, P., 275, 277 Wylie, R. C., 8, 70

Y Yablonsky, L., 190 Yamamoto, J., 233 Ybarra, L., 149

Yosso, T. J., 306, 307 Yun, J. T., 20

Z Zambrana, R. E., 245, 246, 247, 249 Zambrana, M. M., 162 Zane, N. W., 225, 239 Zayas, L. H., 183 Zhao, S., 220 Zhou, M., 53 Zimmerman, R. S., 186 Zimmerman, W., 53 Zsembik, B. A., 168, 169 Zweigenhaft, R. L., 45, 53, 112

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 333

Subject Index A Abuse, elder, 170–171 Acceptability, service, 129 Access, service, 128–130, 145 –147 Accidents, 246 Accountability, service, 129, 135 –136 Acculturation, 101–102 of Central Americans, 33 –36 concept of, 4 –11 of Cuban Americans, 27–33, 215 defined, 4 –5 and depression, 218 gap, 152, 203 and gender, 102–103 and intimate partner violence, 153 –154 and maternal-infant health, 248 and mental health, 219, 220, 221 of Mexican Americans, 11–21 patterns of, 3 –38 of Puerto Ricans, 21–27, 215 and risky sexual behavior, 194 as three-phase process, 5 versus assimilation, 5, 101–102 Acculturative stress, 7–11, 149, 215 –216 and depression and suicide, 186 and familismo, 223 and social welfare, 10–11 Achieving Latinos through Academic Success (ALAS), 199 Activity schedules, 235 –236 Adaptation to United States, 5 –7, 135 and Central Americans, 35 –36 and Cuban Americans, 33 and Mexican Americans, 6 –7, 20 and Puerto Ricans, 26 –27

Adolescents. See also Youth and depression, 114 –115 and pregnancy, 193 –194 Affiliation, 143 Affirmative action, 47, 86 –87 Agoraphobia, 235 Agricultural Research Act, 303 AIDS, 194. See also HIV/AIDS Alamo, The (1960, 2004), 13 –15 ALAS (Achieving Latinos through Academic Success), 199 Alcohol, 258. See also Substance abuse and Cuban Americans, 219 group therapy for women, 232 and intimate partner violence, 156 –157 and Mexican Americans, 219 and Puerto Ricans, 219 use among Latinas, 189–190 use among Latino youths, 187–190 Alianza Dominicana, 197–198 Alternative community delivery systems, 229–230 Alzheimer’s Disease, 171–174 Assault, sexual, 162–166 model agency, 165 –166 service utilization and needs, 165 Assertiveness training, 236 –239 Assessment, 147–151 skills, 125, 126 in social and cultural contexts, 130–133 Assimilation, 5, 72, 101–102 Asylum, political, 34 Availability, service, 129 Awareness: cultural, 79–81 integrative, 76 –77 White, 89–90

333

orga_z03bindsub.qxd

334

2/5/07

10:55 AM

Page 334

SUBJECT INDEX

B Bay of Pigs, 29 Behavior, problem, 183 Bicultural Effectiveness Training, 203, 204 Biculturation, 237 Bilingual education, 57–59, 184, 304 –306 Bilingual Education Act, 304 Biopsychosocial perspective, 122, 130–131 Black Latinos, 114 –115 Border, U.S.-Mexico, 303 –304 Bracero Program, 18 Breast cancer, 260–263 Brown Berets, 75 Buena Alimentación, Buena Salud, 254 –255

C California, 57, 106 –107, 289–290 California Substance Use Survey, 188 Cancer, 246, 258–263. See also specific cancer Caregiver burden, 171–174 Case management, 134 Castro, Fidel, 28–29 Catholic Church, 144 –145, 235, 311–312 Center for Epidemiologic Studies Depression (CES-D) scale, 217 Central Americans: acculturation, 33 –36, 215 adaptation, 35 –36 community-based intervention strategies for youth, 196 –197 conflict, 34 –35 contact, 34 and mental health, 223 –224 problem themes, 150 Cervical cancer, 260–263 Chavez, Cesar, 19

Chicanos, 19–20 cultural awareness and ethnic loyalty, 79–81 defined, 12 ethnicity, 79–82 and gangs, 190, 191 group therapy for adolescents, 206 jobs for youths, 202 and school failure, 184, 199–200 substance use among youths, 185 –186, 187 youth, 181 Child mental health, 145 Child rearing, 143 Church involvement, 261 Círculos de salud, 277 Citizenship, 291 Client expectations, 133 –134 Cognitive-Behavioral Depression Clinic, 232–234 Cognitive-behavioral therapy (CBT), 166, 207, 232 Cognitive disorders, 171 Cognitive restructuring, 234 –235 Cognitive structures, 83 Collaborative prevention programs, 273 –274 Commitment, professional, 127 Communication, 236 –237 Community-based services, 134, 296 –297 disease prevention, 253 for elderly Latinos, 170 for HIV/AIDS prevention, 273 –274 for intimate partner violence, 158–161 for Latino youth, 195 –197 and mental health, 229–231 Community penetration, 146 Competence, cultural, 96 and approaches to physical health, 250–263 current practice, 123 –127 developing, 120 new practice model for working with Latinos, 119–138 responses to family problems, 151–153 three dimensions of, 123 –127 Condoms, 111, 272, 273, 274, 276 –277

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 335

Subject Index Confianza, 143 Conflict with United States, 5 and Central Americans, 34 –35 and Cuban Americans, 28–33 and Mexican Americans, 12–20 and Puerto Ricans, 22–26 Conflict resolution, 201 Conformity, 72–74, 87 Congressional Hispanic Caucus (CHC), 314, 315 Constructionism, social, 93 –95 Contact with United States, 5 Central Americans, 34 Cuban Americans, 27–28 Mexican Americans, 12 Puerto Ricans, 21–22 Continuing education, 127 Contraception, 144, 193, 194 –195 Contract with America, 297 Cooperation, 143 Coping strategies, 144 –145 Corporate America, 53 Corporate welfare, 298–301 Critical White studies, 85 Cross-fire refugees, 33 Cross-generational alliances, 152 Cuban American National Foundation (CANF), 314 Cuban Americans: acculturation, 27–33, 102–103, 215 adaptation, 33 and alcohol use, 219 and bilingual education, 58–59 conflict, 28–33 contact, 27–28 and depression, 217 and education, 55 employment of, 54 as exiles, 29–30, 31–32 problem themes, 150 socioeconomic status, 3 substance abuse, 187–190 youth, 183 Cuban Missile Crisis, 30 Cuban Refugee Program, 31 Cuidando el Corazón, 253 Cultural awareness, 79–81

335

Cultural competence, 96 approaches to physical health, 250–263 current practice, 123 –127 developing, 120 new practice model for working with Latinos, 119–138 responses to family problems, 151–153 three dimensions of, 123 –127 Cultural identity, 85 –89 Culturally Tailored Intervention (CTI) program, 200–201 Cultural sensitivity, 4, 120 Culture, 141 Culture of origin, 6, 135 Curanderismo, 227 Curandero, 227

D Date rape, 164 Death, causes of, 246, 247 Delinquency, 183 Dementia, 171–174 Deportation, 105 –107 Depression: and acculturation, 186, 218 and adolescents, 114–115, 183, 185–187 and Central Americans, 224 and cognitive-behavioral therapy (CBT), 166 and Cuban Americans, 217 and elderly Latinos, 169 and Mexican Americans, 217, 218 prevention of, 230–231 and Puerto Ricans, 217–218 and self-reported health, 218 treating, 232–239 and women, 232 Detroit, 158 Diabetes, 130–131, 171, 251–258 Diet, 251, 252, 254 –258 Disabilities, 47 Discrimination, 26 –27, 47, 53 Disease prevention, 248–250, 250–263 Disempowerment, 131 Distributive system, 42, 43

orga_z03bindsub.qxd

336

2/5/07

10:55 AM

Page 336

SUBJECT INDEX

Diversity, 9 debates about, 99–100 within Latino groups, 92–117 overview, 95 –96 Domestic violence. See Intimate partner violence (IPV) Dominican American National Roundtable (DANR), 314 Dominican Americans, 151, 197–198 Dropouts, school, 184, 305 Drug use. See also Substance abuse among Chicano youth, 185 –186 and HIV/AIDS, 264, 265 prevention programs, 200–201

E East Little Havana Parent Leadership Program, 203, 205 Ecological-systems (E-S) perspective, 120–123 Ecological validity, 229 Economic development, 296 –298 Ecosystemic perspective, 148–151, 152–153 Education, 54 –59, 305 –307 bilingual, 57–59 continuing, 127 and dropouts, 184 median years of schooling, 56 parental, 57 reform, 304 –306 Elder abuse, 170–171 Elderly Latinos, 166 –174 El Portal, 173 –174 El Salvador, 33 Emergency Quota Act, 43 – 44 Employment, 54 Empowerment, 131–132, 309–312 En Acción: The National Hispanic Leadership Initiative on Cancer (NHLIC), 259 English, 184, 304 Enterprise Zone Act, 302 Entitlement programs, 168

Epidemiologic Catchment Areas Study, 219–220 Espiritismo, 231–232 Essentialism, 95 Ethnic agencies, 229–230 Ethnic enclave, 54 Ethnic heritage, mixed, 112–115 Ethnic identity, 65 –91 centrality, 83 conceptualizations of, 82–84 defined, 65 –66 importance of, 66 –67 linear/nonlinear nature of, 80–82 problems, 67–68 research on development of, 78–84 and sexual identity, 108–109 theoretical models of, 70–79 Ethnicity: Chicano, 78–82 and class systems, 42 salience of, 83 –84 and sexual orientation, 108 Ethnic loyalty, 71, 79–80 Ethnic matching, 239 Ethnic prestige, 45 Ethnic pride, 74 Ethnic stratification, 42– 47 Exiles, Cuban, 29–30, 31–32 Expectations, client, 133 –134 Exploitation, 17–18, 23 –24 Extended family, 144

F Familismo, 107, 109, 142, 166 –167, 202, 223, 267 Family, 107, 141–179 cohesion, 186, 188–189 dysfunction and gangs, 191–192 and elderly Latinos, 169–170 extended, 144 problems resulting from breakdown of, 186 structure, 142–145 Family-centered services, 134

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 337

Subject Index Family-focused interventions, 202–205 Family therapy, 152–153, 161–162, 203 –205 Farmworkers, migrant, 18 Female burden-bearer, 173 Fertility rates, 148 Folk healers, 227–228 Fortune 1000 companies, 112 Full-service schools, 197–199

G Gangs, 18, 190–193 and adolescents, 183 and family dysfunction, 191–192 girls, 190, 192–193 and group treatment, 206 intervention with, 201–202 and Latinas, 192–193 and violence, 192 Gay men, 107, 267–271 Gender, 51, 94, 101–104 Gender-role flexibility, 104 Gender roles, 149–151 Generalist practice, 127–128 Generation, 79–81 Genogram, 161 Gerrymandering, 293 Girl gangs, 190, 192–193 Gonzales, Elian, 314 –315 Group therapy, 205 –207 versus family therapy, 153 for HIV/AIDS prevention, 270–271 for mental health treatment, 231–239 Guatemala, 33

H Hatch Act, 286 Health, 245 –282 of Latino youth, 181, 183 –185 obstacles to disease prevention and health promotion, 248–250

337

overview, 245 –248 and poverty, 167–168 and socioeconomic status, 308 Health care, 306, 308–309 Health circles, 277 Health insurance, 248–249, 308 Health policy, 308–309 Health promotion, 250–263 Healthy Families Act, 208 Healthy Families Initiative, 294 –295 Heart disease, 246, 251–258 Hermanos de Luna y del Sol (HLS: Brothers of the Moon and Sun), 269–270 Hierarchical class systems, 41– 42 Hispanic American Alliance, 313 Hispanic Health and Nutrition Examination Survey (HHANES), 217–219, 251 HIV/AIDS, 194, 246, 263 –278 among MTFs, 110, 111 and homophobia, 107 and migrant workers, 271–278 prevention of, 266 –267, 270–271, 273 –274 and Puerto Ricans, 264 –267 and women, 272–273 Homicide, 246 Homophobia, 47, 76, 107, 269 Honduras, 33 Household size, 148 Houston Communities in School, 195 –196 Human capital theory, 51–54 Human services delivery systems, 145 –147 Hypersegregation, 26 –27

I Identity, cultural, 85 Identity, ethnic, 65 –91 conceptualizations of, 82–84 defined, 65 –66 importance of, 66 –67

orga_z03bindsub.qxd

338

2/5/07

10:55 AM

Page 338

SUBJECT INDEX

Identity, ethnic (continued) linear/nonlinear nature of, 80–82 problems, 67–68 research on development of, 78–84 and sexual identity, 108–109 theoretical models of, 70–79 Identity, majority, 85 –89 Identity, racial: conceptualizations of, 82–84 and majority identity, 85 theoretical models of, 70–79 Identity, role, 66 Identity, sexual, 108–109 Idioms of distress, 227 Illegal Immigration Reform and Immigrant Responsibility Act, 303 Immersion, 74 –76, 88–89 Immigration: Cuban Americans, 29–30 and deportation, 105 –107 illegal, 303 –304 and mental health, 8 Mexicans, 17–18 and power, 43 – 44 Puerto Rican, 26 –27 and welfare policy reform, 302–303 Immigration Reform and Control Act, 44 Income, 48–51, 57 Indigenous peoples, 5 Individual therapy, 207–208, 239 Inequality, 39– 41 Inequality, structured, 65 –91, 100 Infant health, 248 Insurance, health, 248–249, 308 Integrative awareness, 76 –77 Intermarriage, 5 Interpersonal conflicts, 151 Interpersonal psychotherapy, 207 Intervention: collaborative approaches, 272–273 community-based, 195 –197 culturally and socially congruent, 228–239 family-focused, 202–205 for intimate partner violence, 158–162 school-based, 183, 195 –197, 199–202

selection of, 133 –135 skills, 125 Intervention field, 120–123 Intimate partner violence (IPV), 153 –157 and alcohol, 156 –157 family therapy for, 161–162 interventions, 158–162 model for understanding, 154 –156 Intravenous drug use, 264, 265 Introspection, 76, 89

J Jackson, Michael, 73 –74 Jump into Action curriculum, 252

L La Alianza Hispano Americano, 313 Labor, 17–18, 23 –24 Labor market, 50, 52–53 Language, 304 –306 Latinas: and cancer prevention, 260–263 and gangs, 192–193 and HIV/AIDS, 263 –264 and risky sexual behavior, 193 –195 and sexual assault, 163, 164, 165 –166 and substance abuse, 189–190 Latinegra, 114, 115 Latino National Political Survey (LNPS), 59–61, 316 Latinos: acculturation, 11 age, 148 Americanization of, 3 –38 Black, 114 –115 common problem themes, 132–133 concentration in labor market, 50 coping strategies, 144 –145 culturally competent responses to family problems, 151–153 deaths, 245 –247

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 339

Subject Index diversity within groups, 92–117 ecosystemic perspective, 148–151 and education, 54 –59, 304 –306, 307 elderly issues, 166 –174 ethnic identity, 65 –91 family, 141–179 and Fortune 1000 companies, 112 gangs, 190–193 gay men, 267–271 GLBT, 107 health, 245 –282 and HIV/AIDS, 263 –278 income and occupation, 48–51 and intimate partner violence, 153 –157 and mental health, 128–129, 215 –244 and outreach efforts, 130 and policy benefit, 289–296 and political participation, 59–61, 285 –286 and poverty, 147–148 power, 283 –319 practice model for working with, 119–138 problem themes, 150–151 and school failure, 184 social stratification, 39–64 sociodemographic profile, 147 socioeconomic positions of, 48–54 substance abuse among youths, 187 underemployment, 54 undocumented, 105 –107 and voting, 59–61, 290–292 vulnerability to labor market shifts, 52–53 youth, 181–214 La Vida, 158 League of United Latin American Citizens (LULAC), 313 Lesbians, 108 Life chances, 112 Life Skills Training, 200–201 Linguistic matching, 239 Los Angeles, 190, 310–311 Low birth weight, 246 Loyalty, ethnic, 79–81 Lung cancer, 258

339

M Machismo, 76, 154, 267, 268 Macro-level systems, 123 Majority identity, 85 –89 Mammogram, 260 Marginality, 9, 304 Marginalization, 72 Marianismo, 155 Marielito Conflict, 31–32 Marin, Muñoz, 23, 24, 25 Mass media, 260, 261 Maternal-infant health, 246 –248 Mediation, 201 Medicaid, 168, 249–250, 303 Melting pot philosophy, 8, 72–74 Mental disabilities, 47 Mental health, 215 –244 and acculturation, 219, 220, 221 among minorities, 129 barriers to utilization of services, 129 child, 145 community-based services, 229–231 culturally and socially congruent interventions, 228–239 cultural obstacles to services, 226 –228 and group therapy, 231–239 and immigration, 8 increasing access to services, 224 –228 and Latinos, 128–129, 216 –224 Meritocracy, 45, 46 – 47 Meso-level systems, 122–123 Mexican American Legal Defense Fund (MALDEF), 313 Mexican American Prevalence and Services Survey, 221–223 Mexican Americans: acculturation of, 11–21, 219–220 adaptation of, 6 –7, 20 and alcohol, 219 and bilingual education, 57–58 and conflict, 12–20 and contact, 12 defined, 12 and depression, 217, 218

orga_z03bindsub.qxd

340

2/5/07

10:55 AM

Page 340

SUBJECT INDEX

Mexican Americans (continued) and education, 55 elderly, 169 full-service school, 198–199 and gangs, 190 and high school dropouts, 184 and HIV risk, 271–278 and intimate partner violence, 153–154 mental health, 185 problem themes, 150–151 relation between acculturation and mental health, 221 and selective migration hypothesis, 220 and socioeconomic status, 3, 215 and teen pregnancy, 193 and voting, 59 women and health, 248 youth, 181, 185 Mexicans, 17–18 Mexico City, 158–160 Mexico-U.S. border, 303 –304 Miami, 33, 203 Micro-level systems, 122 Midwestern Voter Registration Project (MVRP), 314 Migrant farmworkers, 18 and condom use, 276 –277 and HIV/AIDS, 263, 271–278 HIV prevention interventions, 273–278 undocumented, 291–292 Migration: and gender, 103 –104 Puerto Ricans, 26 –27 and sexual orientation, 107 and stress, 224 Militancy, Puerto Rican, 24 –26 Minorities: in corporate America, 53 and mental health, 129 and self-esteem, 68–70 and service provider accountability, 135 –136 Minority status, 51 Mixed racial heritage, 112–115 Modesto, California, 198–199 Molina, Gloria, 310

Morbidity and mortality, 245 –248 Mothers of East Los Angeles (MELA), 310–311 MTF Transgender of Color Study, 110 Muzzle law, 23

N National Alcohol and Family Violence Survey, 154 National American Drug and Alcohol Survey, 187 National Association of Latino Elected and Appointed Officials (NALEO), 314, 315 National Chicano Moratorium, 19 National Comorbidity Survey, 220–221 National Elder Abuse Incidence Survey, 170 National Family Violence Resurvey, 153 National Hispanic Health and Nutrition Examination Survey (NHANES), 251 National Household Survey on Drug Abuse, 187 National Latino Immigrant Survey, 291, 305 National Latino Political Survey, 305 National Longitudinal Study of Adolescent Health, 115 National Survey of Hispanic Elderly People, 167 Naturalization, 291 Needs, client, 133 –134 Neglect, elder, 171 New Federalism, 297–298 New York City, 197 Nicaragua, 33 Nicaraguans, 186

O Obesity, 251 Occupation, 48–51 Operation Bootstrap, 23 –24

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 341

Subject Index Operation Gatekeeper, 303 “Operation Wetback,” 19 Oppression, 94 –95, 95 –96, 97–101, 109–110 Orden de Los Hijos de America, 313 Order of the Children of America, 313 Outreach imperative, 130

P Panic disorder, 235 Pap smear screening, 260, 262 Paternalism, 89 Patriarchy, 104, 143, 149 Peers, 188–189 Penetration, community, 146 Personalismo, 143, 234, 270 Personal Responsibility and Work Opportunity Act, 297, 302–303, 308–309 Pesticides, 258 Phenotype, 112 Physical disabilities, 47 Plática, 143 Policy benefit, 289–296 Political asylum, 34, 224 Political organizations, 312–316 Political participation, 283 –319 Political power, 59–61, 288 Politics, grassroots, 309–312 Posttraumatic Stress Disorder (PTSD), 224 Potential practice field, 120–123 Poverty, 147–148, 215 –216 and depression, 186 and elderly Latinos, 167–168 and gay men, 268 and health, 167–168, 249 and homophobia, 269 and intimate partner violence, 154 and Ronald Reagan, 297 understanding, 301–302 Power, 42, 43 – 44 Practice models, 127–136 Prayer, 235, 257

341

Pregnancy, teen, 193 –194 Prestige, ethnic, 45 Pride, 68–70, 74 Privilege, 46 – 47, 52, 85 –90, 100–101 Problem assessment, 147–151 Problem behaviors, 183 Professional commitment, 127 Proposition 54, 293, 294 Proposition 187, 106, 293 Proposition 209, 10, 293, 294 Proposition 227, 57, 293 Prostitution, 110, 272, 276 Protective factors, 183, 189–190 Proyecto Bienestar (Wellness Project), 230–231 Psychosocial adjustment, 113 Psychosocial problems, youth, 181, 183 –185 Psychotherapy, interpersonal, 207 Public assistance, 249–250 Public policy, 287–289 Puerto Rican Legal Defense and Education Fund (PRLDEF), 313 Puerto Ricans: and acculturation, 21–27, 215 and adaptation, 26 –27 and alcohol, 219 conflict, 22–26 contact, 21–22 and depression, 217–218 discrimination against, 26 –27 and dropout rate, 184 and education, 55 elderly, 169 female gang members, 193 and gangs, 190 and group therapy, 231–232 and HIV/AIDS, 246, 263, 264 –267 labor exploitation, 23 –24 militancy and violence, 24 –26 problem themes, 151 and socioeconomic status, 3, 215 substance abuse, 187 and voting, 59 women’s mental health groups, 232 youth, 181

orga_z03bindsub.qxd

342

2/5/07

10:55 AM

Page 342

SUBJECT INDEX

R Race, 83 –84 mixed, 112–115 and skin color, 111–112 social stratification of, 43 Racial/cultural identity development model (R/CID), 71–72, 77, 87–90 Racial identity: conceptualizations of, 82–84 and majority identity, 85 theoretical models of, 70–79 Racialization, 26 –27 Racial Privacy Initiative, 294 Racism, 87, 114 function of, 44 – 45 and gay men, 268 and homophobia, 269 institutionalized, 84 Racismo, 114 Rape. See Sexual assault Reagan, Ronald, 297–298 Reflected appraisal, 68–69 Refugee Assistance and Education Act, 31 Refugees, 33 –35, 224 Relationship protocols, 125 Religion, 144 –145, 235 Resegregation, 20–21 Resistance, 74 –76, 88–89 RESPECT (Respect Encourages Student Participation in Empowering Communication Techniques), 201–202 Respeto, 143 Resurrection Project, 312 Risk, 215 –216 and Latino youth, 182 and substance abuse, 189–190 Role identity, 66

S Salazar, Ruben, 19–20 Salt of the Earth (1953), 311 Salud en Acción (Health in Action), 261–262

Salud para Su Corazón, 253 –254 San Francisco, 269 Santería, 227 Santero, 228 Scarface (1983), 32 School adjustment, 189, 190 School-based intervention, 183, 195 –197, 199–202 School failure, 55, 183 –185, 199–200, 305 Schools, full-service, 197–199 Secondary labor market, 52 Segregation, 20, 45, 58 Selective migration hypothesis, 220, 221 Self-acceptance, 74 Self-awareness, 99 Self-esteem, 68–70 Self-hate, 192 Self-help, 162 Self-rejection, 68–70, 73 –74 Sensitivity, cultural, 4, 120 Service providers, 95 –96, 283 –319 and cultural sensitivity, 120 and the political arena, 285 –286 Sex. See Gender Sex between men, 272 Sexism, 47, 84 Sexual assault, 162–166 and cognitive-behavioral therapy (CBT), 166 cultural differences, 163 –164 model agency, 165 –166 service utilization and needs, 165 Sexual behavior, risky, 183, 193 –195 Sexual Experiences Survey, 163 Sexual identity, 108–109 Sexually transmitted diseases (STDs), 194, 246 Sexual orientation, 107–111 Simpatía, 143 Single-parent homes, 187 Skills, 125 Skin color, 53, 111–112 Smoking, 219, 258, 262–263 Social: class, 40, 51 comparison, 68–69

orga_z03bindsub.qxd

2/5/07

10:55 AM

Page 343

Subject Index constructionism, 93 –95 justice, 95 –96, 312 oppression matrix, 97–99, 100 stratification, 39–64, 94 stress hypothesis, 216, 220 welfare, 10–11, 47, 296 work, 95 –96, 121, 295 –296 Social Security, 303 Sociodemographic profile, 147 Socioeconomic status (SES): and Cuban Americans, 215 and health, 308 as indicator of social welfare, 3 and Mexican Americans, 215 and political power, 288 and Puerto Ricans, 215 and stability, 147–148 of U.S. Latinos, 48–54 vulnerability of, 296 –309 Somatization, 226 –227 South Americans, 223 –224 Southwest Voter Registration Project (SVRP), 314 Spanish Family Guidance Center, 203 Special education programs, 184 Specialized practice, 127–128 State Children’s Health Insurance Program, 250 Status dimensions, 47 Stereotypes, 84 –85 Stigma, 100–101 Stratification, 51–54, 54 –59 Stratification, ethnic, 42– 47 Stratification, social, 39–64, 94 defined, 39– 41 Strengths perspective, 126, 134 Stress: acculturative, 7–11, 149, 215 –216 caregiver, 173 and Central Americans, 224 and elderly Latinos, 169 and suicide and depression, 186 Structured inequality, 65 –91, 100 Substance abuse, 187–190. See also Alcohol; Drug use and adolescents, 183 among Latinas, 189–190

343

and family cohesion, 188–189 and peers, 188–189 preventing, 200–201 risk and protective factors among Latino youth, 189–190 Suicide, 183, 185 –187 Support groups, 172 Support systems, 144, 168–169

T Task Force on Minority Mental Health, 129 Taxes, 298–301 Teen pregnancy, 193 –194 Teens. See Youth Texas, 13 –16 Theme Project, 199–200 Therapy, family, 152–153, 161–162, 203 –205 Therapy, group, 153, 205 –207 Therapy, individual, 207–208, 239 Thomas, Piri, 114 Tobacco use, 189 Transgender people, 109–111 Transphobia, 109–110 Transsexuals, 109

U Underemployment, 54 Underutilization, 128–129 Undocumented Latinos, 18, 105 –107, 291–292, 308–309 Unemployment, 154 U.S.-Mexico border, 303 –304

V Values, core, 142–143 Vieques, 22 Villaraigosa, Antonio, 295 Violence, 24 –26, 170, 192. See also Intimate partner violence (IPV)

orga_z03bindsub.qxd

344

2/5/07

10:55 AM

Page 344

SUBJECT INDEX

Voting, 59–61, 287, 290–292 Voting Rights Act, 292–295

and HIV/AIDs risk, 272 and politics, 310–311 and therapy, 235 –238 Workers, undocumented, 18, 44

W Washington, D.C., 196 –197 Washington Heights, 197 Wealth, 41 Weight loss, 253 Welfare: corporate, 298–301 reform, 53, 302–303 Western Hemisphere Act, 44 White conformity, 87 White dissonance, 88 White identity, 87–90 White immersion, 88–89 White integrative awareness, 89–90 White introspection, 89 White liberal syndrome, 88–89 White privilege, 46 – 47 White resistance, 88–89 Women: and communication, 237 and group therapy, 232

Y Young Lords, 75 Youth, 181–214. See also Adolescents addressing the problems affecting, 195 –199 involvement in the political process, 291 and mixed racial heritage, 113 psychosocial and health problems of, 183 –195 risk antecedents, markers and behaviors, 182 Youth Risk Behavior Surveillance Study, 187

Z Zoot Suit Riots, 18–19