week 12
Baltic Cultures
Larry Purnell, PhD, RN, FAAN
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Baltic Overview/Heritage
People of Baltic descent come from Estonia, Latvia, and Lithuania.
The countries of origin of these ethnic groups are sometimes referred to as the Baltics or the Baltic countries because each of them is located in Europe on the Baltic Sea.
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Baltic Overview/Heritage
Historical, cultural, religious, and language differences prevent the group from being one cultural entity.
These countries represent three distinct ethnic groups and are treated as such.
The Estonians are a Finno-Ugric people whose language is related to Finnish.
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Baltic Overview/Heritage
The Union of Soviet Socialist Republics (USSR) forcibly annexed Estonia in 1949 and maintained control until 1991 when Estonia regained its independence.
Latvia, situated between Estonia and Lithuania on the Baltic Sea, was independent from 1918 to 1940 when it was forcibly annexed by the USSR.
Latvia regained its independence in 1991.
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Baltic Overview/Heritage
Russians make up 29 percent of the population of Latvia; the remainder is made up of Byelorussians, Ukrainians, and Poles.
Most ethnic Latvians speak a Baltic language related to Lithuanian.
Lithuania was an independent country from 1918 to 1940 when the USSR forcibly annexed it.
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Baltic Overview/Heritage
In 1990, Lithuania re-declared its independence from Soviet rule.
For Lithuania, 83.5 percent are Lithuanians, 6.3 percent are Russians, 6.7 percent are Poles, and 3.7 percent other.
Lithuanian is a Baltic language related to Latvian.
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Baltic Overview/Heritage
The Baltic countries today are democratic, growing economically, and are successful compared with many other former Soviet Union countries where poverty and dictatorship have been predominant.
In 1940, the three Baltic countries lost their independent status to Germany and then to the USSR in 1941.
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Baltic Overview/Heritage
During this time, hundreds of thousands of Latvians, Lithuanians, and Estonians were deported in cattle cars to Soviet prison camps in Siberia.
Fearing death or deportation by the communist regime, Estonians, Latvians, and Lithuanians fled to the West by any means possible.
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Baltic Overview/Heritage
The post-World War II influx of immigrants to the United States came in 1949.
Because the immigrants fled from the religious, cultural, and political persecution of the Soviet regime and could not return to their native countries after World War II, the U.S. Congress facilitated their entry by enacting laws designating them as displaced persons.
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Baltic Overview/Heritage
Many of the post-World War II refugees were professionals.
All three Baltic countries have regular song festivals and dance festivals in the US and in the native countries too.
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Baltic Overview/Heritage
The Baltic countries are strong in the arts, and theater, opera, music of all types, and film continue to flourish.
During the past 10 years, the three Baltic countries have experienced a “brain-drain” to some extent because many of their highly educated have emigrated to the US and Europe.
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Baltic Overview/Heritage
Education is highly valued by people of Baltic descent. All three Baltic countries have high literacy rates.
Education is valued in itself and is seen as a way of improving life circumstances.
These immigrants made many sacrifices so their children could become educated. As a result, many Americans of Baltic descent have advanced degrees. Many are professionals in medicine and law.
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Baltic Communication
People of Baltic descent share thoughts and feelings readily.
The stereotype of quiet, stoic individuals is not borne out by observation or research.
For example, humor can be used to relate to these clients and is appreciated if used in the right context.
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Baltic Communication
Clients of Baltic origin may hesitate to share intimate thoughts and feelings related to their cultural sense of decorum, but this does not mean that they do not experience feelings and emotions.
They may wait to see if the health-care professional is caring and takes the time to actually listen to them.
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Baltic Communication
As a whole, people of Baltic descent are not flamboyant or highly volatile, but individual differences are always present.
Some individuals enjoy touch and close contact, while others do not.
Individuals from these cultures are receptive to a caring use of touch from family and close friends, but they may come across as more aloof with strangers.
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Baltic Communication
People of Baltic descent give attention to the past, present, and future.
The past is revered in the sense that significant historical events for each cultural group continue to be celebrated and acknowledged.
People of Baltic descent value frugality because they have had hard times in the past.
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Baltic Communication
People of Baltic descent view time similarly to the dominant American culture.
Individuals of Baltic descent have become acculturated to time awareness and deadlines; they arrive at appointments on time. Because of their strong work ethic and high value on work, they take pride in the efficient and wise use of their time.
Socially, however, they may be less aware of time and tend to be late.
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Baltic Communication
Individuals of Baltic descent generally use their American last name.
First names of women end in “a” and first names of men end in “as” or “s.” In their native languages, the last names indicate if the person is male or female; for females, the last name indicates if the woman is married or single.
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Copyright © 2013 F.A. Davis Company
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Baltic Communication
In Latvian, the typical last name ends in “ans,” “ins,” or “e” with the endings indicating masculine or feminine genders.
Estonian names are similar to Finnish names.
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Baltic Communication
The father is the head of the household in the typical family of Baltic heritage.
Both men and women in the family may have jobs and discuss major decisions.
Health-care and other major decisions are made jointly by both spouses.
Women in the family are given respect, and decision-making is done by both men and women.
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Baltic Family Roles & Organization
Because education is highly valued, parents encourage and supervise children in their school work and progress.
Corporal punishment was used by older generations but is practiced less by younger families.
Cultural activities, such as song or dance groups and ensembles, frequently unite people.
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ClickerCheck
The language spoken by people from the Baltic countries is
a. The same for Latvians and Lithuanians but different for Estonians.
b. The same for Estonians and Latvians but different for Lithuanians.
c. Different for each country.
d. The same for each country.
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Correct Answer
Correct answer: C
The language spoken by people from the Baltic countries is different for each country.
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Baltic Family Roles & Organization
The traditional nuclear family is still the standard in these cultural groups.
Family is highly valued and divorce is still fairly rare.
Lithuanian Americans are predominantly Roman Catholic, and their religion supports strong family values.
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Baltic Family Roles & Organization
Older people are respected in the Baltic cultures.
If grandparents are unable to live independently, every effort is made to have them move in with an adult child, usually a daughter.
Nursing homes are used when needed.
In America, a certain amount of respect is still given to professionals, but each cultural group has more of an egalitarian sense of community.
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Baltic Family Roles & Organization
The literature does not include information about same-sex couples in these cultures.
Because the dominant religions of the Baltic countries do not sanction homosexuality, few individuals and couples are openly homosexual.
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ClickerCheck
Newer immigrants from the Baltic countries should be assessed for
a. Malaria.
b. Thalassemia.
c. Orthopedic disorders.
d. Endocrine disorders.
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Correct Answer
Correct answer: D
Newer immigrants from the Baltic countries should be assessed for endocrine disorders because of radiation fallout from the Chernobyl accident.
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Baltic Workforce Issues
Material aspects are seen as secondary to the more important family values.
Responsibility is taken seriously and is encouraged.
People of Baltic descent adapt readily to American values of timeliness in the workplace.
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Baltic Workforce Issues
People of Baltic descent have no difficulty maintaining their sense of autonomy and readily take on work roles, responsibility, and decision making.
They usually do not like to confront those in authority directly and find ways to deal with difficult situations or people through the use of humor or deference.
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Baltic Workforce Issues
Recent immigrants who have lived under the Soviet regime may not be accustomed to making decisions for themselves or acting autonomously.
In previous governmental regimes, individuals and their rights were not considered important.
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Baltic Biocultural Ecology
People of Baltic descent have white skin. Estonians are similar to the Finns with brown hair and eyes, but some are blonde and blue-eyed.
Latvians and Lithuanians have fair complexions with blonde hair and blue eyes.
Recent immigrants from the Baltics may be at risk for cancer because of industrial pollution and radiation exposure from the Chernobyl nuclear disaster in 1988.
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Baltic Biocultural Ecology
Some immigrants are survivors of political torture, having spent years in prison labor camps in Siberia.
The incidence of alcoholism is high in the Baltics.
Ashkenazi Jews from the Baltic countries may respond differently to neuroleptic agents.
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Baltic High-Risk Health Behaviors
Exercise and physical activity are valued, and people of these cultures make an effort to get a reasonable amount of exercise.
Individuals who have emigrated to the United States in the last 15 years tend to continue to smoke.
Although many people of Baltic descent maintain jobs and are able to function, their use of alcohol is high.
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Baltic Nutrition
Because many individuals who left the Baltics after World War II experienced food shortages and times of starvation, food is important to these people.
Recent immigrants have left the Baltics for economic reasons and have also experienced food shortages.
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Baltic Nutrition
Some foods common among this cultural group are meats such as pork, chicken, and beef.
Rye and whole grain breads are popular.
Baked goods such as bacon rolls, yeast baked goods, and rich tortes and cakes are common.
Fresh fruits and vegetables are enjoyed.
Potato dishes such as potato pancakes, potato kugel, and potato dumplings are popular.
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Baltic Nutrition
Beets, mushrooms, and cabbage are used in soups and sauces.
Dairy products such as sour cream, butter, and yogurt are included daily in their meals.
Grain porridges are popular, especially among Latvians who have putras porridges.
The content of porridges varies according to regions in Latvia.
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Baltic Nutrition
Foods enjoyed by people of Baltic descent include smoked and unsmoked sausages, and smoked fish, eel, and pork.
The spices used are rather mild compared with those of other cultures, but foods may be high in salt content.
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Baltic Pregnancy & Childbearing Practices
In previous generations in the Baltics, infant mortality rates were very high. Large families were encouraged under communism.
Baltic people in the US use a variety of birth control measures.
Americans of Baltic descent use modern Western medicine practices obtain early prenatal medical care, and are receptive to health teaching for prenatal and postnatal care.
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Baltic Pregnancy & Childbearing Practices
Some women and families from these cultural groups prefer natural childbirth and breast-feeding.
Pregnant women are to remain calm and receive no shock or frightening news.
Godparents are important in the child’s life and traditionally give gifts, including candy, to each other and guests.
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Baltic Death Rituals
Death is viewed as part of life, and ceremonies of the wake and funeral are linked with Christian religious services.
The funeral may take place within 3 to 4 days following the death, providing time for out-of-town friends and relatives to gather.
Cremation is permissible.
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Baltic Death Rituals
The funeral is usually a Christian service, followed by a meal at which all attendees are welcomed. Burial is the usual practice.
Grief is expressed by sadness, crying, and talking about the deceased with fondness and respect.
Individuals from these cultures express emotions readily but not in highly dramatic ways.
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Baltic Death Rituals
Decorum is maintained in public and with strangers.
The dead are often remembered with frequent visits to the cemetery.
All Souls Day, November 2, Ve·line·s, is a significant day for Lithuanian Americans, with religious ceremonies commemorating the dead.
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Baltic Spirituality
Estonian Americans and Latvian Americans are predominantly Lutherans but include some Catholics, while Lithuanian Americans are predominantly Roman Catholic.
All these groups celebrate major Christian religious holidays, particularly Easter and Christmas.
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Baltic Spirituality
Individuals of these cultures consider themselves as having spiritual roots, which may be closely linked with their high value for their language, country, and culture.
Under Soviet rule, religion was forbidden; every effort to eradicate all traces of religious belief.
Religion was replaced by communist dogma for 50 years.
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Baltic Spirituality
A very small percentage of Latvians maintain an ancient pagan religion.
This religious group is called Dievtui (those with God) and has a high priest as the head of the group.
Stories include myths and folk wisdom in rhyme as an important part of their content.
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Baltic Spirituality
Most Americans of Baltic descent consider prayer an individual expression of their faith.
Many have been sustained through hardships by their strong religious faith and continue to have strong religious needs.
Spiritual and religious considerations are considered private and may not be readily shared with health-care professionals.
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Baltic Spirituality
Clergy from the client’s church are usually welcome.
Clients find considerable comfort in speaking with the clergy in times of crises and serious illness.
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Baltic Health-care Practices
Individuals of Baltic descent adhere to modern medical regimens and readily use the health-care system available to them.
Because they consider health and well-being important, they take an active interest in healthy lifestyles, nutrition, and exercise.
Fresh air is considered important, and walking, especially in natural settings such as parks, is enjoyed by all ages.
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Baltic Health-care Practices
People of Baltic descent assume responsibility for their own health.
Because work is highly valued, most are in the workforce and have insurance coverage.
Medical care and hospitalization are sought readily. Attempts are made to maintain health even into old age.
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Baltic Health-care Practices
Recent immigrants from the Baltics to America may have different values because they lived under a communist regime in which the government “took care” of their medical needs.
These immigrants often need help understanding the American health-care system and may be reluctant to use it if they have no medical insurance coverage.
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Baltic Health-care Practices
Chamomile and linden blossom teas may be used for fevers and colds.
Honey is used for colds and sore throats.
Younger people prefer to use over-the-counter cold remedies and analgesics. The use of natural substances for healing purposes is not customary among this generation.
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Baltic Health-care Practices
Among older Baltic immigrants, language may continue to present difficulty if they have not learned English well.
Many older individuals may tolerate pain as a part of life and may not complain about it or report it.
Some stigma is attached to mental illness, but medical care is sought.
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Baltic Health-care Practices
Most people of Baltic descent accept physical handicaps, mental illness, and mental retardation.
The family usually cares for the individual at home.
Americans of Baltic descent do not enjoy the sick role and avoid it when possible.
Work is highly valued and the person returns to normal responsibilities as soon as possible.
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Baltic Health-care Practices
Most people of Baltic descent accept blood transfusions and organ donation and transplantation.
The use of extraordinary means to preserve life is an individual decision, but living wills are frequently used.
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Baltic Health-care Practitioners
Besides family members and friends providing informal traditional health practices, no traditional health-care providers are found among people of Baltic descent in the United States or in the Baltics.
Because education is highly valued by people of Baltic descent, physicians, dentists, and nurses are held with respect.
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Baltic Health-care Practitioners
Advice given to their clients is usually followed.
People of Baltic descent are used to both men and women giving direct physical care.
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Baltic Health-care Practitioners
Nurses and health-care practitioners need to provide for privacy and consider the modesty needs of female and male clients of these cultures as they would for any client.
Older clients of both sexes are used to being treated with respect.
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