Develop an outline for research paper. USE SAMPLE OUTLINE FOR FORMAT

d. In 2000, over 33 million Mexican-Americans lived in the U.S., primarily in California, Florida and Texas -- the largest minority group in the United States.

II. Identify health disparities by comparing descriptive epidemiology of group to majority group or another group

a. Increased morbidity and mortality rates from diabetes and lung disease from not having health insurance.

b. Twice as likely to have chronic type-two diabetes over non-Latinos.

c. Increased risk for cardiovascular disease and myocardial infarction among Mexican-American males

III. Discusses socio-economic, language, political, religious and other factors that contribute to the health disparities

a. First generation Mexican-Americans attempt to keep their culture intact by speaking Spanish as their primary language. Many youth speak “Spanglish.”

b. They comprise 83% of the U.S. farm/agriculture workers and industrial jobs with long hours and low pay.

c. Poverty levels of undocumented workers, moving seasonally, separation from families, hard physical labor results in back pain and arthritis, poor dental health and malnourishment.

IV. Describe all common health behaviors of the group with supporting and detailed evidence

a. Theory of hot and cold imbalances --to cure an illness, you apply the opposite principle.

b. Prayer and herbs, people called yerbero (specializing in herbs).

c. Folk medicine uses healers: Curanderas focus on sins of the patient as the reason for illness. Witches practice black, red and green magic

d. Often diagnosed with advances stages of breast cancer due to fewer cancer screenings.

V. Describe commonly held attitudes, beliefs and values (health beliefs) by the group with supporting and detailed evidence.

a. Family oriented, with many living in neighborhoods where they keep their traditions and language intact. Familiaismo, or family/group values are emphasized over individualism.

b. Concept of respect -- a strong sense of respect for elders or those in authority.

c. Men tend to have a strong sense of machismo so they may not acknowledge mental health issues or seek help from outside the family.

d. Women suffer stress due to changing societal roles where they may be expected to work outside the home while still maintaining household duties and raising their children.

VI. Provide recommendations for improving culturally and linguistically appropriate services for the selected group with supporting evidence and detailed support.

a. Understand overall belief systems: the concept of espiritu, (mind/body/spirit each working together. Personalismo, (developing personal over impersonal - institutional physician/patient – relationships. Confianza (a trust/confidence relationship developed over time).

b. Avoid stereotyping

c. Recognize cultural differences of health values and ethnic practices, family life, diet, and the availability of insurance. Helping navigate health care and education systems.

References

Giger, J. & Davidhizer, R. (2008). Transcultural nursing: Assessment and intervention (5th ed.). St. Louis, MO: Mosby Elsevier.

Jandt, F. (2010). An introduction to intercultural communication: Identities in a global community. London: SAGE, 2010.

Kline, M., & Huff, R. (2007). Health promotion in multicultural populations (2nd ed.). Thousand Oaks, CA: Sage Publications.

Russell, Y., Williams, M, Farr, P, Schwab, J. & Plattsmier, S. (1993). Patterns of contraceptive use and pregnancy among young Hispanic women on the Texas-Mexico border. Journal of Adolescent Health, 14(5), 373-9.