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CALIFORNIA : Cultural Assimilation Is Bad for Your Health

December 17, 1995|David E. Hayes-Bautista and Gregory Rodriguez | David E. Hayes-Bautista and Gregory Rodriguez, associate editors at Pacific News Service, are, respectively, director of the Center for the Study of Latino Health at UCLA and senir fellow at the Alta California Research Center. They just completed a study on the health of Californians for Blue Cross of California

California's Latinas, the women most likely to be poor and lack health insurance, have an infant mortality rate 10% lower than Anglo women and 50% lower than African American women. A country's infant mortality rate has long been considered a primary indicator of its level of progress or lack thereof. While there is no doubt that poverty and inadequate health care take their toll on the quality of a community's health, the extraordinarily low infant-mortality rates of Latinas shed light on a long-overlooked determinant of human well-being: culture.

Most Asians and Latinos--Chinese, Filipinos and Mexicans--who migrate to California have considerably healthier babies and live several years longer than their kinfolk back home. The United States is clearly better for their health. In fact, California's Asian and Latino populations have lower overall death rates, a medical measure of a group's health, than do Anglos and African Americans, according to a Blue Cross-sponsored study.

Asian women live longer than any other segment of California society. Latino men live, on average, four and a half years longer than Anglo men. Asians suffer from virtually all major diseases at lower rates than any other group. Latinos have considerably lower age-adjusted rates of death from all three major contemporary killers: heart disease, cancer and stroke.

To be sure, the two groups have weaknesses in their health profiles. Latinos, for instance, die disproportionately of cirrhosis and diabetes. Asians have a higher rate of tuberculosis than any other group in California. Overall, however, the two are the only groups in the state who have met the major population health goals set for the year 2000 by the state Department of Health Services. A combination of auspicious living conditions and beneficial health behavior are responsible for these positive outcomes.

Before the great advances in public-health standards and modern medicine a half century ago, infectious diseases were among America's major health concerns. Today, the chief threats--heart disease, cancer and stroke--are largely brought on by lifestyle. Henrik Blum, a public-health pioneer, was the first to assert that the social/cultural networks of meaning and affection that mold individual behavior are, by far, the most important of the four major determinants of health in the post-industrial era. (Medical care, genetic predisposition and environment are the other three).

Two generations ago, patients were more or less passive beneficiaries of progress. Today, health is largely in the hands of individuals and the cultural norms and customs that shape their behavior. Dietary habits and cultural attitudes toward drugs, cigarettes and alcohol, as well as an individual's self-image and the role he or she plays in a social support network, are all important.

While researchers have long looked at race, class and socioeconomic status when studying Americans' health, they are only beginning to examine how cultural factors are relevant. The mores and customs of California's predominately foreign-born Asian and Latino adult populations are chiefly imported from the old country. Studies show that cultural norms make immigrant Latinas much less inclined to drink alcohol, take drugs or smoke during pregnancy than are Anglo or African American women. Cultural/religious prescriptions and proscriptions on behavior urging self-discipline, responsibility to others and faith protect people from threats to their health.

The cultural mores linked to social well-being are frequently the same as those that benefit health. In the past, immigrants' "old-world" ways lost their influence as each successive generation "Americanized." The gradual erosion of culturally rooted attitudes has been linked to increased mortality rates among culturally assimilated Asian Americans, as well as a slackening in study habits among third-generation Asian American youth. U.S.-born Latinas, who have higher incomes and greater access to prenatal care than immigrant women, have had higher infant mortality rates than their foreign-born counterparts. Teachers in Los Angeles' elementary schools say third-generation Mexican American children are much more likely to have disciplinary problems than immigrant children.

The American culture that immigrants must adapt to is not as robust and ascendant as it once was. The sad reality is that cultural assimilation has become bad for your health. While the "huddled masses" have never had it easy, the version of American culture that many of today's immigrants come to know first is the poisonous combination of dysfunction, decay, automatic weapons and drugs that characterizes inner cities.

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