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Flashcards in The Family, Culture, and Illness Deck (66):
1

Types of families:

1. The TRADITIONAL NUCLEAR FAMILY.
2. Cohabiting heterosexual.
3. Gay-parent families.
4. Single-parent families.
5. Extended family.

2

The traditional nuclear family includes:

1. Mother.
2. Father.
3. Dependent children (ie under age 18).
living together in one household.

3

The extended family includes family members, such as ...?

1. Grandparents.
2. Aunts.
3. Uncles.
4. Cousins.
Who live outside the household.

4

Demographics and current trends - Marriage and children - In the USA, the average age of 1st marriage is ...?

25 for women.
27 for men.

5

Most people 30-54 are ...?

MARRIED.

6

What is the importance of a good marriage?

An improtant predictor of health.
--> Married people are MENTALLY + PHYSICALLY healthier and have a higher self-esteem than unmarried people.

7

Approx. ...% of children live in families with 2 working parents.

50%.

8

Only ...% of children live in the "traditional family".

25%.

9

Raising children is expensive. The total cost of raising a child to age 17 in the USA is currently more than ...?

200.000USD.
--> Post-secondary education can effectively DOUBLE THIS FIGURE.

10

Percentage of White, African American and Latino Children living in different family types in 2010 - White American:

Married parents --> 71.5%.
Single mother --> 18.3%.
Single father --> 3.5%.
No parent --> 3.4%.

11

Percentage of White, African American and Latino Children living in different family types in 2010 - African American:

Married --> 34.7%.
Single Mother --> 49.7%.
Single Father --> 3.6%.
No parent --> 7.5%.

12

Percentage of White, African American and Latino Children living in different family types in 2010 - Hispanic American (Latino):

Married parents --> 60.9%.
Single mother --> 26.3%.
Single father --> 2.7%.
No parent --> 4%.

13

Divorce and single-parent families - How many marriages in the USA end in divorce?

50%.

14

Factors associated with divorce include:

1. Short courtship.
2. Lack of family support.
3. Premarital pregnancy.
4. Marriage during teenage years.
5. Divorce in the family.
6. Difference in religion or socioeconomic background.
7. Serious illness or death of a child.

15

Physicians have a higher or a lower divorce rate than people in other occupations?

HIGHER.

16

Single-parent families - What is the main features?

Often have LOWER INCOMES + LESS SOCIAL SUPPORT --> Incr. chances of physical and mental illness.

17

While many unmarried mothers belong to low socioeconomic groups, the fastest growing population of single mothers is ...?

EDUCATED PROFESSIONAL WOMEN.

18

Most single-parent families are headed by ...?

WOMEN.

19

Children in single-parent families are at increased risk for:

1. Failure in school.
2. Depression.
3. Drug abuse.
4. Suicide.
5. Criminal activity.
6. Divorce.

20

Children in single-parent families - Even if the noncustodial parent does NOT provide financial support, children who continue to have ...?

REGULAR CONTACT WITH THAT PARENT have FEWER of the aforementioned problems than those who have NO CONTACT.

21

Child custody - After divorce, the types of child custody that may be granted by the courts include ...?

1. Joint.
2. Split.
3. Sole custody.
--> FATHERS are increasingly being granted JOINT or SOLE custody.

22

In sole custody:

The child lives with 1 parent while the other has VISITATION RIGHTS.

23

Until quite recently, what was the MC type of custody arrangement after divorce?

SOLE CUSTODY.

24

In joint residential custody:

Has become more popular --> The child spends some time living with each parent.

25

In split custody:

Each parent has custody of at least one child.

26

Population of the USA:

310 million.

27

The population of the USA is made of ...?

MANY MINORITY SUBCULTURES as well as large, white middle class, which is the major cultural influence.

28

Although many subcultures have formed the American culture, the culture seems to have certain characteristics of its own?

1. Financial and personal independence are valued at all ages and especially in the elderly.
2. Most elderly Americans spend their last years living on their own; only about 20% live with family members and about 5% live in nursing homes.
3. Emphasis is placed on personal HYGIENE and cleanliness.
4. The nuclear family with few children is valued.

29

Culture and illness - In certain ethnic groups, it is believed that illness can be cured by eating certain foods. Therefore,

If NOT contraindicated medically, the doctor should attempt to make available the food the ill patient believes can help him or her.

30

Culture and illness - The idea that an outside influence (eg a hex or a curse imposed by the anger of an acquaintance or relative) can cause can cause illness is seen in some ethnic groups. The doctor should ...?

NOT DISMISS the patient's belief, but rather should ask the patient who can help to remove the curse and involve that person in the management plan.

31

Acculturative stress - Other term is ...?

CULTURE SHOCK.

32

What is acculturative stress?

An emotional response, involving psychiatric symptoms as well as increased susceptibility to disease, which is related to GEOGRAPHIC RELOCATION and the need to adapt to unfamiliar social and cultural surroundings.

33

What may reduce the acculturative stress?

When groups of immigrants of a particular culture live in the same geographic area.

34

Who appears to be at higher risk for acculturative stress?

YOUNG IMMIGRANT MEN - Including symptoms such as PARANOIA + DEPRESSION.

35

Why are young immigrant men at higher risk fo acculturative stress?

1. Young men lose the most status on leaving their culture of origin.
2. Unlike others in the group who can stay at home among familiar people, young men often must get out into the new culture and earn a living.

36

Ethnic disparities in helath care:

Racial and ethnic minorities in the USA often obstacles in obtaining quality mental and physical health care.

37

Ethnic disparities in health care result in part from:

1. Economic factors, for example, the average income of African American families is only about HALF THAT OF WHITE FAMILIES.
2. Decreased physical access to health care.
3. Doctor-patient communication difficulties.
4. Overt bias and negative racial stereotypes held by majority physicians.
5. Relative scarcity of minority physicians.

38

How many African Americans are living in the USA?

37 million (12.4% of the total population).

39

Compared to white Americans, African Americans have:

1. Shorter life expectancies.
2. Higher rates of HTN, heart disease, stroke, infant mortality, obesity, asthma, TB, diabetes, prostate cancer, and AIDS.
3. Higher DEATH rates from heart disease and from most forms of cancer.

40

African Americans - Religion and strong extended family networks play what role?

MAJOR ROLE in social and personal support among many African Americans.
--> This may explain why the overall suicide rate is LOWER among African Americans than among white Americans.

41

Cause of death in African American teenagers?

1st = Homicide.
2nd = Accidents.
3rd = Suicide.

42

Cause of death in white teenagers:

1st = Accidents.
2nd = Homicide.
3rd = Suicide.

43

Hispanic/Latino Americans - Overview - With ..., Hispanic Americans (mainly people from spanish-speaking regions of Latin America, ie Latinos) are now the LARGEST minority group in the USA.

45 million.

44

As a group, Latinos place great value on which types of family?

Nuclear family + On nuclear families with many children.

45

Hispanic Americans - Respect for the elderly?

IMPORTANT --> Younger people are expected to care for elderly family members, to protect elderly relatives from negative medical diagnoses, and, often, to make medical decisions concerning the care of elderly relatives.

46

Among some Latinos, "hot" and "cold" influences are ...?

Believed to relate to illness.

47

Latino women are less likely to get ...?

MAMMOGRAMS.

48

Latino women are more likely to have?

Cervical cancer than are white or African American women.

49

2/3 of all Latinos, especially in the Southwest, are of ... ?

MEXICAN ORIGIN.

50

The 2nd largest group of Latinos is of ...?

PUERTO RICAN ORIGIN (4 million people) - Most live in the Northeastern states.

51

Over ... Latinos are of CUBAN origin and live primarily in the Southeast, especially Florida.

1.5 million.

52

Although the explanation is elusive, Latinos have ...?

LONGER LIFE EXPECTANCIES than African-Americans or White Americans.

53

Asian Americans - How many?

More than 13 million Asian Americans in the USA.

54

Asian Americans - The largest groups are:

1. Chinese.
2. Filipino.
3. Asian Indian.

55

Other Asian American groups include:

1. Vietnamese.
2. Korean.
3. Japanese.

56

Asian Americans - Characteristics of these cultures include the following:

1. As in Latino cultures, adult Asian American children show STRONG RESPECT FOR and ARE EXPECTED TO CARE FOR THEIR ELDERLY PARENTS.
2. Patients may express emotional pain as physical illness.
3. In some Asian American groups, the ABDOMINAL-THORACIC AREA, rather than the brain, is often thought to be the SPIRITUAL CORE of the person. Thus, the concept of brain death and resulting organ transplant are generally not well accepted.

57

Asian Americans - Coining?

Folk remedies include coining (a coin is rubbed on the affected area pressing a medicated oil into the skin).
--> Injuries occurring as a result of use of such remedies may be mistaken by medical personnel for abuse.

58

Native Americans: American Indians and Eskimos - How many?

2.4 million.

59

Native Americans: American Indians and Eskimos - Have their own program of medical care under the direction of the ...?

INDIAN HEALTH SERVICE of the federal government.

60

Native Americans: American Indians and Eskimos - The distinction between mental and physical illness may be blurred:

Engaging in forbidden behavior and witchcraft are thought to result in illness.

61

In general, Native Americans have ...?

1. Low incomes.
2. High rates of alcoholism.
3. High rates of suicide (Particularly among teenagers).

62

Americans of Middle Eastern/North African descent - How many?

1.2 million.

63

People who follow the Muslim religion value ...?

FEMALE MODESTY + purity.
--> Female patients may wish to remain as covered as possible in the examining room (eg head and face covered by a scarf).
--> They often prefer to have a female physician, or, if examined by a male physician, may wish to have their husband or mother present.
--> Physicians SHOULD MAKE EVERY EFFORT TO HONOR SUCH WISHES.

64

Americans of European descent - Anglo Americans:

Those originating in English-speaking European countries, mostly IRELAND.

65

Anglo Americans in general are ...?

1. Less emotional.
2. More stoic.
3. Less vocal about pain and illness than members of groups of Mediterranean origin (eg Jewish, Greek, and Italian people).
4. Therefore, Anglo Americans may become very ill before seeking treatment, while people of Mediterranean origin may be considered complainers and ignored when they are, in fact, quite ill.

66

Overview of the family - Definition:

A group of people related by blood, adoption, or marriage.