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Background

Mexico is a North American country located directly south of the United States of America. It is the top country of origin for US immigrants, accounting for approximately one-quarter of all annual US immigration [1]. While Mexican immigration dates back to the 18th Century, there has been a recent influx starting around the 1980s [2]. St. Louis features a thriving Mexican community centered around Cherokee Street.

 

Mexican Americans predominantly speak Spanish, although a growing number of Hispanic Americans are bilingual and proficient in English [3].Roman Catholicism is the most prevalent religion among Mexicans and Mexican Americans [4]. However, it is noteworthy that Mexicans put a heavier emphasis on traditional health belief systems compared to Mexican Americans despite sharing a large number of cultural roots [4,5] 

Health Beliefs

  • The concept of ‘personalismo’ holds significant value among Mexican families [6].

  • There is an expectation for healthcare personnel to demonstrate warmth and personal engagement while conducting the treatment process with dignity. 

  • In line with Catholic beliefs, they may view illness as divine punishment or God’s will, with life ultimately being in God’s hands. 

  • Physical/mental ailments can be seen as imbalances between the person and their environment or hot/cold humor. 

  • Natural remedies, such as herbs, oils, and massages, have been utilized to treat illnesses, along with consulting folk healers (example). 

  • Some patients could participate in or perform spiritual practices to induce a supernatural being for the healing process [7].

  • Many light candles with pictures of Catholic saints to receive their aid; different saints are associated with specific illnesses [7].

  • “Evil Eye” or “Mal de Ojo” -  the worldwide belief that generally includes an evil figure/object/spirit put on another that causes the victim to fall ill [6].

  • This is particularly prevalent in Mexican culture as babies are considered weak and extremely susceptible to the power of an envious glance [6]. 

Social Traits

  • Patriarchal and age hierarchy 

  • Collectivist

  • Multigenerational living

  • Personalismo [8]

Implications for Health Practitioners/Health Questions

Greeting: Physical interaction signifies friendliness and approachability. A firm handshake along with eye contact is appropriate to greet Mexican patients. Older patients should be treated with heightened respect [4].

 

Many Mexicans may have two surnames: the father’s paternal family name followed by the mother’s paternal family name. This can be abbreviated to addressing the patient by the father’s paternal family name [4].

 

Many Mexicans rely on indirect communication and may avoid expressing their responses directly in sensitive or uncomfortable situations, specifically with regard to topics such as medication adherence or STIs [4].

 

Mental Health: Mental health illnesses and treatments may be stigmatized within the Mexican population. Individuals may view mental health illnesses as religious punishment or a direct burden to their families, resulting in dismissal and neglect of these symptoms. Outreach through religious institutions to promote mental health services can be beneficial to encourage well-being and treatment-seeking.  Interpretation services can also be useful in raising awareness of mental health, as some Mexican Americans may experience difficulties in finding mental health resources given the language barrier [9].

 

Diet: Mexican diets are a combination of Mesoamerican and Hispanic cuisines. Diet includes grains, ​​fruits, vegetables, animal fats, and legumes [10]. A clinical trial from 2016 compared the traditional Mexican diet to commonly consumed American diet, and the traditional Mexican diet showed moderate improvement in insulin sensitivity in healthy women of Mexican descent [10].

Questions

  • Healthcare Challenges:

    • In regard to your family history, are there any diseases/ conditions that you are concerned about? 

      • Pay special attention to coronary artery disease/ cardiovascular disease.  

  • Ask patients about additional treatments that they might be using.

    • At home, in addition to the treatment we are giving right now, is there another treatment that you are planning to follow? 

  • Diet:

    • Tell me about your diet. What does a healthy diet look like to you?

Women's Health

  • Limited access to care, lower income, sedentary lifestyle, and legal status are some of the main barriers to care among Mexican women [19,20]. They are less likely to take/receive preventable measures, such as mammograms or pap tests, which has led to a higher prevalence rate of avoidable conditions. 

  • Mexican women are vulnerable to abuse and mistreatment; specifically, they may suffer from lower self-esteem or intimate partner violence [21]. 

  • Mexican traditional medicine practices and herbal medicine are commonly used for women’s reproductive health complications. Herbal medicine specialists, massage therapists, and midwives may be recruited for women’s reproductive management [22].

Health Challenges

  • Hypertension is a major health challenge among Mexicans; the risk factors include their socioeconomic status, barriers to care, and the lack of health education [11]. Mexicans have high diabetes prevalence and mortality rates that could be attributed to hypertension, obesity, high cholesterol, and smoking [12].

    • For the two health issues above, Mexican women are at greater risk [13,14]. Many also live a sedentary lifestyle that could give rise to other health issues [15].

  • Although the addiction rates of Mexicans are similar to that of the general U.S. population, Mexicans have poorer outcomes from substance abuse programs [16,17]. 

  • Undocumented immigrants do not generally qualify for federal benefits or health programs. However, the Emergency Treatment and Medical Labor Act (EMTALA) ensures all patients, regardless of their immigration/documentation status, receive emergency medical care. EMTALA-related services are usually covered by emergency Medicaid [18].

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Conclusion

  • The concept of ‘personalismo’ expects healthcare personnel to demonstrate warmth and personal engagement while conducting their evaluations.

  • Be conscious of indirect communication with Mexican Americans.

  • Patients may neglect their mental health symptoms given the stigmatization of mental health illnesses and treatments within the Mexican population. Interpretational services or outreach to religious organizations may be beneficial in connecting patients to appropriate resources. 

  • The high diabetes prevalence and mortality rates in Mexican populations can be attributed to hypertension, obesity, high cholesterol, and smoking.

  • Women are more prone to preventable health conditions due to limited access to care.

Resources for Patients

  • Mental Health America

  • The Hispanic Leader Groups of St. Louis

    • Supports the advancement of the Hispanic community through networking, education, and advocacy

    • Link: https://www.stlhlg.org/

    • Address: Saint Louis Community College - Forest Park, Student Center, East Room #SC -031 (2024 April General Meeting Location)

  • Hispanic Chamber of Commerce Metro St. Louis

    • Aims to improve business opportunities for Hispanic and Latino firms and professionals, thereby improving the economic development of the St. Louis region

    • Link: https://www.hccstl.com

    • Address: 20 S. Sarah St., St. Louis, MO, 63108

    • Phone: 314 664 4432

    • Email: staff@hccstl.com

  • Internal Institute Saint Louis

    • An organization that provides opportunities for immigrants and refugees through integration services, such as English classes, employment, orientation, and citizenship preparation

    • Link: https://iistl.org

    • Address: 3401 Arsenal St., St. Louis, MO 63118

    • Phone: 314-773-9090

    • Email: info@iistl.org

  • Casa de Salud

    • A health care clinic that provides health services to uninsured and underinsured immigrants in St. Louis and its metro area. 

    • Link: https://www.casadesaludstl.org/

    • Address: 3200 Chouteau Avenue, Saint Louis, MO 63103

    • Phone: 314-977-1250

    • Email: info@casadesaludstl.org

This information was collected and organized by our team. As of this time, we have not yet been able to connect with any individuals in this community that could review this article. If you are interested in reviewing this article, please contact kaitlynn.borik@health.slu.edu

References

(1) Budiman, A. (2020, August 20). Key findings about U.S. immigrants. Pew Research Center. https://www.pewresearch.org/short-reads/2020/08/20/key-findings-about-u-s-immigrants/

(2) Hispanic Culture . (n.d.). Explore St.Louis.

https://explorestlouis.com/guide/how-to-connect-with-hispanic-culture-in-st-louis/

(3) Krogstad, J. M., & Gonzalez-Barrera, A. (2015, March 24). A majority of English-speaking Hispanics in the U.S. are bilingual. Pew Research Center. https://www.pewresearch.org/short-reads/2015/03/24/a-majority-of-english-speaking-hispanics-in-the-u-s-are-bilingual/

(4) Evason, N. (2018). Mexican Culture. Cultural Atlas. https://culturalatlas.sbs.com.au/mexican-culture

(5) Donoso, J. C. (2014, December 8). On religion, Mexicans are more Catholic and often more traditional than Mexican Americans. Pew Research Center. https://www.pewresearch.org/short-reads/2014/12/08/on-religion-mexicans-are-more-catholic-and-often-more-traditional-than-mexican-americans/

(6) Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Mexican American. (2020, November 2). Lamar Soutter Library. https://libraryguides.umassmed.edu/diversity_guide/mexican_american#:~:text=Mexicans%20have%20a%20strong%20belief

(7) Medina, C. (n.d.). Belief and Traditions that impact the Latino Healthcare. LSU School of Public Health. https://www.medschool.lsuhsc.edu/physiology/docs/Belief%20and%20Traditions%20that%20impact%20the%20Latino%20Healthcare.pdf

(8) Building Our Understanding: Culture Insights Communicating with Hispanic/Latinos. (2010, January 15). Center for Disease Control Healthy Communities Program. Retrieved April 23, 2024, from Center for Disease Control and Prevention. https://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/hispanic_latinos_insight.pdf 

(9) Latinx/Hispanic Communities and Mental Health. (n.d.). Mental Health America. https://www.mhanational.org/issues/latinxhispanic-communities-and-mental-health

(10) Santiago-Torres, M., Kratz, M., Lampe, J. W., Tapsoba, J.deD., Breymeyer, K. L., Levy, L., Villaseñor, A., Wang, C. Y., Song, X., & Neuhouser, M. L. (2016). Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: a randomized crossover feeding trial. The American journal of clinical nutrition, 103(2), 366–374. https://doi.org/10.3945/ajcn.115.119016

(11) Cangiano J. L. (1994). Hypertension in Hispanic Americans. Cleveland Clinic journal of medicine, 61(5), 345–350. https://doi.org/10.3949/ccjm.61.5.345

(12) Diabetes and Hispanic Americans. (n.d.). U.S Department of Health and Human Services Office of Minority Health. https://minorityhealth.hhs.gov/diabetes-and-hispanic-americans#:~:text=In%202018%2C%20Hispanics%20were%201.3

(13) Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA, 307(5), 483–490. https://doi.org/10.1001/jama.2012.40

(14) Mamtani, M., Kulkarni, H., Dyer, T. D., Almasy, L., Mahaney, M. C., Duggirala, R., Comuzzie, A. G., Blangero, J., & Curran, J. E. (2013). Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in mexican american families. PloS one, 8(3), e59153. https://doi.org/10.1371/journal.pone.0059153

(15) Blanding, M. (2021). Improving the Mexican diet. Harvard School of Public Health https://www.hsph.harvard.edu/news/features/improving-the-mexican-diet/

(16) Editorial Staffs of American Addiction Centers. Alcohol and Drug Abuse Among the Hispanic Population. (2024, February 7). American Addiction Centers. https://americanaddictioncenters.org/addiction-statistics/hispanic-americans

(17) Alvarez, J., Jason, L. A., Olson, B. D., Ferrari, J. R., & Davis, M. I. (2007). Substance abuse prevalence and treatment among Latinos and Latinas. Journal of ethnicity in substance abuse, 6(2), 115–141. https://doi.org/10.1300/J233v06n02_08

(18) Fact Sheet: Undocumented Immigrants and Federal Health Care Benefits. (2022, September 21). National Immigration Forum . https://immigrationforum.org/article/fact-sheet-undocumented-immigrants-and-federal-health-care-benefits/#:~:text=The%20Emergency%20Medical%20Treatment%20and

(19) de Leon Siantz, M. L., Castaneda, X., Benavente, V., Peart, T., & Felt, E. (2013). The health status of latino immigrant women in the United States and future health policy implications of the affordable care act. Global advances in health and medicine, 2(5), 70–74. https://doi.org/10.7453/gahmj.2013.066

(20) Paz, K., & Massey, K. P. (2016). Health Disparity among Latina Women: Comparison with Non-Latina Women. Clinical medicine insights. Women's health, 9(Suppl 1), 71–74. https://doi.org/10.4137/CMWH.S38488

(21) Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A.G. et al. Hispanic health in the USA: a scoping review of the literature. Public Health Rev 37, 31 (2016). https://doi.org/10.1186/s40985-016-0043-2

(22) Cabada-Aguirre, P., López López, A. M., Mendoza, K. C. O., Garay Buenrostro, K. D., Luna-Vital, D. A., & Mahady, G. B. (2023). Mexican traditional medicines for women's reproductive health. Scientific reports, 13(1), 2807. https://doi.org/10.1038/s41598-023-29921-1

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