28 Dec 7. Identify strategies for obtai

AFRICAN AMERICAN CASE STUDY #2

Mr. and Mrs. Evans are an African American couple who retired from the school system last year. Both are 65 years of age and reside on 20 acres of land in a large rural community approximately 5 miles from a Superfund site and 20 miles from two chemical plants. Their household consists of their two daughters, Anna, aged 40 years, and Dorothy, aged 42 years; their grandchildren, aged 25, 20, 19, and 18; and their 2- year-old great-grandson. Anna and Dorothy and their children all attended the university. Mr. Evans’s mother and three of his nieces and nephews live next door. Mr.Evans’s mother has brothers, sisters, other sons and daughters, grandchildren, and great-grandchildren who live across the road on 10 acres of land. Other immediate and extended family live on the 80 acres adjacent to Mr. Evans’s mother. All members of the Evans family own the land on which they live. Mrs. Evans has siblings and extended family living on 70 acres of land adjacent to Mr. Evans’s family, who live across the road. Mr. and Mrs. Evans also have family living in Chicago, Detroit, New York, San Francisco, and Houston. Once a year, the families come together for a reunion. Every other month, local family members come together for a social hour. The family believes in strict discipline with lots of love. It is common to see adult members of the family discipline the younger children, regardless of who the parents are. Mr. Evans has hypertension and diabetes. Mrs. Evans has hypertension. Both are on medication. Their daughter Dorothy is bipolar and is on medication. Within the last 5 years, Mr. Evans has had several relatives diagnosed with lung cancer and colon cancer. One of his maternal uncles died last year from lung cancer. Mrs. Evans has indicated on her driver’s license that she is an organ donor.

Sources of income for Mr. and Mrs. Evans are their pensions from the school system and Social Security. Dorothy receives SSI because she is unable to work any longer. Mr. Evans and his brothers must assume responsibility for their mother’s medical bills and medication. Although she has Medicare parts A and B, many of her expenses are not covered.

Mr. and Mrs. Evans, all members of their household, and all other extended family in the community attend a large Baptist church in the city. Several family members, including Mr. and Mrs. Evans, sing in the choir, are members of the usher board, teach Bible classes, and do community ministry.

Study Questions

1. Describe the organizational structure of this family and identify strengths and limitations of this family structure.

2. Describe and give examples of what you believe to be the family’s values about education.

3. Discuss this family’s views about child rearing.

4. Discuss the role that spirituality plays in this family.

5. Identify two religious or spiritual practices in which members of the Evans family may engage for treating hypertension, diabetes, and mental illness.

6. Identify and discuss cultural views that Dorothy and her parents may have about mental illness and medication.

7. To what extent are members of the Evans family at risk for illnesses associated with environmental hazards?

8. Susan has decided to become an organ donor. Describe how you think the Evans family will respond to her decision.

9. Discuss views that African Americans have about advanced directives.

10. Name two dietary health risks for African Americans.

11. Identify five characteristics to consider when assessing the skin of African Americans.

12. Describe two taboo views that African Americans may have about pregnancy.

N512 Diverse Populations & Health Care

Module 4 Assignment

Complete the following Case Studies :

Mexican case study #2

Puerto Rican case study #2

Write a 3-4 page APA essay, using two scholarly sources in addition to the textbook.

MEXICAN CASE STUDY #2

Pablo Gaborra, aged 32, and his wife, Olga, aged 24, live in a migrant-worker camp on the eastern shore of Maryland. They have two children: Roberto, aged 7, and Linda, aged 18 months. Olga’s two younger sisters, Florencia, aged 16, and Rosa, aged 12, live with them. Another distant relative, Rodolpho, aged 28, comes and goes several times each year and seems to have no fixed address. Pablo and Olga, born in Mexico, have lived in the United States for 13 years, first in Texas for 6 years and then in Delaware for 1 year, before moving to the eastern shore of Maryland 5 years ago. Neither of them have U.S. citizenship, but both children were born in the United States. Pablo completed the sixth grade and Olga the third grade in Mexico. Pablo can read and write enough English to function at a satisfactory level. Olga knows a few English words but sees no reason for learning English, even though free classes are available in the community. Olga’s sisters have attended school in the United States and can speak English with varying degrees of fluency. Roberto attends school in the local community but is having great difficulty with his educational endeavors. The family speaks only Spanish at home. Not much is known about the distant relative, Rodolpho, except that he is from Mexico, speaks minimal English, drinks beer heavily, and occasionally works picking vegetables. The Gaborra family lives in a trailer on a large vegetable farm. The house has cold running water but no hot water, has an indoor bathroom without a shower or bathtub, and is heated with a wood-burning stove. The trailer park has an outside shower, which the family uses in the summer. The entire family picks asparagus, squash, peppers, cabbage, and spinach at various times during the year. Olga takes the infant, Linda, with her to the field, where her sisters take turns watching the baby and picking vegetables. When the vegetablepicking season is over, Pablo helps the farmer to maintain machinery and make repairs on the property. Their income last year was $30,000. From the middle of April until the end of May, the children attend school sporadically because they are needed to help pick vegetables. During December and January, the entire Gaborra family travels to Texas to visit relatives and friends, taking them many presents. They return home in early February with numerous pills and herbal medicines.

Olga was diagnosed with anemia when she had an obscure health problem with her last pregnancy. Because she frequently complains of feeling tired and weak, the farmer gave her the job of handing out “chits” to the vegetable pickers so that she did not have to do the more-strenuous work of picking vegetables. Pablo has had tuberculosis for years and sporadically takes medication from a local clinic. When he is not traveling or is too busy picking vegetables to make the trip to the clinic for refills, he generally takes his medicine. Twice last year, the family had to take Linda to the local emergency room because she had diarrhea and was listless and unable to take liquids. The Gaborra family subscribes to the hot and cold theory of disease and health-prevention maintenance.

Study Questions

1. Identify three socioeconomic factors that influence the health of the Gaborra family.

2. Name three health-teaching interventions the health-care provider might use to encourage Olga to seek treatment for her anemia.

3. Identify strategies to help improve communications in English for the Gaborra family.

4. Identify three health-teaching goals for the Gaborra family.

5. Name three interventions Olga must learn regarding fluid balance for the infant, Linda.
7. Identify strategies for obtai
6. Discuss three preventive maintenance–teaching activities that respect the Gaborra family’s belief in the hot and cold theory of disease management.

7. Identify strategies for obtaining health data for the Gaborra family.

8. Identify four major health problems of Mexican Americans that affect the Gaborra family.

9. If Olga were to see a folk practitioner, which one(s) would she seek?

10. Explain the concept of familism as exhibited in this family.