Mark Glazer

Variation in Asthma Beliefs and Practices Among Mainland Puerto Ricans, Mexican-Americans, Mexicans, and Guatemalans

This study reports on community surveys of 160 representative Latino adults in Hartford, CT; Edinburg, TX; Guadalajara, Mexico; and in rural Guatemala. A 142-item questionnaire covered asthma beliefs and practices (e.g., causes, symptoms, and treatments). The cultural consensus model was used to analyze the agreement among respondents within each sample and to describe beliefs. Beliefs were then compared across the four samples. Analysis of the questionnaire data shows that there was overall consistency or consensus regarding beliefs and practices among individuals at each site (intraculturally) and to a lesser extent across respondents of all four different Latino cultural groups (i.e., interculturally). This pattern of response is indicative of a shared belief system among the four groups with regard to asthma. Within this shared belief system though, there is systematic variation between groups in causes, symptoms, and treatments for asthma. The most widely recognized and shared beliefs concerned causes of asthma. Notable differences were present between samples in terms of differences in beliefs about symptoms and treatments. The biomedical model is shown to be a part of the explanatory model at all sites; in addition to the biomedical model, ethnocultural beliefs such as the humoral (“hot/cold”) aspects and the importance of balance are also evident. The Connecticut Puerto Ricans had a greater degree of shared beliefs about asthma than did the other three samples (p<0.00005). It was concluded that the four Latino groups studied share an overall belief system regarding asthma, including many aspects of the biomedical model of asthma. In addition, traditional Latino ethnomedical beliefs are present, especially concerning the importance of balance in health and illness. Many beliefs and practices are site-specific, and caution should be used when using inclusive terms such as “Hispanic” or “Latino,” since there is variation as well as commonality among different ethnic groups with regard to health beliefs and practices.

A Cross-Cultural Approach to the Study of the Folk Illness Nervios

To systematically study and document regional variations in descriptions of nervios, we undertook a multisite comparative study of the illness among Puerto Ricans, Mexicans, Mexican Americans, and Guatemalans. We also conducted a parallel study on susto (Weller et al. 2002, Culture, Medicine and Psychiatry 26(4): 449– 472), which allows for a systematic comparison of these illnesses across sites. The focus of this paper is inter- and intracultural variations in descriptions in four Latino populations of the causes, symptoms, and treatments of nervios, as well as similarities and differences between nervios and susto in these same communities. We found agreement among all four samples on a core description of nervios, as well as some overlap in aspects of nervios and susto. However, nervios is a much broader illness, related more to continual stresses. In contrast, susto seems to be related to a single stressful event.

Regional variation in Latino descriptions of susto.

Susto, a folk illness notrecognized by biomedical practitioners as adisease, is now formally part of the diagnosticclassification system in psychiatry as a“culture-bound syndrome.” Susto has beenreported among diverse groups of LatinAmericans, but most of those reports areseveral decades old and many were conducted inIndian communities. This study focuses oncontemporary descriptions of susto anduses a cross-cultural, comparative design todescribe susto in three diverse Latinopopulations. Mestizo/ladino populations wereinterviewed in Guatemala, Mexico, and southTexas. An initial set of open-ended interviewswas conducted with a sample of “key” informantsat each site to obtain descriptive informationabout susto. A structured interviewprotocol was developed for use at all threesites, incorporating information from thoseinitial interviews. A second set of structuredinterviews was then conducted with arepresentative sample at each site. Resultsindicate a good deal of consistency in reportsof what susto is: what causes it, itssymptoms, and how to treat it. There appear tobe, however, some notable regional variationsin treatments and a difference between pastdescriptions and contemporary reports ofetiology.

Beliefs about AIDS in five Latin and Anglo‐American populations: The role of the biomedical model

Abstract This paper focuses on variability in beliefs about AIDS among Latin Americans, as compared with middle class Americans. Four geographically dispersed groups of Latin Americans were chosen for study as well as a middle class, largely Anglo‐American population. Coherent sets of beliefs were found at each site, and despite tremendous variability among the five populations, beliefs were remarkably similar across sites. The biomedical model is widely shared, and the critical variable in the extent to which it is understood is community prevalence of AIDS.

Susto and Soul Loss in Mexicans and Mexican Americans

Susto is a Latin American folk illness attributed to having a fright-ening experience, often including “soul loss” as part of the etiology. This article focuses on contemporary descriptions of susto among mestizos in Mexico and Mexican Americans in south Texas and explores the link between susto and soul loss in detail. Interviews conducted in Guadalajara, Mexico (n = 50), and in the Rio Grande Valley of Texas (n = 951) indicate that only a minority of informants aware of susto have also heard of soul loss and that even among those who have had susto, soul loss is not necessarily a part of susto. Soul loss, in fact, is more often equated with death. Our data, as well as a careful review of earlier reports of susto and soul loss, suggest that what was thought to have left the body may not be the “soul” but rather a “vital force.”

Crowding in Households: Chicago, Illinois Versus Istanbul, Turkey

The object of this paper is to do a cross-cultural analysis of household size and interaction, the goal being a better understanding of dense households as opposed to low density households, and the human interaction which takes place in these households. The households under scrutiny are in North Metropolitan Chicago and Istanbul, Turkey, and they are the households of the Jewish communities of these two areas. The results of the study show that the American community has smaller households and less human interaction than its Turkish counterpart, which seems to lead towards more personal stress.