Health traditions between cultures vary according to the heritage a family is part of. The Heritage Assessment Tool helps evaluate the family whom is interviewed in order to develop a plan for health maintenance, health protection, and health restoration. Each culture offers a different set of traditions and beliefs that contribute to the health care practices they participate in and how the traditions of that heritage are incorporated into the health practices present in the United States.
The three families that were interviewed using the Heritage Assessment Tool were families from Native American Indian ancestry, Mexican ancestry, and Portuguese ancestry. All three families were born and raised in the United States, but their ancestors were from other countries, except the Native American family. Although these families were born and raised in the United States, they still carried on some of the traditions from their ancestors.
There are many similarities within the three cultures above. All three cultures are family oriented, family is considered to be very important and family gatherings to celebrate holidays and rituals are huge gatherings that involve all the relatives old and young. It is common for these cultures to have large families; it is not unusual to have more than just the immediate family living in the home. In Mexican, Portuguese, and American Indian households, other family members also live in the same household.
All three cultures also have many differences, such as difference in traditional foods, religious practices, and health traditions. It is important to assess these differences and utilize cultural awareness and competency in order to provide quality health care. Therefore, their cultural preferences should be incorporated to protect, maintain, and restore health among their community.
There are cultural patterns that are represented in the Native American family, Mexican family, and Portuguese family that were interviewed, not all traditions and rituals were still being practiced in the families. These families had relatives of American Indian, Mexican, and Portuguese descent, but they themselves were not living in a current tribe, traditional Mexican or Portuguese atmosphere. Some traditions are still carried on within the families and some are not.
The American Indian, Mexican, and Portuguese people traditionally place a huge value on family, which includes all of the immediate family and extended family as well as tribal members of the American Indians. The women in the American Indian family are traditionally the caregivers. Grandparents play a big role in the family, they often are the ones who counsel and care for the grandchildren in the family. Children must respect their elders and follow their advice. Children are also expected to care for their elders when they need it too. There is a huge sense of pride within the American Indian culture and children are raised to be proud of their heritage. Elders are always catered to first during gatherings; they are served their meal first and are given special seating arrangements. It is important for the youth to be educated on the traditions and cultures of the American Indian community they are from (“Cultural Group Guides,” 2010).
In the traditional Mexican family, extended family such as grandparent, aunts, uncles, and cousins along with godmothers and godfathers live in the same home or neighborhood. The head of the household is traditionally the man. Families in the United States will send home money to support families who are still Mexico. It is a vital part of Mexican culture to spend most of their time with family and friends in their community. There is high value on children and a respect for elders is also traditionally followed. Mexicans value respect and friendliness and utilize eye contact and physical contact to show respect among each other (“Cultural Group Guides,” 2010).
Portuguese families are a lot like the Mexican and Indian families. The family highly values the extended family as being part of the family structure. The Portuguese person relies on family as a social network and for assistance with needs. Portuguese people value loyalty to their family and all family members come before any social relationships including business relationships (Norden, 2015). The traditional diet of the American Indian used to be healthy and nutritious and consisted of three staples, corn, squash, and beans. Other foods that have been used widely in Native American culture include greens, deer meat, berries, pumpkin, squash, and wild rice (“Native American Food,” 2015). Now their diet is poor in quality and contains more high fat, and salt, and sugar, and less fruits, vegetables, and whole grains. There is also a disparity within the American Indian Community due to poverty and lack of healthy food in this cultural group (“Native American Food,” 2015).
The traditional diet among the Mexican culture consists of fruits, vegetables, corn tortillas, whole grains, and eggs. The diet adopted by the Mexican culture within the United States is lower on fruits and vegetables and higher on the processed foods, along with flour tortillas, and white rice, which are unhealthy compared to the traditional diet. In the traditional Mexican family, large meals were eaten at noon with a smaller meal at dinnertime that was shared with the extended family. Now, the tradition has been replaced with less home cooked meals and more fast food meals which has increased the obesity, diabetes, and hypertension rates in this heritage. There is also a high consumption of alcohol in this population that creates a health risk. Other considerations with food in the Mexican tradition is treating illness with hot foods and balancing hot and cold foods to preserve health (“Cultural Group Guides,” 2010).
Traditional Portuguese dishes include fish, due to the countries position on the Atlantic Ocean, salted cod is a popular food eaten in this family along with sardines, sea bass, anchovies, shellfish and swordfish. Pork, vegetables, rice, and potatoes are also common foods eaten by Portuguese’s people (Norden, 2015). In the family interviewed on Portuguese heritage, the traditional dishes of Portugal are not incorporated into their lifestyle. They consume more American foods with the unhealthy practice of eating more high fat, high sodium containing foods and fast food, which contributes to obesity, diabetes, and hypertension.
Religion within the American Indian Culture is centered on spirituality and is holistically viewed. Nature is seen as being interconnected to the person. Furthermore, all forms of life have a spirit and are sacred; thus, all life must be nurtured and respected with the spirits. Indians use prayer and purification rituals to nurture and develop a relationship with spirits they perform these rituals in a sweat lodge which involves a medicine man as the spiritual leader. Sage and sweet grass are burned, along with smoking a ceremonial tobacco, to cleanse, bless, or heal during these ceremonies. Singing, dancing, and drumming are also practiced at these ceremonies to practice healing (“Cultural Group Guides,” 2010). The family I interviewed does not participate in these ceremonial practices, probably due to the past assimilation policies that made American Indians intergrade into the dominant society, which made it illegal for them to practice theses ceremonies until the American Indian Religious Freedom Act was passed in 1978 (“Cultural Group Guides,” 2010). This resulted in many Indians adopting the Christian religion as their religion today. The family who was interviewed is practicing Christians and practice religion with the bible and prayer. A culturally competent nurse should assess the religious practices of an American Indian patient and allow any safe practices associated with their traditions. Lighting sage may not be allowed in a hospital setting; however, song and dance may be incorporated in care if desired. If the family is a practicing Christian, then prayer and the utilization of a pastor are religious considerations you can offer the family.
The Majority of Mexican families are Roman Catholics. Most Mexican Catholics attend church on a regular basis and their religion is a huge part of their daily life. Catholics pray to God, Jesus, the Virgin Mary and Saints as part of their rituals in church and at home (“Cultural Group Guides,” 2010). They celebrate religious holidays such as Christmas an Easter and practice baptism and confirmations. Shrines of their religious figures are important in their homes and churches that they light candles for and pray to. It is important as nurse to incorporate their religion into their health by allowing prayer and religious items to be used and offering to call a Priest to visit. This will help gain and establish trust from the patient and family.
The majority of Portuguese families are also Roman Catholics, and the Portuguese culture follows the same religious practices as the Mexican families. Therefore, the Portuguese population believes in God, and believes that they have a gift from God. This gift belongs to their family and is passed down within the family generation to generation (Norden, 2015).
Medical issues and disparities within the American Indian Culture include heart disease, cancer, diabetes, chronic liver disease, cirrhosis, chronic respiratory disease, suicide, flu/pneumonia, kidney disease, obesity, alcohol abuse, and smoking. Heart disease, cancer, diabetes, and stroke are the leading cause of death in this culture (Centers for Disease Control and Prevention [CDC], 2012). Prevalence of smoking is the highest in all ethic groups because there is not state laws on Indian owned lands that prohibit minors from tobacco products, therefore increasing the rate of chronic smokers. Smoking is a huge risk factor in health problems described above. Since health and spirituality are related in the Indian culture, being sick is viewed as being a disharmony among the sources of life (“Cultural Group Guides,” 2010). It is important to know if a patient has sought treatment from a medicine man or a traditional healer, in order to recognize what medications were utilized that may react with medications prescribed by a western practice. Furthermore, it is important to discuss all beliefs and practices with the patient and try to gain trust by using cultural awareness. This enables the nurse to find out what can be safely prescribed and how to educate the patient on their health concerns.
In the Mexican culture diabetes is twice as prevalent than in the white population. Obesity and hypertension are also common health issues in the Mexican population. Cervical Cancer is more prevalent in Mexican women than in white women (“Cultural Group Guides,” 2010). A lack in health insurance is a disparity among this culture. Mexican’s may consult folk healers or spiritualists to use herbal remedies if they cannot afford healthcare. Cultural competent care is vital to gain trust from this culture. A nurse should be gracious, address them by their preferred name, establish a rapport with the family, address the male in the family, use friendly touch, use eye contact, address family members, address religious considerations, address language barriers by utilizing a trained interpreter, and ask if they used ay home remedies. This will help establish a relationship before care begins (“Cultural Group Guides,” 2010).
In Portuguese populations there are less health issues reported than the Indian and Mexican populations. They do not have any specific health problems related to their heritage and they take pride in their health and longevity in life. Health disparities do not afflict this population like the other minority groups such as lack in health insurance or poverty (Norden, 2015). The Portuguese traditionally have their own healers that are called Curandeiras, this translates into good and evil. The Curandeiras is also tied into the Catholic religion. They believe that with their gift from God the Curandeiras will help them to heal. The Lord will provide a sign, which is a feeling they will get of what they should do and how they should do it to heal someone who is sick. The use of prayer and rosary beads are thought to be the most powerful way to heal, but oils, massage, water, herbs, and salt are also used to heal physical and emotional problems (Norden, 2015). Another common belief in Portuguese religion and some Mexican cultures is that certain people have the power of the evil eye, which is believed to have the power to cast evil spells on others with their eyes.
If it is safe to incorporate the traditional practices with the modern practices, then it should be done to improve the patient-nurse relationship. Religious considerations are always important to assess and include in the care of the patient, families, and communities to provide quality care in any cultural group.
Heritage and culture are two factors that are essential when assessing the health and well being of an individual, family or community. It is important to understand the cultural norms and practices of a patient in order to establish rapport and trust for effective communication between nurse and patient. In order to protect health, restore health, and maintain health in all three heritages, a focus on proper nutrition, common health disparities in each culture, and high risk factors that contribute to these illnesses need to be educated on in the community that each of these populations live in. A holistic, and spiritual approach that addresses the physical, emotional, and economical needs of the community will help reduce health issues and disparities with in that cultural community (“Cultural Group Guides,” 2010).

References
Centers for Disease Control and Prevention. (2012). Addressing chronic diseases in the
Americas. Retrieved from http://www.cdc.gov/prc/stories-prevention-research/stories/addressing-chronic-disease.htm
Countries and Their Cultures. (2015). Mexico. Retrieved from http://www.everyculture.com/Ma-Ni/Mexico.html
Dimensions of Culture. (2010). Cultural group guides. Retrieved from http://www.dimensionsofculture.com/culture-fact-sheets/
Indians.org. (2015). Native American food. Retrieved from http://www.indians.org/articles/native-american-food.html Norden, E. (2015). Portuguese Americans. Retrieved from
http://www.everyculture.com/multi/Pa-Sp/Portuguese-Americans.html