DEMOGRAPHIC AND HEALTH DATA For Demographic information Filipinos are included in the Asian American/Pacific Islander category and are considered the second largest Asian American group in the United States. Even though California, New York, Hawaii have the largest Asian American population, Florida is the eighth highest with 2.1% according to the department of health. Alachua County in which Gainesville is its largest city has an Asia American population of 4.2 % (Alachua County Department of Community Support Services, 2005). This is double the rate for the state. This may be attributed to the University of Florida and the large amount of Filipino nursing families (2-4 hundred) that was brought to the area by Shands Hospital @ UF between 2001-2005 (Gala Beach, Employment Director, Shands at UF, Personal communication, June 25, 2011). HHS 5: HHS, Personal Conversations FILIPINOS IN GAINESVILLE Because the Asian American/Pacific Islander community is so small, not much is know on when they came to Gainesville and what percentage is Filipino. According to Aragon the earlier Filipinos came to Gainesville as spouses of veterans. Mrs. Aragon’s mother came to Gainesville almost 30 years ago as the wife of a navy officer who was stationed in the Philippines. Personal Conversations COMMUNITY RESOURCES AVAILABLE PAGASA and the UFFSA have a Barrio Fiesta once a year where students perform the traditional folk dances of the Philippines one of which is “Tinikung PAGASA PAGASA was established in 1994 and means “hope” the acronym is Pilipino American Association of Gainesville and Surrounding Areas. They have a social/ get together monthly. 6: PAGASA, 7: UFFSA, Personal Conversations UFFSA the Filipino Student Association at the University of Florida LANGUAGE AND CULTURE • In the Philippines more than 100 dialects are spoken but Filipino or Tagalog is the national language, and English is the second official language. English is used to conduct internal and global business and legal transactions. Among Filipino Americans, a combination of English/Tagalog or “Tag-Lish” a hybrid language, is spoken by many and used in health education. • Filipinos are not confrontational they will walk away from an argument; they speak politely and in a gentle tone, and avoid any conflict their communication is highly contextual. • Non verbal communication is very important to Filipinos and they are comfortable with silence, do not always maintain eye contact and often learn best if shown a task then asked to demonstrate. A: Purnell, RELIGION AND FAMILY BELIEFS • The majority of the Filipino population is catholic. However, there are very superstitious and still believe in some of the “old ways” • Fathers are the head of the families and the providers, whereas mothers are considered soft and calm who take care of the domestic needs and promote the development of ones emotions and values • Multigenerational households are accepted arrangements where respect and love for parents and older family members are taught and expected of the children, • An important belief to be aware of as a healthcare worker is that they believe in family centered decision making, which contributes to the beliefs that a patient should not be informed of a terminal illness, preferring to protect them from despair and allowing them to maintain hope. • Dating at an early age is discouraged and sex education or sex is not openly discussed. It is desired that women remain chaste until marriage and pregnancy out of wedlock is frowned upon and shames the family. A: Purnell, Personal Conversation FILIPINO HEALTH ISSUES • Filipino women have the life expectancy 81.5 years in comparison to that of Asian American women with that of 85.8 years the highest of any other ethnic group in the U.S. • • There are still many things that influence the health of many Filipinos like lack of medical care/doctor visits, language/cultural barriers as well as a lack of insurance. Many conditions such as terminal illness, mental illness, unwanted pregnancies, HIV/AIDS as well as criminal offenses and divorce are not shared with outsiders unless trust has been developed. • • Asian American/Pacific Islander’s are most at risk for the following health conditions: cancer, heart disease, stroke, unintentional injuries (accidents), and diabetes. There is a high prevalence rate also have a high prevalence of the following conditions and risk factors: chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease. TB is 24 times more common in Asians than in Whites and SIDS is the fourth leading cause of infant mortality 5: HHS, CDC, A: Purnell HEALTH CARE PRACTICES • Filipinos do not seek medical attention usually until an illness is advance, often they accept minor illnesses stoically and as a natural imbalance that will run its course naturally and disappear. • Often times the decision to seek medical care is that of a family decision. This includes the nuclear and extended family. • Pain is often not complained about is is viewed as part of living an honorable life and a opportunity to reach a fuller spiritual life, so as a healthcare worker offer and encourage pain medication educating to the advantages. • They place a high value on cleanliness, and often times take aromatic baths for both pleasure and to restore balance. It is believed that a bad body odor is bad for the heath and to be unkempt and disorderly is shameless. • Western medicine is acceptable and familiar but folk medicine/healers are also consulted, but are not as common here in the united states. Utilizing a primary care physician or a linguistically and ethnically congruent practitioner will often improve the Filipinos acceptance and learning . A: Purnell Both the birth and death are significant and moments for the Filipino family. But a loved one’s death is much more ritualistic and extended. Births Pregnancy is a family and community affair. Everyone gets involved especially grand parents. Fathers are involved in the baby showers and birthing if they want to be. There is no exclusion. Children are celebrated and everything is centered on the children. The christening is a very big celebration in the Filipino culture, this usually occurs before the first birth Deaths After a loved one dies for most Filipinos there is three stages of grieving. The first nine days then the 40 day followed by a one year mourning period. First stage is the nine-day novena (prayer) is held every evening after the Holy Mass. Second celebration is the 40 day mourning period (soul goes to heaven after 40 days ) Last is the one year mourning often the Filipino culture holds that the “longer the grief, the better.” so for most frequently a year and often beyond that, men will wear a black ribbon and women will dress in black to indicate they are in mourning . Then on the first anniversary a celebration mass is held. rituals surrounding death as very “showy.” Women are expected to grieve very openly -publicly sobbing, swooning, fainting, and/or hugging the casket of the dead person -- while men are typically more reserved considered disrespectful to show emotions that are anything but “somber and depressed.” STRENGTHS OF THE FILIPINO CULTURE • • Most Filipino families function within an extended family structure with strong emphasis on interpersonal dynamics, group harmony and loyalty, respect for elders and authority, and maintenance of a natural support system by a complex process of building interdependent/dependent relationships and family roles Caring for aging relatives is integrated over time into these relationships, and interdependence is deeply embedded in the culture. Caring for others is a complex skill that is learned throughout Pakikipagkapwa-Tao which is regard for others, it is a word Filipinos live by. They regard others with dignity and respect, and deal with them as fellow human beings. Pakikipagkapwa-tao is manifested in a basic sense of justice and fairness, and in concern for others. It is demonstrated in the Filipino's ability to empathize with others, in helpfulness and generosity in times of need. Pakikipagkapwa-tao results in camaraderie and a feeling of closeness one to another 1:crvp, personal discussion. STRUGGLES FILIPINOS ENCOUNTER • One of the Filipino's greatest strengths is also their weakness, they are family focused and centered but this can be their flaw in extremes. Excessive concern for the family creates an in-group to which the Filipino is fiercely loyal, to the detriment of concern for the larger community or the common good. • Their lack of discipline incorporates several related qualities for example their casual and relaxed attitude towards time and space which displays itself in lack of precision and compulsiveness, in poor time management and procrastination. • The Filipino's are also generally passive and lacking in initiative. They will wait to be told what has to be done. 1: crvp, Personal Conversation REFERENCES A. Purnell, L. D. (2009). Guide to culturally competent healthcare (second ed., pp. 128-142). Philadelphia, PA: F.A Davis. Find cdc website source 1. 2. 3. 4. 5. 6. 7. 8. Multiple conversations with Filipino Gainesville community members: Pamela Aragon, Agnes E, and Ruth Tuazon. http://www.crvp.org/book/Series03/III-7/chapter_iv.htm http://en.wikipilipinas.org/index.php?title=Philippine_Culture http://www.everyculture.com/No-Sa/The-Philippines.html http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=53 http://www.pagasagainesville.org/home2011/index.php http://www.uffsa.org/
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