Transcript Slide 1

Caribbean Islanders
and
South Americans
Chapter 10
Caribbean Islanders
Bahamas
 Greater Antilles

◦ Jamaica
◦ Cuba
 Largest Island
◦ Hispaniola
◦ Puerto Rico






 US territory

Lesser Antilles

◦ Aruba
◦ Bonaire
◦ Curacao

US Virgin Islands
 Martinique





Antigua/Barbuda
Barbados
Dominica
Dominican Republic
Grenada
Haiti
St. Christopher
/Nevis
St. Lucia
St. Vincent /Grenadines
Trinidad
Tobago
Caribbean Islanders
Introduction
Homelands vary greatly
geographically
 Ethnic backgrounds very different
 Variety of regional fares with few
national cuisines
 Native dishes with food introduced
from Europe, Africa, Asia
 Strong, spicy flavors

History of Caribbean Islanders in the
US: Immigration Patterns
About 20% of the
Latino population
 Puerto Rico, then
Cuba, then the
Dominican
Republic

◦ Smaller numbers
from Jamaica and
Haiti
Puerto Ricans
Not immigrants
 Over half the population of Puerto
Rico lives in the US
 NYC Puerto Rican population is larger
than the largest city in Puerto Rico
 Largest numbers came to the US after
WWII
 A very fluid population

Cubans
Majority came to US in 1959 after
Fidel Castro gained control
 Most were of the upper socioeconomic
class fleeing communism
 More Cubans came to the US in the
60’s and 70’s with the airlifts
 Recent arrivals from the Mariel boatlift
are poor, less skilled

◦ Called marielitos
Dominicans
Information is limited on immigration
 4 Groups
 1930-1960: Political dissidents came to
escape the Trujillo regime
 Post-Trujillo era and improvements
slowed immigration
 Flotilla group in the 1980’s
 Those who have left after the early 80’s

◦ Often better educated
◦ Seeking employment opportunities
Current Demographics:

Puerto Ricans
◦ Largest group in
NYC

Cubans
◦ Miami

Dominicans
◦ NY, NJ, MA, FL

Others
◦ NE and South
Socioeconomic Status



Economic and education levels vary
greatly
Puerto Ricans have highest
unemployment, Cubans the lowest
25% of Puerto Ricans live in poverty
◦ 2nd generation Puerto Ricans income is
higher
Cubans have highest income among
Latinos, but still below national average
 Dominicans have lowest median family
income and highest rates of poverty
among Latinos

Education Rates

Puerto Ricans and Cubans graduate from
high school at below general population for
1st generation
◦ Lower for those born in Puerto Rico or Cuba

Cubans graduate from college at about rate
of the general population
◦ Double those of Puerto Ricans
◦ Over half attend private schools
Half of Dominican Americans have graduated
high school, slightly lower for those foreign
born
 62% of foreign born Haitian adults have
graduated high school

Factors Influencing
Socioeconomic Status




Frequent changes in residence
Low education levels and undeveloped
job skills translate into unemployment
and low-level employment
Racial bias
Cubans immigrated out of necessity and
brought with them upper class values
◦ Importance of education and financial
success
Worldview: Religion

Majority are Roman Catholic
◦ 95% of Dominicans

Majority of Jamaicans are Protestant
◦ Church of God
◦ 7th Day Adventists

Judaism
Worldview: Folk Religions

Voodoo
◦ Combo of W African tribal rituals and Catholic
beliefs, local customs
◦ Catholic rites practiced with ancestor
worship, drums, African dancing
◦ Worship is family based
◦ No central leadership/organization of
activities
◦ Ceremonies conducted for Christmas,
harvest, funerals
◦ Originated in Haiti
Worldview: Folk Religions

Santeria found in Cuba and Puerto
Rico
◦ Afro-Catholic cult similar to Voodoo

Rastafari
◦
◦
◦
◦

Jamaica
Natural, simple lifestyle
Sacramental use of marijuana
Considered a political movement
Both Afro-Caribbean religions
Worldview: Family







Puerto Rico
Compadrazgo – co-parenting
Men are head of household
Women maintain the home
Men are aggressive, women reserved
Elders are honored
Children well behaved

Traditional Cuban families are similar
and extend to include relatives
Worldview: Family

Families change in the US
◦ Women work in greater numbers than
men
◦ May make higher income
◦ Have greater authority
◦ Children gain greater autonomy

Dominicans and Jamaicans have high
levels of divorce and abandonment
Worldview: Family
Common-law marriage common in
rural Haiti
 Man may maintain several households
as long as he supports each wife and
children

◦ Similar to West African polygamous
societies
◦ Gender roles inflexible

Have maintained more traditional
families while living in the US
Traditional Health Beliefs and
Practices
Beliefs similar to other Latin American
cultures
 Puerto Ricans, Cubans, Dominicans, Haitians

◦
◦
◦
◦
Illness is punishment from God or sent by devil
Fate determines life/death
Prayer, lighting candles to saints
Laying on of hands
Dominicans employ the promesa
 Guardian angel to protect from evil
 Illness caused by evil spirits or the devil

◦ Dominicans and Haitians
Traditional Health Beliefs and
Practices


Puerto Ricans
Nervios
◦ Experienced trauma as child may be nervous
for life

Ser nervioso
◦ Crying bouts, headaches, stomach maladies,
tendency toward violence in men

Padecer de los nervios
◦ Mental illness associated with depression
◦ Psychologists or psychiatrists
Puerto Ricans, continued

Ataques de nervios, or ataques
◦ A hysterical reaction to stressful events
◦ Acute breathing difficulties, frenzy, sudden
onset of illness

Nervios
◦ Found in more women than men
◦ Associated with a weak character
◦ Helped by prayer, massage, sedatives, and
herbal teas
◦ Physicians and mental health specialists also
help
Puerto Ricans, continued

Pasmo
◦ Type of paralysis from imbalance of hot
and cold
◦ Cured through folk remedies

Fatique
◦ Acute breathing difficulties
◦ Responds to emergency care provided by
a physician
Traditional Health Beliefs and
Practices: Haitians

Concerned with flow of blood
◦ Hot, cold, weak, thin, thick, dirty, yellow

Febles
◦ Insufficient blood or anemia due to poor diet

Gaz (gas)
◦ pain settles anywhere – from eating leftovers

Nursing mother’s milk may thicken or spoil
◦ Move san is more serious
◦ After a fright mother’s milk spoils with resulting
failure to thrive, diarrhea for infant

Evil eye
◦ mal dyok
Traditional Health Beliefs and
Practices




Closely related to African beliefs
Mild conditions treated by older women
Entire family is consulted
Conditions due to supernatural
◦ Priests, priestesses, healers consulted
◦ Santeros specialize in soul possession and
mental disorders
◦ Ancestors provide instructions regarding
health behaviors through dreams
◦ Brujos (witches) and curenderos (healers)
Traditional Health Beliefs and
Practices
Good hygiene
 Daily bathing
 Good diet
 Regular sleep
 Various other practices
 Teas and OTC
preparations used by
all
 Home remedies
 Bodegas, Botanicas
have remedies to
purchase

Traditional Food Habits: Indigenous
Foods – Fresh fruits and vegetables

Cassava

◦ Manioc and Yucca











Malanga
◦ Cocoyam
Acerola
Avocados
Bananas
Plantains
Beans
Calabaza

◦ Pumpkin

Cashew apples
Cocoa
Coconuts
Corn
Guavas


Mammee apples
Papayas
◦ Pawpaws


Pineapple
Sapodilla
◦ Naseberry



Soursop
Squash
Sweet potatoes
Tomatoes
Fish and Small game
Traditional Food Habits:
Indigenous Foods

Chile peppers
◦ Extremely hot varieties
favored
◦ Pepper sauces


Allspice
Recao
◦ Long cilantro

Annatto
◦ Achiote

Cooking techniques
underdeveloped
Traditional Food Habits:
Indigenous Foods - Cassava

Staple starch is Cassava
◦ Also called Yucca or Manioc
◦ Tapioca comes from cassava
◦ Bitter and sweet
Baked into bread made from pressed,
dried, grated cassava that was fried in
a flat loaf
 Must be cooked as it contains
hydrocyanic acid which is toxic in
large amounts

Traditional Food Habits:
Foreign Influence

Spanish brought cattle, goats, hogs,
sheep
◦ Introduced rice
◦ Breadfruit, coffee, limes, mangoes, oranges
◦ Spices like ginger, nutmeg, mace

African slaves cultivated
◦ Akee
 Can cause fatal hypoglycemia
 Most akee products are banned in the US
◦ Yams, okra, taro

Asians introduced soybean, greens,
lentils
Traditional Food Habits: Staples

Legumes
◦ Rice and peas
◦ Rice with red beans
 Puerto Rico
◦ Black beans with
rice
 Moors y Cristianos
 Cuba
◦ Black-eyed peas
with rice
 Haiti
◦ Pigeon peas
◦ Lentils
◦ Chickpeas
 Garbanzo beans
◦ Bodi beans
 Chinese long beans
Traditional Food Habits: Staples



Cassava bread
Chili sauces
Pepper pot

◦ Taro greens w/ okra


Tamales
Pasteles
◦ Dough packets w/
savory fillings

Kerry or Colombo
◦ Curried dishes
Bacalaitas
◦ Dried salt cod fritters
◦ Stamp and go, arcat
de marue, many
different names
◦ Meat stew w/ cassava

Callaloo

Foofoo
◦ Okra and plantain

Coocoo
◦ Cornmeal-okra bread
Traditional Food Habits: Staples

Coffee
◦ Most popular beverage
◦ Jamaica produces some of the most
expensive coffee in the world

Rum
◦ Fermented molasses
 Originated in Barbados in early 1600’s
 Byproduct of sugarcane industry

Juices from tropical fruits
◦ Spiced with ginger, coconut milk may be
added
Traditional Food Habits:
Regional Variations

Butter preferred in French-influenced
countries
◦ Roux used to thicken sauces and stews

Lard in Spanish-influenced nations
◦ Use more tomatoes, onions, annatto,
sweet bell peppers
Coconut oil common in Jamaica
 British-influenced countries use
scallions, parsley, cilantro, thyme

Traditional Food Habits:
Regional Variations: Puerto Rico

Puerto Rico known for distinctive
flavorings
◦ Alcaparrado, sofrito, adobo

Starchy foods
◦ Side dish or in soups and stews
◦ Called Viandas
Pork is a favorite meat or beef or goat
 Black beans common
 Many finger foods for snacks

Traditional Food Habits:
Regional Variations: Cuba
Black beans very popular
 Viandas

 Foofoo
 Cassava balls
 Tostones
 Fried plantains

Meats and viandas served with mojito
◦ Sauce of olive oil, juice from limes or sour
oranges, onions, and garlic

Many foods with Spanish origins
Traditional Food Habits:
Regional Variations: Dominican Republic

Stews a specialty
◦ Mondongo (tripe soup)
◦ Sancocho (soup with several meats)

Locrio
◦ Origins from paella but uses only a single item
(protein)


Salads, avocados, hearts of palm
Common side or dessert is Habichuelas con
dulce
◦ Red beans, coconut milk, evaporated milk, whole
milk, sugar, and butter

Desserts of flan, fruit compotes, puddings
Traditional Food Habits:
Regional Variations: Jamaica
Akee
 Salt cod
 Curried goat
 Bammies

◦ Type of cassava bread

Mackerel rundown
◦ Cooked in coconut milk with vegetables

“Jerk” foods
◦ Wet spice used in BBQ
Traditional Food Habits:
Regional Variations: Haiti

Banana-stuffed chicken
◦ Poulet roti a la creole

BBQ goat with chile peppers
◦ Kabrit boukannen akbon piman

Griot
◦ Pork marinated in seasoned sour orange juice,
boiled, fried

Patties
◦ Curried meat turnover

Side dishes of
◦ Cornmeal mush
◦ Black rice (riz noir)
 Rice cooked in mushroom broth
Traditional Food Habits:
Regional Variations: Others

Curaçao
◦ An orange-flavored liqueur

Dominica
◦ Crapaud or “mountain chicken”
 A large, tasty frog

Barbados
◦ Unusual seafood dishes
 Flying fish
 Green turtles
 Sea urchins
Meal Composition and Cycle

Emphasis on starchy vegetables
◦ Some leafy vegetables

Some meat, poultry or fish
◦ Fried or grilled
◦ May be cooked first with sugar to caramelize




Served with rice and beans
Breads of all sorts
Soups and stews are popular
Fruits maybe for snack or dessert
Meal Composition and Cycle
Ethnic heritage and social class
determine which dishes are served
 Poor native Indian

◦ Cassava, tomatoes, chiles with some
salted fish

Asian Indian
◦ Adapt to Caribbean ingredients
◦ Curry dish with coconut, fried plantains,
pineapple

Most have muticultural mix
Meal Composition and Cycle:
Daily Patterns

3 meals a day
◦ Haiti may have only 2

Traditionally has been larger breakfast
and lunch
◦ Often toast and coffee for breakfast
◦ Changing somewhat to heavier evening meal
◦ Jamaicans may have fish at breakfast




Lighter, leisurely dinner
Rice, beans, squash
Desserts daily
Coffee, snacks
Meal Composition and Cycle:
Daily Patterns: Special Occasions
Emphasis on Christian (Catholic) holidays
 Christmas

◦ Pasteles commonly served
 Similar to tamales
◦ Noche buena (Christmas Eve)
 Mass followed by a feast
Carnival
 Day-long birthday open house in Curaçao
 Thanksgiving in Puerto Rico
 Sunday meals emphasize fresh meat and/or
picnics

Meal Composition and Cycle:
Daily Patterns: Etiquette
Knives and forks held European-style
 Pass dishes to the left
 Keep hands visible
 Wait until host starts the meal
 In Cuba, do not consume fruits and
vegetables with the hands
 In Puerto Rico don’t waste food

◦ Don’t take more than you can eat
Therapeutic Uses of Food

Hot-cold classification system of diet and
health
◦ Puerto Ricans add cool
◦ Balance hot-cold elements in meals
◦ Puerto Ricans, Dominicans, Haitians most likely
to follow
Haitians believe women are warmer than
men and people cool as they age
 Heavy or light foods in addition to
hot/cold/cool
 Consume heavy foods (starches) during the
day
 Light foods (soup) in the evening

Therapeutic Uses of Food
Puerto Ricans follow hot/cold carefully
during pregnancy (hot condition)
 Infants are particularly watched
 High calorie tonics to stimulate
appetite, provide strength, energy

◦ Especially for pregnant women, children,
post-partum women
Therapeutic Uses of Food

Dominican Americans use hot/cold for
numerous ailments
◦ Nutritional practices during lactation may
be problematic

Haitians apply hot/cold/heavy/light to
many factors influencing health
◦ Life cycle, reproductive cycle, climate, etc.
◦ Heavy focus on mother’s milk and
illnesses it may cause
Therapeutic Uses of Food
Non-Hispanics may believe cassava
helps prevent heart disease and
cancer
 Plantains used to decrease risk of
heart disease, HTN, ulcers,
constipations
 Teas for numerous ailments
 Many herbals
 Rum and marijuana to treat several
problems

Contemporary Food Habits in the US:
Adaptations of Food Habits


Traditional food habits easily maintained
Study of Puerto Rican women:
◦ Nonmigrants and return migrants ate more
starchy vegetables, sugar, and sweetened
foods
◦ Forward migrants ate a greater variety of
foods
◦ Quickly reverted to their traditional food
habits when they returned to the island

Study of Afro-Caribbean immigrants
◦ Ate traditional foods frequently
◦ Few Western foods were popular
Ingredients and Common Foods
Data is limited
 Rice, beans, starchy vegetables, sofrito, and
bacalao remain basis of diet for Puerto
Ricans

◦ Poultry used when possible

Cubans increase intake of meat
◦ Poorer Cuban immigrants have diet similar to
subsistence Puerto Rican diet

Some Western foods accepted
◦ Convenience foods, frozen and dehydrated foods

Low intake of leafy vegs, consume local fruits
Ingredients and Common Foods
Dominicans report more varied and abundant
diet in US
 Rice main contributor to energy for MA
Latinos

◦ Bread main contributor for non-Hispanics

Hispanics who have lived in the US >20
years have similar profiles to non-Hispanics
 Increased consumption of simple sugars
Nutritional Status: Intake
Limited information
 Lower rates of preventative care and
insurance coverage
 Higher rates of risk factors

◦ Puerto Ricans have worst health
indicators
 Diabetes prevalent
 LBW infants, preterm delivery, infant mortality
high in US, higher in Puerto Rico
◦ Cubans have the best
Meal Composition and Cycle


Light breakfasts of bread and coffee
Light lunch
◦ Often sandwich and beverage

Heavier dinner
◦ More traditional foods


More high calorie snacks between meals
Grocery shopping a social occasion for
many women
◦ More trips to store, less advance planning

Prefer frying, then boiling, baking and far
last grilling
Special Occasions
Foods remain the same
 More special occasions in the US

◦
◦
◦
◦
West Indian Carnival in NYC
Puerto Rican Day in June
Dominican Day parade in August in NYC
Reggae festivals throughout on Feb 6
 Bob Marley’s birthday
Nutritional Status: Nutritional
Intake

Lower rates of preventative care
◦ Inoculations and screenings

Lower rates of health care insurance coverage
◦ Hispanics have highest rate of uninsured in the US

Higher rates of risk factors
◦ Puerto Ricans have the worst health indicators
◦ Cubans have the best

Puerto Ricans living on the mainland experience
more physical illness, have less access to health
care
◦ Low socioeconomic, education levels associated with
some disparities.
Nutritional Status:

Elders with disabilities and diabetes
more prevalent in Puerto Ricans than
whites in same neighborhoods
◦ Physiological responses to life stress may be
affected by nutritional status
◦ Intake of B vitamins and antioxidants

Younger men die in disproportionately
high numbers
◦ Often from preventable causes

Puerto Ricans born in Puerto Rico have
lower mortality rates than those born on
mainland
Nutritional Status: Puerto Ricans

High infant mortality rate
◦ Preterm
◦ LBW
◦ 40% higher than whites

Risk factors
◦
◦
◦
◦
Poverty
Young maternal age
Low educational attainment
Inadequate prenatal care
Nutritional Status
Infant mortality, LBW, preterm delivery
rates even higher in Puerto Rico
 High rates (8.2%) of LBW infants in
the Haitian American community

◦ Hypertension and preeclampsia

Infant mortality rate of Cuban
American babies well below the
national average.
Nutritional Status





Data on breastfeeding is conflicting
Overweight Hispanic women in NY less
like to initiate and more likely to
discontinue BF than lower-weight women
Many switch to bottle feeding in 2 – 4
weeks
Whole milk, condensed milk, evaporated
milk and juices frequently fed to infants
Solid food started early
Nutritional Status
Caribbean diet limited due to low income
 Emphasis on carbohydrates and
vegetable protein, with a low
consumption of leafy vegetables and
often fruit
 Results in inadequate intake of calories,
vitamins A and C, iron, and calcium
 Puerto Rican and Dominican elders with
B12 deficiency due to inadequate intake

Nutritional Status


Low iron intake among AfricanCaribbean Islanders
Anthropometric measurements and
physical observation
◦ 20 percent of children under fifteen showed
signs of malnutrition
◦ 37 percent of the men and 17 percent of the
women had adipose tissue measurements
consistent with adult marasmus
◦ 12 percent of immigrants suffered from
anemia
Nutritional Status

Native Puerto Ricans
◦
◦
◦
◦
◦
◦
◦
Parasitic diseases
Dysentery
Malaria
Hookworm
Filariasis
Schistosomiasis
High blood lead levels
Nutritional Status

Overweight /obesity higher than
national or state averages
◦ Women and children
◦ Associated with a traditional diet of rice,
beans, poultry, oil
◦ Larger portion size
◦ Low levels of physical activity
◦ Cultural norms
 Well-being associated with “a little fat”
Obesity Rates in Hispanics
Nutritional Status:

Heritability may be involved in metabolic
syndrome
◦
◦
◦
◦



Obesity/waist circumference
Insulin resistance
Hypertension
Dyslipidemia
At increased risk for Type 2 diabetes,
CVD
Impaired glucose tolerance after
gestational diabetes
Death and renal failure rates higher
Nutritional Status:
Hypertension rates lower than that of
whites
 Mortality from HTN, CVD, stroke
varies

◦ Puerto Ricans have highest
◦ Cubans have lowest rates
Deaths higher for men
 Noncompliance rates are high

Nutritional Status:

CVD rates are lower than national
average
◦ Heart disease is leading cause of death

Chronic liver disease and cirrhosis
◦ 7th most common cause of death
◦ Men drink more heavily than women
Dental health problematic
 Lactose intolerance may be a problem

Counseling





Language issues
Health beliefs
Access to health care limited
God or fate determines outcome
interfering with seeking health care
Seeking preventive measures lower than
average
◦ Ex: Puerto Ricans not seeking vaccinations

Illness a sign of personal weakness
◦ Ex: Haitians

Highest uninsured rates in the US
Counseling





Expressive conversational style
Respect/politeness practiced, not rude to
interrupt
Shaking hands upon greeting and
leaving customary
Touching is common
Direct eye contact is the norm
◦ Haitians will divert eyes with authority figures
◦ Cubans see looking away as disrespectful or
dishonest
Counseling: Puerto Ricans







Open about physical and emotional complaints
May not ask questions
Give adequate time and consideration of
symptoms
Very modest – health providers of same gender
best
Present oriented
Flexible appointments helpful
Some hot/cold practices may be harmful
◦ Pregnancy


Be clear with terms involving blood
May believe that ulcers lead to cancer
Counseling: Haitians








Expect quick diagnosis with a stethoscope
Men are doctors, women are nurses
Expect a prescriptions
Dominicans
Traditional healers used to complete
treatment
May not understand prescription drugs are for
a specific condition
May use briefly and then resort to home
remedies
All share prescriptions
Counseling
Physicians, then television source of
health care information
 High context communicators
 Participation greater if men in family
are supportive and if respected
community members are supportive
 Place significant emphasis on
socioeconomic status
 In depth interview should be
conducted

South Americans
Introduction






Widely varied
geography
Extremes in terrain
and climate limit
agriculture
Spanish were first to
arrive
Portuguese, Italians,
Germans
Forced labor from
West Africa
Japanese immigration
in recent years
Countries in South America








Argentina
Brazil
Bolivia
Chile
Colombia
Ecuador
Guyana
Paraguay






Peru
Suriname
Uruguay
Venezuela
France has French
Guyana
Great Britain has
the Falkland
Islands
Immigration Patterns

First South Americans in US from Chile
◦ Came to CA for the Gold Rush
◦ Counted as “Other Hispanics” prior to 1960
in census

Most South American immigration
occurred in the past twenty years
◦ Periods of land reform, economic hardship,
or political repression
◦ Came for jobs and educational opportunities

Significant numbers of political exiles
from Argentina and Chile.
Current Demographics






South Americans account for only 5% of
Latinos
Many South American populations have
almost doubled since 2000.
Colombia, Ecuador, Peru with highest
numbers
Settle in the Northeast, especially NY
and NJ
Proud of their ethnic identity
Differentiate themselves from other
Latinos
Socioeconomic Status
Recent immigrants well-educated
professionals
 Advanced degrees
 Columbia, Ecuador, Brazil have
higher rates of poverty
 Peru, Guyana, Argentineans,
Bolivians, and Chileans have lower
rates of poverty

Worldview: Religion

Predominately Roman Catholic
◦ Influence seen in many South American
institutions

Blended belief systems
◦ Incan gods included in Catholic rites
◦ Venezuelan Cult of Maria Lionza mixes
indigenous, Catholic and African practices
Worldview: Religion
Brazil
 Spiritism

◦ Christian precepts with scientific principals
◦ Communicate with dead through mediums

Umbanda
◦ Afro-Brazilian faiths plus Christian charity and spiritism

Candomblé
◦ Afro Brazilian faith founded by blacks in the Bahia region
◦ African beliefs regarding health/wealth with Catholic beliefs
◦ Yoruba (African) deities called orixás venerated with animal
sacrifice, feasting, and dancing
◦ Orixás correlate with a Catholic entity
Worldview: Religion

Protestant missionaries during 20th
century
◦ Guyanese Episcopal church
◦ Ecuador has about 40% Protestant
◦ Brazil has Baptist, Pentecostal, 7th Day
Adventist, Universalist
◦ Chilean Protestants are Pentecostal of 7th
Day Adventists



Germans follow Lutheran or Baptist
Small numbers of Jews and Buddhists
Come to US and are very active in their
churches
Worldview: Family
Family life important in all South
American societies
 Argentina has Spanish and Italian
influence

◦ Extended families gather weekly
◦ Grandparents involved in family decisions
◦ Children stay home until marriage

Brazil has extended family living close
◦ Relatives mentor children through rites of
passage
Worldview: Family
Chilean fathers are head of household
but mother makes all decisions
 Colombian fathers hold all authority
and children obey their parents
 Ecuadoran families

◦ Spanish influenced ruled by father who
provides financial support
◦ Indian influenced father and mother share
more power and household
responsibilities
Worldview: Family

Peruvian families include extended
families and godparents.
◦ Families patriarchal in Spanish speaking
◦ Less so in poor, rural Indian homes

Venezuelan family changed rapidly
◦ Urban
◦ Declined in size
◦ Extended family less common
Worldview: Family
Less acceptable for women to work
outside the home
 Indian women often work on farm
 Urban areas of Venezuela women
have outside jobs but retain
responsible for household chores
 Chilean women involved in local social
and political issues

Worldview: Family
Immigrate as family groups if possible
 Suffer from stresses of American
informality and freedom

◦ Men lose some authority over wives and
children
◦ Women find it difficult to adjust to working
outside the home
◦ Women may not be able to have paid help
and have to work and run the home
Traditional Health Beliefs and
Practices
Self-diagnosis
 Health advice from
mothers or friends
 Visit pharmacy

◦ Can buy meds by
the pill
Traditional Health Beliefs and
Practices
Brazilians may attribute bad health to
liver problems or hot/cold imbalance
 Faith with health

◦ Catholics will believe in fate
◦ Seek intervention from patron saints when
ill

Spiritists use homeopathy, exorcism,
past-lives therapy, acupuncture, yoga
therapy, chromotherapy
Traditional Health Beliefs and
Practices
Candomlé followers believe must have
balance between earthly and spiritual
spheres
 Ecuadoran healers treats many illness
 Peruvian urban dwellers typically
obtain biomedical care

◦ Rural regions use home remedies and
ritual magic
Traditional Health Beliefs and
Practices








Herbal teas
Soursop treats diabetes
Seeds of the guarana relieve fatigue/help
with weight loss
Retained urine treated w/ avocado leaves
Papaya leaves for intestinal worms
Rue for uterine pain
Black nightshade for coughs
Pau d’arco (tree bark) to treat rheumatism,
diabetes, VD, yeast infections, enlarged
prostate and several cancers
Traditional Food Habits:
Ingredients and Common Foods

Similar to other LAC regions
◦ Combines native ingredients, preparation
techniques with foods of colonial Europeans





Corn based w/ chile pepper as spice
Tomatoes
Cassava or yucca
Pumpkin, bananas, plantains
Beef, rice, onions, olive oil
◦ Introduced by Spanish and Portuguese and
eaten regularly

Tropical fruits
Ingredients and Common Foods

Potatoes
◦ First cultivated by Incas and popular in
Peru and Ecuador

Sweet potatoes
◦ Called yams in the US
◦ Sweet potatoes colored similar to
potatoes
◦ yams are darker and more reddish
colored
◦ True yam is drier and starchier
Tubers or roots

Apio or arracacha
◦ White root similar to a mild carrot
◦ Found in Colombia, Peru, and Venezuela

Oca
◦ Like a potato in appearance, leaves like
clover

Yacón
◦ Taste and texture of a sweet turnip
◦ Commonly eaten raw and cooked in Bolivia,
Brazil, Colombia, Ecuador, and Peru

Aahipa (jicama)
◦ Native to the Amazon River basin.
Ingredients and Common Foods
Beans are common but not eaten at
every meal
 Peanuts and cashew used often
 Grilling popular for meats
 Indigenous meats

◦ Llama, Deer, Rabbit, Wild pig, Capybara,
Tapir,
◦ Cuy (guinea pigs)


Fish in coastal areas
Iguana and alligator
Ingredients and Common Foods

Grilling favored way to prepare meats
◦ Asado: Sides of beef, whole lambs, hogs, and kids
hung over smoldering wood to slowly cook for hours
◦ A grill is used today
 Steaks, organ meats and marinated kebobs favorites

Pachamanca
◦ Steam foods in a pit oven (Peru)
◦ Young pig or goat with guinea pigs, chickens,
tamales, potatoes and corn tucked around layers of
hot stones and aromatic leaves and herbs

Curanto is closer to an elaborate coastal
clambake (Chile)
◦ Shellfish, suckling pig, sausages, potato patties,
peas, and beans layered with seaweed.
Ingredients and Common Foods

Stuffed Foods
◦ Empanadas in Argentina
 Fried or baked
 Numerous fillings
◦ Empadinhas in Brazil
 Spicy shrimp mixture
 Abalone in Chile
◦ Salteñas in Bolivia
 Filled with cheese
◦ Tamale like steamed
packets
◦ Champanas in Peru
 Made with cassava dough
◦ Bollos in Ecuador
 Chicken with plantain
dough
◦ Pamonhas in Brazil
 Corn kernal dough with
cassava and coconut
◦ Hallacas in Venezuela
 Ground corn meal dough
with tomatoes and annato
◦ Humitas in Argentina,
Bolivia, Brazil, Chile and
Ecuador
Regional Variations: Peru and
Ecuador
Highland fare of the Andes
 Lowland dishes of the tropical coast
 Mountain cuisine preserves many
ingredients and dishes of the Incas
 Potatoes eaten at almost every meal and
for snacks

◦ Boiled, dried, or made into potato starch


Corn in the mountains
Bananas and plantains
◦ Chips and made into flour
Regional Variations: Peru and
Ecuador


Picante and lots of chile peppers
Salsa de aji
◦ Condiment at most meals (chiles, onion, salt)

Charqui
◦ Dried llama

Anticuchos
◦ Marinated beef heart skewered and grilled


Rabbit or Seafood
Chucula
◦ Thick plantain and milk beverage w/ cinnamon

Pisco
◦ Grape brandy
Regional Variations: Argentina,
Chile, Bolivia, Uruguay, Paraguay


Argentina
Hearty foods with emphasis on beef
◦ Eats more beef per capita than any country
worldwide


Influence from immigrant populations
Matambre: national dish
◦ Flank steak dish with eggs and spinach
◦ Means “to kill hunger”


Pasta popular on Sundays in Argentina
Coffee popular but most popular is maté
Regional Variations: Chile,
Bolivia, Paraguay, Uruguay

Robust soups and stews
◦ Sopa Paraguay, fish soups and stews in Chile

Uruguay
◦ Eat beef like in Argentina, but also mutton and lamb




Chilean wine
Lots of beans in Chile
Frog legs in Bolivia
Chicha
◦ Corn liquor popular in Bolivia

Maté is popular
◦ From a holly family plant native to Paraguay
◦ Dried, powdered leaves called yerba
Regional Variations: Colombia
and Venezuela
Colonial Spanish in character w/ typical Spanish
flavors
 Guascas/Huascas- Flavor of boiled peanuts in
soups/stews
 Naranjillos used for their tart juice
 Colombia:

◦ Bogata chicken stew (chicken, 2 types potatoes,
cream)
◦ Sancocho (boiled dinner w/ beef brisket, starchy vegs

Venezuela
◦ Ropa vieja: Shredded flank steak served in a sauce
◦ Pabellon caraqueno: Flank steak, rice w/black beans
◦ Arepa: Staple cornmeal bread formed into patties
and cooked on a griddle, sometimes stuffed
Regional Variations: Guyana

Influenced by the Caribbean
◦ Pepper pot, coocoo, black cake (dense fruitcake)

African
◦ Foofoo

Asian influence
◦ Chinese noodles
◦ Indian curries, roti
National specialty: Portuguese garlic pork
 Famous for demerara sugar

◦ Source of demerara rum
Regional Variations: Brazil

Portuguese and African influence
◦ Dried salt cod and very sweet desserts from
Portugal
◦ Dendê oil, okra, and spicy foods from Africa
◦ Malagueta - a small, mouth-searing chile pepper
popular with Africans in Brazil

Afro-Brazilian fare cozinha baiana from state
of Bahia
◦ Fritters made from dried shrimp, dried salt cod,
yams, black-eyed peas, mashed beans, peanuts,
and ripe plantains fried in dende oil
◦ Vatapa is a paste made with smoked dried
shrimp, peanuts, cashews, coconut milk, and
malagueta chiles
Regional Variations: Brazil

National dish is feijoda completa
◦ Black beans w/smoked meats, sausages,
served w/rice, sliced oranges, boiled greens,
and hot sauce mixed w/lemon or lime juice


South influenced by Argentina, Germany
Grilled meats and chimichurri sauces
popular
◦ Churrascaria rodizio – an outdoor bbq

Coffee, rum, beer, maté popular
◦ Guaraná is a soft drink from Guaraná fruit
◦ Cachaça distilled from sugar cane
 Used to make batidas or caipirinhas
Meal Composition and Cycle:
Daily Pattern
3 meals w/ afternoon snack
 Poor areas, early breakfast, large dinner
about 6
 Light breakfast of bread or roll w/ jam, coffee
 Lunch is main meal and consumed leisurely

◦ Appetizers, meat/seafood dish, side dish, salads,
dessert
Nap
 Lighter dinner about 9 of cold cuts, seafood
salad, soup, or stew
 Beer, wine, fruit juice and soft drinks

Meal Composition and Cycle:
Daily Pattern







Afternoon break typically throughout South
America
Coffee consumed in Colombia, Ecuador,
Brazil
Tea in Chile and Uruguay
Maté in Argentina, Paraguay, Uruguay, Brazil
Snacks of fruit, sandwiches, pastry
Street vendors are common
Poor may skip lunch and snacks and have
dinner of soup/stew with starchy side dish
Special Occasions




Catholic traditions influence holidays
Rich Christmas Eve Dinner
Epiphany
Easter and Carnaval
◦ Animals associated with water are allowed on
fast days



St. John’s Day in Brazil and Ecuador
All Soul’s Day
Independence Days of their country in
the US
Etiquette




Women prepare meals, serve to men.
Women eat last
European-style fork in left hand, knife in right
Bread at side of plate without butter
◦ Only food eaten with hands

All other items require cutlery
◦ Fold salad, do not cut
◦ Even sandwiches



Pass left, keep hands above table
Wait for host to begin meal
Don’t pour wine with your left hand or hold
bottle at base when pouring
Therapeutic Use of Foods
Candomblé orixás associated with
certain foods and followers honor their
deity by eating those items
 Use hot/cold system of medicine and
adapted by their healers

◦ Hot conditions treated with hot orixás
◦ Cold conditions treated with cold orixás
◦ Classification system is inconsistent
Therapeutic Use of Foods

Hot/cold classifications not associated
with candomblé
◦ Food hot in temperature or irritating to the
stomach to be avoided during fevers
◦ Menstruation, pregnancy, lactation require
specific foods
◦ Eat specific foods at specific times of the day
 Fruit is good in the morning, harmful in the evening
◦ Avoid some combinations of foods
 Acidic fruits with milk
Adaptation of Food Habits in the
US
Very little data
 Continue eating favorites from home
with adapted ingredients
 Adaptation to schedules difficult

◦ Late dinners, early American work
schedule
◦ Short lunch
◦ No leisure time after lunch

Poorer Chileans diets may improve in
US
Nutritional Status: Intake

Parasitic infection, iron-deficiency
anemia, protein calorie malnutrition
◦ Common in many rural areas of South
America

Chronic Chagas’ disease endemic in
some regions
◦ Can affect the esophagus and colon
◦ Risk factor in CVD
Nutritional Status: Intake
Overweight and obesity prevalent
 Ecuadoran elders deficient in B12, D,
folate, iron, zinc despite being
overweight
 Metabolic syndrome present

◦ Central body fat present

Hypertension common in many
populations
Counseling
Access to health care may be limited
 Preventive practices uncommon
 May seek help only in emergency
situations
 Many without health insurance
 Unauthorized persons will avoid
contact with any government agency
 Many do not speak English well

Counseling






More formal in their interaction
Conversations reserved, little emotional
expression
Venezualans are very direct
Brazilians typically restrained with strangers
Less personal space than Americans
Direct eye contact
◦ Except Columbia – not with authority figures or
embarrassing situations



Present oriented and polychronic
Immediate interventions valued, not preventative
In Argentina will protect patient from negative
diagnosis
Counseling


May seek homeopathic or OTC remedies
Brazilian women with diabetes reported
◦
◦
◦
◦
◦

Dietary restrictions burdensome
Sadness when following diet
Cravings for sweets
Loss of autonomy
Had no symptoms therefore restrictions
unnecessary
In depth interview is needed