The Intersection of Pain and Culture ____________________________________________________________
Fiji, and many others [22]. There are more than 25 Asian/ Pacific Islander groups, each with a different migration his- tory and widely varying sociopolitical environments in their homelands [23]. Asian American groups have differing levels of acculturation, lengths of residency in the United States, languages, English- speaking proficiency, education attainment, socioeconomic statuses, and religions. For example, there are approximately 32 different languages spoken among Asian Americans, and within each Asian subgroup (e.g., Chinese), multiple dialects may be present [23; 24]. The diversity of this group makes generalizations difficult. HISPANICS/LATINOS The term “Hispanic” refers to individuals who self-identify as having origins in Spain or Spanish-speaking countries, such as Mexico, Guatemala, Peru, Ecuador, or the Dominican Republic [25]. Persons of Latin American descent or origin are considered Latino/a/x. In 2022, there were 63.7 million Hispanics in the United States, which represents 19.1% of the U.S. population [185]. The majority of the Hispanic population in the United States (63.3%) identify themselves as being of Mexican descent [26]. Approximately 27% of the U.S. Hispanic population identify as Puerto Rican, Cuban, Salvadoran, Dominican, Guatemalan, Colombian, Honduran, Ecuadorian, or Peruvian [26]. By 2060, Hispanics are expected to represent 31% of the U.S. population [132]. In 2019, the three states with the largest His- panic population also had the most growth: Texas, California, and Florida [154]. They are also a young group, with a median age 30.7 years in 2022 [185]. NATIVE AMERICANS The Native American population is extremely diverse. According to the U.S. Census, the terms “Native American,” “American Indian,” or “Alaskan Native” refer to individuals who identify themselves with tribal attachment to indigenous groups of North and South America [29]. In the United States in 2023, there are 574 federally recognized tribal governments and 324 federally recognized reservations [190]. In 2022, it was reported that there were 7.3 million Native Americans in the United States, which is approximately 2% of the U.S. population [190]. By 2060, this number is projected to increase to 10.1 million, or 2.5% of the total population [135]. In general, this group is young, with a median age of 31 years, compared with the general median age of 37.9 years [155]. According to the 2020 U.S. Census, the top five states with the greatest number of residents identifying as Native American are Oklahoma, Arizona, California, New Mexico, and Texas [191]. In 2022, this group had the highest poverty rate (25%) of any racial/ethnic group in the United States, more than double the national poverty rate of 11.5% [192].
CULTURE, RACE, ETHNICITY, AND CULTURAL COMPETENCE AND AWARENESS
Culture refers to the values and knowledge of groups in a society; it consists of approved behaviors, norms of conduct, and value systems [33; 34]. Culture involves attitudes and beliefs that are passed from generation to generation within a group; it is continually evolving and fluid [157]. These pat- terns include language, religious beliefs, institutions, artistic expressions, ways of thinking, and patterns of social and interpersonal relations [35]. Culture can also represent world- views—encompassing assumptions and perceptions about the world and how it works [36]. Understanding culture helps to elucidate why groups of people act and respond to the environ- ment as they do [37]. On the other hand, historically, race has been linked to biol- ogy. In this traditional definition, race was partially defined by physical markers, such as skin or hair color [38]. It does not refer to cultural institutions or patterns, but it is generally used as a mechanism for classification, and social meanings are ascribed to these classifications. Historically, the census in the United States defined race according to ancestry and blood quantum; today, it is based on self-classification. Further, in modern society, race is viewed as socially constructed without a true biological basis [193]. Racial characteristics are also assigned differential power and privilege, lending to differ- ent statuses among groups [40]. It is important to recognize that, for individuals, racial categorization is based on self- identification due to adherence to cultural norms, language, religion, and geography as well as physical appearance [193]. All this lends to the complexity and dynamic nature of the definition [193]. Ethnicity is also a complex phenomenon and has been defined in many different ways. Four components of ethnicity have been identified [41]: • Social class • Political process • Traditions • Symbolic token When ethnicity is viewed as social class, the individual’s ethnicity is compared to or equated with their socioeconomic class (e.g., working class or lower class). This is most clear in ethnic enclaves, the residents of which have strong cultural and familial ties [42]. Ethnicity may also be associated with persecution, both politi- cal and social. Ethnic unity may serve as a tool for social change and political reform [42]. Several famous ethnic movements took place in the 1960s, such as the unification of farm work- ers headed by César Chávez. Ethnicity has also been viewed as
59
MDIL1526
Powered by FlippingBook