FOUR The Helping Relationship

The Influence of Race and Ethnicity on Consumer Behaviors



Hispanics, interchangeably identified as Latinos, are one of the fastest-growing ethnic groups in the United States. The Latino population in the United States increased by 43% between 2000 and 2010 to 50.5 million, representing 16.3% of the total population (Pew Hispanic Center, 2011). The overall youthfulness, birthrate, and levels of immigration have contributed to the growth of the Hispanic population. In addition, the diversity of national-origin groups among Latinos has increased. Hispanics can be of any race and from over 20 national origins, with emerging communities of Dominicans, Colombians, Salvadorans, Nicaraguans, and Peruvians, for example, adding to the larger and more established communities of Mexicans, Puerto Ricans, and Cubans. According to the Pew Hispanic Center (2011), Mexicans are by far the largest Latino immigrant group, accounting for more than half of the Hispanic immigrant population, and they are the largest foreign-born group in the nation.

Hispanic immigration to the United States has reached unprecedented levels and has dispersed across the nation, including states, regions, cities, and towns that previously had virtually no Latino residents. Hispanics are concentrated in a number of metropolitan areas. The largest Latino immigrant groups—Mexicans, Cubans, Dominicans, and Colombians, as well as island-born Puerto Ricans— are located in four metropolitan areas: New York City, Los Angeles, Miami- Dade, and Chicago. Each area has a significant Latino population with a diversity of Hispanic national-origin groups. These areas are traditional destinations for the largest and most longstanding Latino groups (Mexicans, Puerto Ricans, and Cubans) and are the chosen destination of emerging Latino groups such as

Dominicans, Colombians, Salvadorans, and Guatemalans (Suro & Singer, 2002). Mexicans live largely in Los Angeles and several cities in Texas. Caribbean-born Latinos tend to live in New York or Miami.

Hispanics are one of the poorest ethnic groups in the United States. Latinos have high rates of poverty among full-time workers and poverty among working husbands in intact families with children, and may suffer from the effects of economic downturns more than non-Latinos and benefit less from periods of economic growth (Suro, 1998). In their report Wealth Gaps Rise to Record Highs Between Whites, Blacks and Hispanics, Kochhar, Fry, and Taylor (2011) found that median household wealth among Hispanics fell from $18,359 in 2005 to $6,325 in 2009. The percentage drop—66%—was the largest among all racial and ethnic groups. Low levels of educational attainment among Hispanics compound this negative economic shift.

In light of these demographic shifts, and the differences between and within the various Hispanic national-origin groups, including linguistic diversity and immigration status, understanding how race and ethnicity affects consumer or client behaviors within the helping process takes on increased significance. The mental health and psychosocial issues associated with the emigration experience are reason enough to justify integrating race and ethnicity into the clinical care of Hispanics and all persons of color. Drawing from the fields of health and mental health, the general objectives of this chapter are (1) to examine the sociocultural factors that influence the health, mental health, and illness behavior ofHispanics, including their use of medical, mental health, and general social work services; (2) to demonstrate how knowledge of social and cultural influences—including race and ethnicity—on health, emotional well-being, illness, and disability affects the accuracy of assessment and psychosocial diagnosis and the appropriateness of treatment planning and intervention; and (3) to explore how the use of health, mental health, and social services is enhanced by assisting individuals and families of color to mitigate the impact of negative factors and to tap into the positive influences of protective social and cultural factors. The general objectives of this chapter are consistent with the overall aim of the book: to address difficult service-delivery issues that are informed and sustained by interpersonal bias and institutional and structural racism and that contribute to persistent ethnic and racial disparities among marginalized and vulnerable populations treated within health and human service systems of care.

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