An Integrative Review of the Cultural Context of Health, Illness, and Healing Traditions of Mexican-Americans with Clinical Implications for Cardiovascular Health Promotion

Tuesday, 14 July 2009: 2:25 PM

Viola Benavente, PhD(c), RN, CNS
Center for Health Disparities Research, University of Pennsylvania, Philadelphia, PA

Learning Objective 1: Explain the cultural constructs of health, illness, and healing of Mexican-Americans, and their integration with the biomedical model.

Learning Objective 2: Describe a research agenda with direct clinical application for cardiovascular health promotion of Mexican-Americans.


The purpose of this integrative literature review is to provide a selected summary of key research findings regarding the cultural context of pathways to health, illness management, and healing traditions of Mexican-Americans, in order to document a research agenda with direct clinical application for cardiovascular health promotion. Mexican-Americans, the largest sub-cultural group of the United States (US) Hispanic population, experience a disproportionate burden of death and disability from cardiovascular disease. For Mexican-Americans, “care” typically occurs in a cultural context, which then guides health behaviors and illness responses whether they are health-promoting or risk-enhancing. Failure of health care professionals to understand ethnic variations of health and illness can be detrimental to care planning and delivery.

Methods: Four databases were searched from 1980 to 2008 for published research in US journals. A total of 25 articles met inclusion criteria, consisting of nine experimental studies, two mixed methods, and fourteen non-experimental studies with two literature reviews. Key information and core topics were coded and grouped based on conceptual similarities, facilitating identification of emergent themes and demonstrating a qualitative technique of content analysis that accentuates the clinical importance of literature reviews. Results: Data synthesis highlights lack of empirical research, and consolidates thematic outcomes. Three themes indicate cultural factors explain (a) prevalence of service access and utilization, (b) relative advantages and disadvantages of health behaviors, and (c) importance of “ethno-specific” cultural care considerations. Intra-cultural diversity, intergenerational differences, varying acculturation levels, and cultural care competency persist as remaining gaps in the literature and contributory factors to misunderstanding Mexican-American cultural mores and health. Conclusion: Increased understanding can contribute toward developing culturally coherent intervention programming and achieving culturally congruent care that may extend short-term gains of coronary heart disease prevention and risk reduction into long-term effectiveness for better cardiovascular health profiles among Mexican-Americans.