Latino Psychosocial and Health Problems

Solving
Latino Psychosocial
and Health Problems
Theory, Practice, and Populations
Kurt C. Organista
John Wiley & Sons, Inc.

Solving
Latino Psychosocial
and Health Problems
Theory, Practice, and Populations

Solving
Latino Psychosocial
and Health Problems
Theory, Practice, and Populations
Kurt C. Organista
John Wiley & Sons, Inc.

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Library of Congress Cataloging-in-Publication Data:
Organista, Kurt C.
Solving Latino psychosocial and health problems: theory, practice, and populations /
Kurt C. Organista.
p. cm.
Includes bibliographical references.
ISBN-13: 978-0-470-12657-8 (pbk.)
1. Hispanic Americans—Social conditions. 2. Hispanic Americans—Psychology. 3. Hispanic
Americans—Health and hygiene. 4. Hispanic Americans—Services for. I. Title.
E184.S75O74 2007
305.868′073—dc22
2006034370
Printed in the United States of America.
10 9 8 7 6 5 4 3 2 1
➇

To my wife Pamela Balls Organista
who inspires the best in me by being the person she is,
daughters Zena Laura and Zara Luz
who fill my heart with joy, and to
Ricardo Rico Organista, a good man and great father.

Contents
Foreword by Doman Lum ix
Preface xi
Acknowledgments xxi
About the Author xxiii
Part I Essential Social Science Theories, Frameworks,
and Research to Enhance Culturally Competent Practice
1 The Americanization of Latinos: Patterns of Acculturation
and Adaptation in the United States 3
2 The Social Stratification of Latino Ethnicity, Power, and
Social Welfare in the United States 39
3 Latino Ethnic Identity: Psychological Impacts of
Structured Inequality 65
4 Diversity within Latinos: Subgroups, Identities, and
Social Welfare 93
5 A New Practice Model for Working with Latinos 119
Part II Selective Reviews of Major Problem Areas,
Latino Groups, and Best and Promising Practices
6 The Latino Family 141
7 Latino Youth 181
8 Latino Mental Health 215
9 Latino Health 245
vii

10 Latino Power: Political Participation, Policy Benefit, and
the Role of Service Providers 283
Epilogue: Adelante—Proceeding Forward 321
Author Index 323
Subject Index 333
viii CONTENTS

Foreword
I AM DELIGHTED that Dr. Organista has finished his book on Latino Americans. Having borne the test of teaching, research, and writing, Dr. Organista now shares his thoughts and findings with us in print.
Understanding and Solving Latino Psychosocial and Health Problems: Theory,
Practice, and Diverse Populations is a landmark book that brings together important current research on Latino Americans in 10 major areas: acculturation, social stratification, ethnic identity, diversity, competent practice,
family, youth, mental health, health care, and politics. Its contributions
to theory, practice, and populations make this a very important book with
research-oriented studies and a focus on innovative practice principles.
Dr. Organista points out in his introduction that Latinos are the largest
minority group in the United States (35 million in 2006) and that by the
year 2050 they will compose 25% of the American population. His book is
“must” reading for those who will likely help and work with this important cohort. He takes an integrative approach that compares and contrasts
different U.S. Latino groups as distinct but related entities. Dr. Organista
distinguishes the various nuances between Mexican Americans, Puerto
Ricans, and Cuban Americans. He divides his book into two parts: theories, frameworks, and research and best and promising practices in dealing with problem areas.
Each chapter contains themes and their related parts, theory models, relevant research studies, and possible directions. Kurt Organista has built
this book on comprehensive research studies of Latino Americans and relevant theories that shed light on issues related to this population. He
achieves a sense of practice-oriented research and research-oriented practice consistently throughout the entire text. He takes an inductive approach
to finding out what the research on Latino Americans says and groups the
research data under the main themes of the text. At the beginning of this
book, he pursues some important systemic issues, such as the Americanization of Latinos, social stratification, and Latino ethnic identity, that are
important foundational topics for this text. Then he shifts to two important
practice-oriented themes, Latino diversity and a creative and interesting
new practice model for working with Latinos. Here he introduces the theories of social constructionism and essentialism, brings together cultural
ix

competence and social diversity, and makes the case for the inclusion of
both cultural and social components into competent practice. He offers a
working model that intersects two practice levels (generalist and specialized practice) and four major dimensions of service (increasing access,
problem assessment in social and cultural context, selection of culturally
and socially congruent interventions, and accountability).
Then Dr. Organista focuses on the Latino family and skillfully interweaves the themes of the family, culturally and socially competent practice, interpersonal violence, and family therapy. He also deals with the
issues and concerns of the Latino elderly and the caregiver burden in
Latino families. He is concerned about Latino youth and their problems
that are “the results of unmet developmental needs due to the breakdown
of conventional social and cultural supports and resources within the
family, ethnic community and greater society.” He advocates school-based
interventions and family-focused interventions. He examines two major
problem areas: mental health and physical health. Under mental health, he
offers a Latino demographic profile, examines social barriers (e.g., underutilization of mental health services and cultural obstacles), and makes
recommendations (culturally and socially congruent mental health inventions for Latinos).
Dr. Organista reports on the demographics of and obstacles to Latino
disease prevention and health promotion and concentrates on culturally
and socially competent assessment and intervention regarding diabetes
and heart disease, cancer, and HIV/AIDS.
Finally, he offers a relevant and realistic analysis of Latino politics and
power, focusing on the dynamics of Latino political power and a political
agenda that includes economic development and reform, immigration and
welfare policy reform, language and education policy reform, health care
policy reform, grassroots politics, church-based activism, formal Latino
political organizations, and pan-Latino political power.
When I started my teaching and writing career over 30 years ago, there
was sociological theory, a few practice principles, and anecdotal case studies
on ethnic minorities. Those of us who taught ethnic minority content (which
eventually became cultural and ethnic diversity and later human diversity)
were forced to be creative pioneers. Kurt C. Organista represents this present generation of scholars/educators who reflect maturity and insight into
the present discussion on diversity, culturally and socially competent practice, and population groups such as Latino Americans.
DOMAN LUM, PHD, THD
Professor Emeritus of Social Work
California State University, Sacramento
x FOREWORD

Preface
IMAGINE THE DILEMMA of trying to write a social science, practiceoriented book about the social welfare and psychosocial and health
problems of Latinos in the United States—complete with solutions—in
view of their imposing and rapidly growing population size, a complex
set of challenging problems and issues, and the tremendous heterogeneity between, as well as within, each major U.S. Latino group (e.g., Mexican Americans, Puerto Ricans, Cuban Americans, Central and South
Americans, Caribbeans). Although the term “solving” in the book’s title
may understandably strike some as presumptuous, it is meant to convey
optimism and seems so much better than other terms considered, such
as “addressing” (too tentative) and “confronting” (too combative)
Latino psychosocial and health problems.
The historical and current diversity across Latino groups also seriously
challenges blanket terms such as Hispanics and especially the overly popular largest minority group in America. Indeed, the 2000 U.S. census estimated that the Latino population is now 31 million, or about 13% of the
U.S. population, and that they are projected to grow to be 25% of the U.S.
population by 2050, which has long been the case in states like California,
Texas, Illinois, New Mexico, Florida, and Arizona. The U.S. census further confirms that Latinos now reside in every state throughout the
United States, rapidly forming enclave communities and supplying essential labor to vital American industries and markets, ranging from agricultural farmwork to poultry preparation and meat packing, construction,
gardening and landscaping, restaurant services, hotel housekeeping and
private domestic work, and other jobs too numerous to name in the vast
service sector. At the other end of the socioeconomic spectrum, Latino
representation continues to grow in America’s traditional centers of
power and influence (i.e., professional, business and corporate sectors,
political representation), although parity continues to be a long way off.
Even in popular media and culture, we are finally beginning to witness
the overdue integration of Latinos into the arts and entertainment industry, professional sports, and other areas.
xi

Although it is popular to say that Latinos have now surpassed African
Americans as the largest ethnic group in America, such assertions exaggerate the cultural and social similarities between major and minor Latinos groups. Thus the saying amounts to a half-truth. Latino group
variations in their relations with dominant Anglo-American society (e.g.,
degrees of conflict and cooperation) are described in this book using an
integrative approach that compares and contrasts many of the different U.S.
Latino group scenarios. Such an approach, which is followed throughout
the book, departs from the tendency in the cultural diversity literature to
confine each racial/ethnic group to its own separate chapter. This integrative approach to diverse Latino populations is also applied to a variety
of social science theories (e.g., from sociology, psychology, public health,
education, political science) to more thoroughly analyze and provide a
more comprehensive understanding of the Latino experience in America.
The book’s integrative approach emphasizes the oldest and largest of
U.S. Latino groups (i.e., Mexican Americans, Puerto Ricans, Cubans,
Central Americans), comparing and contrasting their acculturation
histories, related socioeconomic status, and general levels of social welfare. Numerically small (i.e., South Americans) and more recent (e.g.,
Dominicans) U.S. Latinos certainly deserve more attention, yet literature on these groups is just beginning to accrue. For these reasons, as
well as space limitations, the latter Latino groups are less emphasized
in this book.
BOOK STRUC T UR E, ORGANIZATION, AND
PRACTICE MODEL
This book is composed of 10 chapters divided into two parts. Part I contains the first five chapters and is designed to enhance cultural awareness
and sensitivity by applying a series of highly relevant social science theories
or frameworks that deepen the reader’s understanding of the historical
and current cultural and social experiences of diverse Latino populations
in the United States. Part I culminates, in the fifth chapter, with a new practice model for working with Latinos that synthesizes many of the best elements
of past and current multicultural and Latino-focused practice models in social work, counseling and clinical psychology, and other allied disciplines
and fields. Part II, spanning Chapters 6 through 10, is designed to provide
detailed illustrations of culturally competent best and promising practices
with various Latino groups, problem areas, and intervention approaches
(i.e., family- and youth-related psychosocial and health problems, health
and mental health problems in general, and Latino politics-related socioeconomic vulnerability and social policy issues).
xii PREFACE

Part I, “Essential Social Science Theories, Frameworks, and Research to
Enhance Culturally Competent Practice,” is designed to enhance cultural
sensitivity by grounding the study of U.S. Latinos in some of the most relevant social science theories and frameworks that show how minoritystatus factors have resulted in nonrandom patterns of major psychosocial
and health problems that have compromised the social welfare of U.S.
Latinos. Thus, Chapter 1, “The Americanization of Latinos: Patterns of
Acculturation and Adaptation in the United States,” describes historical
forms of adaptation to American society for each of the major Latino
groups under study. This is accomplished by applying the sociological
framework of acculturation to explicate major forms of contact and conflict
between Latinos and the host society, varying degrees of acculturative
stress, and predominant forms of adaptation (e.g., segregation, integration,
assimilation, marginality) for each major Latino group under study.
Chapter 2, “The Social Stratification of Latino Ethnicity, Power, and Social Welfare in the United States,” picks up where Chapter 1 leaves off by
analyzing and describing where different Latino groups are located in
the American social stratification system and the implication of such locations for general patterns of well-being or social welfare. Issues of economic and educational vulnerability are covered in detail to render
visible social structural and institutional issues central to Latino social
problems and solutions. How Latino communities have responded to oppressive dynamics is also highlighted. The psychological, individual-level
impacts of group-level phenomena are addressed in Chapter 3, “Latino
Ethnic Identity: Psychological Impacts of Structured Inequality,” which
provides a psychological analysis of the development of Latino racial and
ethnic identity in the United States, including analysis of the relation between subordinate minority status and race/ethnicity-related selfconcept and self-esteem. This level of analysis speaks to the considerable
heterogeneity of attitudes and behaviors of Latinos both within and
across different Latino groups, and necessarily addresses White racial
identity as discussed in the new area of critical White studies. Chapter 4,
“Diversity within Latinos: Subgroups, Identities, and Social Welfare,”
speaks to today’s pressing need to go beyond race and ethnicity to better
understand how human variation within any single group of Latinos interacts with social problems and solutions. Chapter 4 challenges the tendency in the multicultural literature of providing monolithic discussions
on race/ethnicity, and thus begins to address diversity within groups, including gender and sexual orientation, social class, skin color, and legal
status, and shows how such dimensions interact with psychosocial and
physical health problems. Addressing diversity within Latinos is imperative considering the preponderance of Latinas as consumers of social and
Preface xiii

human services, as well as the continued marginalization of gay, lesbian,
bisexual, and transgendered Latinos both in the larger society and in the
Latino community.
Chapter 5, “A New Practice Model for Working with Latinos,” the final
chapter in Part I, presents the book’s new practice model for working with
Latinos that integrates many of the best elements of multicultural and
Latino-focused practice models in social work and psychology. Elements
of Doman Lum’s (1999) Culturally Competent Practice: A Framework for
Growth and Action were selectively integrated into the book’s practice
model because of its comprehensiveness and deep-rootedness in the social work literature on cultural competence. Lum’s model addresses two
levels of social work practice (generalist and advanced) across four domains of culturally competent practice (cultural awareness, knowledge
acquisition, skill development, and inductive learning). However, because
some of Lum’s dimensions overlap more than others (i.e., cultural awareness and knowledge acquisition; generalist and advanced levels), they are
streamlined in the current practice model to highlight the knowledge,
skills, and professional growth commitment necessary in multicultural
learning and practice.
Lum’s work is also complemented by that of Rogler, Malgady, Costantino,
and Blumenthal (1987) based on their classic American Psychologist article,
“What Do Culturally Sensitive Mental Health Services Mean? The Case of
Hispanics.” Although this model is excellent in its special attention to issues of access and culturally congruent interventions, it is weak where
Lum’s model is strong: problem definition and assessment issues. Thus,
here is where synthesizing models become highly advantageous. Another
tremendous advantage is that the Rogler model dares to advocate intervention strategies that explicitly deviate from Latino culture in the best
interests of Latino clients. For example, although teaching Latinos to communicate assertively may run contrary to traditional Latino communication
protocol, it helps to expand their bicultural repertoire and adaptation to the
United States and is even a therapeutic tool for combating problems such as
depression, as described in Chapter 8. Too often multicultural practice
models appear to play it safe by advocating practice only within ethnic culture. Such a cautious bias is understandable in view of the historical treatment of ethnic minority groups, which has generally devalued ethnic
culture and indeed deviated from culture in an imperialistic manner (e.g.,
forced assimilation boarding schools for Native Americans, antibilingual
measures for Latinos). Yet, advanced cultural competence not only involves
knowing how to biculturate Latinos in a nonoppressive manner, but it must
also occasionally critique cultural elements that can be maladaptive to some
group members in certain situations.
xiv PREFACE

Perspectives that inform the new practice model for Latinos are also described in Chapter 5 and include ecological-systems theory, the major contemporary social work perspective for understanding human behavior in
the social environment, and a social constructivist perspective. Advantages
of an ecosystems model include thinking about client problems and solutions at multiple levels (i.e., micro [individual] through macro [social]).
Critics of this perspective (e.g., Wakefield, 1996), however, rightly point
out that it is descriptive and not prescriptive and hence must be brought
to life by combining several domain-specific theories and methods to address particular problem areas at the local level—precisely the overriding
objective of this book. A postmodern social constructivist perspective is
also provided to assist readers in considering the politics and power dynamics inherent in all human systems and relations and how “truths” can
often be more relative than monolithic and hence open to being questioned and challenged, especially by those experiencing social injustice.
The result is a user-friendly practice model that is fairly easy for practitioners, as well as administrators, to keep in mind as they actively provide, design, and critique the broad array of interventions needed to
comprehensively address Latino psychosocial and health problems. The
pragmatic approach to model development in this book is also meant to
build on the current state of practice and to counter the frequent rhetorical tendency in the literature to overwhelm readers with long wish lists
of all the things practitioners should but often can’t do, lists that can be
exhaustive to a fault and thus exhausting to readers.
Part II, “Selective Reviews of Major Problem Areas, Latino Groups,
and Best and Promising Practices,” provides detailed descriptions and illustrations of best (i.e., empirically tested) and promising practices (i.e.,
conceptually well conceived and executed despite lack of evaluation)
with diverse Latino populations and subgroups across a wide variety of
significant psychosocial and health problems. The term psychosocial is
used here to refer to the interaction between individual psychological
factors and macro-social—including cultural institutional—factors that
frame so many problem patterns affecting racial and ethnic minority
groups given their link to historical and current issues of inequity, marginality, and social injustice. This definition includes many health
problems related to racial/ethnic status (e.g., health disparities). Conceptualizing Latino psychosocial and health problems in this manner necessitates thinking about problems and solutions at multiple levels, from
micro-individual (e.g., case management, therapy) to meso-community
(e.g., comprehensive school-based services) to macro-societal strategies
aimed at changing institutional practices and social policy, all of which
are illustrated in Part II.
Preface xv

It is the overriding objective of Part II to provide detailed illustrations
of culturally competent practice with Latinos by carefully selecting from
among some of the best and clearest examples in the literature, including
the author’s many years of experience in Latino health and mental health
work. Because it is impossible to address all of the important psychosocial
and health problems affecting Latinos in a single book, I instead chose to
illustrate how the major dimensions of culturally competent practice
(e.g., as laid out in Chapter 5) are applied in real-life examples of practice
with Latinos aimed at some of the most pressing issues affecting families
(domestic violence, dementia in the elderly), youth (school failure, gang
involvement), health (diabetes, heart disease, HIV/AIDS), mental health
(prevention of depression in the community, treatment of major depression), and policy concerns (economic development, immigration and welfare policy reform, health policy).
As the single most important cultural institution across different
Latino groups, even those varying in level of acculturation, la familia
Latina must be adequately addressed as the site of both problems of and
solutions to various psychosocial and health issues confronting U.S.
Latinos. Thus, Chapter 6, “The Latino Family,” is purposefully broad
but primarily focuses on family and community problems and issues
pertinent to culturally competent practice. For example, how immigration and acculturation dynamics help and hinder family functioning,
and how the Latino community is affected by disproportionate poverty
and related problems (e.g., domestic violence, elderly abuse) are addressed. State-of-the-art and cutting-edge practice with Latino families
and communities are also addressed by highlighting work by leaders in
this area, such as Celia Falicov, José Szapocznik, Monica McGoldrick,
and Ruth Zambrana. Chapter 7, “Latino Youth,” focuses on the experiences, problems, and issues affecting the burgeoning population of
Latino youth in America. School failure, teen pregnancy, HIV/AIDS,
and STDs, delinquency and gang involvement, and substance abuse are
persistent and related psychosocial and health problems that significantly impact Latino youth, families, and communities. They require
sensitive assessments that consider developmentally related issues of
minority status and marginality, the negative incentives of poverty,
and ecological-family system considerations of problem manifestations
and resolution.
Chapter 8, “Latino Mental Health,” provides an overview of Latino
mental health in America followed by a selective review of best and
promising practices in major problem areas (e.g., depression) and with
various subpopulations (e.g., women). The disciplines of psychiatry and
counseling and clinical psychology have made major advancements in the
xvi PREFACE

past 25 years that are highlighted before targeting important mental
health issues that overaffect Latino refugees, immigrants, and urban
poverty dwellers.
An overview of the state of Latino health in America is presented in
Chapter 9, “Latino Health,” with attention to pertinent macro-level social
(e.g., access to health care) and cultural (e.g., culture-based health attitudes and beliefs) factors. With regard to best and promising practices in
health assessment and practice, a selective review of significant health
problems (e.g., diabetes, HIV/AIDS, cancer) and issues is provided to
teach cultural competence through important key illustrations.
Chapter 10, “Latino Power: Political Participation, Policy Benefit, and
the Role of Service Providers, returns to a focus on socioeconomic vulnerability as the core issue undermining the health and well-being of the majority of Latinos in the United States today. This chapter provides an
overview of Latino politics with an emphasis on political participation,
policy benefit, and potential roles for social workers and other service
providers in the frequently ambiguous political arena. Historical and current, formal and informal, grassroots movements and initiatives on the
part of local and national Latino organizations are provided as illustrations of the historical agency and self-advocacy of Latinos that can be
augmented by mainstream professionals and institutions. Chapter 10
brings the reader full circle to the major social justice issues raised in Part
I that must be understood and addressed, simultaneous with micro-level
problems, if we are to continue solving Latino psychosocial and health
problems in America.
The book ends with a brief Epilogue in which the author reflects on the
challenges of this ambitious book project while also looking adelante or
forward to what future editions of this book could contain as well as looking forward to the future contributions of other Latino and Latino interested scholars and practitioners.
BOOK GOALS AND I NTENDED AUDIENCE S
Rarely are Latino-focused social science theory, research, and practice information all in the same place. For example, over the past decade and a
half, I have repeatedly compiled thick course readers, packed with articles, book chapters, and various governmental and nonprofit agency reports, in order to teach Social Work Practice with Latinos, a course
increasingly common in schools of social work throughout the country.
While at times frustrating, it was from such experience that I learned to
mine Latino-specific and Latino-relevant literature from throughout the
social sciences to better capture the complexity of the Latino experience
Preface xvii

and its links to socioeconomic status, consequent social welfare, and social and human service needs.
It is a major goal of this book to integrate such literature in ways that
make most of the chapters read like reviews of the literature in order to answer some basic and vital questions: How do we understand the tendency
for Latinos to underutilize various human, social, and health services,
while overutilizing others? What kinds of outreach or service development
strategies can be employed to improve the situation? How do we assess
problems in ways that consider cultural and social-environmental contexts,
and then select interventions congruent with the lived realities of Latino
groups and individuals? And while the multicultural literature is filled
with mantra-like rhetoric about working within the culture, how and when do
we work outside of Latino culture in a nonoppressive manner that is in the
best interest of our clients?
Although it is intuitively optimal to integrate multidisciplinary research, theory, and practice, such efforts continue to be more the exception than the rule. In some ways, the interdisciplinary-oriented field of
social work, which regularly mines, integrates, and expands on all of the
areas just enumerated, is an ideal domain for such knowledge development, integration, and sharing. Social work has indeed made its fair share
of contributions to the cultural competence literature (cited throughout
this text), yet general books on social work practice with Latinos have
been very slow to emerge.
This book is designed for students and professionals interested in and
already serving Latino populations in social work and allied fields such
as counseling and clinical psychology, marriage and family therapy, psychiatry, and public health care, who share a common commitment to providing Latino clients and patients with sensitive and effective care for a
wide spectrum of psychosocial and health problems. As such, the book
can serve as the primary text for the growing number of Latino-focused
undergraduate and graduate courses in social work and allied fields
(e.g., Latino health, Latino mental health, the Latino family). Further,
because helping professionals are now serving Latino clients and addressing Latino issues more than before, the book can be a valuable
guide in proving culturally competent health, mental health, education,
and family- and youth-oriented services, as well as social policy analysis
and development.
In 1970, the Council on Social Work Education (CSWE) declared ethnic
minority concerns its number one priority, following the lead of counseling and clinical psychology. This mandate included the integration of
multicultural content into social work school curricula. A number of
books and articles have appeared since then, but it is generally agreed
xviii PREFACE

that such publications continue to constitute only a small percentage of
the professional knowledge base. For example, in Lum’s classic 1996 book,
Social Work Practice and People of Color, he describes a study of 28 social
work practice textbooks published between 1970 and 1995 in which he
found no chapters devoted to multicultural issues. In fact, only 1% of the
pages in this set of texts (121 of 12,570) were devoted to ethnicity. In this
same study, Lum also reviewed three of the top social work journals (Social Work, Social Service Review, and Families in Society [formerly Social Casework]) from the same time period and found that 2% (87 of 3,716) of the
articles related to general multicultural issues and 2% (80) related to
African Americans, 1% (36) to Native Americans, 1% (44) to Asian Americans, and 1% (49) to Latinos.
Thus, more than 35 years since the CSWE mandate, the field of social
work continues to operate with too little information, illustration, and
technology regarding how to conceptualize and respond to the various
social welfare needs of Latinos and other people of color. And the situation is not markedly better in allied fields of professional practice. It is
with this awareness of the state of the art in culturally competent practice
with Latinos that the current book is offered as a sincere attempt to continue pushing this important topic of inquiry toward the cutting edge.
REFERENCES
Lum, D. (1996). Social work practice and people of color: A process stage approach (4th
ed.). Pacific Grove, CA: Brooks/Cole.
Lum, D. (1999). Culturally competent practice: A framework for growth and action. Pacific Grove, CA: Brooks/Cole.
Rogler, L. H., Malgady, R. G., Costantino, G., & Blumenthal, R. (1987). What do
culturally sensitive mental health services mean? The case of Hispanics.
American Psychologist, 42(6), 565–570.
Wakefield, J. C. (1996). Does social work need the eco-systems perspective? Pt. 1.
Is the perspective clinically useful? Social Service Review, 1–32.
Preface xix

Acknowledgments
FIRST AND FOREMOST I’d like to fly my Latino colors by expressing my
deepest appreciation to my loving family. My heart doubled in size when
my wife, Pamela Balls Organista, decided to share her life with me, and
with our two beautiful daughters, Zena Laura and Zara Luz Organista, it
doubled again. I cannot express the profound joy and meaning that these
extraordinary human beings give my life each day. But any personal and
professional accomplishments would not even have been possible without
the epic-size love and support of my extended Mexican family: My father,
Ricardo Rico Organista, completes our two-generation quest to be what a
Latino father and son can be, while trying to improve the Latino experience in the process; my grandmother, Adela Rico Organista, was exactly
the mother that I needed growing up in East Los Angeles; and Alex Rico
Organista continues to be the loving big brother that I never had.
Fortunately, other family members have become too numerous to
name over time, but I want to make sure to thank the Arriola family, especially Auntie Glo and prima-hermana Jo Ann; the Uncle Art and Aunt
Olivia branch of the Organistas, including cousins “Guy,” Yvette, and
Danny; my Aunt Norma and cousins Lauren “Tinker” and Dennis Beaman; cousins Debbie and Patricia, daughters of my much loved second
father, Manny Organista. Compadres Celina and Pablo Ramirez, daughters Quetzali and Rubi, and my godson, Diego, provide much needed
family support out here in the Bay Area. Though friends may come and
go, David “T-Bone” Torres and his compañera, Jo Ann Orge, are loyal to
the end.
And while family and academia struggle to coincide, here’s to my
touchstone colleagues who have enriched my experience at UC Berkeley: Former Dean Harry Specht was a genuine ally during my early
years; Dean Jim Midgely gave me a handy compass to this book; Emeritus Professor Jewelle Taylor Gibbs continues to help me “keep it real” in
this business; Paul Terrell has generously shared his friendship and
Berkeley spirit; Joseph Solis, Rafael Herrera, and Peter Manoleas have
been hermanos bien educados from day one; Lorretta Morales is a blessing
xxi

of a support staff person whose talented mark has graced all of my work
over the years, including this book; and Sharon Ikami provides friendly
backup when Lorretta is away. Special thanks to my internship mentor,
Ricardo F. Muñoz, and graduate school mentor, Manuel Barrera Jr., for
guidance and support at critical times, and heartfelt gratitude to my editor Lisa Gebo, who manages to gracefully blend professionalism and
human warmth in the creation of needed book projects and caring
friendships. ¡Mil gracias!
xxii ACKNOWLEDGMENTS

About the Author
KURT C. ORGANISTA is an associate professor of social welfare at the University of California at Berkeley. Organista is a bilingual and bicultural Mexican American who was born and raised in predominantly Latino East Los
Angeles. As such, he brings a sensitive insider’s perspective to his scholarly
analysis of Latino social welfare. Organista conducts cross-cultural, interdisciplinary, and international research on a variety of Latino-related social
welfare topics. He has published a series of journal articles and book chapters on the treatment of depression in Latinos with cognitive-behavioral
therapy alone and in combination with case management. Organista is a nationally recognized expert in HIV/AIDS prevention with Mexican/Latino
migrant laborers, with a second series of book chapters and articles published in social work, health, psychology, ethnic studies, and HIV/AIDSfocused journals. He was appointed by Secretary of Health Tommy Thompson to serve on the National Office of AIDS Research Advisory Council
(2004–2008). Organista is also a member of the editorial boards for the Hispanic Journal of Behavioral Sciences, Journal of Ethnic and Cultural Diversity in
Social Work, and the American Journal of Community Psychology.
xxiii

1
PA R T I
Essential Social Science
Theories, Frameworks,
and Research to
Enhance Culturally
Competent Practice
PART I IS DESIGNED to inform culturally competent practice by enhancing
the reader’s awareness of, knowledge about, and sensitivity to Latino culture and experience in the United States, culminating with a new practice
model that synthesizes some of the best elements of past and current thinking in social work, counseling, and clinical psychology, and other allied
disciplines and fields. Although ambitious, such a foundational objective
is accomplished by using an integrative approach to address the diversity
within both the Latino population and social science theories and frameworks needed to best analyze and understand the Latino experience in the
United States. Thus, essential theories of acculturation, social stratification, racial and ethnic identity, and human diversity, including feminism
and perspectives on sexual orientation, are used to frame the historical
and current group-level and individual experiences of U.S. Latinos. Further, rather than confining each major Latino group to its own separate
chapter, all chapters in Part I compare and contrast different Latino groups
for a more thorough and integrated analysis of Latino problems and issues
needed to inform culturally competent practice.

3
CHAPTER 1
The Americanization
of Latinos
Patterns of Acculturation and
Adaptation in the United States
THE PROCESS OF becoming Americanized can result in very different levels
of adjustment and adaptation for different ethnic groups. Why is it that
some ethnic groups have considerable success achieving the American
Dream while others do not? That is, why is it that some ethnic groups
achieve high levels of power and participation in mainstream culture, politics, and economics, while other groups struggle and suffer at the margins? Using socioeconomic status (SES) as perhaps the most central
indicator of general social welfare, it’s fairly easy to rank-order ethnic
groups, with Euro-Americans mostly at the top and people of color
mostly at the bottom.
Even focusing just on Latinos, we can see considerable differences in
SES, with Cuban Americans ranking nearly as high as non-Latino White
Americans, Puerto Ricans ranking much lower or about the same as
African Americans, and Mexican Americans ranking in between. The
ways we perceive and understand these social positions have tremendous implications for how we respond to ethnic group needs and problems. For example, do we view ethnic groups as primarily responsible for
their locations in society, or do we view social structural and environmental factors as primarily responsible? To be most effective, human service professionals must be able to think deeply and critically about the
origin and perpetuation of psychosocial and health problems affecting
different groups.

4 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
It is a basic tenet of cultural sensitivity to make ourselves knowledgeable
about the historical experiences of ethnic minority groups with whom we
work as service providers. Thus, though practitioners don’t have to become historians, it is important that we obtain sufficient background information to better appreciate the current circumstances, problems, and
postures of ethnic minority clients. This chapter uses an acculturation
framework for organizing a brief yet salient review of Latino-relevant
American history and sociology. As with the book in general, this review
emphasizes the oldest and largest of U.S. Latino groups (i.e., Mexican
Americans, Puerto Ricans, Cubans, Central Americans), comparing and
contrasting their acculturation histories and related SESes and general
levels of social welfare.
An acculturation framework can help human service professionals understand the historical development of contemporary Latino psychosocial
and health problems in a way that depathologizes Latinos without minimizing the gravity of their many life-compromising challenges. This
framework will also help the reader to build cultural sensitivity by placing Latino problems and issues within a context that considers the dynamics of U.S. race relations, processes of dominance and subordination,
and how majority and minority groups coevolve over time.
It is worth noting that most U.S. Latinos generally refer to themselves
based on historical national origins (i.e., Mexican American, Puerto
Rican, Cuban American, Central American), while also using the U.S.
government term, Hispanic, in more formal, institutional settings (e.g.,
when filling out forms) or when referring to U.S. Latinos in general. Because many U.S. Latinos have reacted unfavorably to the term Hispanic,
which they perceive to be a top-down government-imposed label, they
have instead elected to use Latino as a general term, in addition to their
national origins labels. Of course, there are many regional variations on
preferred terms (e.g., Puerto Ricans who self-identify as Boriquen as an
assertion of indigenous heritage; Mexican Americans from New Mexico
whose historical mistreatment led to an emphasis of their Euro-Spanish
heritage through the terms Spanish and even Hispano long before Hispanic became the official term of the U.S. government). With such variety
in Latino terminology, the sensitive service provider simply asks clients
what they prefer to be called rather than making assumptions frequently
likely to be wrong.
THE CONCEPT OF ACCULT URATION
The classic definition of acculturation dates back to the mid-1930s when
anthropologists Redfield, Lipton, and Herskovits (1936) defined it as

The Americanization of Latinos 5
those phenomena that result when members of different autonomous cultural groups come into continuous firsthand contact, with subsequent
changes in the original cultural patterns and customs of either or both
groups (e.g., language, values, lifestyle, attitudes, identity). Although
many today use the terms acculturation and assimilation interchangeably,
Redfield et al. specified that acculturation refers to cultural changes,
whereas assimilation refers specifically to intermarriage between members of groups in contact. They noted that assimilation or intermarriage
may or may not be a phase of acculturation for some groups. For example,
the rate of intermarriage for Cuban American women is nearly 50%, compared to 16% for Mexican American women (Gonzales, 1993). This is
quite a difference considering that the vast majority of Cubans have been
in the United States less than 50 years, whereas Mexican Americans have
been here for over a century and a half.
ACCULTURATION AMERICAN STYLE
More recently, Canadian psychologist John Berry (2003) studied the process of acculturation by focusing primarily on indigenous peoples and
ethnic groups in North America and their historical experience with dominant European colonial powers. As such, Berry’s conceptualization of
acculturation is particularly relevant to Native Americans, African Americans, and Latinos in the United States. For example, in discussing the nature of acculturation, Berry notes that although in theory two groups in
contact can influence each other, in reality the larger and more powerful
group usually dominates the smaller and less powerful group (see Figure
1.1). As such, the dominant group typically wields considerably more
power to control, influence, and even oppress the nondominant group, and
these dynamics set the stage for a process of acculturation that is usually
resistant, stressful, and conflictual for the nondominant group. Just how
stressful the acculturation process can be depends on its course.
Berry (2003) summarizes the course of acculturation as a three-phase
process characterized by contact, conflict, and adaptation. Contact refers
to the conditions under which two cultural groups meet (e.g., invasion,
immigration, seeking refuge); conflict refers to the predictable tension
and fighting that results when one group attempts to dominate another;
and adaptation refers to the eventual form of accommodation between
groups that is intended to reduce conflict. It is theoretically possible for
conflict not to occur, as indeed some individuals may experience, but the
all too common dynamics of group-level dominance and subordination
make conflict a probable phase of acculturation. Accommodation can take
many forms, ranging from assimilation, as when a nondominant group

6 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Figure 1.1
The Nature of Acculturation
Culture B
In Theory
In Reality
Culture A
Culture A Culture B
marries into the dominant group, to separation, as when a nondominant
group exists mostly apart from the dominant group.
Which form of adaptation an ethnic minority group eventually experiences depends on a number of factors, including the original conditions of
contact, the degree of conflict between groups, and the dominant society’s
tolerance for cultural diversity. All of these factors influence the degree to
which the nondominant group attempts to maintain its culture of origin
and the degree to which positive relations between groups is possible. According to Berry (2003), the four major forms of adaptation evident in most
societies can be understood by listing all possible combinations of yes/no
answers to the following two questions: Does the minority group attempt
to retain its culture of origin? and Are positive relations possible between
the minority and majority groups? (See Table 1.1.)
For example, the historical experience of Mexican Americans has predominantly been one of segregation due to strained relations with the
dominant culture and their relatively high retention of Mexican culture.
The fact that Mexican American adaptation has slowly been shifting from
segregation to integration speaks to the dynamic nature of acculturation
of group relations not depicted in Table 1.1.

The Americanization of Latinos 7
Table 1.1
Varieties of Adaptation to Acculturation for U.S. Minority Groups
Positive Relations Predominant
Attempt to Possible with Form
Retain Culture? Dominant Culture? of Adaptation
No Yes Assimilation
Yes Yes Integration
Yes No Segregation
No No Marginalization
Source: “Psychology of Acculturation: Understanding Individuals Moving between Cultures” (pp. 232–253), by J. W. Berry, in Applied Cross-Cultural Psychology, A. Brislin (Ed.),
1990, Newbury Park, CA: Sage. Reprinted with permission.
Still, the depiction of the four major forms of adaptation can give us a
basic understanding of how stressful the acculturation process can be for
different groups. Indeed, the four forms of adaptation can be viewed almost as a stress gradient in which the scenarios of assimilation and integration would be far less stressful forms of adaptation to American society
than segregation and certainly marginalization. A solid conceptualization
of acculturative stress is essential for understanding the basis of an ethnic
minority group’s relative patterns of success and failure in America.
ACCULTURATIVE STRESS
Berry and Annis (1974) define acculturative stress as collective confusion
and anxiety, loss of identity, feelings of alienation, and striking out
against the larger society. More specifically, acculturative stress refers to
behaviors and experiences generated during acculturation that are
pathological and disruptive to the individual and ethnic group (e.g., deviant behavior, psychosomatic symptoms, feelings of marginality). This
definition can be extended to refer to the negative disparity in overall
health and quality of life between majority and minority cultural groups.
The Acculturation Stress Formula
Based on extensive research of both ethnic immigrant and indigenous
groups in North America, Berry (2003) has developed a useful formula for
estimating a group’s general level of acculturative stress that can be used
to examine the influential role of factors such as race, ethnicity, culture,
and racism embedded in the process of acculturation.
According to Berry (2003), acculturative stress will be highest when the
cultural and behavioral similarity between two groups in contact is lowest

8 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
and where pressure is placed on the minority group to acculturate due to
the dominant group’s low tolerance for racial and cultural diversity. For
example, the acculturation experiences of Native Americans and African
Americans rank highest in terms of stress given their low cultural and
racial similarity to Anglo-Americans and the tremendous historical pressure placed on these involuntary Americans to relinquish their culture of
origin. Such pressure has been especially stressful considering that the
original contact experiences of these two groups involved invasion and
forced relocation, followed by policies of rejection and separation from
mainstream society (e.g., reservations for Native Americans and enslavement followed by legal segregation for African Americans).
In contrast, European immigrants have historically experienced low acculturative stress relative to people of color, given their high cultural and
racial similarity to the dominant group and because the pressure to acculturate has been buffered by their voluntary immigration to America
(i.e., their collective inclination to relinquish their culture of origin in exchange for American culture and identity). However, this is not to say
that European immigrants have not experienced acculturative stress
stemming from America’s low tolerance for diversity even within European immigrants. Such low tolerance was most clearly exemplified by the
famous “melting pot” philosophy, which strongly discouraged foreigners
from retaining their culture of origin and served as the major guiding
philosophy for socializing and including European immigrant groups
into American society during the twentieth century. And although we
would expect all societies to be nationalistic, the melting pot philosophy
made immigration and acculturation overly stressful because it promoted
the American standard while devaluing dissimilar cultures of origin,
with no vision of healthy, functional biculturalism or multiculturalism.
Classic research by Murphy (1965, 1975) established that a melting pot
orientation places immigrants in the stressful position of having to either
conform to or oppose the dominant group. In contrast, countries with
higher tolerance for cultural diversity allow immigrants to maintain supportive cultural traditions and practices that buffer acculturative stress.
In Murphy’s classic review of the relation between immigration and mental health, he found that immigrants had significantly higher rates of psychiatric hospitalization relative to nonimmigrants in countries with low
tolerance for diversity such as the United States. In contrast, hospitalization rates did not differ between immigrants and natives in more tolerant
societies such as Canada. Thus, even though European immigrants rank
far lower than, say, Native Americans and African Americans in acculturative stress, they have experienced unnecessary degrees of stress prior to
their assimilation.

The Americanization of Latinos 9
But as unnecessarily stressful as melting pot-driven acculturation was
for European Americans, they were still eventually regarded as the “right
stock” for the melting pot recipe, whereas non-European people of color
were not. For example, although the Americans of predominantly Northern European ancestry were initially threatened by Southern and Eastern
Europeans (i.e., Jews, Italians, Poles, Hungarians) of the second great immigration stream at the turn of the twentieth century, given their frequently darker Mediterranean appearance and impoverished peasant
backgrounds, their current levels of SES parity and beyond, along with
very high rates of marital assimilation, reveals that such initial rejection
was short-lived compared to that of non-European ethnic minorities
(McLemore, Romo, & Gonzalez Baker, 2001).
Berry (1990) notes that acculturative stress is particularly high when
countries develop policies that largely exclude certain groups from participation and access to power. Herein lies a precarious predicament for
people of color in the United States who have historically been coerced
not to practice their culture yet disallowed from fully joining American
society. The result of this predicament is marginality (see Table 1.1), most
evident for Native Americans and African Americans but also for subgroups of Latinos such as members of Chicano and Puerto Rican youth
gangs who walk a line between cultures without sufficient guidance and
support, role models, and self-affirming cultural values.
In response to the double bind of melting pot pressure to assimilate and
forced separation, segregated groups have urgently needed to retain their
culture of origin, or, if necessary, reclaim and re-create it, in order to survive and feel human in an often hostile environment. For people of color,
group survival and basic sense of humanity have depended on culturebased mutual aid and social traditions that have served as an organizing
principle for physical and social survival. It is an irony of history that the
racist exclusion of people of color from participation in mainstream America has done more to create and strengthen ethnic culture and identity
than any nationalistic movement generated by people of color. Spurts of
nationalism, often seen at the fringes of civil rights movements, are more
reactions to rejection than proactive efforts to live as a separate nation.
The majority of people of color have been and continue to be fiercely patriotic believers in America who would willingly integrate and assimilate in
spite of their historical mistreatment. On a related note, it is a double irony
that the most voluntarily self-segregated groups in America are of European background (e.g., Amish, Mennonites).
While America continues to struggle to embrace diversity, this new
multicultural philosophy of socialization and inclusion continues to face
ample resistance, as seen in the recent rash of “English Only” laws

10 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
spreading across the country, the scapegoating of immigrants for economic problems, and widespread “diversity fatigue,” as exemplified by
anti-affirmative action policies such as California’s recent Proposition
209. Ironically, current racial politics seem in direct opposition to the
globalization of business that depends heavily on sophisticated levels of
competence in working with multicultural people and countries.
ACCULTURATIVE STRESS AND SOCIAL WELFARE
In examining the acculturative experiences of different ethnic groups in
America, it becomes apparent that the degree of acculturative stress is inversely related to a group’s general level of well-being or social welfare.
That is, in general, the higher the degree of acculturative stress, the lower
the overall level of social welfare for a group. Given this relation, Berry’s
three-stage model of acculturation described earlier can be expanded to
include degree of acculturative stress and social welfare in order to better
connect acculturation dynamics with current levels of well-being in different groups in America (see Table 1.2).
Table 1.2
Model of Acculturation, Adjustment, and Social Welfare for
Ethnic Groups in the United States
Ethnic
Group
Conditions
of
Contact
Degree
of
Conflict
Predominant
Form of
Adaptation
Degree of
Acculturative
Stress
General
Level of
Social
Welfare
European
Americans
Voluntary
immigration
Low Assimilation Low High
Native
Americans
Invasion High Marginalization →
Segregation
High Low
African
Americans
Forced
relocation
High Marginalization →
Segregation
High Low to
medium
Old*
Chinese,
Japanese
Voluntary
immigration
Medium Segregation →
Integration →
Assimilation
Low to
medium
Medium
to high
Latinos Varies by
subgroup
Medium Segregation →
Integration →
Medium Medium
*Old refers to Chinese and Japanese populations with immigration histories in the United
States since the early 1800s.
Note: Arrows indicate change over time.

The Americanization of Latinos 11
The expanded model of acculturation explains general historical patterns of adaptation and consequent level of social welfare for different
ethnic groups. No model is comprehensive enough to adequately explain
all of the variance within or between groups, but the expanded model
presented here provides a basic framework for beginning to understand
major patterns of group-level adjustment in American ethnic groups.
It is relatively easy to use the expanded model of acculturation to contrast the general adaptations of non-Latino Whites, African Americans,
and Native Americans, yet different Latino groups also vary greatly in
their conditions of contact with American society and subsequent degrees of acculturative stress and social welfare. The same is true of Asian
groups, which is why the examples in Table 1.2 are confined to the oldest
and largest Asian populations with immigration histories dating back to
the early 1800s.
A selective review of salient historical details is necessary to appreciate
the conditions of acculturation that undergird current levels of social welfare and need for different Latino groups in the United States, as described in Table 1.3.
MEXICAN AMERICANS
Americans of Mexican ancestry constitute two-thirds of all Latinos in the
United States, and their extensive, 150-year history in America predates
Table 1.3
Model of Acculturation, Adjustment, and Social Welfare for
Latinos in the United States
Latino
Group
Conditions
of
Contact
Degree
of
Conflict
Predominant
Form of
Adaptation
Degree of
Acculturative
Stress
General
Level of
Social
Welfare
Chicanos Invasion +
immigration
Medium Segregation →
Integration
Medium Medium
Cuban
Americans
Legal
refugees
Low Segregation →
Integration →
Assimilation
Low High
Puerto
Ricans
Colonization Medium Segregation Medium to
high
Low to
medium
Central
Americans
Illegal
refugees
Medium Segregation Medium Low
Note: Arrows indicate change over time.

12 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
all other U.S. Latino groups. As such, application of the expanded acculturation model requires more analysis and serves as a salient point of reference for understanding Latino adaptation and adjustment in the United
States. In this section, the term Mexican American is used to refer generally
to this population; the term Chicano, self-imposed by civil rights activist
members of this group, partly as a rejection of the government-imposed,
hyphenated term Mexican-American, is also honored. Used historically
by Mexican people as a derogatory term affixed to low-class people, Chicano activists chose to infuse it with pride, much as African Americans
turned the term Black on its head during the 1960s.
CONTACT
Although contact for the vast majority of today’s estimated 14 million
Mexican Americans might be best characterized as voluntary immigration,
it is important to note that like Native Americans, Mexican people were
native to what is now the southwestern portion of the United States. They
are the only other minority group in U.S. history to be annexed by conquest and to have their rights “safeguarded” by treaty. As such, the stage
for protracted conflict and difficult adjustment was set in motion long
ago. Major forms of conflict include international war, major loss of land
holdings, and continuous exploitation of labor, still highly in evidence in
farmwork as well as the urban service sector.
Prior to America’s westward expansion during the 1800s, Mexico
extended north to include a vast area corresponding roughly to what we
now know as Texas, California, New Mexico, Arizona, Oregon, Nevada,
and parts of Utah and Wyoming. Although sparsely populated, it is
estimated that as many as 100,000 Mexicans occupied this area
(McLemore et al., 2001). Fearful of American encroachment, the Mexican government offered American settlers tracts of land to develop in
the 1820s on the condition that they obeyed Mexican law and eventually
became Mexican citizens and even members of the Catholic Church. A
few American settlers complied with Mexican regulations; most did not
and entered Mexico illegally, an interesting historical footnote given
today’s widespread resentment of undocumented Mexicans in the
United States.
CONFLICT
By 1835, American settlers outnumbered Mexicans five to one in northern Mexico and tensions mounted given Mexico’s tenuous control over
the region and the settlers’ belief in manifest destiny, or the God-given

The Americanization of Latinos 13
right to expand American society from east to west or from “sea to shining sea,” as we would later learn to sing. Settlers strongly resented the
idea of being governed by people they considered inferior and policies
such as Mexico’s antislavery law, which many settlers violated. Major
conflict soon ensued when Texas declared itself an independent republic
in 1836, resulting in battles with the Mexican army sent to put down the
rebellion.
Remembering the Alamo(s)
Americans generally imagine the Texas revolt as portrayed in the movie
The Alamo in which American heroes Davy Crockett and Jim Bowie, along
with nearly 200 other settlers, occupied the old Spanish mission of the
same name and fought valiantly to their deaths in the effort to free Texas
from an oppressive Mexican government. It is this Hollywood myth of
the Texas revolt that continues to overshadow what many historians consider a rather calculated effort on the part of American settlers and the
U.S. government to take Mexican land by force. Indeed, Mexicans and
Americans “Remember the Alamo” quite differently.
The Alamo (1960)
The battle of the Alamo was forever mythologized in 1960 in the nearly 3-hour long,
epic-size production directed and produced by John Wayne, who also played the lead
role of Davy Crockett, the legendary coonskin hat-wearing frontiersman from Tennessee who was also a savvy congressman. Opening to gorgeous oil paintings of the
Alamo mission beneath big Texas skies and the reverent choral sounds of the battle
hymn The Siege of Alamo (Thirteen Days of Glory), the stage is quickly set by a pair
of written narratives, the first of which tells us that in 1836 Texas was composed of
settlers from throughout the United States who were all Mexican citizens. The next
narrative informs us that General Santa Anna “was sweeping north across Mexico toward them, crushing all who opposed his tyrannical rule. They now face the decision
that all men in all times must face . . . the eternal choice of men to endure oppression
or resist.” Much of the film develops the characters of Crockett and Jim Bowie as
hard-drinking yet brave and loyal freedom fighters, and of the equally brave Colonel
Travis, who is nevertheless a hopelessly rigid and overly formal military man. Mexicans in the film are reduced to one-dimensional human props, though there is sparse
intermittent dialogue about their dignity and bravery and even more dialogue about
beautiful Mexican women who are seen dancing flamenco. Bowie even admits to
marrying a Mexican woman, and Crockett defends the honor of a pretty señorita
being harassed by the movie’s one bad, pro-Santa Anna, Anglo-American. Before the
Alamo mission is eventually overrun by a heavily armed and beautifully uniformed
Mexican army of 2,000, we’re privy to clever night raids led by Crockett and Bowie
in which Mexican cannons are destroyed, soldiers are dispensed with over humorous
dialogue, and in one amazing scene several hundred longhorns are stolen out from

14 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
under the noses of Mexican soldiers and then run back right through the front door of
the Alamo! When it is learned that backup will not be coming and that the battle of
the Alamo is really a suicide mission, all decide to fight alongside Colonel Travis to
their death, despite the Mexican army’s granting them the option of surrender and allowing women and children to vacate, thus sparing the latter.
According to Acuña (1981), Mexican General Antonio Lopez de Santa
Anna put down revolts at both the Alamo and the nearby town of Goliad
and resumed control of the San Antonio area. The U.S. government responded by sending massive aid into Texas in the form of volunteers,
arms, and money; on April 22, 1836, General Sam Houston coordinated a
surprise attack on Santa Anna’s resting army, resulting in the slaughter of
630 of the 1,000-plus Mexican soldiers. Santa Anna was captured and had
little choice but to sign away the Texas territory.
From 1836 to 1846, Texas survived as an independent republic in constant conflict with a resentful Mexico over the highly disputed border between the nations. Texans regarded the Rio Grande River as the boundary,
and Mexicans regarded the Nueces River as the proper boundary. As a result, this large tract of land between rivers became a bitter battleground
and a metaphor for the protracted conflict and resentment that has characterized Anglo-American and Mexican race relations. McWilliams (1968,
p. 101) notes, “In the bloody zone between the two rivers an uninterrupted
guerrilla warfare continued throughout the life of the Texas Republic” and
“murder was matched by murder; raids by Texans were countered by raids
from Mexico. Because a peace treaty was never negotiated, no boundaries
could be fixed.”
The Alamo (2004)
In the 2004 movie version of the Alamo little has changed in Hollywood-style myth
making. This time two written narratives inform us that, established in 1718, the
mission had become a makeshift fort against marauding Indians, rebels, and a succession of conquering armies, and its location, its proximity to settlements, and perhaps even fate made the Alamo a crossroads for siege and battle. Straight-arrow
Colonel Travis claims, “As goes the Alamo, so goes Texas,” and is seen defiantly firing a cannon at the massive surrounding Mexican army as they grant the option to
surrender. Slight improvements include Mexican mariachi music instead of Spanish
flamenco and a muttered comment by a Mexican bystander that “Santa Anna may
want to rule Mexico, but these wretched creatures want to rule the world!” This time
a more subdued Davy Crockett, played by the talented Billy Bob Thornton, is seen
being executed at the battle’s end, unlike John Wayne, who literally goes out with a
bang, taking a band of would-be captors with him, as he explodes a barrel of gunpowder. In the more recent movie, Crockett is confronted just before his execution
by General Santa Anna himself, to whom Crockett wisecracks, “I thought you’d be

The Americanization of Latinos 15
taller!” and “If you surrender, I’ll try and protect you.” General Santa Anna is portrayed as the consummate egomaniac that he was, but he did have more lines in this
version. For example, in justifying his take-no-prisoners position, he exclaims that
the fight must stop here or “our grandchildren will be begging the Americans for
crumbs.” Toward the movie’s end, we learn that 9 years following the battle of the
Alamo, Texas became the 28th state, as if preordained.
The War with Mexico
As the Texas Republic prepared to join the Union, the president of Mexico
declared that the annexation of Texas would be considered equivalent to a
declaration of war (McLemore et al., 2001). After annexation in 1846,
President Polk ordered General Taylor into the disputed land between the
Rio Grande and Nueces rivers, provoking Mexico to battle over what was
considered an invasion by the United States. Next, Polk petitioned Congress to declare war, claiming that Mexico had invaded the United States.
Although Abraham Lincoln condemned Polk’s petition of war as unconstitutional, international war ensued, with far more at stake than the
strip of land between Mexico and Texas.
By 1848, Mexico surrendered under the terms of the Treaty of GuadalupeHidalgo, in which approximately half of Mexico (the current-day southwestern United States) was ceded to the United States. Mexicans who
remained in this region became American citizens by default, constituting
the new Mexican American minority group. It is important to note that, like
a defeated neighbor, Mexico has never recognized the moral right of the
United States to Mexican land. As late as 1943, maps in Mexican schools
still designated northern Mexico as “territory temporarily in the hands of
the United States” (McWilliams, 1968, p. 103).
While the Treaty of Guadalupe-Hidalgo granted Mexican Americans
full rights of citizenship, Anglos generally considered them a conquered,
inferior people with rights not to be taken seriously. In fact, protection of
property, under Article X of the treaty, was omitted during the treaty’s
ratification by the U.S. Senate (del Castillo, 1990). As a result, Mexicans
were rapidly dispossessed of their substantial land holdings through various devious means.
Seizing Mexican Land
Acuña (1981) describes the “land grab” in New Mexico as a well-organized
seizure of land by the following methods: (a) Mexicans were required to
register their land, often by inadequately posted announcements in
English, and their land was seized when they failed to do so; (b) Mexican
lands were heavily taxed and seized when taxes could not be paid (taxes
were later lowered after land was acquired by Anglos); and (c) land was

16 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
seized when Mexicans could not pay for agricultural land “improvements”
provided by the government.
An estimated 2 million acres of private land and 1.7 million acres of
communal land were lost between 1854 and 1930 in New Mexico alone in
a pattern that repeated itself throughout Texas, California, and the rest of
the Southwest (Feagin & Booher Feagin, 1999a). Both elite and peasant
Mexicans quickly found themselves landless laborers subjugated to the
bottom of the new American stratification system. As recently as the
1960s, Chicano activist Reies Lopez Tijerina formed the Alianza Federal
de Mercedes (Mercedes Federal Alliance of Land Grants) in New Mexico
and sought to recover what he considered to be stolen Mexican land (Feagin & Booher Feagin, 1999a). In addition to marching and presenting
grievances to Santa Fe officials, the Alianza also occupied Kit Carson National Forest, once part of a Mexican communal land grant. When forest
rangers tried to remove the protesters, the rangers were seized and tried
for violating old land-grant boundaries that the group had researched. Tijerina and other members of the Alianza were arrested after a shootout
with police.
Bandidos or Folk Heroes?
Like Tijerina, Mexican people in the new frontier protested their outrage
through a variety of methods, ranging from strikes and court battles to
outright raids on Anglo settlers, who retaliated in return. Between 1850
and 1930 it is estimated that the number of Mexican Americans killed in
the Southwest was greater than the number of African Americans
lynched during this same period (Moquin & Van Doren, 1971).
The enduring stereotypic image of Mexicans as bandidos (bandits) has
an interesting basis in anti-Anglo outlaw activity on the part of Mexicans. Whereas Americans have attempted to create images of these
early outlaws simply as mere criminals, Mexicans and Chicanos see
them more as folk heroes who revolted against Anglo imperialism and
discrimination.
For example, in 1859, Texas-born Juan Cortina organized a band of outlaws and invaded Brownsville, Texas, to protest violations of the Treaty of
Guadalupe-Hidalgo. Later that same year, Cortina and 1,200 men fought
and defeated local Brownsville militia, who were backed by the Mexican
army. He also defeated the legendary Texas Rangers, well-known for their
abuse of Mexicans, who pursued him after the Brownsville battle. In
1860, General Robert E. Lee, veteran of the war with Mexico, was sent to
Texas to put down Cortina. But even with the cooperation of the Mexican
army, Lee could not capture Cortina, who became a Mexican/Chicano
hero of mythic proportions.

The Americanization of Latinos 17
In New Mexico, the famous Mexican revolutionary Francisco “Pancho”
Villa raided the city of Columbus, killing a few Anglos, as a protest to the
U.S. recognition of the New Mexico government (McLemore et al., 2001).
General John J. Pershing spent 9 long and unsuccessful months pursuing
Villa in Mexico as Pershing’s men sang “It’s a long way to capture
Villa/It’s a long way to go/It’s a long way across the border/Where the
dirty greasers grow” (Jacobs, Landau, & Pell, 1971, p. 242). In California,
folk heroes Joaquin Murrietta and Tiburcio Vasquez avenged Anglo
wrongs perpetrated against Mexicans by terrorizing Anglo settlers and
robbing Anglo establishments vigilante style.
Exploiting Mexican Labor
Despite the legacy of conflict between Mexicans and Anglos in the
United States, significant Mexican immigration to the United States continues to the present day. In the decades following the war with Mexico,
hundreds of thousands of Mexicans, pushed by the political upheaval and
lack of work in Mexico, were pulled by the tremendous need for unskilled
labor in the United States, which continues to this day. Throughout the
Southwest, Mexican labor was essential to the early economic growth of
this new region in such basic industries as agriculture, canning, mining,
and the railroad. Fewer than 30,000 Mexicans “immigrated” between
1820 and 1900, but nearly 750,000 immigrated between 1900 and 1930,
pushed by the Mexican Revolution and pulled by the American industrial
revolution (McLemore et al., 2001).
Most Americans today have little understanding of how essential Mexican labor has been and continues to be to American industries and services. Most Americans are also unaware of the historical pattern of
exploitation of Mexican labor that continues to fan the flames of intergroup conflict. A decade-by-decade analysis of Mexican labor in the twentieth century reveals a distinct cyclical pattern of exploiting Mexican
labor during labor shortages and then abusing Mexican civil rights during periods of diminished labor need and economic recession.
During the 1910s, federal authorities waived immigration restrictions
due to a World War I labor shortage in agriculture, allowing some 70,000
Mexicans to enter the United States. Improved canning and shipping
technologies opened new markets during the 1920s, and some 500,000
Mexicans came to work. When the Immigration Act of 1924 barred most
Southern and Eastern Europeans, Mexicans were exempted because they
comprised the main source of cheap labor for the southwestern and midwestern United States (Feagin & Booher Feagin, 1999a).
But when the Great Depression hit in 1929, undocumented entry into
the United States was elevated to a felony and deportation campaigns

18 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
were initiated against Mexicans, who were scapegoated for the country’s
economic problems. An estimated 500,000 or 40% of the Mexican American population, both documented and undocumented, were either deported or coerced to leave by U.S. authorities in a program called
repatriation (Acuña, 1981). But as soon as the World War II labor shortage
struck in 1942, the United States initiated a binational agreement with
Mexico to import agricultural labor.
The Bracero Program
From 1942 to 1964, The bracero (arms—a very loose translation of work
hand) program, as it was called, brought in approximately 5 million
braceros (Feagin & Booher Feagin, 1999a) to fill U.S. labor shortages. The
bracero program also stimulated a parallel stream of undocumented
workers into the United States who were extremely desirable to employers who wished to avoid the bracero program’s bureaucratic red tape, including stipulations of fair pay and treatment of braceros. It is estimated
that since 1920, between 6 and 9 million undocumented migrants have
entered the United States, many of them temporary migrants who have
returned to Mexico. Undocumented workers are essential to agriculture,
industry, and tourism in southern California and elsewhere in the United
States (L. R. Chavez, 1992). Mexican workers and U.S. employees are
linked together in one international labor market. Today Mexican migrants still make up more than two-thirds of the nation’s migrant farmworkers, estimated by the U.S. Department of Labor (1992) to be between
2.7 and 4 million people.
Zoot Suit Riots
In 1943, conflict between Anglos and Chicanos came to a dramatic head
during the so-called Zoot Suit Riots, in which U.S. sailors, off-duty police,
and other servicemen staged mob-style attacks on Chicano street gang
members. These gang members wore flashy zoot suits consisting of chesthigh baggy pants, fingertip-length broad shoulder jackets, a hat, and
pointed shoes. In one highly publicized incident, 200 sailors in 20 taxicabs invaded the East Los Angeles barrio, beating and stripping zoot suiters. These “riots” made headline news across the country during an
all-time high in WWII-fueled patriotism that condemned most things foreign (Mazon, 1984). Indeed, these second-generation, U.S.-born Chicanos
displayed their alienation and marginality in their provocative dress and
delinquent youth gang membership. These were culturally displaced
youth looking for a sense of belonging and identity that made easy targets of what Mazon called “symbolic annihilation” on the part of the
American military, local militia, and the press.

The Americanization of Latinos 19
Yet, in spite of national anti-Mexican sentiment, disproportionately
high numbers of Chicanos joined the war effort, resulting in disproportionately high deaths, injuries, and medals of valor. In fact, Chicanos were
the most decorated ethnic group in WWII, with 39 Congressional Medals
of Honor. Sadly, some of these war heroes could not even get served a cup
of coffee upon returning to their segregated barrios in the United States.
Between 1950 and 1955, the U.S. border patrol initiated “Operation Wetback” in which an estimated 3.8 million Mexicans were deported
(Healey, 1995). As in the 1930s, the civil rights of Mexican Americans
were commonly violated as homes and businesses were raided for suspected illegal aliens.
The bracero program was eventually halted by Mexico in 1964 due to
mistreatment of Mexican laborers in Texas. This same year, the United
States extended immigration quotas to Mexico and the rest of the Western Hemisphere. In addition to Mexico, Chicano farmworker activist
Cesar Chavez also favored ending the bracero program, which he perceived as antithetical to his efforts to unionize farmworkers to gain bargaining leverage with agricultural growers. In 1962, Chavez and Dolores
Huerta organized the United Farm Workers union (UFW) in California
(McLemore et al., 2001). Unlike other Chicano protests, the UFW movement brought the plight of Mexican and other farmworkers to international attention, partly because of its nonviolent philosophy modeled on
the works of Gandhi and Martin Luther King Jr.
The Chicano Movement
Between WWII and the 1960s, Chicano determination to fight injustice
and inequality grew into the climax of the Chicano civil rights movement
of the 1960s. Court battles and street battles pushed the movement forward. One climactic event was the National Chicano Moratorium of 1970
in which thousands of Chicanos marched on East Los Angeles to protest
the disproportionately high death toll of Chicanos in the Vietnam War.
The rally turned violent when busloads of sheriffs in full riot gear attacked the crowd with teargas and batons. A full riot ensued, with millions of dollars in damage to local merchants, thousands of injuries and
arrests, and even a few deaths. The most famous death was that of Ruben
Salazar, an L.A. Times columnist and the director of L.A.’s Spanishlanguage television station, KMEX. Salazar had been covering the moratorium and was killed when an L.A. County sheriff illegally shot a teargas canister into the Silver Dollar bar on Whittier Boulevard, striking
him in the temple. Although four of seven jurors voted for the death
penalty for the sheriff, District Attorney Evelle Younger concluded that
the “split decision” and facts from the inquest did not justify criminal

20 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
charges, and thus closed the case before it could move on to trial. He also
refused requests for further investigation from the Latino community, as
well as from 22 California state legislators (M. T. Garcia, 1995).
ADAPTATION
The predominant form of adaptation for Mexican Americans, still considerably in evidence today, has been segregation. Segregation in residence,
work, and school has historically been the rule for Chicanos, resulting in
painstakingly slow yet steady progress toward integration and moderate
levels of success compared to European immigrants. Neoconservative
Mexican Americans like Linda Chavez (1991) applaud what they consider
to be “real progress” on the part of Mexican Americans, yet such assertions minimize the blatant fact that it has taken Chicanos a century and a
half to move from complete segregation to a moderate degree of integration. Worse yet, such assertions fail to recognize the urgency of Latino civil
rights rooted in the human suffering that impeded progress can engender.
Segregation continues to be the living legacy of racism and discrimination that still describes the general welfare of most Latinos and other people
of color in America. For roughly 75 years after the end of the war between
Mexico and the United States, Chicanos faced segregation in most public facilities, including schools, restaurants, movie theaters, swimming pools,
barbershops, primary election procedures, and housing (McLemore et al.,
2001). “Mexican schools” were instituted in Texas in 1902, and by 1940 separate schools for Mexicans existed throughout the state (Montejano, 1987).
Bean and Tienda (1990) analyzed 1980 census data to calculate a segregation index for Chicanos. This index ranges from 0 (no segregation) to
100 (complete segregation) and represents the percentage of Chicanos
that would need to move out of their residential tract to eliminate segregation. For example, the segregation index for Los Angeles is .57, indicating that 57% of Chicanos would need to move out of their residential
tracts to produce an even residential distribution of Chicanos and Anglos
in that city. Hence this index indicates moderately high segregation similar to indices from other heavily Chicano cities, such as Chicago (.63) and
San Antonio (.57).
RESEGREGATION?
Gary Orfield and associates (e.g., Orfield & Yun, 1999) at the Civil Rights
Project at Harvard University have been researching and writing on what
they call the “resegregation” of American schools, especially in poor
Black and Latino communities. They report that although most White

The Americanization of Latinos 21
Americans polled believe that equal educational opportunity is being provided, school data now show that the American South is resegregating
after nearly 3 decades of civil rights laws that resulted in some of the highest integration rates in the nation. Further, the data show continuously increasing segregation for Latinos, who are now even more segregated than
African American students. Finally, the majority of resegregated Black
and Latino students are concentrated in poor schools, and the majority of
White students are segregated in schools composed of middle-class peers.
PUERTO RICANS
To understand the pride and predicament of Puerto Ricans is to understand the impact of a double legacy of conquest and colonization, the triple
blending of races that compose this unique Latino group, and the rather
unfortunate timing of Puerto Rican migration to the U.S. mainland.
CONTACT
Back in 1493, Spanish conquistadors landed on the Caribbean island of
Borinquen, where they encountered and conquered an estimated 50,000
indigenous Taino people. The name of the island was changed to Puerto
Rico and the native Taino people were soon decimated through a combination of forced labor, disease, and violent suppression of rebellion (Feagin & Booher Feagin, 1999b). African slaves were soon imported to
compensate for the diminishing Taino population, and marriages between Spaniards, Africans, and remaining Taino created the rich racial
blend of the Puerto Rican people.
After four centuries of Spanish rule, Puerto Ricans pressured Spain for
internal autonomy, which was granted in 1897. Puerto Ricans appointed
their own governor, established a house of representatives, and enacted
democratic laws. But this taste of freedom was extremely short-lived
when Puerto Rico was ceded to the United States in 1898 following the
brief Spanish-American War.
The American warship Maine had been stationed in the turbulent waters of Havana’s harbor, where Cuban revolutionaries had been waging a
30-year fight for their own independence from Spain. The Maine mysteriously exploded, tragically killing 258 American sailors, giving the United
States a reason to declare war on Spain. Assistant Secretary of the Navy
Theodore Roosevelt quickly assembled his famous “Rough Riders,” and
with patriotic cries of “Remember the Maine!” drove the Spanish out of
Cuba. Within 4 months, Spain ceded Puerto Rico, as well as the Philippines, to the United States, and Cuba won a nominal independence.

22 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
The United States had long coveted the Caribbean islands, as well as
the Philippines in the South Pacific, primarily for their militarily strategic
locations and secondarily for developing agricultural business enterprises. There are currently 12 U.S. military installations in Puerto Rico.
The Puerto Rican island of Vieques contains two U.S. military bases that
are highly resented by natives, who claim that bombing raids and military maneuvers have destroyed their beach, fishing, and coral industries.
During World War II, an estimated 15,000 American troops used Vieques
as a military training site.
With such military and industrial goals, the United States had little intention of fostering autonomy in Puerto Rico or Cuba, and to date Puerto
Rico remains a controversial U.S. commonwealth (a polite term for
colony), rife with long-term conflict that accompanies such dominantsubordinate nation relations. Cuba is discussed later in the chapter.
CONFLICT
Puerto Rico came under U.S. control with no input from autonomystarved Puerto Ricans. In 1898, U.S. General Nelson Miles invaded independent Puerto Rico while claiming to liberate it from Spanish
oppression. Miles was well-known for his previous military work, which
included arresting Chief Geronimo and driving the Nez Perce Indians out
of Montana and into Canada. The United States soon installed an American governor, made English the official language, and reserved the right
to veto any locally elected legislature (Feagin & Booher Feagin, 1999b).
Seizing Puerto Rican Land
Puerto Ricans, who were largely subsistence farmers, went from owning
over 90% of the island’s lush farmlands to less than 33% within 30 years
(Feagin & Booher Feagin, 1999b). By 1930, absentee-owned U.S. companies controlled 60% of Puerto Rican sugar and tobacco production as
well as shipping lines. Massive land loss resulted from heavy taxation
and credit restrictions imposed by the United States on Puerto Rican
farmers, as well as forced devaluations of the Puerto Rican peso that
compelled small farmers to sell their land. The United States also expelled European competitors to monopolize island industries and to relegate Puerto Ricans to low-wage farm laborers on lands they had
previously owned. Puerto Ricans were also segregated from Americans
in both private and public spaces. Although most Puerto Ricans favored
autonomy during the first half of the twentieth century, Puerto Ricans
were declared U.S. citizens in 1917, just in time to be drafted into World
War I.

The Americanization of Latinos 23
During the 1930s, Puerto Ricans protested their exploitation by forming
unions, staging strikes in the sugar cane fields, and even periodically attacking U.S. colonial government buildings on the island (Feagin & Booher
Feagin, 1999b). This decade also saw the rise of the pro-independence nationalist movement. In 1930, Harvard-educated Pedro Albizu Campos
was elected president of the Nationalist Party. Albizu’s passionate and unrelenting anti-U.S. platform was perceived as a threat, and President
Franklin Delano Roosevelt appointed Georgia southerner Blanton Winship
governor of Puerto Rico with the charge of quelling nationalism.
Social Control of Island Nationalism
Governor Winship had Albizu tried and jailed for insurrection. While in
jail, Albizu was subject to torture by the military; it is believed the military used him for radiation experiments. Conflict soon came to a head in
1937, when unarmed Nationalist Party members organized a peaceful
march in the Capital city of Ponce to celebrate the island’s early abolition
of slavery. On Governor Winship’s orders, heavily armed police shot and
teargassed the marchers, killing 20 and wounding 150. The Ponce Massacre, as it came to be known, marked a turning point for nationalists,
who would now incorporate violence into their anticolonial cause.
Like Albizu, Luis Muñoz Marin also favored independence, but he pursued his politics by forming the Popular Democratic Party (PDP) and
seeking a seat in the U.S. Senate. The United States pressured Muñoz
Marin and the PDP to oppose nationalism in exchange for supporting his
bid for the Senate, which he won in 1938. Muñoz Marin quickly enacted
pro-peasant land reform in the late 1930s and early 1940s, promoted voter
registration, and earnestly combated poverty.
In 1948, Puerto Ricans were allowed to elect their own governor, and
Luis Muñoz Marin was the unanimous choice. Puerto Ricans were also
allowed to draft their own constitution, raise their own flag, and reinstate Spanish as the official language. To date, Puerto Ricans have no vote
in national elections, they cannot be elected to the U.S. House and Senate,
and their sole U.S. Congress representative has only observer status with
no vote.
Exploitation of Puerto Rican Labor
The pressure to repress nationalism was highly evident in the controversial “muzzle law” of 1948, which forbade nationalism and caused anticolonial resentment to smolder. Also in 1948, Muñoz Marin assisted
the United States in enacting a program called Operation Bootstrap,
ostensibly to stimulate economic development on the island by attracting U.S. corporations. Unfortunately, incentives for U.S. corporations

24 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
included a 10-year local tax exemption and the freedom to pay wages
lower than on the mainland. Clearly, Puerto Rico’s poverty and exploitation wages were the program’s primary selling points to U.S.-based
multinational corporations.
According to Feagin and Booher Feagin (1999b), around 1,700 factories
came to the island between the late 1940s and the mid-1970s, creating
more than 140,000 new manufacturing jobs in the process. Capital investments grew from $1.4 billion in 1960 to $24 billion in 1970. But despite
these impressive accomplishments, the new manufacturing jobs could
never offset the island’s loss of agricultural jobs. In addition, the tax exemptions granted to corporations resulted in high personal income taxes
for Puerto Ricans to pay for basic island infrastructure such as water,
electricity, and sewer systems. Many corporations relocated after their
10-year tax-free status expired rather than pay Puerto Ricans a fair wage
and contribute to the island’s welfare. This program of exploitation
served to consolidate island poverty in the guise of an opportunity for
Puerto Ricans to pull themselves up by their own bootstraps. Operation
Bootstrap represents one of the many missed opportunities to genuinely
invest in Latino social welfare for the mutual benefit of both the United
States and Latinos in the United States.
Militancy and Violence
In 1950, armed revolts broke out in five island cities in which hundreds
were killed and thousands were arrested. In 1952, Governor Muñoz
Marin urged the Puerto Rican people to vote for commonwealth status,
claiming that the island would become an area libre asociado (liberated associated area), and thus one step closer to independence. Despite opposition from nationalists, the measure passed.
But commonwealth status and the repression of pro-independence politics proved to be explosive. In 1954, four armed radical nationalists led by
Lolita Lebron broke into a meeting of the U.S. House of Representatives in
Washington, DC, and opened fire, striking five senators in a volley of bullets before being subdued. A year later, pro-independence radicals attempted to assassinate President Truman by shooting up Blair House, his
temporary residence. These are dramatic and desperate acts of political
violence of which most Americans, including other Latinos, have little
knowledge.
During the 1960s, Governor Muñoz Marin retired and the conservative
pro-statehood party gained prominence and elected party member Luis
Ferer as governor in 1968, much to the chagrin of pro-independence
forces. During the 1970s, divisive pro- and anti-statehood politics resulted in Puerto Rico’s bloodiest decade. U.S. military aircraft were

The Americanization of Latinos 25
bombed in San Juan and a bus of navy personnel was machine-gunned,
killing two and wounding 10. Puerto Rican police retaliated by killing
two independistas but were brought to trial and found guilty. To make matters worse, massive unemployment on the island resulted in nearly a
third of the population relocating to the U.S. mainland during the 1970s.
During this same decade hundreds of thousands of Puerto Ricans traveled back and forth between the United States and Puerto Rico in what
has been called “revolving door” migration.
On the U.S. mainland, pro-independence groups bombed a café in
lower Manhattan, killing five and wounding many, and robbed a Wells
Fargo armored truck in Hartford, Connecticut. In less violent protests,
mainland Puerto Ricans organized dozens of civil rights-oriented groups
addressing justice in schools, courts, and communities. In East Harlem,
Puerto Rican radicals established the Young Lords Party, an organization
styled after the Black Panther Party and advocating democratic-socialist
reform and greater control of Puerto Rican communities.
The Young Lords occupied the admissions building of the McCormick
Theological Seminary in Chicago as well as the First Spanish Methodist
Church in New York City. They organized a march to the United Nations that was 20,000 people strong. The Young Lords also set up free
lunch programs for children and tuberculosis-testing clinics for adults
in Puerto Rican communities. A young Geraldo Rivera served as the
party’s lawyer.
In 1980, former Puerto Rican Governor Muñoz Marin died, uniting
Puerto Ricans in mourning despite the political divisions that colonialism engenders. Poverty reached new heights on the island, with as many
as 50% needing government assistance in the form of food stamps and
health aid. In 1983, Puerto Ricans again voted for commonwealth status
over statehood, but this time only by a 3% margin, the lowest ever. Puerto
Ricans also petitioned the United States to sign a sovereign bilateral compact to grant the island full autonomy in all areas except military defense,
which is still pending.
Unemployment peaked at 23% in 1983 and leveled off to 17% in the early
1990s (Feagin & Booher Feagin, 1999b). Today, manufacturing wages on
the island are about half of those on the mainland, and Puerto Rico’s per
capita income is less than that of the poorest state in the United States. In
1993, 37% of Puerto Ricans fell below the poverty line, compared to 10%
for European Americans. Thus, the perennial push to the mainland is understandable. But what Puerto Ricans have historically encountered there
has been traumatic in terms of general adaptation. Puerto Rico remains a
pseudo-colony in the midst of dynamic conflictual transition. Puerto Ricans remain a people politically divided yet culturally united in their

26 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
assertion of their unique identity and need for greater control over their
own fate.
ADAPTATION
The push of island poverty resulted in the first wave of Puerto Rican migration to the United States during the 1920s, shortly after being declared
U.S. citizens (Feagin & Booher Feagin, 1999b). By 1940, there were approximately 70,000 Puerto Ricans on the mainland, almost exclusively in
New York City. But the “great migration” occurred between 1940 and
1970, resulting in a 10-fold increase to approximately 887,000 Puerto
Rican migrants, concentrated mostly in New York but with communities
also in New Jersey, Connecticut, and Chicago. To understand the creation
of today’s Puerto Rican underclass in the United States, we must understand not just colonization but the racialization of Puerto Ricans on the
U.S. mainland and the poor timing of Puerto Rican migration as a result
of mid-twentieth-century labor market shifts.
Like Mexicans, thousands of poor Puerto Rican migrants came to the
United States as contract farmworkers at the bottom of the economic ladder. During the 1950s, about 40,000 Puerto Ricans migrated to the mainland annually, often lured by U.S. Department of Labor propaganda films
like ¡Trabajo Para Usted! (Work for you!), which depicted happy Puerto Ricans picking crops by day and dancing the rumba by night while making
money in the United States.
The Racialization of Puerto Ricans
Most Puerto Ricans, however, poured into labor-intensive urban-based
industries such as the textile and garment industry sweatshops of New
York. Like European immigrants before them, this new group of workingclass Latinos hoped to succeed in America through industrial labor jobs.
Unfortunately, Puerto Rican migrants soon learned the bitter lesson of
racism in America when they were perceived and treated as Blacks. The
color gradient on the island of Puerto Rico had fewer implications for
marriage and social mobility, but Puerto Ricans on the mainland often
faced intense anti-Black and anti-Latino discrimination.
As is true for African Americans, discrimination in work and housing
quickly contributed to a poverty scenario difficult for Puerto Ricans to
escape. Labor unions often excluded Puerto Ricans or greatly restricted
their participation (Feagin & Booher Feagin, 1999b). And like African
Americans before them, Puerto Ricans faced significant housing discrimination, resulting in “hypersegregation” alongside African Americans.
U.S. census data clearly show that whereas both Mexicans and Cubans

The Americanization of Latinos 27
are highly segregated from Blacks, Puerto Ricans are less segregated
from Blacks and more segregated from Whites (Bean & Tienda, 1990).
Underclass experts Massey and Denton (1989) warn that, like many
African Americans, Puerto Ricans are in danger of becoming a permanent part of the urban underclass, or those lacking work and routes out
of poverty.
Unfortunate Timing of Puerto Rican Migration
Puerto Rican migration to the United States peaked in the 1950s just as
the American economy began its major economic structural shift from an
industrial giant to a postindustrial service-oriented society. Most Americans have been affected by this nationwide shift, but unskilled and semiskilled poor people have been most frequently dislocated.
In New York, where most Puerto Ricans have resided, nearly half a
million manufacturing jobs were lost between 1960 and 1990 (Feagin &
Booher Feagin, 1999b). According to C. E. Rodriguez (1989), manufacturing accounted for 60% of the Puerto Rican workforce in 1960. Between 1960 and 1970, manufacturing jobs in New York decreased
by 173,000, and in the next decade another 268,000 jobs were lost. Further, this loss was not offset by an increase in lower-level service jobs,
the other area of Puerto Rican workforce concentration. Today, almost
40% of Puerto Ricans in the United States live in poverty, with high
rates of single female-headed households, patterns similar to African
Americans.
CUBAN AMERICANS
Cuban Americans have been called the Latino “model minority” for their
remarkable success in America. Though complex, this success story
comes down to the predominantly elite composition of this relatively recent Latino refugee group, coupled with unprecedented refugee support
and aid provided by the U.S. government.
CONTACT
Cuba became “independent” in 1898 when the United States drove out
Spain during the brief Spanish-American War. But the United States continued to occupy Cuba for the next 4 years, declaring it a U.S. protectorate
in 1902 (Feagin & Booher Feagin, 1999b). Based on the 1900–1901
Platt Amendment to the U.S. military appropriations bill, the United
States reserved the right to military intervention in Cuba, ostensibly to
protect life, property, individual liberty, and the island’s independence.

28 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
In reality, however, the pseudo-colonization of Cuba resulted in political,
economic, and military domination from 1898 to 1959, and of course the
United States still occupies and operates a military base in Guantánamo
Bay despite a trade embargo and no diplomatic relations.
CONFLICT
Within 15 years after Cuba’s independence from Spain, U.S. investments
grew from $50 million to an estimated $220 million. By the late 1920s, the
United States controlled 75% of Cuba’s sugar industry, and by 1960,
the United States controlled 90% of Cuba’s mines, 80% of its public utilities, 50% of its railways, 40% of its sugar production, and 25% of its bank
deposits (Feagin & Booher Feagin, 1999b).
With regard to political domination, no elected Cuban president opposed to the United States could remain in office. Both U.S. military and
diplomatic interference regulated American-friendly Cuban politics.
During the first half of the twentieth century, international relations between the United States and Cuba epitomized general U.S.-Latin American relations in that the United States was instrumental in implementing
repressive dictators who could be manipulated by U.S. economic interests. For this reason, grassroots rebellions constantly simmered beneath
the tenuous Cuban political surface.
The Castro Revolution
During the 1950s, a young Fidel Castro made several attempts to overthrow the Cuban president and former army chief, Fulgencio Batista,
who had come to power in 1952. By 1958, Batista was losing most battles
with revolutionary factions and fled when the United States withdrew its
support in 1959, leaving Castro and his bearded army to claim the country and implement a socialist-style government. Castro’s anti-American
platform can be understood as a strong response to America’s historical
choice to exploit Cuba instead of investing in a mutually beneficial
relationship. The upshot is today’s miniature cold war with our Latino
neighbor.
To the majority of Cubans, Castro’s rise to power was regarded with
hope and optimism that was initially validated by land grants to tenant
farmers and guaranteed compensation to small sugar growers. Indeed,
significant improvements were noted in the basic areas of quality universal health care and high educational level relative to international standards. But the new regime quickly became oppressive, as characterized
by mass trials and executions to cleanse nonsupporters of the revolution.
Phone tapping and spying were also common.

The Americanization of Latinos 29
Next, the stated goal of nationalizing both Cuban- and American-owned
businesses (Feagin & Booher Feagin, 1999b), as well as a general lack of tolerance for U.S. manipulation, greatly threatened U.S. and Cuban business
and political interests. Open hostility broke out between Cuba and the
United States as well as between the new government and Cuban elites
concerned about persecution and losing their considerable wealth. The
United States broke off diplomatic relations with Cuba and established an
“open door” policy of welcoming Cuban exiles fleeing “communist oppression” and seeking refuge in the “free world.”
Between 1959 and 1962, about a quarter of a million Cuban exiles relocated to the United States, almost all to southern Florida, where they
could be a mere 90 miles from home in the event of Castro’s anticipated
demise (M. C. Garcia, 1996). Today, over half of all Cuban Americans continue to live in the area. Although they are highly integrated into the economic, political, and social networks of their environment, Cubans have
also hung tenaciously to their culture given their history as exiles planning to return to their beloved country.
The First Wave of Exiles
Not surprisingly, the first major wave of Cuban exiles began with those
whose success in Cuba was directly related to Cuba’s political and economic relations to the United States. These were elite government officials, bankers, and successful industrialists under the Batista dictatorship,
followed by middle- and upper-class professionals, managers, merchants,
landlords, and more than half of all of Cuba’s doctors and teachers (Feagin & Booher Feagin, 1999b). In contrast to Puerto Ricans, the overwhelming majority of first-wave Cuban exiles were White Cubans, even though
over a quarter of Cubans on the island were Black. Castro greatly resented
the exodus of such human capital and resources and labeled the exiles
self-interested, disloyal gusanos, or worms.
The Bay of Pigs Fiasco
In the minds of both Cuban exiles and Americans, the Cubans were temporary exiles who would eventually return to their homeland once Castro
was overthrown. On this note, President Kennedy and the CIA trained
and funded some 1,500 Cuban exiles in a plan to take back Cuba. In what
has come to be known as the Bay of Pigs fiasco, the ill-conceived plan
failed miserably as the well-alerted Cuban army quickly put down the rebellion of the Cuban exile brigade soldiers. In just a few days, 120 brigade
soldiers were killed and 1,125 were jailed. Castro later ransomed these
prisoners of war for millions of dollars’ worth of medicines, baby food,
pesticides, and other products.

30 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
The Cuban Missile Crisis
Conflict between Cuba and the United States came to a head in 1962,
when the United States staged a showdown with Russia over the presence
of midrange nuclear warheads on the island. Castro had been cultivating
relations with Russia and cleverly declared Cuba a socialist government
on the night before the Bay of Pigs fiasco. His plan was to garner Russian
support by exploiting the Bay of Pigs attack as an American invasion on a
fellow socialist country. The plan worked well, with Russia supplying billions of dollars in aid to Cuba until the Soviet Union’s demise in the
1990s. Russia was also quite interested in establishing an armed communist stronghold in the Western Hemisphere. The American blockade of
Russian ships into Cuba eventuated in negotiations between President
Kennedy and Soviet Premier Nikita Khrushchev in which Russia agreed
to remove the warheads in exchange for a promise that the United States
would not invade Cuba.
The Second and Third Waves of Exiles
Although U.S.-bound flights out of Cuba were suspended in 1962, a second wave of 56,000 Cubans came to the United States between 1962 and
1965. Most were relatives of the first-wave immigrants, many of whom
came by way of Spain and Mexico. Between 1965 and the late 1970s, a
third wave of Cubans relocated to the United States (Feagin & Booher
Feagin, 1999b). At a ceremony at the base of the Statue of Liberty, President Johnson guaranteed this wave of Cubans refuge in America and
arranged for daily “freedom flights” to transport them (M. C. Garcia,
1996). Before flights from Cuba were permanently halted in 1973, more
than 3,000 flights had transported almost 300,000 Cuban refugees to the
United States.
Again, this latter group was predominantly composed of White Cubans
who were relatives of prior exiles, but also included more working-class
and small business people than in previous waves. The majority of these
individuals also settled in southern Florida, where they were quickly integrated into the thriving Cuban ethnic enclave that was beginning to accept its permanence in America.
As with Puerto Ricans, the timing of Cuban immigration to the United
States was not good in terms of labor market shifts. But unlike Puerto Ricans, poor timing was no obstacle to success for the following reasons:
(a) Cubans were not racialized and treated as Blacks; (b) they were predominantly middle- and upper-class professionals; and (c) they received
tremendous support from public and private sectors of U.S. society. The
magnitude of government and private assistance provided to help Cubans
resettle in the United States is not only unique among Latino groups but

The Americanization of Latinos 31
also unprecedented for any refugee group in American history (M. C.
Garcia, 1996).
Investing in Cuban Americans
President Eisenhower responded to the immediate resettlement needs of
first-wave Cubans by allocating $1 million in federal funds to create the
Cuban Refugee Emergency Center in Miami. In 1961, President Kennedy
established the Cuban Refugee Program and expanded aid to include employment, health services, education, vocational training programs, surplus food distribution, and aid to more than 14,000 unaccompanied
children who were sent by Cuban parents who feared their children being
educated in a communist state as well as being conscripted into the military. Even Pan American Airlines assisted in smuggling these children
out of Cuba in what was cleverly called “Operation Peter Pan.”
Between 1961 and the mid-1970s, the Cuban Refugee Program provided
nearly $1 billion of resettlement support across a wide array of services
(Feagin & Booher Feagin, 1999b). In fact, between 1959 and 1965, government assistance to Cuban exiles actually exceeded what was granted to
native-born Americans in Florida (M. C. Garcia, 1996). In Dade County,
Florida, the nation’s first federally funded bilingual education program
was set up for Cuban children.
One exile problem area heavily targeted had to do with the significant
downward mobility of Cubans whose professional skills needed to be
adapted to the United States. For Cuban doctors, lawyers, and teachers,
federal grant monies were poured into local universities and community
organizations to create intensive retraining programs in which many
could graduate with American licenses while others were prepared for licensing exams.
Marielito Conflict in the United States
Although conflict between the United States and Cuba has been mostly
confined to the island, some conflict did occur with the fourth wave of
approximately 125,000 exiles that arrived suddenly in 1980. Known as
Marielitos because they sailed from the Cuban port of Mariel, these exiles
received a rocky reception for a number of reasons. Not only did Marielitos arrive during an economic recession, but 75% were blue-collar workers and up to 40% were dark-skinned Black Cubans. Some were forced to
leave Cuba, but most were allowed to leave given their desire to escape
growing island poverty. As such, they were initially denied the federal financial support granted to political refugees. However, an amendment to
the Refugee Assistance and Education Act of 1980 eventually allowed
them to receive full refugee benefits (M. C. Garcia, 1996).

32 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Still, the reception of Marielitos was harsh. They were housed in temporary “tent cities” upon arrival and flown to military detention centers
to be screened for dangerousness. American apprehension over the
Marielitos stemmed from Castro’s well-publicized “tainting” of the migration stream with hardened criminals, mental patients, homosexuals,
and other undesirables. Although fewer than 4% of Marielitos were actually hardened felons and mental patients, the exaggerated media attention fueled Americans’ fears (M. C. Garcia, 1996).
Scarface, the Movie
The extremes of Americans’ fear of Cubans were best exemplified in
movie director Brian DePalma’s 1983 remake of the classic James
Cagney gangster film Scarface. The updated version begins with footage
of the Mariel boatlift, followed by the detention center interrogation of
Tony Montana, a Marielito criminal played by Al Pacino. The rest of the
film depicts Tony’s violent rise as a cocaine drug lord who flaunts a
buxom Anglo-American girlfriend, buries his face in a mountain of cocaine piled on his desk, and wields a bazooka-size gun while screaming
“You want to fuck with me?!” in a feeble Cuban accent. But that’s not
all. Tony is also a pervert who kills his sister’s boyfriend (formerly
Tony’s best friend) to incestuously possess her. The film is so absurd
that it has become a humorous cult classic in both the barrios and ghettos of America!
But for all of the media hype about Cuban criminals, only 2% of
Marielitos ever ended up in penitentiaries for serious violations of the
law (Feagin & Booher Feagin, 1999b), and by the mid-1980s, the majority
of Marielitos were well absorbed into Cuban American communities.
Ironically, it was America’s almost neurotic overreaction and restrictiveness that resulted in Marielito protest and violence during the 1980s. Angered by their treatment and the crowded conditions in detention camps
and prisons, several inmates rioted and clashed with National Guard
troops. Between 1980 and 1983, a few Marielitos also protested by hijacking airliners back to Cuba. In 1987, riots broke out at the Atlanta federal
penitentiary in Georgia and the Oakdale federal detention center in
Louisiana, where about 3,000 Marielitos awaited deportation for committing serious crimes in the United States. Angry about being jailed indefinitely, these inmates burned several buildings and took more than 100
people hostage (M. C. Garcia, 1996). They demanded parole board reviews
to remain in the United States but were difficult to negotiate with. It took
Reverend Agustin Roman, auxiliary bishop of the Archdiocese of Miami,
to negotiate with the inmates, resulting in the parole of the majority of inmates and the deportation of 400 back to Cuba.

The Americanization of Latinos 33
In 1994, the United States finally reversed its 3-decades long “open
door” policy to Cuba in response to some 30,000 Cuban “boat people”
who attempted to enter the United States when Cuba again lifted its ban
on emigration. Hundreds of thousands of Cubans tried to escape the disastrous economic crisis in Cuba caused by the breakup of the Soviet
Union, which had supplied Cuba with billions in annual foreign aid. This
last wave was returned to Guantánamo Bay, and the United States and
Cuba reached an agreement in which the United States would increase its
number of visas granted to Cubans to 20,000 annually in return for
Cuba’s halting the mass exodus of refugees.
ADAPTATION
According to Gonzales (1993), by 1990 there were more than 28,000 Cubanowned businesses in the Miami area; in Dade County there are more than
18,000 firms in the areas of finance, construction, textiles, leather, furniture, and cigar production. There were also 16 Cuban American bank presidents and 250 vice presidents, 3,500 doctors, 500 lawyers, 500 supermarket
owners, 250 drug store owners, and 60 auto dealership owners.
Cuban adaptation to the United States began with self-imposed segregation and retention of culture born of the exile dream to return to Cuba
after a temporary stay in the United States. But with Castro’s lengthy stay
in power, Cuban exiles became permanent Cuban Americans who rapidly
became integrated into all spheres of American society. Although it was
not Cubans’ original intention, the combination of high Cuban SES and
high U.S. government investment in Cuban adjustment to the United
States resulted in one of the best-case scenarios for a refugee group in
America. Parenthetically, some writers warn that the portrait of Cubans
as a model minority is a disservice to those struggling with poverty, discrimination, and adjustment to the United States.
CENTRAL AMERICANS
The majority of Central Americans currently living in the United States
can be considered “cross-fire refugees” whose lives were interrupted by
recent intense civil wars in El Salvador, Nicaragua, Guatemala, and
Honduras. More than 1 million Central Americans have fled to the
United States due to intolerable guerrilla warfare, counterinsurgency
activities, and the incorporation of civilians into the conflict (Ferris,
1987). Although these refugees are grateful to have escaped La situación,
as they refer to it, relocating to the United States has been a mixed blessing for many.

34 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
CONTACT
The majority of Central Americans have sought refuge in the United
States only since the late 1970s, beginning with Salvadorans, followed
by Guatemalans in the early 1980s, and then Nicaraguans and Hondurans in the mid-1980s (N. Rodriguez, 1987). They leave behind countries characterized by extreme poverty, where 50% of the population
cannot afford adequate food, where 75% of children under 5 years of age
are malnourished, and where infant mortality can average as high as 200
per 1,000 births in rural areas (Chelala, 1990). Such immense poverty is
due to the extreme concentration of wealth, land, and resources in the
hands of tiny elite ruling classes that make up between 1% and 4% of
the population, but that own between 33% and 80% of the land (Cordova, 1987; Ferris, 1987).
Such economic factors create the perception of Central Americans as
economic immigrants, yet civil war in El Salvador, Nicaragua, Guatemala,
and Honduras has been the primary expelling factor. In addition to frequent displacements of civilians by Central American governments, violence and repression against civilian populations have been extreme and
unconventional (Amnesty International, 1983). Whether it is government
forces (e.g., military death squads) displacing and destroying communities as a way of weakening rebel factions, or rebels conscripting civilians
into the struggle, civilians have been routinely pulled into the conflict in
ways that make them more than simply casualties of war.
CONFLICT
Despite these factors, the United States has generally elected to deny
refugee status to Central Americans. As a result, no more than 25% of
Central Americans claim legal documentation (Leslie & Lietch, 1989;
Montes Mozo & Garcia Vasquez, 1988). The adaptation of Central Americans in the United States is hampered by a general denial of refugee status and consequent lack of government assistance and entitlement to
social services due to their limited ability to prove direct political persecution (Ferris, 1987).
Denial of political asylum also leads to inhibited social and community
life, mistrust, and perceptions of the U.S. government as supporting repressive governments in Latin America (Dorrington, 1995; Farias, 1991).
Denial of refugee status has to do with two macro-level factors that compromise the well-being of Central Americans. The first factor involves
how a refugee is defined. Based on the United Nation’s 1967 protocol on
the status of refugees, the most widely used definition is that of a person

The Americanization of Latinos 35
outside of his or her country of origin who is unwilling to return due to
fear of persecution for reasons of race, religion, nationality, or social or
political group membership (Ferris, 1987). Unfortunately for Central
Americans, this definition excludes displaced persons not individually
singled-out for persecution. Further, current U.S. policy fails to recognize
that economic repression has been a common tool of warfare in Central
America, blurring the distinct between political refugees and economic
immigrants.
The second reason involves a long-standing national policy of accepting
refugees when relations are poor between the United States and the Latin
American government in question (e.g., Cuba). Such a policy often places
politics above compelling refugee needs. Thus, although most Central
American refugees are poor, unskilled, undocumented, and traumatized
by war, they are not entitled to the kinds of government support that was
so essential to Cuban exile adaptation to the United States.
The predicament is complicated by U.S. policies that support pseudodemocratic rebels opposed to new socialist governments. During the
1980s, the Reagan administration enthusiastically supported the Contra
rebels in Nicaragua in their opposition to the new socialist Sandanista
government, despite the fact that Contra rebels routinely used U.S. aid
and military training to destroy public facilities such as water supplies,
schools, clinics, and mills, as well as killing workers within those facilities (Ronstrom, 1989). Eventually, Congress voted against such support.
ADAPTATION
Central Americans typically migrate to small but established enclaves in
major U.S. urban centers such as Los Angeles, New York, Houston, San
Francisco, and Washington, DC. A handful of studies on community samples found that Central Americans report a higher than average number
of stressful life events, primarily of a work-related nature and secondarily
having to do with housing, health, mental health, and documentation
problems (Leslie & Lietch, 1989). Two studies of Central Americans in Los
Angeles found that the primary stressors reported by participants were
not having a job, not knowing English, and lack of help with these problems (Padilla, Cervantes, Maldonado, & Garcia, 1988; Plante, Manuel,
Menendez, & Marcotte, 1995). Most cope with such problems by relying
almost exclusively on friends and family and by pooling their resources
(Dorrington, 1995; Leslie & Lietch, 1989; Padilla et al., 1988; Vlach, 1992).
Despite these pressing basic needs, Leslie and Lietch (1989) found
that 65% of their Central American sample had never sought social services despite the availability of Spanish-language services that do not

36 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
inquire about documentation in the Washington, DC, area. The few services utilized by subjects in this study included community colleges
and churches.
CONCLUSION
Armed with knowledge about the varied acculturation histories of different U.S. Latino groups, service providers can begin to understand that
the various patterns of Latino success and failure in America, including
psychosocial and health patterns, are neither random nor simply of Latinos’ own making. What emerges from a careful analysis of historical conditions of acculturation is recognition of the living legacies of people
actively coping with forces of racism and discrimination, partly by maintaining their life-supporting and self-affirming Latino culture.
Acculturation knowledge quells naive questions, such as “Why can’t
Mexican Americans be like Cubans or Asians?” and provides human and
social service providers with an empathic understanding of the role of social injustice in the general social welfare of U.S. Latinos. Understanding
the conditions of acculturation and their connections to ensuing patterns
of SES and psychosocial adjustment is essential for working sensitively
with Latinos and other ethnic minority groups in need of culturally competent social service assessment and intervention.
Knowledge of conditions of acculturation for Latinos can form a primary foundation for sensitively understanding the Latino experience in
America. The acculturation framework also forms the basis for proceeding to the next theoretical framework, involving a sociological analysis of
the stratification of power and Latino ethnicity in America. It is within
the process of stratification that the generalities of acculturation dynamics become particularized, institutionalized, rationalized, ignored, or addressed in American society.
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38 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

39
CHAPTER 2
The Social Stratification
of Latino Ethnicity, Power,
and Social Welfare in the
United States
THE SOCIOLOGICAL CONCEPT of social stratification is extremely helpful for
understanding where Latinos are located relative to other racial/ethnic
groups in the American hierarchy of success, power, and social mobility
and welfare. This discussion picks up where Chapter 1’s discussion of acculturation and adaptation left off. That is, while acculturation theory
helps us to understand the general historical dynamics of group-level
dominance and subordination, stratification clarifies how a group’s general level of socioeconomic status (SES) and well-being become institutionalized in various ways and even justified by mainstream ideologies,
values, and myths. In describing the stratification of Latinos in America,
this chapter provides socioeconomic profiles of the major Latino groups
under study that underscore uneven levels of integration into mainstream
society. These profiles emphasize the occupational and educational dimensions of the Latino experience in America, with some attention to the
political (an important dimension of Latino social welfare to which Chapter 10 is dedicated).
THE CONCEPT OF STRATIFICATION
According to Marger (2000a), stratification refers to the structured inequality of society’s resources and power as determined by key social institutions such as government, business, education, and social services.
That is, stratification refers to how all societies are unfairly biased in
favor of those groups with the most power and against those with the
least. Such glaring social inequities are not denied but justified by ideologies that rationalize and “explain” inequality in ways that serve to

40 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Table 2.1
The Stratification of Social Class in America
Percent of the Number
Social Class Population Employed
Elite 1–2
Upper middle class 28–30
Professionals 20,883,000
Managerial 19,584,000
Lower middle class 27–29
Sales workers 16,118,000
Technicians 4,355,000
Clerical 18,448,000
Working class 27–29
Craft workers 14,593,000
Operatives 7,386,000
Transportation workers 5,516,000
Protective services 2,440,000
Farm workers 3,426,000
Service workers 6,164,000
The poor 14–16
Food and cleaning services 8,480,000
Domestic workers 831,000
Unskilled workers 5,265,000
Unemployed 6,008,000
Source: “Employed Persons by Detailed Occupation,” Employment and Earnings, 47
(January 2000), Table 11, pp. 177–183, and “Unemployed Persons by Reasons for Unemployment,” Monthly Labor Review, 123 (June 2000), Table 8, p. 59.
stabilize stratification or the status quo and that impede progress toward
distributive social justice.
Because stratification is the rule the world over, it appears that human beings characteristically monopolize power and organize themselves into unequal social hierarchies that promote endless discord. International
comparisons allow some evaluation of our own system. For example, Central
American countries such as El Salvador, Nicaragua, and Guatemala can be
depicted as primitive pyramid-shaped stratification systems in which small
elite ruling classes that comprise only between 1% and 4% of the population
own between 34% and 80% of the land, resulting in extreme, third world
labor exploitation, oppression, and dramatic abject poverty (Cordova, 1987;
Ferris, 1987). By comparison, our own, more diamond-shaped stratification
system ensures better distribution of wealth and resources, resulting in most
people being middle class and fewer people being either rich or poor. For example, Table 2.1 shows that between 50% and 60% of Americans are middle
class, whereas only 20% to 25% are poor and 1% to 2% are superrich or elite.

The Social Stratification of Latino Ethnicity, Power, and Social Welfare 41
But a critical analysis of our relatively good stratification system reveals inequities between ethnic groups that have led Marger (2000a) to
conclude that the United States continues to have one of the most castelike systems in the world, citing the legacy of African American segregation and Blacks’ extremely low intermarriage rates with Whites as but
one index of impeded assimilation.
Marger’s (2000a) point is driven home by analysis of persistent gaps between Whites and people of color with respect to wealth. For example,
Rothman’s (1999) analysis of household net worth in America reveals that
the average White household has a net worth of $45,740 as compared to
only $499 for Latinos and $250 for African Americans! Net worth refers to
the total value of private assets, including bank accounts, stocks and
bonds, home and business equity, pensions and life insurance, and all personal property. Further, the top 20% of households in America (with regard to income) own 44% of all private assets, whereas the bottom 20% of
households own only 7.2%. The same patterns emerge with respect to
wages earned in the United States. That is, the wealthiest 20% of Americans earn half of all wages (average annual income = $98,589), whereas the
bottom 20% earn only 3.6% of all wages (average annual income = $7,411).
In fact, the richest 5% of all Americans earn 20% of all wages in the United
States. Hence, even within our decent stratification system (relative to
other countries) extreme concentrations of wealth among small percentages of Americans are highly evident.
DIMENSIONS OF STRATIFICATION
With regard to dimensions of stratification, Karl Marx is most famous for
his predominantly one-dimensional description of societies as composed
of those who control the means of production and those who do not (i.e.,
the famous “haves” and “have nots”). In Marx’s theory of economic determinism, he views the classic division between the ruling and working
classes as the basis for social-political tension and struggle. But whereas
the economic dimension is obviously central to stratification, it is only
one of several interrelated dimensions that work in concert to influence
probabilities of success and failure for different groups in a given society.
Further, Marxism does not give much attention to multicultural societies
where class and racial/ethnic differences are conflated.
Lenski’s (1966) classic multidimensional model of stratification is composed of several hierarchical class systems, each of which is based on a
key social criterion such as wealth, occupation, or education. Together,
these interacting class systems compose a society’s system for distributing its resources. Lenski’s distributive model of stratification is important

42 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
because it reveals the relative importance of each class system in determining a group’s location throughout a society’s stratification system.
Central to the current discussion of Latinos is Lenski’s inclusion of an ethnic class system showing the relation between ethnicity and other class
systems, or the consistency of locations across related class systems for
different ethnic groups in multicultural societies.
ETHNIC STRATIFICATION: POWER
AND I NEQUALI T Y
Marger (2000a) has used Lenski’s (1966) theory to illustrate the American
distributive system that shows the various locations of major ethnic
groups within the U.S. hierarchy. As can be seen in Table 2.2, four major
subclass systems are included in Marger’s illustration: the political, property, occupational, and ethnic class systems.
More class systems can be added to the extent that they are relevant to
the discussion at hand (e.g., educational, home ownership). Of utmost
importance in this discussion is the powerful relationship between ethnicity and a group’s placement or location across all other class systems,
that is, the consistent relationship between ethnicity and resources,
power, and consequent well-being. As with the acculturation framework,
this model of stratification elucidates nonrandom patterns of social welfare
that have been and continue to be linked to race and ethnic background
in America.
Marger (2000a) emphasizes the concept of power in his discussion of
stratification as the capability to control the flow of resources in society.
Obviously, groups and individuals at the top of a stratification system
are the most powerful. People at the top are also highly invested in
maintaining and justifying a stratification that distributes a disproportionately greater amount of resources to themselves. Complex ideologies, value systems, and myths are generated and infused into the
socialization process through mainstream institutions and culture to
rationalize and justify a society’s particular distribution of precious,
life-enhancing resources.
For example, as we saw in Chapter 1, historical accounts of American
territorial expansion are described by historians and depicted in movies
as righteous patriotic myths of defending freedom and defeating oppression (e.g., “Remember the Alamo!” and “Remember the Maine!”). Thus,
the maintenance of power is accomplished by exercising a wide range of
power, from creating and sustaining biased ideologies (e.g., via the educational system and media) to controlling resistance and protest (via the
military or militia) that challenge attempts to redistribute power.

The Social Stratification of Latino Ethnicity, Power, and Social Welfare 43
Table 2.2
The Social Stratification of Race and Power in America
The Distributive System
Class System
Political Property Occupational Ethnic
The Elite The Upper Class Capitalists
The bureaucracy
(A)
The upper-middle
class
(A)
Professionals,
managers,
entrepreneurs
(A)
Anglo Americans
(A)
The electorate
(B)
The middle class
(B)
Skilled workers,
technicians
(B)
Other EuroAmericans
(B)
The apolitical
populace
(C)
The working
class
Unskilled workers
(C)
Asian Americans
The poor
(C)
The unemployed Latino Americans
The underclass African Americans
(C)
American Indians
Note: A, B, and C represent three individuals.
From Power and privilege: A theory of social stratification, by G. Lenski, 1966, New York:
McGraw. Copyright University of North Carolina Press. Adapted with permission.
IMMIGRATION AND POWER
Control of immigration is an extremely important dimension of power
that has been used historically and currently not only to regulate our capacity to absorb immigrants, but to further consolidate power at the top
and to regulate the ethnic composition of American society. Consider, for
example, the evolution of policies to restrict immigration that took place
when the color and ethnicity of European immigrants changed from
White northern Europeans during the 1800s to darker southern and eastern Europeans at the turn of the century and into the early 1900s.
In response to the second great immigration wave at the turn of the
twentieth century, Congress passed the Emergency Quota Act of 1921
that limited each European immigrant group to 3% of its U.S. population

44 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
size based on the 1910 census. Because northern and western Europeans
made up the largest groups in America in 1910, this immigration policy
effectively allowed far greater numbers of these groups to immigrate and
far fewer numbers of southern and eastern Europeans (McLemore, Romo,
& Gonzalez Baker, 2001). Then, in 1924, the limit was change to 2% based
on the 1890 census, further limiting the percentage of southern and eastern European immigrants relative to northern and western.
Today, we continue to experience effects of the third major immigration stream, composed this time of even more ethnically distinct peoples
from Latin America, Asia, and other non-European countries. This
stream dates back to around the middle of the twentieth century and has
elicited its share of ethnic-linked immigration policies. For example, the
Western Hemisphere Act of 1976 limited immigration to 20,000 per
country of origin, and the Immigration Reform and Control Act (IRCA)
of 1986 attempted to curb Mexican immigration by imposing penalties
for employers of undocumented workers (McLemore et al., 2001). The
1986 act also attempted to deal with the high number of undocumented
workers by granting them citizenship if they could prove long-term residency, which most did. Sanctions against employers, however, were
rarely, if ever, implemented because undocumented workers have been
able to produce false documents and because some employers are able to
sidestep their role as employers by using labor contractors to provide
workers (e.g., in farmwork).
The latest nativistic backlash against predominantly Mexican/Latino
undocumented immigrants is the current congressional proposal to not
just criminalize but felonize the estimated 11 million such immigrants
who compose an estimated 5% of the U.S. workforce. Couched in the
usual debatable rhetoric of taking American jobs and sponging social services, as well as the new rhetoric of undermining homeland security, the
proposal is sparking the expected national debate. This time, however,
the Catholic Church is branding the proposal a human rights violation
and Latino communities are quickly mobilizing on a national level to assert both their U.S. patriotism and their condemnation of the proposal.
THE FUNCTION OF RACISM
In the context of stratification, the ideology of racism, or the belief in the
inherent racial and/or cultural inferiority and superiority of different
groups, becomes a major driving belief system for justifying discrimination and the unequal distribution of society’s opportunities and resources
across racial groups. For example, the historical conviction that African
Americans were genetically inferior subhumans relative to Whites justi
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 45
fied the practice of slavery for nearly two centuries, followed by another
century of separate and unequal segregation. In the less extreme example
of Latinos, the belief that Mexicans and Puerto Ricans were an inferior
and docile peasant class was frequently used as a rationale for maintaining exploitive dual-wage systems, excluding Latinos from unions, and subduing strikes and protests.
It is only when stigmatizing and dehumanizing ideologies are challenged that shifts in the stratification system lead to more just distributions of power and resources (e.g., civil rights movements). But when
members of various minority groups internalize and believe such ideologies, the unchallenged stratification system remains stable and minorities remain at risk for self-compromising conformity as well as ethnic
identity problems (to be reviewed in Chapter 4).
A central American ideology that continues to stabilize structured inequality is the belief that our society is fair and that opportunity structures
are open to all who have enough achievement motivation, intelligence, talent, and industriousness to take advantage of such opportunities. This core
ideology of meritocracy continues to justify the stratification of ethnicity and
power because it attributes a group’s social position only to the internal and
cultural characteristics of its members, while minimizing the external effects of prolonged dominance and subordination and the dynamics of stratification. The current national movements to abolish affirmative action and
reform the welfare system are emblematic of the core American ideology
that people of color need to solve their own problems and that the role of
racism and discrimination has minimal impact.
ETHNIC PRESTIGE
Ethnic stratification is also a ranking of social prestige and acceptance
based on a group’s racial and cultural similarity to Anglo-Americans.
Perceptions of prestige are also a function of popular cultural and formal
educational information and stereotypes that a society generates about
different groups. Culture-wide prestige rankings are part of interpersonal norms and socialization that influence minority-majority relations,
formally and informally, and have a direct relation to probabilities of integration and assimilation. Sadly, prestige rankings follow a familiar
color gradient, from positive White to negative Black. For example, using
intermarital assimilation rates as one index of ethnic prestige and interpersonal acceptability, we find that although over 50% of Japanese, Chinese, Filipino, and Cuban Americans are married to non-Hispanic
Whites, the figure is about 30% for Mexican Americans and an amazingly low 3.5% for African Americans (Zweigenhaft & Domhoff, 1998).

46 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
WHITE PRIVILEGE
Recently, discussions of White privilege and the new area of critical studies (McIntosh, 1998; Tatum, 1997) have invigorated the tired national debate about race and ethnic problems in America. Critical White studies
aim to de-center White power and privilege by reinserting White people
into the mix of American race problems, whereas focusing just on minority disadvantage conveniently distances Whites from their major role in
such problems, thereby making it easy for them to either ignore or superficially respond. Reinvolving Whites is partly accomplished by focusing
on what they have accrued and continue to gain from historical and contemporary racism and discrimination, in both their informal and institutional forms. It is understandably a touchy subject because although most
Whites are generally willing to admit that ethnic minorities have been
discriminated against and disadvantaged, they are too often oblivious to
or only vaguely aware of how Whites have been simultaneously advantaged by such conditions of inequality.
Historically and through today, being racially White has meant having
tremendously better life chances, opportunities, and general social welfare in America. Whites have generally succeeded not only because of
their considerable hard work and talent, but also because they have not
been stigmatized and limited by race. Such a privileged condition does
not guarantee Whites success, but it allows them to take fuller advantage
of their human potential, and this is exactly what ethnic minorities in
America continue to demand. Critical White studies also include historical analyses of how various European immigrant ethnic groups (e.g., the
Irish, Italians, Jews) became White and thus privileged in America, and
distant from people of color, despite centuries of inter-European rivalries
and tensions in the old country.
In McIntosh’s (1998, p. 71) now classic article on White privilege, she
states:
I have come to see white privilege as an invisible package of unearned assets that I can count on cashing in each day, but about which I was “meant”
to remain oblivious. White privilege is like an invisible weightless knapsack
of special provisions, assurances, tools, maps, guides, code books, passports, visas, clothes, compass, emergency gear, and blank checks.
McIntosh discloses:
For me, white privilege has turned out to be an elusive and fugitive subject.
The pressure to avoid it is great, for in facing it I must give up the myth of
meritocracy. If these things are true, this is not such a free country; one’s
life is not what one makes it; many doors open for certain people through
no virtues of their own. These perceptions mean also that my moral condi
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 47
tion is not what I had been led to believe. The appearance of being a good
citizen rather than a troublemaker comes in large part from having all sorts
of doors open automatically because of my color. (pp. 75–76)
The concept of White privilege is emphasized here to remind us that
Whites even have the privilege to be average or to fail without its being attributed to their race. In contrast, people of color who benefit from affirmative action cannot be average or fail without its being used as evidence
of their racial inferiority and/or proof that affirmative action is a failure.
The irony here is that affirmative action has never advantaged people of
color in the way White privilege has unfairly advantaged Whites throughout the American experience.
The more conscious Whites become of their race privilege, the more
likely they will fairly consider their coevolution with people of color.
Surrendering White privilege runs counter to mainstream culture and
daily lived experience, yet the benefit for all Americans is immense in
scope: fuller overdue human rights for people of color, a less distorted
sense of self and society on the part of Whites, more authentic interpersonal majority-minority relations, and unlimited multicultural potential
in America.
MULTIPLE STATUS DIMENSIONS
Needless to say, racial and ethnic minorities are not the only groups singled out for discrimination leading to lower positions in the social hierarchy. Historical and contemporary ideologies of sexism, homophobia, and
prejudice against people with mental and physical disabilities continue to
justify discrimination against these groups on the basis of characteristics
that distinguish them from society’s more powerful members. The struggle for a fairer distribution of resources, and even special accommodations for these individuals, to overcome tenacious legacies of prejudice
and discrimination continues to be an uphill battle led primarily by
members of these groups who most feel the sense of urgency. Issues of
multiple status dimensions and identities, even within the same individual, are addressed in Chapter 4 (“Diversity within Latinos”).
Hence, the matrix of intertwined ethnic, economic, educational, and
political class systems has tremendous implications for the mobility and
general social welfare of different groups in America, including their concentrations within particular social classes, types of work, levels of education, political clout, formal and informal relations with members of the
dominant and other subordinate groups, and consequent well-being or
social welfare.

48 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
THE SOCIOECONOMIC POSITIONS
OF U.S. LATI NOS
As reviewed in Chapter 1, most Latinos were historically incorporated
into the American stratification system at the lowest social class, characterized by segregation and economic exploitation with little collective
bargaining power. In particular, Mexican Americans and Puerto Ricans
were incorporated into local, distinct labor markets with limited advancement opportunities and high vulnerability to structural changes in
the labor market (e.g., farmwork, low-skilled industrial work). As such,
the rate of Latino progress has been painfully slow and poorly understood, leaving too many compromised lives in the balance.
Thus, any comprehensive analysis of Latino SES must move beyond the
overused immigrant model and recognize the distinctiveness of Latinos
as a national minority group as well as their heterogeneity and shared
characteristics with Native and African Americans and European immigrants (Melendez, Rodriguez, & Figueroa, 1991a). Such an approach will
help us make better sense out of continuing SES problems in Latino communities that are the major determinants of related psychosocial and
health problems.
INCOME AND OCCUPATION
Marger (2000b) maintains that Latinos generally occupy a space in the
stratification system approximately between European and African
Americans. A comparison of socioeconomic indicators appears to substantiate this point. As can be seen in Table 2.3, median annual family income for Latinos ranges from a high of $35,616 (Cubans) to a low of
$23,646 (Puerto Ricans), with an average of $25,347 (closest to Mexican
Americans). As compared to a fairly impressive 8.6% poverty rate for European Americans, Latino poverty rates are twice as high for Cubans,
over three times as high for Mexican Americans, and over four times as
high for Puerto Ricans.
With the exception of Cubans, Latinos are generally underrepresented in high-status occupations and vice versa. As reviewed in Chapter 1, historical discrimination set the stage for this distinct economic
pattern, especially for Mexicans in the Southwest and Puerto Ricans in
the Northeast. The consequent pattern of Latino job concentration is presented in Table 2.4.
As can be seen, the underrepresentation of Latinos in upper-white-collar (i.e., managerial and professional) and lower-white-collar (technical,
sales, and administrative support) jobs is due mostly to the historical
locations of Mexicans and Puerto Ricans, in addition to the relatively

49
Table 2.3
Latino Socioeconomic Status
High School Bachelor’s
Median Families in Graduate Degree
Group Income Poverty Unemployed or Higher or Higher
($) (%) (%) (%) (%)
)
Hispanic 26,179 29.4 7.7 54.7 10.3
Mexican 25,347 31.0 7.7 48.6 7.4
Puerto Rican 23,646 35.7 9.8 61.1 10.8
Cuban 35,616 17.3 6.6 65.2 19.7
Central/South American 29,960 20.8 7.0 63.3 14.8
Other Hispanic 26,171 29.9 7.6 66.6 14.9
Non-Hispanic White 49,636 8.6 2.8 83.1 24.6
Sources: Money Income in the United States, 1997 (CPR P60-200); Poverty in the United States, 1997 (CPR P60-201); and Statistical abstracts of the United States, 1998, by the U.S. Bureau of the Census, 1998c, Washington, DC: Government Printing Office.

50
Table 2.4
Concentration of Latinos in the U.S. Labor Market
Men Women
White Mexican Puerto White Mexican Puerto
American American American American American American
Employment Category (%) (%) (%) (%) (%) (%)
Managerial and professional specialty 29.2 8.7 15.5 30.9 13.6 18.5
Technical, sales, and administrative support 21.7 13.8 18.0 43.9 40.7 48.4
Precision production, craft, and repair 18.7 20.5 15.1 1.7 2.8 2.4
Operators, fabricators, and laborers 17.8 29.9 27.3 6.6 15.2 10.8
Service occupations 8.8 15.2 22.4 16.0 24.9 19.9
Farming, forestry, and fishing 3.7 11.9 1.8 0.9 2.8 —
Totals 99.9 100.0 100.1 100.0 100.0 100.0
Source: “Mexican Americans” (pp. 291–335), by J. R. Feagin and C. Booher Feagin, 1999, in J. R. Feagin and C. Booher Feagin (Eds.), Racial
and Ethnic Relations, sixth edition, Upper Saddle River, NJ: Prentice-Hall.

constant immigration of Mexicans to the United States. The same is true
for Latino overrepresentation in lower-blue-collar and service sector work
(e.g., operatives, laborers).
STRATIFICATION VERSUS HUMAN CAPITAL THEORY
One of the predominant current economic theories for understanding occupational gaps between ethnic groups in America is human capital theory, which attributes group differences to differences in human capital or
accrued characteristics such as education, job skills, and experience
needed to secure good jobs and mobility. But although such variables
clearly predict SES for everyone, the theory has serious shortcomings for
understanding the SES of Latinos, as well as other people of color. Bean
and Tienda (1987b) note that human capital theory does not consider how
“ascribed” characteristics such as race or gender influence the allocation
of labor rewards, and how dominant groups are prone to protect their interests beyond human capital variables. That is, “fixed” characteristics
such as race and ethnicity are simply rewarded differently, and work opportunities are influenced by social and ethnic affiliations. For example,
Rothman (2002) has constructed a table of unequal wage earnings for different races/ethnicities and sexes within different economic classes (see
Table 2.5).
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 51
Table 2.5
Class, Minority Status, Gender, and Income in the United States
Men Women
Social Class White Black Hispanic White Black Hispanic
Upper middle class
Professions $36,975 $28,775 $32,846 $19,324 $21,122 $21,302
Managers 39,273 29,712 32,264 20,800 20,281 19,819
Lower middle class
Technicians 27,238 19,404 20,402 17,250 16,227 n/a
Sales 28,242 16,358 20,494 10,752 7,937 9,336
Clerical 20,018 17,590 16,417 12,712 14,068 12,498
Working class
Craft workers 22,068 18,066 17,246 14,040 13,378 12,994
Semiskilled 19,249 15,501 15,214 10,684 11,167 8,560
The poor
Service work 10,510 8,595 10,282 6,756 7,855 7,022
Unskilled 12,110 11,041 11,930 8,615 8,113 7,865
Source: Money Income of Households, Families and Persons in the United States, 1989,
Table 40, by U.S. Bureau of Census, Washington, DC: U.S. Government Printing Office.

52 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
As can be seen, people privileged by race and sex earn more money
than those stigmatized by these dimensions, even within the same occupational categories (i.e., comparable education and work experience).
According to Torres and De La Torre (1991), human capital theory,
though partly correct, minimizes labor history and the starting place of
ethnic groups, continuing job discrimination, and the disproportionately negative impact of structural labor market shifts on Latinos and
other economically vulnerable groups (i.e., downsizing, outsourcing,
relocating industry outside of the United States, the rise of dead-end
service sector work).
Latino Vulnerability to Labor Market Shifts
Two-thirds of Latinos are currently located in what has been called the
“secondary labor market,” characterized by low wages and benefits,
higher unemployment, poor working conditions, low advancement, less
unionization, high turnover and low investment in employees, arbitrary
and poor management, and sectoral decline. As a result, they are disproportionately dislocated by negative labor market changes. For example,
during the 1980s, Latino SES dramatically declined 21% relative to
Whites’ (Melendez et al., 1991a). Whereas Latino SES had been 85.1% of
White SES in 1970, it declined to 64.2% in 1980, largely due to the disappearance of work for Puerto Ricans in the Northeast and declines in
wages for Mexicans in the Southwest.
And although declines in manufacturing jobs were offset by service
sector jobs for Mexican Americans, wages and hours in the service sector
declined throughout the 1980s. Harrison (1987) found that workers in the
service sector are seven times more likely to earn below the poverty line
than workers in manufacturing jobs. Further, the current trend of converting full-time jobs to part-time work is overly impacting Latinos in the
secondary labor market. Estimates of part-time jobs indicate an increase
from 8 million in 1980 to 18 million in 1991 (Torres & De La Torre, 1991).
Such employees not only earn less than full-time employees but have
fewer benefits, if any at all. For example, 70% have no retirement pension
and 42% no health insurance, according to Ehrenberg, Rosenberg, and Li
(1988), and they are thus almost certain to remain segmented in secondary labor market work.
Thus, the traditional lower rungs on the economic ladder to advancement have practically disappeared, threatening to create an hourglassshaped distribution of SES in America. Proof of this unfortunate scenario
can be found in the income gap between rich and poor in America that
has continued to widen since the 1960s. For example, between 1974 and
1994, the income share for the top 20% of Americans rose from around

The Social Stratification of Latino Ethnicity, Power, and Social Welfare 53
43% to 49%, while the income share of the poorest 20% of Americans
shrank from 4.3% to 3.6% (and this occurred regardless of recession and
expansion and successive Republican and Democratic administrations
during this period; Rothman, 1999).
Zhou (1997) notes that whereas the economic dislocations of the poor
during the 1970s and 1980s were offset by accessible welfare (e.g., subsidized housing), the current policy of welfare reform exacerbates poverty
by gutting accessible welfare while doing nothing to reverse the hourglass configuration of economics in America.
Labor Market Discrimination
Not only has historical discrimination shaped Latino economic vulnerability, but contemporary discrimination persists, to the disbelief of many.
For example, a report by the Urban Institute (Cross, Mell, & Zimmerman,
1990) concluded that discrimination accounted for the hiring of Whites
over Latinos for low-skilled, entry-level jobs in both Chicago and San
Diego, where Mexican Americans are numerous. Even after controlling
for human capital variables (which were essentially irrelevant in these
low-skilled work settings) the study found that Whites were favored over
same-age Latinos when using similar resumes that differed only in indicating a different national origin for Latinos. On a related note, Telles
and Murguia (1990) found that Mexican American workers with darker
skin received significantly less money than those with lighter skin. Their
analysis was based on a national survey of Latinos conducted in 1979 that
included ratings of participants’ skin color.
Another interesting way of understanding the stratification of ethnicity and power in the United States is to examine the extreme underrepresentation of ethnic minorities in the upper echelons of corporate
America. In the most comprehensive study of diversity in the power elite,
Zweigenhaft and Domhoff (1998) found that Latinos constitute less than
1% of corporate directors of Fortune 1,000 boards and only 1.4% of executives at vice presidential levels and above. In fact, the actual number of
corporate directors went from a mere 40 in 1990 to 51 in 1995. Furthermore, an analysis of the backgrounds of the Latino corporate elite revealed that the majority were Cuban Americans from middle-class and
elite backgrounds. In fact, a subsequent analysis of skin color and facial
features by a pair of independent raters also revealed this group to be
light in complexion and more European- than Indian-looking. Hence this
group is highly unrepresentative of most Latinos in America and far more
advantaged with regard to both SES and skin color. Thus, discrimination
based on fixed characteristics continues to happen irrespective of human
capital variables.

54 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
The Cuban Enclave
Not surprisingly, Cubans are the glaring exception to Latino underemployment. Their historical experience in America has resulted in a vibrant ethnic enclave subeconomy as a mechanism for economic livelihood
and mobility. Torres and De La Torre (1991) define “ethnic enclave” as
business enterprises that serve both the ethnic and mainstream markets
and also offer subsequent immigrants jobs when work in the regular labor
market is less available. Ethnic enclaves provide opportunity for advancement, and there is even a sense of solidarity in that workers are expected
to be loyal and employers are expected to provide skills and advancement. The Cuban enclave has been able to take full advantage of its location by working with Caribbean and Latin American companies.
Over 20 years ago, Boswell (1985) offered the following awesome profile
of Cuban Americans during the mid-1980s: In Dade County, Florida, there
are more than 18,000 Cuban-owned firms, most in construction, finance,
textiles, leather, furniture, and cigar making. In addition 16 Cuban Americans are presidents of banks and 250 are vice presidents; 3,500 are doctors, 500 are lawyers, and they own 500 supermarkets, 250 drug stores,
and more than 60 auto dealerships.
THE STRATIFICATION OF LATI NO EDUCATION
With the exception of Cubans, Latinos are second to Native Americans in
scholastic underachievement, which of course drives occupational mobility
and related well-being. Only 54.7% of Latinos over the age of 25 have graduated from high school, as compared to 83.1% for European Americans
(Marger, 2000b). More specifically, the percentages of Latinos over age 25
without a high school diploma are over 50 for Mexicans, 39 for Puerto Ricans, and 35 for Cubans. With regard to higher education, about 25% of
non-Latino Whites graduate with a bachelor’s degree or higher, as compared to 7.4% of Mexicans, 10.8% of Puerto Ricans, and 20% of Cubans.
While in school, Latino students score lower than their non-Latino White
counterparts on educational tests and have higher rates of “school delay” (a
polite term for flunking; Bean & Tienda, 1987a). Such student profiles lead
to placement into lower curriculum tracks (e.g., vocational rather than college preparation) and low expectations on the part of teachers, career counselors, and, unfortunately, many of the students themselves.
The Richest Latino in America?
Hailing from a wealthy sugar plantation family in Cuba and of Spanish-Basque heritage, Roberto Goizueta worked for a subsidiary of Coca-Cola from 1954 to 1960

The Social Stratification of Latino Ethnicity, Power, and Social Welfare 55
after graduating from Yale with a degree in engineering. But with Fidel Castro threatening to nationalize capitalist enterprises, Goizueta fled Cuba in 1960 with his family to become the assistant to the senior vice president of Coca-Cola in the Bahamas.
Over the next 20 years, he would relocate to company headquarters in Atlanta and
receive a series of major corporate promotions, culminating in chairman of the board
and CEO of Coca-Cola in 1981, with an annual salary of almost $5 million. But that
was just the beginning! In addition to introducing the ill-fated New Coke (a Pepsi
taste alike) in 1985, Goizueta also gained notoriety in 1992 for arranging a compensation package so immense that it made Johnny Carson’s monologue on The Tonight
Show. ABC’s Nightline devoted an entire show to it, and David Cay Johnston (2003)
recently devoted a chapter to it in his book, Perfectly Legal: The Covert Campaign to
Rig Our Tax System to Benefit the Super Rich—And Cheat Everybody Else. On top of
his annual income of nearly $5 million, Goizueta arranged to be paid 1 million shares
of Coke worth $81 million, and at a federal income tax rate of less than 2%!
In one of the most thorough analyses of Latino education, Bean and
Tienda (1987a) analyzed census data from 1960 to 1980 to both profile and
analyze predictors of educational success and failure in Latinos. Their report begins with a descriptive comparison of adult education differences
between Latino national origin groups from 1960 to 1980. As can be seen
in Table 2.6, there has been a slow but steady increase in adult education
levels since the 1960s. Included in these trends is more years of schooling
in native-born versus immigrant Latinos and younger versus older individuals, and in Latinos more proficient in English (gender differences
were not included in this profile because they were very small overall). At
first blush, these descriptive data would seem to suggest that the scholastic problems of Latinos are basically due to lack of English skills and high
immigration rates (e.g., over 40% of Mexicans in the United States are immigrants). Such reasoning is consistent with the immigrant model of assimilation that drives social (anti-immigrant) and educational (e.g.,
current efforts abolishing bilingual education) policies.
Such simple explanations, however, do not come close to explaining the
most glaring difference in Table 2.6: The large and persistent gap between
Mexicans and Puerto Ricans on the one hand and Cubans and non-Latino
Whites on the other. To better understand this discrepancy, Bean and
Tienda (1987a) performed a series of regression analyses designed to assess the net effect of social class and Latino cultural variables on school
success and failure. What these researchers consistently found was that
cultural factors (i.e., limited English and immigrant status) do contribute
to school failure, as expected, but only in combination with disadvantaged social class rooted in the acculturation histories of Latinos in the United
States (reviewed in Chapter 1). That is, the effects of limited English and

Table 2.6
Median Years of Schooling of the Adult Population Aged 25 and Over by Race, Hispanic Origin, and Nativity, 1960–1980
1960 1970 1980
Native Foreign Total Native Foreign Total Native Foreign Total
Mexican 7.6 3.6 6.4 9.2 5.6 8.2 11.1 6.1 9.1
Puerto Rican 9.8 7.1* 7.5 11.5 7.9* 8.2 12.0 9.2* 10.0
Cuban 8.4 8.4 8.4 11.8 10.0 10.0 12.1 11.7 11.7
Central/South American 11.6 11.5 11.6 12.0 11.6 11.7 12.4 11.7 11.7
Other Hispanic 10.7 7.6 8.0 10.5 9.2 10.0 11.9 11.3 11.8
Black 8.0 8.0 8.0 10.0 12.0 10.0 12.0 12.0 12.0
Non-Hispanic White 11.0 8.0 11.0 12.0 9.0 12.0 12.0 12.0 12.0
*Foreign refers to island born.
Source: “Hispanics in the U.S. Labor Force” (pp. 280–337), by F. D. Bean and M. Tienda, 1987b, in F. D. Bean and M. Tienda (Eds.), The Hispanic Population of the United States, New York: Russell Sage Foundation. Reprinted with permission.
56

foreign-born immigrant status on school delay were overshadowed by
family income and parental education. In fact, for Cubans, school delay
was higher in children from homes that were monolingual English or
English-dominant! For Mexican Americans, the probability of school
delay decreased 2% for each yearly increment in parental education. Similarly, dropping out of high school was inversely related to family income
yet generally unrelated to household language for Latinos overall.
Thus, the gap between Mexicans and Puerto Ricans on the one hand
and Cubans on the other cannot be explained by Spanish-language maintenance nor immigration rates because these background factors are
shared by all three of these Latino groups. Where these groups differ is
in their SES and historical conditions of acculturation (i.e., treatment) in
the United States. Unfortunately, these informative analyses of U.S. census data are ignored in heated public and political debates about bilingual
education.
THE BATTLE OF BILINGUAL EDUCATION
Californians attempted to abolish bilingual education by passing Proposition 227 in 1999. The rationale is that such programs do not help immigrant children to learn English; they retard assimilation and, even worse,
contribute to the “decay of the core parts of our civilization” according to
the former speaker of the U.S. House of Representatives Newt Gincrich.
Just as bold as Gincrich’s assertion is the opinion of bilingual education
expert Hakuta (1986), who claims that such condemnations result from the
fact that bilingual education affirms the legitimacy of non-English languages and cultures, which in turn threatens the high status of English
and the domination of Whites over people of color. The latter assertion is
consistent with the stratification perspective as well as the definition and
history of bilingual education in America.
Californians today would never imagine that the first California state
constitution of 1849 was published in both Spanish and English and legislated that all state laws, degrees, regulations, and provisions were
printed in both languages (Feagin & Booher Feagin, 1999). But since then,
Spanish has been declared “foreign” despite the fact that it is an indigenous language that predates English in America. Another irony is that
bilingualism has historically been equated with “mental confusion,”
whereas research shows that advanced bilingualism promotes academic
achievement (Moran & Hakuta, 1995). Worse yet, the so-called language
deficiency of Mexican children was also the main historical rationale for
segregating Mexican Americans in the Southwest and thereby stratifying
their inferior education. Viewed in its historical context, the bilingual
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 57

58 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
education movement has been an effort to protect Latinos, and other nonEnglish-speaking children, from being pathologized, marginalized, and
undereducated.
As early as 1939, the Congress of Spanish Speaking Peoples denounced racist segregation and demanded that the bilingual needs of
Mexicans be addressed by Spanish-speaking teachers, materials, and
programs. But it took a series of demonstrations and protests by Mexican parents to eliminate the segregation of their children. For example,
in Lemon Grove, California, Mexican parents, backed by the League of
United Latin American Citizens, protested the placement of their children in “Mexican schools” and an appeals court ruling that the school
district had the right to separate Mexican kids based on “their English
language handicaps.” San Diego Superior Court overruled the appeals
court. In 1946, 8 years before the landmark Brown v. Topeka Board of Education decision, which declared segregation illegal, the court in Mendez
v. Westminster School District ruled that Mexican schools in this district
were unconstitutional. But despite these victories, the punishment of
children speaking Spanish was commonplace, eventuating in a series of
civil rights laws passed to protect the human rights of non-Englishspeaking children.
In 1974, the court in Lau v. Nichols ruled that inattention to the language
needs of Asian and other English-limited children in California was a denial of their participation in public education. Bilingual education was recommended by the Office of Civil Rights as the best solution to this
problem. But whereas most people view bilingual education as a way to
transition children from their native language to English, it was originally
intended to provide instruction in both languages in order to affirm and
maintain native language and culture while simultaneously acquiring English and American culture (i.e., the bicultural model). Unfortunately, the
majority of bilingual education programs have been transitional in design,
reflecting deep resistance to legitimating languages such as Spanish or
Chinese.
Best-Case Scenario for Bilingual Education
With regard to the effectiveness of bilingual education, we need look no
further than the Cuban American experience to study the best-case scenario, which involved high U.S. investment in Latino bilingualism and
biculturalism. In the early 1960s, the Ford Foundation funded an experimental bilingual education program in which equal numbers of Cuban
refugee and non-Latino White children from a middle-class school district were instructed in both English and Spanish. Refugee Cuban teach
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 59
ers, highly invested in the success of Cuban children, were hired to assist. Not only did White children learn an extremely valuable second
language, but both groups of children also improved their reading
scores (Hakuta, 1986)!
In 1982, the U.S. Supreme Court ruled that all children will be provided an education and cannot be discriminated against on the basis of
parent immigrant status. This is why former governor Pete Wilson’s California Proposition 187, passed by voters in 1994, was ruled unconstitutional in its intention to deny public education (and nearly all other
human services) to the predominantly Latino children of undocumented
Californians.
LATI NO POLI TICAL ( DI S)EMPOWERMENT
Latino political power is addressed in Chapter 10, but the topic is introduced here as an essential element of understanding the social
stratification of Latino ethnicity and power. Historically, Mexicans in
the Southwest and Puerto Ricans in New York have been victimized by
many of the same kinds of explicit voting deterrents used against
African Americans, such as poll taxes, literacy tests, gerrymandering,
and outright intimidation. Current lack of participation is more a
function of age, nativity, continuing poverty, and less explicit discrimination. For example, 35% of Latinos are too young to vote, and over
50% are ineligible noncitizens (Marger, 2000b). Further, the continuous immigration of Mexicans and the revolving-door migration of
Puerto Ricans slow the development of political loyalties, interests,
and investments. Finally, considering that political participation is
largely a function of SES resources (i.e., time and money, relevant work
experience), the current lack of political power on the part of Latinos is
not that difficult to understand.
THE LATINO NATIONAL POLITICAL SURVEY
One of the best sources of recent data on Latino political power comes
from the Latino National Political Survey (LNPS), which was the first national probability survey of Mexican Americans, Puerto Ricans, and
Cuban Americans in the United States. The LNPS randomly surveyed
2,816 adult Latinos in 40 primary sampling units in 28 metropolitan areas.
This sample included 1,546 Mexican Americans, 589 Puerto Ricans, 679
Cuban Americans, and, for the sake of comparison, 598 European Americans from the same primary sampling units.

Table 2.7
Patterns of Latino Political Participation
Mexican Puerto
Voting Activity Origin (%) Rican (%) Cuban (%) Anglo (%)
Ever been registered to vote in the
United States 76.0 73.0 82.0 89.0
Currently registered to vote in the
United States 65.0 63.0 77.0 86.0
Voted in November 1988 elections 49.0 50.0 67.0 89.0
Voted for U.S. representative
in 1986 36.0 32.0 51.0 61.0
Note: Percentages represent proportion of Latinos who are eligible to be registered to
vote (i.e., citizen, over 18 years). Noncitizens not included.
Source: “Political Participation: Resources and Involvement among Latinos in the American Political System” (pp. 44–71), by J. A. Garcia, 1997, in F. C. Garcia (Ed.), Pursuing
Power: Latinos and the Political System, Notre Dame, IN: University of Notre Dame Press.
Reprinted with permission.
In Garcia’s (1997) analysis of LNPS findings, he begins by noting that
46% of Mexican Americans and 54% of Cuban Americans are ineligible
to vote because they are either too young or aren’t citizens. All Puerto
Ricans are citizens, but they are also younger than mainstream Americans. Table 2.7 shows Latino rates of voting activities relative to nonLatino Whites.
As can be seen, Mexican and Puerto Rican rates of registration and voting are comparable but significantly lower than Cuban Americans’, which
in turn are lower than Anglos’. This overall pattern of political participation is highly consistent with SES differences for all comparison groups.
The high correlation between SES and political participation is especially
evident for Puerto Ricans, who have voting rates as low as Mexicans even
though all Puerto Ricans are citizens. In contrast, Island Puerto Ricans
have much higher rates of registration and voting than mainstream
Puerto Ricans (as well as all mainstream Americans!).
Interestingly, Garcia (1997) also examined LNPS findings on involvement in Latino-focused political activities such as signing petitions, attending public meetings, writing letters or making phone calls to public
officials, and contributing time or money to Latino-focused campaigns.
He found that less that 10% of all Latinos surveyed had been involved in
these types of activities and concluded that such activities depend on organizing and mobilization efforts that have limited success in lowresource communities.
60 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH

In his analysis of Latinos’ low to moderate political participation, Garcia (1997) examined the role of socioeconomic factors as well as politically
relevant occupational skills and experience. Not surprisingly, he found
that the various forms of political participation assessed in the LNPS
(e.g., registration, voting, nonvoting political activities) were predicted by
higher SES, higher age, being born in the United States, and possessing
politically relevant work skills such as being involved in collective efforts
to work on local problems.
Garcia (1997) concludes that implications for future Latino political
power are mixed. On the downside, because Latino SES continues to lag
behind that of non-Latino Whites, considerable grassroots organizing
and political mobilization on the part of willing Latino leadership will
continue to be crucial in counteracting the negative effects of low SES on
political participation. Many such efforts are described in detail in Chapter 10. Ironically, the current wave of antimulticulturalism and antiimmigration and the frequently nativistic political climate is one of the
biggest motivators of future Latino political participation and activism!
On the upside, the Latino political base will grow significantly in the
next few years as this generally young group approaches a median age of
30 (political participation generally increases after 30), and naturalization rates are uniformly high across all Latino groups. Marger (2000b)
notes that there has been a 50% increase in the number of elected Latino
public officials since 1984, for a total of 5,500 at local, state, and federal
levels. However, Latinos continue to constitute only 1% of all elected officials in the United States.
CONCLUSION
Whereas acculturation theory helps to explain the general historical dynamics of group-level dominance and subordination, stratification theory
clarifies how a group’s general level of SES and consequent quality of life
become institutionalized in many different ways and justified by mainstream narratives, values, and cherished myths. The historical and current roles of key institutions (e.g., educational, political, occupational) in
stratifying society not only by human capital assets but also by race and
ethnicity are compelling and elucidate how influential stigma and privilege continue to be in unfairly penalizing and rewarding different groups
in society. Latinos continue to be overrepresented at lower levels of SES,
with consequential psychosocial and health vulnerabilities. At the same
time, slow but steady progress continues for U.S. Latinos despite frequent
political backlash in the form of anti-bilingual-education ballot initiatives
and anti-immigration policy deliberation at the national level. In addition
The Social Stratification of Latino Ethnicity, Power, and Social Welfare 61

62 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
to high rates of work participation, retention of traditional Latino culture
helps to push Latinos forward with occasional high-profile accomplishments, such as the recent election of a Latino mayor in Los Angeles, who
represents the experiences and values of most local Latinos.
L.A.’s First Latino Mayor (in 134 years) the Real Deal
The election of Antonio Villaraigosa as mayor of Los Angeles in 2005 is a victory of
immense significance for many different reasons: the size of both L.A. (the secondlargest city in the United States) and its Latino population (just under 50%), its historical precedence (first Latino elected as mayor of L.A. in 134 years), Villaraigosa’s
ability to deftly weave an all too rare multicultural coalition to oust a sitting mayor,
and the fact that Villaraigosa’s Latino credentials are impeccable. That is, Villaraigosa’s liberal-progressive values and politics truly reflect his being born in East
Los Angeles and raised, along with his siblings, by his single-parent mother in
poverty. His street credibility was honed by shining shoes and selling newspapers as
a boy, tattooing “Born to Raise Hell” on his shoulder, and, like too many Chicanos,
getting kicked out of one high school and dropping out of another. But his resilience
would not deny him going back to finish high school, earning a bachelor’s degree
from the University of California, Los Angeles, and earning a law degree at night. Villaraigosa’s career included working as a union representative for African American
public school workers and later as the director of the L.A. chapter of the American
Civil Liberties Union. In 1994, he was elected to the California State Assembly and
served as a highly effective speaker of the house who was able to broker agreements
between rival factions. In the George W. Bush era of appointing only ethnic and
racial minorities and women that mirror his ultraconservative political ideology, including the first Latino attorney general, Alberto Gonzales, and thus creating merely
an illusion of diversity at the top, Villaraigosa’s life, values, politics, and victory bode
well for the majority of U.S. Latinos, as well as the rest of America.
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Ehrenberg, R., Rosenberg, P., & Li, J. (1988). Part-time employment in the United
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65
CHAPTER 3
Latino Ethnic Identity
Psychological Impacts of
Structured Inequality
THE SOCIAL SCIENCE frameworks of acculturation and adjustment in
Chapter 1 and social stratification in Chapter 2 are valuable in helping
us to understand the historical and continuing experiences of Latino
populations in the United States, especially with respect to strained
race relations, stigmatized ethnic minority status, and social-structural
forms of racism and discrimination that ultimately disadvantage the
majority of Latinos. But what are the individual-level, psychological,
and emotional impacts of such group-level dynamics? More specifically,
in what ways does being Chicano, Puerto Rican, Cuban, or Dominican
affect one’s self-concept as a Latino or one’s ethnic identity? These are
exceedingly complex questions with a wide variety of answers. There
has accrued, however, a fair amount of literature on ethnic identity in
Latinos and other racial/ethnic groups in America that is informative
for conceptualizing key dimensions of identity, including healthy and
less adaptive forms, as well as implications for intervening at psychological and social levels.
ETHNIC IDENTITY
In her exhaustive review of 70 published studies on ethnic identity, Phinney (1990) notes that very few studies actually bothered to define ethnic
identity, although its importance was widely presumed. For the sake of
this chapter, ethnic identity is defined as one of several role identities
within the self-concept, each of which varies in importance depending

66 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
on the different contexts of a person’s experience. For example, role identities related to age group (child, adolescent, young adult, elderly, etc.),
gender, and sexual orientation have tremendous psychosocial importance for the ways they structure our lives and how we are socialized to
enact such roles (e.g., how we are socialized to be a child, male, or female). The term role identity is meant to convey both the internal psychological conception of self (e.g., artist) as well as associated external
behaviors (e.g., artistic activities and productions). Given the various degrees of influence that role identities have in our lives, the self-concept is
viewed here as consisting of a flexible hierarchy of role identities that
vary and change over time, typically becoming more numerous and complex as we take on adult career and relationship roles (e.g., lover, wife,
parent, professional), as well as other group memberships and activities
(e.g., Democrat, record collector).
THE SALIENCE OF ETHNIC IDENTITY
Ethnic identity is important in the lives of ethnic minorities because of
the way American society has historically socialized us to define, prejudge and perceive, and treat people of different racial and ethnic backgrounds. Given the negative stereotypic content and mistreatment
historically associated with people of color, members of these groups
continue to struggle with the meanings and feelings associated with
their group membership and how to regard the ethnic component of self.
That is, as the ethnic/racial component of self, ethnic identity is generally a force to be reckoned with given its potential influence on psychosocial adjustment.
As a Chicano child growing up in East Los Angeles from the mid-1950s
to the mid-1970s, the author can share an experience in which Chicanos
were virtually absent from mainstream media such as television,
newspapers, and magazines or were negatively characterized, on the
rare occasions when they were represented, as gang members, prostitutes, bandidos (bandits), and servile Sí señor peasants. Further, as with
too many Latino barrios in the United States, ELA residents were predominantly poor and often struggling, whereas barrio-based police,
firefighters, teachers, supermarket managers, and lifeguards were predominantly White. So, what’s a Latino child to conclude from such a social environment, too often without the positive role models or messages
from parents and other trusted authority figures needed to instill pride,
explain subordination, and inoculate one from distorted negative images, feelings, and conclusions about one’s ethnic group and self?
Although societywide Latino representation has begun to expand con
Latino Ethnic Identity 67
siderably, it remains inadequate, with problematic ethnic identity development too much of a possibility.
THE ETHNIC IDENTITY CRISIS OF “HANK”
Imagine a young Latino adult named Enrique who insists on being
called “Hank,” which is short for Henry, the English translation of Enrique. He takes pride in speaking English with little if any Latino accent
and of moving out of the barrio as soon as he could. He works in the
software industry, and his coworkers and friends are predominantly
White. He married an Anglo woman after years of dating exclusively
White women and has a beautiful young son. Politically, Hank is very
conservative and supports such initiatives as “English Only,” antibilingual education, anti-affirmative action, immigration and welfare reform, and U.S.-Mexico border control. When asked about the lingering
social problems of Latinos, Hank says that they lack initiative and motivation, that their culture holds them back, and that they should spend
more time learning to be like Anglos and less time complaining and depending on the federal government. Hank encourages his son to work
twice as hard as Anglos to prove his worth.
On the surface nothing is inherently wrong with this portrait of Hank
(i.e., people have the right to their political opinions, loving whom they
please, and living their own law-abiding lifestyle). But conversations with
him reveal that he considers White women to be more physically attractive
than Latinas, and all other women of color for that matter. More important, he also believes that marrying a White person is a sign of getting
ahead and that his child is more attractive and smarter than Latino children because he is half White and being raised to be American in all respects and Latino in none. Hank’s friends from back home, and even some
of his family members, say that Enrique wants to be White and that he is
ashamed of his culture and family. Sometimes they feel resentful of him
and call him a vendido, or sellout. On the infrequent occasions that he visits his family of origin, he often gets into heated debates about political issues or about how family members should be running their lives.
There is something troublesome in this vignette, not because we don’t
all have the right to live the life that we choose, but because some of our
perceptions, feelings, behaviors, and lifestyles may be overly influenced
by internalized racism and oppression. At the heart of such internalized
oppression is an unnecessary and preventable dislike of one’s own racial
or ethnic group and self, as well as the consequences of being socialized
to believe in the inferiority of one’s ethnic group and the superiority of
the dominant Anglo group.

68 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Many of us are capable of recognizing ethnic identity problems. They
can be subtle, complex, energy draining, and ultimately debilitating. For
example, one could imagine this vignette without the rejection of ethnic
group and self. That is, a Latino marrying an Anglo could simply be a
matter of mutual love and compatibility rather than bettering oneself,
and finding Anglo women and friends attractive but not necessarily more
attractive than women of color and Latino friends. Conservative political
views can also be based sincerely on how one weighs both sides of political issues and arguments. For many progressive Latinos, it is tempting to
dismiss conservative Latinos as Latino rejecting, partly because such
views are overly welcomed and publicized by the dominant group that
has become weary of minority “complaints.” That is, there are excessive
rewards and attention for the Linda Chavezes and Ward Connerlys who
espouse ultraconservative views and policies that perpetuate the status
quo by essentially blaming minorities for their problems versus holding
society accountable for its mistakes.
Thus, understanding when beliefs and behaviors do and do not reflect
ethnic identity problems is important in both our personal relationships
and our professional work with clients and can be informed by a substantial amount of race and ethnic identity research and theory.
MI NOR I T Y STAT US AND SELF-E STEEM: PR IDE
OR SELF-REJECTION?
CLASSIC THEORETICAL FOUNDATIONS
Prior to the 1970s, most social scientists, as well as the public, assumed
that because African Americans and other devalued minority groups
were so negatively treated and stereotyped, they passively internalized
these messages. Challenges to this national mind-set came from many
scholarly sources, including a definitive review of the minority selfesteem literature by Wylie (1979), who found that presumptions of low
self-esteem in African Americans could not be supported given the generally flawed methodology of previous work and the fact that race group
comparisons generally have shown the self-esteem of Blacks to be equal
to or greater than that of their White counterparts. But how can this be,
when the social psychological principle of “reflected appraisal” has been
used in past research to demonstrate that people appraised negatively by
society eventually reflect or internalize such appraisals? How can this be,
when the social psychological principle of “social comparison” explains
low self-esteem in lower status people as a result of comparing themselves to people of higher status?

Latino Ethnic Identity 69
These questions were addressed by Rosenberg (1979) in his classic book
Conceiving the Self, in which he demonstrated that the principle of reflected appraisal is valid only if four assumptions are met: (1) that a minority individual is aware of negative appraisals; (2) that the minority
individual agrees with such appraisals; (3) that the individual considers
the negative appraisals to be personally relevant; and (4) that the minority
individual considers the appraisals of dominant society to be interpersonally significant or important. Rosenberg also demonstrated that the principle of social comparison does explain self-esteem but depends on to
whom people compare themselves. Utilizing a sample of more than 5,000
public high school juniors and seniors from New York and just under
2,000 students from grades 3 through 12 from Baltimore city public
schools, Rosenberg was able to impressively demonstrate the validity of
his four assumptions, as well as clarify how the principle of social comparison operates:
1. Awareness: Rosenberg found that most White students were aware
of the low ranking of Blacks in society, but most Black students
were not. That is, when asked to guess where most people rank
Blacks from among four racial-religious groups (Jewish, White
Catholic, Negro, White protestant), only 2% of Black children
guessed “last” as compared to 72% of White students. It should be
noted, however, that as Black children grew older, their rankings
became more “accurate.”
2. Agreement: About 33% of White students considered Whites to be
superior to Blacks in the areas of intelligence, good behavior, and
honesty, as compared to only 8% of Blacks. In fact, the majority of
Black students considered Blacks and Whites to be equal.
3. Personal relevance: Although he did not directly test personal relevance,
Rosenberg found no differences in the self-esteem scores of the four
groups of Black children who guessed that Blacks were ranked either
first, second, third, or fourth by society. He also found no appreciable
differences in the self-ratings of Black and White students on 21 positive characteristics (e.g., smart, good-looking, well-behaved, friendly).
Thus, he concluded that it is possible for minorities to be aware of and
even agree with their group’s stigma yet see themselves positively (i.e.,
as exceptions to the rule). For example, it is not unusual for some Latinos to make disparaging comments about other members of their ethnic group, such as recent or undocumented immigrants or those
struggling with significant problems. When confronted by what appears to be self-disparagement, such people will often responded ¡Pero
somos diferentes! (But we’re different!).

70 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
4. Interpersonal significance: Rosenberg examined the relationship between self-esteem and student ratings of how favorably they were perceived by significant others such as mothers, fathers, teachers, kids in
class, brothers and sisters, and best friends. He found that 70% of
Black children who perceived the attitudes of significant others as favorable also had high self-esteem, allowing him to conclude that Black
children’s self-esteem was influenced more by the “interpersonally
significant” appraisals of the important people in their life than the
negative appraisals of dominant society. Still, as noted in Chapter 2,
it’s difficult to diminish the power of dominant images and narratives
from mainstream society that pervade our social environment and
compete with the inconsistent messages of family and friends.
5. Social comparison: Interestingly, Rosenberg did find lower self-esteem
in Black children attending predominantly White schools as compared
to Black children attending predominantly Black schools, despite the
fact that the integrated Black children had higher grades than their
segregated counterparts. He concluded that when Blacks are a tiny minority in White schools, they most likely compare themselves to more
advantaged majority Whites than to their less advantaged and segregated Black counterparts. Thus, the social psychological principle of
social comparison can predict self-esteem depending on who the comparison group is. This is a noteworthy finding considering the frequency with which upwardly mobile minorities find themselves a tiny
numerical minority in mainstream American settings (e.g., college
campuses, professional work sectors, and networks). The potential impact of social comparison on self-esteem for such individuals will depend on how adaptively their ethnic identity serves them.
The classic works of Wylie (1979) and Rosenberg (1979) are reviewed
here to convey three important and durable points: (1) We cannot assume
what the effects of ethnic minority status are on an individual member’s
psychological adjustment, (2) we should be impressed with the extent to
which ethnic minorities develop healthy ethnic identities in spite of
mainstream messages about their group, and (3) it is important to understand the messages and circumstances that influence the development of
ethnic identity in both negative and positive directions.
THEORETICAL MODELS OF ETHNIC AND
RACIAL IDENTITY
In their pioneering text, Counseling the Culturally Diverse: Theory and practice (4th ed.), Sue and Sue (2003a) address the issue of racial and ethnic

Latino Ethnic Identity 71
identity by introducing their racial/cultural identity development model
(R/CID) based on past stage models of African American racial identity
(Cross, 1978; Parham & Helms, 1981) and oppressed groups in general
(Atkinson, Morten, & Sue, 1989). The R/CID is designed to describe the
development of ethnic identity in all oppressed ethnic minority groups in
the United States. Indeed, the authors assert that the R/CID can also be
applied to Anglo-American racial identity development.
Table 3.1
Racial/Cultural Identity Development (R/CID) Model
Stages of
Minority
Development
Model
Attitude
toward Self
Attitude
toward Others
of the Same
Minority
Attitude
toward Others
of Different
Minority
Attitude
toward
Dominant
Group
Stage 1:
Conformity
Selfdepreciating
Groupdepreciating
Discriminatory Groupappreciating
Stage 2:
Dissonance
Conflict
between selfdepreciating
and selfappreciating
Conflict
between groupdepreciating
and groupappreciating
Conflict
between
dominant-held
views of minority hierarchy
and feelings
of shared
experience
Conflict
between groupappreciating
and groupdepreciating
Stage 3:
Resistance
and Immersion
Selfappreciating
Groupappreciating
Conflict
between feelings of empathy
for other minority experiences
and feelings of
culturocentrism
Groupdepreciating
Stage 4:
Introspection
Concern with
basis of selfappreciation
Concern with
nature of
unequivocal
appreciation
Concern with
ethnocentric
basis for judging others
Concern with
the basis
of groupdepreciation
Stage 5:
Integrative
Awareness
Selectiveappreciation
Selectiveappreciation
Selectiveappreciation
Selectiveappreciation
Source: From “Racial/cultural minority identity development: Therapeutic implications”
(pp. 205–233), by D. W. Sue and D. Sue, in Counseling the culturally diverse: Theory and
practice, fourth edition, D. W. Sue and d. Sue (eds.), 2003b, Hoboken, NJ: Wiley.
Reprinted with permission.

72 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
As can be seen in Table 3.1, the R/CID model is a matrix consisting of
five stages of minority identity development which are inferred from four
corresponding sets of psychosocial attitudes toward oneself as a minority,
one’s own minority group, other ethnic minority groups, and the dominant group. Sue and Sue (2003b) qualify that the five stages are continuous and blending, neither sequential nor irreversible, and that many
individuals do not experience all five stages in their lifetime. Further, minority individuals may begin at any of the stages, depending on their parenting and socialization, and may even skip stages, forward or backward,
depending on their life experiences. Despite such qualifiers, the R/CID
and similar stage models have been criticized for being overly linear and
typological. Nevertheless, it remains a handy introduction to the complex
world of ethnic identity development.
STAGE 1: CONFORMITY
Ethnic identity problems are most evident in the conformity stage in
which, in Rosenberg’s (1979) terms, members of oppressed minority
groups are aware of, agree with, consider personally relevant, and consider interpersonally significant the negative perceptions and messages
generated by the dominant group. Historically, such stereotypes have assaulted every conceivable dimension of a group’s humanity (e.g., intelligence, culture, behavior, physical appearance, sexuality).
Melting-Pot Theory
Conformity is reflected in the famous melting-pot theory of twentiethcentury America that was the guiding philosophy for socializing European immigrant groups for inclusion. Even diverse European immigrant
groups were viewed as inferior to the American WASP-based amalgam of
assimilation. Southern and Eastern European immigrants were especially mistreated and negatively stereotyped in ways that we continue to
stereotype people of color (i.e., inferior intelligence and culture, criminal,
dirty, clannish). It was the goal of social institutions to pressure immigrants to discard their inferior cultures, leave their ethnic ghettos, and
assimilate or “melt” into American society.
With regard to non-White minorities, Ramirez and Castañeda (1974)
were among pioneering Latino scholars to clarify how the American
melting pot was historically exclusive of non-Whites, creating marginalization by rejection even for those minority groups that might have
exercised the assimilation option had it been available to them. Thus,
people of color were the “wrong stock” for the American melting
pot, and their stigma of race continues to be an immensely greater ob
Latino Ethnic Identity 73
stacle than the stigma of ethnicity historically attached to European
immigrants.
In the vignette describing Hank, Latino cultural and physical markers
(e.g., Spanish name, accent, skin color, Latino features, and affiliations) are
sources of shame and embarrassment for Hank and are thus to be minimized and avoided. Hank has also bought into the idea that White people
are physically, intellectually, and morally superior to Latinos and other
people of color. Historically, the predominantly positive and normative representations of White people versus the mostly negative and abnormal portrayals (or lack of portrayals) of minorities contributed to a conformity
mind-set, especially in the absence of contradictory images and messages
regarding people of color. It is theorized that conformist minorities can
never be fully psychologically adjusted because race and ethnically linked
reminders are difficult to avoid or conceal. Even if one could conceal one’s
race and/or ethnicity and “pass” for White, there remains the burden of expending energy to hide a dimension of self too frequently salient in the social psychological world. For example, Hank’s average Latino features often
prompt majority Whites in his social world to ask him “What are you?” and
to seek his opinions about Latino issues of the day (forced role taking).
Hank views the problematic social position of Latinos and other people
of color as a product of their own making. Such a belief denies social injustices and fails to challenge the status quo because it does not comprehend
how powerful historical and social forces have dramatically and systematically shaped Latino realities, as described in Chapter 2. Most minority individuals who conform to the majority culture don’t consciously register
self-rejection and may have other compensating identities and assets (e.g.,
Hank is an attractive guy with an outgoing personality, good athletic
skills, and talented enough to succeed in the software industry). Awareness of internalized oppression would require ethnic identity development beyond conformity.
In a penetrating personal exposé, Iwata (1991) reveals how self-rejection
as an Asian American caused him to undergo blepharoplasty, a form of
cosmetic surgery designed to transform almond-shaped Asian eyes into
round Anglo eyes by removing some of the epicanthic fold of the upper
eyelid to simulate double eyelids. Such cosmetic surgery is not that unusual among Asian Americans graduating from college and embarking on
their career paths in mainstream America. Further, Iwata underwent
rhinoplasty to give his relatively flat Asian nose “more definition.” Such
needless surgeries are like the hundreds of thousands of nose jobs for
which many Jewish and African American people are famous.
When, on national television in the early 1990s, Oprah Winfrey asked
Michael Jackson about surgical alterations to make him look White, he

74 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
insisted that he was a proud Black man. He also attributed his new white
skin to a rare disease. But though he directly denied racial self-rejection,
the pattern that has emerged suggests otherwise (i.e., marrying and having children with exclusively White women, straightening his hair, having a series of nose jobs, and showing off his supposedly diseased skin
by wearing nothing more than a scant loincloth in his “You Are Not
Alone” music video). The example of Michael Jackson is poignant for its
illustration of the power of racial self-rejection in spite of immense artistic talents, riches, world fame, and pre-surgery good looks. As stated by
Iwata (1991), ultimately nothing is more attractive than self-acceptance.
STAGE 2: DISSONANCE
Cognitive dissonance occurs when people in the conformity stage are
exposed to experiences or information that contradicts their prejudiced
socialization. “Disconfirmatory” experiences need not be directly experienced, as in the case of news stories or the negative experiences of others
in one’s social environment. For example, Hank denied accusations of
racial profiling until high-profile investigations and headlines substantiated such systemic problems. Even then, he reasoned that criminal Latino
and African Americans provoke such action from exasperated police—
until he was one day pulled over for “driving while Latino.” When he
eventually complained about being stopped for no apparent reason, he
was sternly put in his place under the threat of arrest and bodily harm.
This minitrauma created a dilemma in which Hank’s overvaluing of the
police competed with his ethnic-linked experience of discrimination. It
should be noted that the dissonance created by Hank’s experience can be
resolved by either recognizing discrimination previously denied, or by
using a conformity explanation (i.e., Hank could blame his misfortune on
bad Latinos who make the world worse for good Latinos like himself).
STAGE 3: RESISTANCE AND IMMERSION
The hallmarks of this stage are resistance to and wholesale condemnation
of the dominant culture along with a passionate, ethnocentric immersion
into one’s culture of origin as a way of experiencing newfound ethnic
pride and expressing anger at social injustice. Resistance and immersion
are frequently exemplified by ethnic political activism, overvaluing of all
things ethnic, and near total devaluation of the dominant group’s culture,
history, and humanity, including harsh criticism and rejection of Latinos
in the conformity stage, who are viewed as brainwashed Tío Tacos (Uncle
Tacos, the Chicano version of “Uncle Tom”).

Latino Ethnic Identity 75
The author recalls that while growing up in East Los Angeles during
the 1960s and 1970s, a Stage 3 piece of Chicano political literature claimed
that the blue-eyed, white-faced Jack in the Box fast-food restaurant clown
was oppressing Chicano people by staring down on the barrio from his
perch on the corner of Brooklyn Avenue (now Cesar Chavez Avenue) and
Mott Street in Boyle Heights (this was long before “Jack” starred in TV
commercials as a talking, able-bodied, smart-aleck clown). Though humorous, this example is reminiscent of the Nation of Islam or Black Muslim rhetoric of White people as blue-eyed devils placed on earth to
torture Black people. Such beliefs, though understandable, are overly reactive and fall into the racist trap of counter-dehumanization and Black
supremacy (West, 1993).
During the 1960s and 1970s, resistance and immersion at their extreme
were best exemplified by the Brown Berets in the Chicano community
and the Young Lords in the Puerto Rican community, both modeled after
the Black Panther Party. These groups represented organized militant resistance that stirred fears in mainstream society of armed retribution that
was occasionally provoked by the overreaction of the law enforcement
and legal systems. More often, however, these groups generally organized marches and public demonstrations against discrimination well
within their constitutional rights.
The anger and activism of resistance and immersion can be politically productive and viewed as a healthy and logical departure from
the ignorance of conformity or the confusion and paralysis of dissonance. However, this stage can also result in the problem of overresponding to all manner of provocation and insinuation of injustice
versus fighting the good fight. For example, a Latino client once relayed a
story to his social worker about speeding on a Texas highway with his
Stage 3 brother, who overreacted to a patrolman who pulled the client
over. Although disappointed to be cited, the client did not perceive the
patrolman or the situation as unfair, given that he had been doing 80
miles per hour. His brother, however, whose strong dislike of police was
rooted in a racist beating by police during his youth, looked menacingly at the ranger and began confronting him with angry questions,
such as “What’s the problem here?” and “What law are we really
breaking on this empty highway, anyway?” The client became quite
anxious when the officer harshly reminded the brother that he was
speaking to the driver and not him, and that he’d better mind his business. When the client’s brother persisted, the officer sternly stuck his
head partially into the driver’s window and warned him that if he did
not shut up, he would arrest him for interfering. The client promptly
pleaded with his brother to allow him to handle the situation. The

76 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
brother has an impressive record as a community organizer and advocate for Latino rights. However, he appears to be susceptible to overresponding to cues and situations perceived as race-linked that, even if
they are, may not be worth the fight.
STAGE 4: INTROSPECTION
This pensive stage of development involves looking within and seriously
questioning the basis for one’s idealized attitudes toward one’s own and
other ethnic groups, as well as one’s overdevaluation of the dominant
group. Such personal analyses typically result in more balanced and
fairer assessments of the negatives and positives in all groups. For example, although majority Whites have exercised excessive racist power historically, they have also promoted a democratic ideal and vision for the
world, in addition to creating a technologically advanced, modern nation
to which people want to belong. The twentieth century was undoubtedly
the American century, and it is precisely for this reason that Latinos and
other ethnic minorities continue to believe in the American dream despite race-linked obstacles to its full realization. Holding society accountable is ultimately a patriotic act designed to advance the democratic ideals
of America.
Latinos in the introspective stage recognize that though they have many
wonderful culture-based values and practices, there are also elements
that need to change or to be discarded in order to progress in a healthier
manner, for example, extreme forms of machismo that are oppressive to
women and homophobia resulting in the rejection of family members and
friends. Thought is also given to shaping one’s own identity in a less reactive (e.g., feeling obligated to serve Latinos in Stage 3) and more proactive (feeling free to address other causes beyond Latinos) manner. Many
successful Latinos are frequently reminded by Latino advocates of their
“obligation” to give back to Latinos and the community; perhaps a better
motivator is one’s own personal desire to address injustice within the
Latino experience and beyond.
STAGE 5: INTEGRATIVE AWARENESS
There’s something inherently funny about this stage’s portrayal of such a
highly evolved, advanced, almost cosmic humanistic stage of identity development. Partly, this has to do with integrative awareness being perceived as an end state of enlightenment rather than a keenly conscious and
responsive place from which to operate in a society characterized by both

Latino Ethnic Identity 77
democracy and social injustice at various levels both within and outside
of the individual. Individuals with integrative awareness are described as
taking social justice issues to the highest level by addressing human
rights for all oppressed groups. The example of Martin Luther King publicly opposing the Vietnam War is instructive for the criticism that it drew
from Black activists who feared that not focusing on the Black agenda
would dilute King’s time and energy. Although the logic of this criticism
makes sense from a resistance and immersion perspective, it is inherently
reactive and limiting. Individuals at this more developed level are also
critical of oppression within their own group, such as sexism and homophobia, that are viewed as dehumanizing and divisive. There is also faith
that because majority Whites are human, they can rise to the occasion
and become allies, while not minimizing the obstacles to this challenge.
Proactive personal development attempts to integrate a variety of overlapping identities, such as being Latino, American, and a human being.
Such development is reflected in more autonomous choices, ranging from
lovers and friends to occupational calling. Herein lies the dilemma of trying to gauge someone’s level of ethnic consciousness by merely observing
social affiliations, career paths, and political behavior. Stage 5 individuals may be viewed with suspicion and confusion, yet they are empathic
and understanding of such views and work to form alliances between factions within their ethnic group, as well as between their ethnic group
and other minorities, and the dominant group.
SO WHERE DOES RICHARD RODRIGUEZ FIT INTO THE MODEL?
The R/CID model reflects enough of the ethnic identity puzzle to be a
useful starting place. But the fact that people are too complex to simply fit
into, or move between, five ethnic identity types becomes evident when
we ponder ourselves or people we know, or consider in which stage someone like writer Richard Rodriguez would fall in this model. Rodriguez is
an American of Mexican ancestry who claims that human beings are
“fluid” with everyone they encounter, whether real or fictional. For example, he claims to be Chinese while riding the bus through Chinatown
in San Francisco and even imagines himself as a woman giving birth
while pondering this miracle. Rodriguez’s artistic worldview and fundamental rejection of simple social categories of people are a sobering reminder of our basic humanity and potential freedom to construct
ourselves in creative ways (integrated awareness?).
In his acclaimed and controversial book Hunger of Memory: The Education
of Richard Rodriguez, Rodriguez (1982) eloquently describes his process of

78 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
assimilation while eschewing affirmative action, bilingual education,
and ethnic identity politics along the way. You’ve got to admire Rodriguez’s unshakable insistence on his claim to America and its enchantments, but does this reflect integrated awareness or something
beyond? In an intriguing book entitled Postethnic America, David
Hollinger (1995) similarly advocates “cosmopolitanism” as a freer and
more fluid alternative to multiculturalism and what he considers to be
its limiting identity politics. In his view, people now have the opportunity to form freer, less forced affiliations and can creatively experiment
with multiple identities and “ethnic options” to emphasize ethnicity
and other identities as they please.
But however alluring the stories and visions of Rodriguez (1982) and
Hollinger (1995), they need to be balanced with the sobering realities of
persistent stigma and the oppression of various groups in society whose
human potential, fluidity, and options remain severely constrained. For
example, how fluid and free are Latino youth gang members whose maladaptive response to marginality too often pins their lives between rival
gangs, prisons, and the cemetery? And though Richard Rodriguez
may indeed be speaking about something that he considers radically
above identity politics, he is far too smart not to realize that his immense popularity among majority Whites comes from how conveniently
his antibilingual education and anti-affirmative action views fit
into their conservative identity politics! The visionary scenarios described by Rodriguez and Hollinger ultimately depend on freedom and
social justice extended to all groups in the United States. Hollinger
confuses multiculturalism and ethnic identity politics for movements
that advance pluralism or even nationalism, when such movements
have generally sought to advance civil and human rights (i.e., full inclusion) and ultimately the freedom needed to make his vision a truly viable option.
RESEARCH ON ETHNIC IDENTITY DEVELOPMENT
Despite the limitations inherent in stage models of ethnic identity development, there is some empirical evidence that higher stages are associated with better psychological adjustment. For example, research shows
higher levels of self-esteem in Mexican American, African American,
and Asian American adolescents (Phinney, 1989) and minority college
students (Phinney & Alipuria, 1990) at higher stages of ethnic identity
development, in which they have actively grappled with negative racial
and ethnic messages and have come to a decision about who they are
with respect to this domain of self-concept. With this in mind, we can

Latino Ethnic Identity 79
turn to empirical research on the complexity of ethnic identity in Latinos and others.
AN EMPIRICAL MODEL OF
CHICANO ETHNICITY
Keefe and Padilla (1987) developed an empirically derived model of
Chicano ethnicity that impressively demonstrates the complex, multidimensional, linear, and nonlinear nature of both ethnicity and the process of acculturation. Based on a review of past research, these
researchers theorize that ethnic identity and acculturation are related
but separate processes and that cultural change occurs at different
rates across different cultural dimensions (e.g., language, social affiliations, self-identifications). Further, they theorize that ethnic identity is
composed of two distinct developmental dimensions: (1) cultural
awareness (CA), which refers to more objective knowledge of one’s culture of origin, such as the ability to speak Spanish, knowledge of Mexican values, history, and traditions, and cultural heroes, as influenced
by parents’ and spouse’s backgrounds as well one’s own; and (2) ethnic
loyalty (EL), which refers to more subjective feelings of ethnic-related
pride, preferences in social affiliations, and perceived discrimination.
Keefe and Padilla then developed a questionnaire to assess CA and EL
and administered it to a stratified random sample of 370 Chicanos in
southern California. Factor analysis of the questionnaire data revealed
that CA and EL did indeed emerge as the two major dimensions comprising ethnic identity.
CULTURAL AWARENESS, ETHNIC LOYALTY, AND GENERATION IN
THE UNITED STATES
An examination of CA and EL over time in the United States reveals that
CA drops sharply from the first to the second generation, and then
steadily declines from the second to the fourth generation. In contrast, EL
drops somewhat from the first to the second generation but then
remains stable from the second to the fourth generation (see Figure 3.1).
Thus, although Chicanos lose much of their Mexican culture from one
generation to the next, they retain pride in and preference for members of
their own group while continuing to perceive discrimination. This finding suggests that the development of ethnic identity in Chicanos is heavily influenced not so much by retention of Mexican culture, as many
believe, but by ethnic minority status in the United States with its characteristic segregation (i.e., limited in affiliation choices) and discrimination

and the need to accentuate ethnic pride often as a defense against stigma,
as well as a political vehicle for civil rights or identity politics. Whereas
high EL can be helpful in fueling identity politics as well as Stage 3 cultural explorations, ethnic identity void of sufficient cultural content can
be a vulnerability when opportunities to integrate or assimilate into
mainstream society are limited. For example, many Chicano gang members claim intense ethnic pride, loyalty to their own, and perceived discrimination, yet their brown-on-brown violence betrays labels and
symbols with too few prosocial adaptive cultural elements to prevent acting out their psychosocial marginality.
THE LINEAR AND NONLINEAR NATURE OF ETHNIC IDENTITY
Linear Ethnic Identity Types
A cluster analysis of their data allowed Keefe and Padilla (1987) to derive
five Chicano ethnic identity types based on different combinations of CA
and EL scores. As can be seen in Table 3.2, Types I, III, and V conform to
a linear model of ethnic identity development in that their respective CA
and EL scores are high, average, and low. That is, the high CA and EL
scores of Type I describe Chicanos generally low in acculturation and
80
Figure 3.1
Cultural Awareness and Ethnic Loyalty by Generation in Chicanos. (Note: 2M
refers to having one first-generation parent and one second-generation parent.
From Chicano Ethnicity, by S. E. Keefe and A. M. Padilla, 1987, Albuquerque:
University of New Mexico Press. Adapted with permission.)
Generation
Cultural Awareness and
Ethnic Loyalty
Score
Ethnic
Loyalty
Cultural
Awareness
60
50
40
30
1 2 2M 3 4

Table 3.2
Empirically Derived Model of Chicano Ethnic Identity Based on Cultural Awareness (CA)
and Ethnic Loyalty (EL) Questionnaire Scores
Type I Type II Type III Type IV Type V
(N = 94) (N = 50) (N = 129) (N = 78) (N = 19)
CA EL CA EL CA EL CA EL CA EL
Questionnaire Scores High High High Average Average Average Medium Low Medium Low Low Medium Low
Percentage of sample 25 14 35 21 05
Generation
First 79 86 18 16 0
Second 12 14 58 63 22
Third 9 0 24 21 78
Education
0–8 grades 74 74 30 26 5
9–11 grades 16 14 33 23 37
12 grades 10 8 23 37 42
College 0 4 14 14 16
From Chicano Ethnicity, by S. E. Keefe and A. M. Padilla, 1987, Albuquerque: University of New Mexico Press. Adapted with permission.
Latino Ethnic Identity 81

82 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
with high identification with their ethnic group. In fact, correlational
analysis reveals Type I Chicanos to be mostly first-generation, low SES,
and barrio-dwelling. However, almost 10% of Type I Chicanos were thirdgeneration, with many years in the United States!
At the other extreme, the low CA and EL scores of Type V describe
Chicanos high in acculturation or Anglicized with low knowledge of or
connections with their ethnic group. Correlational analysis reveals
Type V to be predominantly third-generation or higher, out of the barrio, and of slightly higher SES than all other types. Type III is the most
common ethnic identity type (i.e., 35%), with average scores on both
CA and EL, representing the most bicultural participants. Indeed,
Type III Chicanos are mostly second-generation, with higher SES than
Types I and II.
Nonlinear Ethnic Identity Types
But here’s where it gets messy (and closer to real life): In contrast to
Types I, III, and V, Types II and IV conform less to a linear model of Chicano ethnic identity. That is, the 14% of respondents that compose Type
II had high CA scores like Type I, yet had average EL scores like Type
III. As such, they were low in acculturation yet not highly identified
with their ethnic group despite having low SES and being barriodwelling. Similarly, 21% of Chicanos are categorized as Type IV because
of below-average scores on both CA and EL. Like Type III, Type IV individuals are mostly second-generation, but they are also higher in SES,
out of the barrio, and more likely to be Protestant than Catholic. Interestingly, 16% of Type IV Chicanos are first-generation! Thus, Keefe and
Padilla’s (1987) empirically derived typology demonstrates the existence of linear trends in ethnicity related to acculturation as well as
nonlinear exceptions. More research is needed to better understand how
such ethnic identity types self-identify and function in different social
situations and roles.
T OWARD I NCR EASI NGLY COM PLEX
CONCEPT UALIZATIONS OF RACIAL AND
ETHNIC IDENTITY
Recent theory and research on racial identity in African Americans by
Sellers, Chavous, and Cooke (1998) describes how various cognitive structures and situational factors influence how people think and feel about
being Black and how they might actually behave and perform in situations that suddenly become racially charged.

Latino Ethnic Identity 83
COGNITIVE STRUCTURES
With regard to cognitive structures, centrality refers to how central racial
or ethnic identity is within a hierarchy of identities that compose an individual’s self-concept. Regard refers to an affective evaluation of one’s own
group. More specifically, public regard refers to one’s sense of how society
views one’s group; private regard refers to one’s personal evaluation of
oneself as a group member. Ideology refers to political beliefs about the
most desirable direction for one’s group in society, including assimilation, Black nationalism, building coalitions with other groups to fight oppression, and humanism in which race has low centrality either because
one is highly developed or because one is defending against stigma.
Surely there is plenty of room for other ideologies (e.g., integration) as
well as uncertainty (e.g., as discussed in Sue & Sue’s, 2003b, dissonance
and introspection stages). Cognitive structures mediate the relation between social situations and responses to them on the part of people of
color and stigmatized groups more generally. Such situations vary in
terms of how important or salient race/ethnicity is.
SALIENCE
In addition to cognitive structures, Sellers et al. (1998) use the term
salience to convey the fluctuating importance of race or ethnicity in different social situations. That is, race is not uniformly salient but is situationally important, as when a particular situation or interaction invokes race.
For example, poor service in a restaurant could be an indiscriminant
problem for all customers or it could be aimed at African Americans, as in
the recent case of Denny’s restaurants. Thus, one’s perception of a situation as race-linked or not, and to what degree, is influenced by the interaction of cognitive structures and the particular situation. In the case of
Denny’s, African American customers organized to file a class action suit
that resulted in public apologies, financial compensation, and managerial
policies designed to reduce discrimination.
So how might the thinking of Sellers et al. (1998) play out with Latinos?
With regard to our vignette, Hank’s identity as a Latino would be low in
centrality, but not because of advanced humanism given his conformist
ideology. Hank’s public regard would justify society’s negative view of
Latinos, and his private regard would either view himself as an exception
to his ethnic group or as marked and needing to compensate for it. How
Hank would react to Latino salient situations would depend on complex
interactions between such situations and his cognitive structures. For example, when his White peers ask him what he is or seek his opinion
on Latino issues, Hank is liable to be annoyed by these reminders of his

84 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
ethnicity because of its low centrality and his efforts to blend in with
White affiliates. If pressed, he might quickly mention his Latino background and spend more time emphasizing his American side and
lifestyle. He might also publicly blame Latinos for their social problems
with a mix of disgust and perhaps embarrassment.
The work of Sellers et al. (1998) is a sober reminder of the complexity of
ethnic identity with its many cognitive structures that interact with situations to influence feelings, perceptions, and the behaviors of ethnic minority people. Unfortunately, situations that invoke stigma related to one’s
race, ethnicity, or gender can actually impact the performance of people.
T H E R EAL -LI F E I M PAC T OF S T E R E OT YPE S
Let’s say you’re a member of a minority group who is committed to performing well on tests of ability in areas in which your group has traditionally been stereotyped as inferior (e.g., women in math and physical
sciences, African Americans and Latinos on standardized tests, Asian
Americans in majors other than math and science). How can such
stereotypes hurt your performance when you don’t believe them to be
true? In his research on what he calls “stereotype threat,” Steele (1997)
has demonstrated that in important performance situations where such
stereotypes are invoked, even subtly, minority performance can suffer.
For example, Steele administered a challenging math exam to academically matched male and female college students who were strongly
identified with mathematics (e.g., math majors). In one condition, the
test was introduced as being able to detect sex differences; in another
condition it was not described as such. Results showed significantly
poorer performance on the part of women in the sex-primed condition,
yet no significant differences in the nonprimed condition. Steele and
Aronson (1995) demonstrated comparable results when they administered a verbal GRE test to African American and White college students
at Stanford University. In the race-primed condition, the test was presented as diagnostic of intelligence and students were asked to indicate
their race on the test form; in the nonprimed condition, no such description or request was made.
Steele (1997) concludes that institutionalized racism and sexism can
undermine identification with school and performance in areas important to even qualified women and minority students. Whereas school
disidentification may protect self-esteem in the face of chronically experiencing low expectations, it can also result in a lack of sustained motivation in important performance situations where such expectations fill
the air. Steele’s work does much to explain continuing performance gaps

Latino Ethnic Identity 85
between majority and minority individuals in educational performance,
even on the part of equally qualified women and minorities. It also alerts
us to the real and pernicious impact of stereotypes on various important
forms of work and performance.
WHITE RACIAL AND CULTURAL IDENTITY AND
THE NEW CRITICAL WHITE STUDIES
It is now understood that it is impossible to speak of minority identity
without implying its counterpart, majority identity. There has been a recent shift toward directly analyzing who White Americans are in the
racial identity mix, and why it is they think they do not have much of an
“ethnic” identity despite their historical insistence on labeling and categorizing ethnic minority groups. The term critical White studies has recently emerged to describe a growing trend toward analyzing and
de-centering Whites in the discussion of race relations so as to highlight
their historically dominant role toward minorities and to render them
amenable to study under the microscope, the same as minorities.
In her widely cited article, McIntosh (1988) generated a long and revealing
list of 46 different ways in which White privilege makes life better for her as
a White person and worse for Blacks with whom she has worked on a daily
basis, in ways she was socialized not to notice. Among the 46 instances of
White privilege she cited in her autobiographical article are the following:
• I can turn on the television or open to the front page of a newspaper and
see people of my race widely and positively represented.
• I can be reasonably sure that if I ask to talk to “the person in charge,” I
will be facing a person of my race.
• I can go home from most meetings or organizations I belong to feeling
somewhat tied in, rather than isolated, out of place, outnumbered, unheard, held at a distance, or feared.
• I can worry about racism without being seen as self-interested or selfseeking.
• If my day, week, or year is going badly, I need not ask of each negative episode or situation whether it has racial overtones.
• I can be pretty sure that my children’s teachers and employers will tolerate them if they fit school and workplace norms; my chief worries about
them do not concern others’ attitudes toward their race.
• I can do well in a challenging situation without being called a credit to
my race.
• I can be sure that if I need legal or medical help, my race will not work
against me.
• I can be late to a meeting without having the lateness reflect on my race.

86 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Even more important than McIntosh’s (1988) now famous list is her explanation of how members of the dominant group are socialized, directly
and indirectly (i.e., indoctrinated), to be “oblivious” to their race privilege, and how such lack of awareness serves to perpetuate a biased status
quo. That is, the White experience in America is one that generally recognizes, reflects, validates, and supports its members. From the overrepresentation of Whites in virtually all social positions of power to their
predominance in popular cultural media, theirs is a world that largely
elicits comfort, security, and confidence, as opposed to the disproportionately high discomfort, alienation, and insecurity experienced by too
many people of color. That is, America generally is “as advertised” for
Whites, whereas minorities more frequently experience false advertising.
Frankenberg (2000) refers to Whiteness as an “unmarked” racial category and to White people as the “unmarked markers of others” for their
historical practice of labeling and defining non-Whites while assuming
themselves to be the desirable central racial norm. This colonial practice
conveys immense privilege and an inverse relation between how well defined an ethnic identity is and its degree of power in America. That is,
Whites have historically been an unexamined norm (Tatum, 1997).
Frankenberg also asserts that progress in race relations must include decentering and de-norming White Americans by insisting that they are
also a cultural group, despite historical homogenizing forces.
A CLOSER LOOK AT PRIVILEGE
Johnson (2001) suggests how Whites can avoid the trap of feeling defensive about their race privilege by explaining that privilege has nothing to
do with who one is as a White person, and that belonging to a privileged
group does not automatically make one an oppressive person. Further, it
is important to realize that one can be privileged without feeling privileged. For example, there are plenty of poor and working-class Whites in
America whose daily experience would make them balk at the idea of
being advantaged in any way. Yet compared to Blacks and other nonWhites within the same social class, their lives are better on average because they are free of race stigma and its impediments. This point easily
escapes the awareness of poor Whites because they usually do not use
Blacks or poor Latinos as their basis of social comparison (i.e., they make
negative social comparisons to higher SES Whites).
Interestingly, about the only time Whites bother to compare themselves
to ethnic minorities is when the latter become beneficiaries of affirmative
action. The irony of such a comparison is that Whites feel threatened and
resentful because they perceive minorities as receiving an unfair advan
Latino Ethnic Identity 87
tage akin to privilege. There’s no awareness of how being privileged by
race has historically given Whites the ultimate unfair advantage in America versus how affirmative action has produced only minuscule numbers
of minorities in power positions and no significant displacement of
Whites from the power structure. On the other hand, some Whites see affirmative action as a necessary extreme solution to an extreme problem
and also see both themselves and society as the beneficiaries of enhanced
diversity and social justice at all levels of society.
APPLYING THE RACIAL/CULTURAL IDENTIFY DEVELOPMENT MODEL TO
WHITE IDENTITY DEVELOPMENT
Sue and Sue (2003c) assert that the R/CID should also be used to analyze
racial identity development in majority group White Americans. Although the dominant group has no history of racial oppression in the
United States, Sue and Sue maintain that Whites can experience a parallel form of racial identity development ranging from White conformity to
White multiculturalist identity:
1. White conformity: Whites are viewed as overwhelmingly socialized
within Stage I, where there is little questioning of the status quo
(i.e., social stratification of race, ethnicity, and power) because the
generally higher social positions of Whites and generally lower positions of ethnic minorities are attributed to individual-level, internal factors such as intelligence, hard work, and cultural values, as
opposed to external social factors such as racism and discrimination. Thus, inequities between Whites and others are viewed as normal and natural. Indeed, White culture is experienced as central
and normal, and different cultures are viewed as deviations.
Vaguely aware of past and continuing racism, White Americans in
the conformity stage generally minimize the intensity of its legacy
and do not perceive themselves as personally responsible for racism,
even though they have inherited the advantages of this legacy.
Tatum (1997) asserts that whereas it is the task of oppressed minorities to resist and challenge racism and to try to develop positive
identities, it is simultaneously the task of Whites to develop a nonracist, reality-based identity that requires letting go of a distorted
view of themselves as superior and as having earned all that they
have accumulated. This requires a complete view of racism, not just
as occasional blatant acts on the part of mean individuals but as an
entrenched social, cultural, institutional system that differentially
rewards and punishes different categories of people.

88 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
2. White dissonance: In Sue and Sue’s (2003c) dissonance stage, information and experiences that disconfirm the perceptions of conformitystage Whites cause them to question their socialization around
racial inequality and White superiority. Awareness of one’s own
membership in the privileged race group sometimes elicits feelings
of guilt and shame, although ultimately these are unhelpful emotions in the quest for human rights. Although dissonance sets the
stage for progression into a White version of resistance and immersion (Stage 3), it is important to note that the subjective discomfort
of dissonance can potentially cause Whites to minimize the truth
and retreat into their privileged White experience with rationales
such as “It can’t be that bad,” “There’s really nothing I can do about
it,” and “It’s not really my problem.” But retreating is yet another
option within the invisible knapsack of privilege. That is, whereas
people of color must deal directly with the White experience on a
daily basis, Whites can generally avoid and minimize their interactions with people of color.
In addition to the option of withdrawing from dissonance,
Whites at this stage also run the risk of overresponding to the
racism all around them and sometimes alienating other Whites in
the process. In her revealing book The Education of a WASP, Lois
Stalvey (1989), herself a majority American, describes how becoming aware of, discussing, and taking action against racism frequently alienated her majority White friends and neighbors who
could not imagine why she was bothering with such issues that they
viewed as irrelevant to their comfortable lives.
Tatum (1997) discusses Whites at the dissonance stage as tending to get frustrated and angry at people of color for supposedly
bringing on their own problems. There’s an urgent sense that people of color should change and “get with the program” as well as an
insistence that everybody is an individual, overlooking the fact that
Whites are uniquely privileged to make such a claim. Part of the
distress this stage engenders for Whites is a growing awareness
that their prideful well-being and accomplishments were obtained
partly by race privilege and not solely by their individual efforts
and abilities.
3. White resistance and immersion: In Sue and Sue’s (2003c) resistance
and immersion stage, Whites become angry about their biased socialization and begin to devalue their group while idealizing minorities, with whom they sometimes overidentify. Although this
stage represents significant growth on the part of Whites, Sue and
Sue caution that some in this stage get caught up in a “White liberal

Latino Ethnic Identity 89
syndrome” in which their guilt-driven efforts to help minorities are
unintentionally paternalistic in nature. Such paternalism is viewed
as part of the White script to take charge, especially where the affairs of people of color are concerned.
The author recalls being in high school during the early 1970s
when a group of Anglo college students were sent to Roosevelt high
school to enrich our poor East Los Angeles public school curriculum.
These talented students did indeed enhance the modest course offerings with advanced arts and science classes and activities, but we
slick continental-style dressers were a bit shocked when they arrived on the scene dressed in ponchos and guarachi sandals! We
couldn’t articulate it at the time, but they were overidentifying with
an off-putting stereotype of Mexicanness despite their otherwise
good deeds and intentions.
4. White introspection: For Whites, introspection is a way to question the
basis of their wholesale rejection of their own majority group, including themselves, as well as their overidentification and occasional
valorization of minorities. It is a way to more fairly evaluate both majority and minority groups, to begin to reject racism in all groups,
and to distill the best elements in each. Tatum (1997) describes the
need to advance beyond White guilt and shame and the role of victimizer or oppressor. Such growth requires a search for White allies,
historical as well as contemporary, fictional as well as real. Sometimes there is a need to vent to other Whites about how genuinely
challenging it is to be an antiprivilege, multiculturalist White person, especially when such expressions of pain fall on the deaf ears of
minorities whose larger race-linked pains make it difficult, and
sometimes impossible, to hear and validate such legitimate White
suffering. Ignoring the pain of Whites struggling with their racial development is often seen as giving them a taste of their own medicine,
yet such reactions do not advance multicultural alliances. One of the
fundamental shifts for Whites in this stage of development is a refocusing of energies from helping poor minorities to challenging the
institutional racism and inequality in one’s own daily life.
5. White integrative awareness: In this advanced stage Whites develop a
nonracist White identity that actively explores the best in White culture while not denying racism and effectively ending one’s paralysis
to do something about it. There is also selective appreciation for the
humanistic values in all cultures. Privilege is properly viewed as
damaging to Whites and society for the distortions that it creates regarding social inequalities, beliefs about who merits reward and
support and who does not, and how it perpetuates inequality.

Tatum (1997) refers to this stage of development as a basis for authentic cross-group alliances that ultimately promote human rights
and a fairer world. She reminds us that this stage is a work in progress because salient race-linked situations can unexpectedly trigger
primitive, counterproductive reactions in diverse people. Still, this
advanced stage is characterized by fewer negative reactions to uncomfortable race-linked experiences. The bottom line is no longer
denying the ever-present effects of group memberships.
CONCLUSION
How does all this theory and research on ethnic identity play out in the
lives of women as compared to men, or in the lives of sexual minorities?
How does Latino ethnicity become complicated by within-Latino diversity, such as being a racially Black Latino (e.g., from Puerto Rico, Cuba,
Dominican Republic, or Panama)? And where do Latinos of mixed racial
and ethnic heritage (e.g., Latino and Anglo or Latino and African American) fit into the racial/cultural minority identity puzzle? These questions
are beginning to emerge with increasing frequency and intensity and deserve our attention as service providers, researchers, and simply as people. Though potentially deeply influential, ethnic identity is but one
dimension of the self-concept, coexisting and often evolving alongside so
many other identities and roles in our complex lives. The next chapter
considers how other human status dimensions and identities, such as
gender and sexual orientation, play out in the lives of American Latinos,
as well as other salient dimensions receiving greater attention these days.
REFERENCES
Atkinson, D. R., Morten, G., & Sue, D. R. (1989). Counseling American minorities: A
cross-cultural perspective (3rd ed.). Dubuque, IA: Brown.
Cross, W. (1978). The Thomas and Cross models of psychological nigrescence: A
literature review. Journal of Black Psychology, 4, 13–31.
Frankenberg, R. (2000). Whiteness as an “unmarked” cultural category. In K. E.
Rosenblum & T. C. Travis (Eds.), The meaning of difference: American constructions of race, sex and gender, social class, and sexual orientation (3rd ed.,
pp. 92–98). Boston: McGraw-Hill.
Hollinger, D. A. (1995). Postethnic America: Beyond multiculturalism. New York:
Basic Books.
Iwata, E. (1991, May). Race without face. San Francisco Focus, 51–53, 128–132.
Johnson, A. G. (2001). The trouble we’re in. In A G. Johnson. Privilege, power, and
difference (pp. 12–41). Mountain View, CA: Mayfield.
Keefe, S. E., & Padilla, A. M. (1987). Chicano ethnicity. Albuquerque: University of
New Mexico Press.
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McIntosh, P. (1988, July/August). White privilege and male privilege: A personal
account of coming to see correspondence through work in women’s studies
(Working Paper 189). Wellesley, MA: Wellesley Collage Center for Research
on Women.
Parham, T., & Helms, J. (1981). The influence of Black students’ racial identity attitudes on preferences for counselor’s race. Journal of Counseling Psychology,
28, 250–257.
Phinney, J. S. (1989). Stages of ethnic identity in minority group adolescents.
Journal of Early Adolescence, 45, 1297–1303.
Phinney, J. S. (1990). Ethnic identity in adolescents and adults: Review of research. American Psychologist, 45, 1297–1303.
Phinney, J. S., & Alipuria, L. (1990). Ethnic identity in older adolescents from
four ethnic groups. Journal of Adolescence, 13, 171–183.
Ramirez, M., III, & Castañeda, A. (1974). The ideology of assimilation. In M.
Ramirez III & A. Castaneda (Eds.), Cultural democracy, bicognitive development
and education (pp. 1–20). New York: Academic Press.
Rodriguez, R. (1982). Hunger of memory: The education of Richard Rodriguez. New
York: Bantam Books.
Rosenberg, M. (1979). Minority status and self-esteem. In M. Rosenberg (Ed.),
Conceiving the self (pp. 149–176). New York: Basic Books.
Sellers, R. M., Chavous, T. M., & Cooke, D. Y. (1998). Multidimensional model of
racial identity: A reconceptualization of African American racial identity.
Personality and Social Psychology Review, 2(1), 18–39.
Stalvey, L. M. (1989). The education of a WASP. Madison: University of Wisconsin
Press.
Steele, C. M. (1997). A threat in the air: How stereotypes shape intellectual identity and performance. American Psychologist, 52(6), 613–629.
Steele, C. M., & Aronson, J. (1995). Stereotype threat and the intellectual test
performance of African Americans. Journal of Personality and Social Psychology, 69(5), 797–811.
Sue, D. W., & Sue, D. (2003a) Counseling the Culturally Diverse: Theory and practice
(4th ed.). Hoboken, NJ: Wiley.
Sue, D. W., & Sue, D. (2003b). Racial/cultural minority identity development:
Therapeutic implications. In D. W. Sue & D. Sue (Eds.), Counseling the culturally diverse: Theory and practice (4th ed., pp. 205–233). Hoboken, NJ: Wiley.
Sue, D. W., & Sue, D. (2003c). White racial identity development: Therapeutic implications. In D. W. Sue & D. Sue (Eds.), Counseling the culturally diverse: Theory and practice (4th ed., pp. 235–264). Hoboken, NJ: Wiley.
Tatum, B. D. (1997). The development of White identity: “I’m not ethnic, I’m just
normal.” In B. D. Tatum (Ed.), Why are all the Black kids sitting together in the
cafeteria? (pp. 93–113). New York: Basic Books.
West, C. (1993). The pitfalls of racial reasoning. In C. West (Ed.), Race matters
(pp. 23–32). Boston: Beacon Press.
Wylie, R. C. (1979). Racial/ethnic status, integration/segregation, and self-concept
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Latino Ethnic Identity 91

93
CHAPTER 4
Diversity within
Latinos
Subgroups, Identities, and
Social Welfare
IT WAS THE project of Chapter 3 (on racial/cultural identity development)
to bring down to an individual level of analysis some of the psychological
impacts of Latino-relevant macro-level historical and social forces reviewed in Chapters 1 (acculturation) and 2 (social stratification). But how
do such macro- and micro-level (racial/cultural identity) phenomena play
out across the many within-group differences among Latinos? For example, how might the dynamics of migration and acculturation play out differently for Latino men and women? What salient identity issues emerge
for Latinos who are gay, lesbian, bisexual, or transgender (GLBT), in addition to the racial/ethnic identity issues raised in Chapter 3? Further, how
does the Latino experience vary for those who are darker in skin color,
more indigenous-Indian-looking, or for racially Black Latinos? Addressing such questions can lead to a more in-depth analysis of the uneven impacts of oppression across Latino subgroups.
SOCIAL CONSTRUCTIONISM
The consideration of multiple social status dimensions and identities
within a group or even within the same person is becoming more apparent in the literature, as well as graduate and professional training. The
tradition of separately examining race, ethnicity, or sex has begun to
shift toward focusing on human diversity or inequality on the basis of social constructions of human difference. Social constructionism is the

94 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
position that what we believe to be true about ourselves, others, and the
world can only be the result of perceptions and interpretation-driven
beliefs that are ultimately bounded by the historical era in which we
live, our social and political context, our network of social affiliations,
and so on. Thus what we believe to be true and real is more an arbitrary
function of how far knowledge has advanced (e.g., the world is round
versus flat) and/or what powerful social leaders claim to be true, right
and wrong, good and evil. The latter point emphasizes the inevitable relation between power and perceptions of reality in that those with
power have more resources with which to project their view of what’s
real and right to members of society. As was mentioned in the discussion of social stratification in Chapter 2, the rich, powerful, and elite are
highly invested in maintaining a stratification system that distributes a
disproportionately greater amount of resources to their own groups.
Thus, status quo maintenance is accomplished through the production
of pervasive narratives and ideologies, value systems, and myths and
legends that are infused into the socialization process, through mainstream institutions and culture, in order to rationalize and normalize a
society’s uneven distribution of life-sustaining power and resources
(Marger, 2000).
Social constructivism does not deny the world available to our perceptions, including the tremendous biodiversity around and within it, but it
does define as arbitrary our interpretations of things or their social meanings. For example, sex is considered a social construction not because
men and women aren’t biologically different, but because our culture
has developed elaborate constructions of what such biological differences mean, with tremendous consequences for how men and women
are socialized and treated differently. Thus the fact that we’ve never had
a female president in the United States is rooted in a traditionally sexist,
albeit changing, conception of women as not biologically (i.e., emotionally, intellectually) suited to the task. Fortunately the women’s movement (both old and new) has challenged stigmatizing and limited social
constructions of women, resulting in considerable social liberation and
less oppressive conceptions of sex and gender.
For the purposes of this book, and for the human diversity movement
in general, the social constructivist perspective can be a liberating and
humanistic view that challenges essentialist and stigmatizing constructions of minority groups as the sole creators of their own problems due to
individual and groupwide flaws. This is because it can inspire those experiencing oppression to question authority and contest the truth: “Says
who, and based on what evidence?” and “Does this social construction

Diversity within Latinos 95
allow some groups to benefit at the expense of others?” (e.g., the monopolization of power by men).
Social constructionism flies in the face of essentialism, or the position
that an objective reality exists apart from human perceptions and interpretations. But because in our youth we are raised in an essentialist manner, and because important human enterprises such as science purport
essentialist truths, social constructivism can be initially hard to grasp
and is often harshly criticized (“If you think that gravity is a social construction, then try jumping off the roof!”). But such criticisms miss the
point. Zen Buddhists have long known that just because you attach a term
such as “gravity” to some phenomenon doesn’t make the word “gravity”
real. This lesson is driven home by the famous Zen koan in which the
master first shows his fist to a student and asks, “See the fist?” Then,
once the student nods, the master quickly unballs his hand and asks,
“Where did the fist go?” It is the student’s job to realize that there is no
such thing as a fist, merely a label that we invent and attach to a conception of something that may serve a useful purpose (e.g., in verbal communication). Thus, the critical questions become: Which social constructions
are useful and adaptive, and which are not? and By whom are they used,
and for what purpose?
Shifting our focus to social injustice on the basis of social constructions of human differences makes clearer the links between the
many “isms” in society that privilege some categories of people at the
expense of others, thus rendering more visible the overarching nature
of human systems of oppression in society. This chapter focuses on
human diversity within Latino groups by first outlining a broad social
justice approach to understanding the dynamics and consequences of
multiple yet related systems of oppression, which result in variations in
problem patterns, as well as many unique problems and special needs
among subgroups of Latinos. Following this framework of oppression
and social justice, a brief review of major Latino subgroups and issues is
ventured.
DI VER SI T Y, OPPR E SSION, AND SOCIAL JUSTICE
Interestingly, the vast majority of most human service providers come
from academic and professional training with very strong ethics about
promoting social justice, fighting oppression, respecting human differences, and providing culturally competent services. In the National Association of Social Workers’ (1999, p. 5) Code of Ethics, it explicitly states on
the very first page of the Ethical Principles section:

96 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Value: Social Justice
Ethical Principle: Social workers challenge social injustice
Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’
social change efforts are focused primary on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities
seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed
information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people.
Then the links between social justice, human diversity, and culturally
competent services are further fused:
Cultural Competence and Social Diversity
• Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.
• Social workers should have a knowledge base of their clients’ cultures
and be able to demonstrate competence in the provision of services that
are sensitive to clients’ cultures and to differences among people and
cultural groups.
• Social workers should obtain education about and seek to understand the
nature of social diversity and oppression with respect to race, ethnicity,
national origin, color, sex, sexual orientation, age, martial status, political belief, religion, and mental or physical disability. (p. 9)
RHETORIC AND REALITY
Such progressive professional ethics provide ideals worth striving for. But
they can be difficult to approximate in practice unless social workers and
other service providers have a solid conceptual grasp of the complex nature of human oppression and how we are all socialized to play various
roles within its social matrixlike structure. With deeper understanding of
how the dynamics of oppression operate, we can better recognize and respond to oppressive tendencies at structural and individual levels, both
outside of and within ourselves. As both practitioners and citizens, it is
our ethical responsibility to recognize the collective legacy of oppression
that we all inherit, through no volition of our own, and that must be challenged in an informed manner to truly promote social justice. Such
insight minimizes our knee-jerk reaction of denying any personal responsibility for past or ongoing oppression of minority groups (“I’m not responsible for what happened in the past!”) and maximizes our motivation
to work for a fairer society for all.

Diversity within Latinos 97
DEFI NI NG FEAT UR E S OF OPPR E SSION
It is helpful to take note of the word press embedded in the word oppression given that oppression refers to a pressing down on a person or group
to limit movement, expression, power, freedom, and indeed life itself.
Bell (1997) notes five defining features of oppression that capture its complexity: (1) restricting life chances by limiting access to material and structural resources; (2) hierarchical, characterized by dominant-subordinate
relations of power; (3) pervasive, consisting of a complex web of relations
in socially structured environments; (4) composed of individuals who occupy complex, multiple, and cross-cutting relations with varying degrees
of internalized subordination and dominance; and (5) consisting of an
overarching system that includes the many “isms” that privilege some
categories of people at the expense of others. Most people are aware of the
first two defining features of oppression (i.e., that some powerful individuals and groups occasionally abuse the less powerful); but many are
unaware of the pervasive and institutionalized nature of oppression and
how it structures their daily social experiences, or how we all occupy
multiple status dimensions simultaneously, some of which are privileged
(e.g., being White and middle class) and some of which are stigmatized
(e.g., being female and nonheterosexual). This latter point reminds us
that we are talking about social categories of people and not individuals
per se, whereas the former point stresses the degree to which such categories shape our social existence (i.e., the social class and predominant
racial group in which we grow up).
Bell’s (1997) fifth dimension of oppression is meant to emphasize the
ideal of addressing all forms of oppression given that each is part of the
same overarching system of dehumanization. This can be very difficult to
achieve given our tendency to rank-order the suffering of various groups,
from most to least, and/or to prioritize our own group’s cause above others perceived as less urgent.
THE SOCIAL OPPRESSION MATRIX
All of the dimensions of oppression can be thought of as forming a matrixlike social structure in which members of society are socialized to
live, work, think, feel, and love. This idea is illustrated in Hardiman and
Jackson’s (1997) social oppression matrix, which contains at least three
levels of oppression about which we need to remain aware (see Figure
4.1): (1) individual, where conscious and unconscious cognitive and behavioral activities are experienced (although we should also include
subconscious here to capture our occasional semi-awareness of oppressive tendencies); (2) institutional, where family, government, educational,

98 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Figure 4.1
The Social Oppression Matrix. (Source: “Conceptual Foundations for
Social Justice Courses,” by R. Hardiman and B. W. Jackson, in Teaching
for Diversity and Social Justice: A Sourcebook, pp. 16–29, M. Adams,
L. A. Bell, and P. Griffin, Eds., 1997, New York: Routledge.
Reprinted with permission.)
Conscious
Subconscious
Unconscious
Attitudes
Behaviors
Societal
Institutional
Individual
and corporate-industrial-work activities play out (e.g., historical social
policies of inclusion and exclusion); and (3) social and cultural, which
refers to societywide cultural norms that serve to bind institutions and
individuals (e.g., values, life philosophies, and role prescriptions that
contain rationales and justifications for practices of exclusion, persecution, and social control of certain groups and individuals that challenge
oppressive conditions).
The social oppression matrix helps us to better envision ourselves immersed within oppressive social structures and cultural forces. As such
we can become more aware and critical of oppressive psychosocial
processes, such as when privileged individuals and groups perceive their
attractive locations within the matrix as normal (e.g., the sole result of
honest hard work and merit) rather than partly resulting from unfair advantages at the expense of others. The matrix metaphor also helps us un
Diversity within Latinos 99
derstand how we have been socialized in biased ways to perceive and interact (or not interact) with other categories of people.
DIVERSITY: CAN WE TALK ABOUT IT?
Unfortunately, we can’t talk about diversity very easily. The urgently
needed dialogue and critical debates about social justice and human difference continue to be undermined by our socialization around human
difference. How often have we heard those we most love and trust while
growing up (parents, teachers, clergy) resort to superficial hyperbole
about race (e.g., “Everyone is the same”; “It doesn’t matter if you’re black,
white, green, or purple”) and merit (“Anyone can make it if they try!”) in
place of more honest and informed critical discussion about how the unequal treatment of different groups of people leads to different life
chances? Within a social matrix of oppression, questions, and experiences about stigmatized human differences elicit considerable discomfort
and anxiety throughout the life cycle with which we are ill prepared to
deal. Hence, it is difficult to think and act outside of the matrix.
Thandeka (2003) has come up with a helpful explanation of our impaired ability to genuinely think and talk openly about the categories of
human differences that we all occupy along the stigma-privilege differential. With regard to race, she contends that our racial self-awareness too
often emerges through what she calls naive transgressions of the “racial
order” that result in punishment (e.g., admonishment or rejection and consequent feelings of shame, guilt, and discomfort). Consider the example of
a White colleague of mine who recalled that as a young child, raised on
her family’s small farm, she invited the children of Mexican farmworkers
into her home to play, only to be sternly reprimanded by her parents and
told that they didn’t socialize with those children, whose families were
there only to pick crops on the farm. According to Thandeka, the result of
such encounters is that normal, naive, and innocent curiosity is quickly
transformed into a “transgression” of racist cultural norms, resulting in
the child’s experiencing a harsh lesson about what it means to be White.
On a gut level, such “transgressions,” many of them early and even preverbal, may include a sense of something being wrong with oneself for
having interests and feelings at odds with powerful, trusted, and even
loved authority figures (i.e., parents). My colleague recalls feeling very
sad, unable to understand why it was wrong to want to play with the
Mexican children milling around the house as their parents worked the
farm. No wonder feelings about being White and about racially different
others commonly become walled off, compartmentalized, and shrouded
in vague tension and discomfort. Later in life, racial encounters and

100 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
experiences can automatically trigger anxiety and avoidance without
much understanding or analysis.
As another example, I recall observing the outrage of a father in response to his 4-year-old son’s polishing his nails while at Montessori day
care. When the teacher patiently explained that the children are free to
explore all of the different stimuli and activities in the classroom, later
discussed for their learning value, the angry father demanded that his
son not be allowed to engage in activities for girls. As Thandeka (2003)
would argue, on the day of his father’s display of rage, the little boy
learned a harsh lesson about what it means to be a boy. Visibly disabled
people note that when out in public, children who innocently stare at
them or ask what’s wrong with them are frequently admonished by their
parents and told not to stare or ask such questions. Such parents justify
their actions as curbing rudeness, but it has more to do with the anxiety
we experience around disabled people based on our negative social constructions of the disabled (e.g., as pitiful, miserable, dependent), and
hence our need to render them invisible.
PRIVILEGE AND STIGMA
Implicit in the preceding discussion is the profound role of privilege and
stigma in limiting human understanding across differences. Whether we
are privileged by race (White), sex (male), sexual orientation (heterosexual), or disability status (able-bodied), we are socialized to minimize the
experience of those stigmatized in these domains (a person of color, a female, a nonheterosexual, a disabled person) because such stigmas play little if any negative role in our lives. Simply put, privilege makes our lives
better in a variety of ways; stigma does the opposite. Thus, people mistreated on the basis of race are keenly aware of racism, whereas those
treated better on the basis of race are less aware of racism because race
doesn’t limit their ability to make society work for them the way it
should. If this sounds abstract, consider the horrendous bombing of the
Oklahoma federal building in 1995 by American terrorist, and former
Gulf War veteran, Timothy McVey. Viewed solely as an individual, McVey
incited no backlash of hate crimes against White men because no such
stigma exists for these categories. In contrast, Americans of Middle
Eastern background were randomly beaten and even killed in the wake
of 9/11 because they belong to a group stigmatized on the basis of
racial/ethnic background.
The point is that the social oppression matrix, which endows us with
both privileges and stigmas, reinforces structured inequality by making
it exceedingly difficult for us to recognize our privileges or to understand

Diversity within Latinos 101
the pervasive inequality experienced by stigmatized individuals. Yet the
unfair advantages and disadvantages of privileged and stigmatized backgrounds, respectively, have real-life consequence of which we are too
often unaware, despite research that should raise our consciousness. For
example, in the first large-scale study of treatment decisions made by primary care physicians (Schulman et al., 1999), it was found that when
faced with videotapes of identical complaints of chest pain, doctors were
less likely to recommend African American women for further cardiac
testing (79% of the time) compared to patients that were either White or
male (91% of the time). Such findings do not mean that doctors are necessarily racist and sexist at the individual level, but that they are socialized at
the institutional and cultural levels to perceive the complaints of African
American women and the concerns of Whites and males through lenses
biased by racism and sexism. Interestingly, this study controlled for access to medical care, thereby minimizing the bias of social class, and also
suggests how a pair of stigmas may work against a person (i.e., being a
Black female) and how a pair of privileges can work for a person (i.e.,
being White or male).
Given such limited and biased socialization that distorts our perceptions
of human difference, it’s no wonder our emotional tolerance for genuinely
thinking (and feeling) about and discussing human differences rarely goes
beyond the kind of defensive and superficial hyperbole that leaves social
oppression unchallenged. Additional costs noted by Thandeka (2003) include the early suppression of natural curiosity, a low probability of authentic relationships across categories of human difference, and decreased
openness to oneself, to others, and to human possibilities.
A basic grounding in social injustice on the basis of stigmatized and
privileged social constructions of human differences beckons us to explore differences within differences as we struggle to comprehend the variegated effects of oppression on various members of society. Some of these
effects within U.S. Latino subgroups, and their unique experiences, problems, and engendered needs, are selectively considered next. In some
cases, groups and issues are raised and pursued in the second half of the
book, where culturally competent interventions are addressed. In other
cases, important groups and issues are merely raised given the limited
state of the literature and available space herein.
SEX AND GENDER
Hurtado (1997) asserts that traditional sociological theorizing about
the acculturation and assimilation of minority groups to American society has traditionally neglected the role of sex in such processes.

102 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Surely acculturation has different impacts on men and women, in part
because of male-dominated sexist structures operative in both majority
and minority cultures. Thus while people of color have been racially
and ethnically subjugated, as described in Chapters 1 and 2, women
within these groups have been further subjugated on the basis of gender in both majority and minority cultural contexts. There’s a great
scene in Chicano, the documentary about the Chicano movement of the
1960s and 1970s: At the first national conference to discuss political empowerment, Chicanas confront their compañeros (male counterparts or
companions) for relegating them to the coffee- and food-serving periphery despite their consistent participation in the movement. That is,
while the hombres were keenly aware of their stigma on the basis of ethnicity, they were less aware of, or considered less important, their privileged status as males in both Mexican and U.S. cultures. The
predictable logic in such situations runs along the lines of “Let me get
mine first, and yours will follow.” This is why a broad social justice
framework is imperative if we are to avoid the oppression-related
blinder of not seeing the links between different forms of oppression
(e.g., racism and sexism), and if we are to lessen our tendency to rankorder oppressions in terms of importance (a tempting yet ultimately
derisive endeavor).
GENDERED ACCULTURATION
In their pioneering work on acculturation in Cuban American refugee
families in Miami, Szapocznik, Scopetta, Kurtines, and Arnalde (1978)
demonstrated that the degree and speed of acculturation varies with the
age and sex of family members, as depicted in Figure 4.2. For example,
Cuban children generally acculturated much faster to the United States
than their parents, and females within both younger and older age
groups acculturated more slowly than their male counterparts, given the
cultural bias of allowing males more freedom and latitude to explore
their environment. Although only a preliminary analysis, the consideration of sex and age in acculturation became critical in Szapocznik and colleagues’ understanding of Latino family problems. They found that
tensions occurred most often between what they called overacculturated
children and underacculturated parents trying to adapt to life in the
United States. Further, some of the worst conflicts and behavior problems
occurred between the most and least acculturated family members (i.e.,
between male adolescents engaged in substance use and mothers abusing
prescription drugs). Such attention to sex and age spawned a prolific line
of clinical work, research, and theorizing by Szapocznik and colleagues

Diversity within Latinos 103
Figure 4.2
Rates of Acculturation by Age and Gender. (Source: “Theory and
Measurement of Acculturation,” by J. Szapocznik, M. A. Scopetta, W. Kurtines,
and M. A. Arnalde, 1978, Interamerican Journal of Psychology, 12, pp.
113–130. Reprinted with permission.)
Time
Youths
Parents
Acculturation
Male
Female
Male
Intergenerational/
Acculturational Differences
Female
about how to help Latino families deal with dysfunctional acculturation
gaps. Such family interventions are discussed in more detail in Chapter 6.
GENDERED MIGRATION
Although traditional Latino gender roles may generally slow the acculturation for women relative to men, Espin (1987) asserts that changes in
gender roles may actually be more dramatic for Latina versus Latino immigrants, given the pressing need for women to work outside of the home
and the consequent larger changes in lifestyle for such women compared
to changes for their male counterparts. Indeed, in Guendleman’s (1987)
research on female Mexican migrants, she noted considerable gender-role
expansion in terms of women’s earning power and subsequent gains in decision making in family matters. On this same topic, Hondagneu-Sotelo
(1994) conducted an ethnography of a Mexican migrant settlement

104 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
community in the San Francisco Bay Area based on the participantobservation of 44 men and women from 26 different migrant families.
She concluded that the relation between international “push and pull”
factors and individual-level decisions to migrate is mediated by gender
roles in the family and broader social networks that serve to constrain
or facilitate migration for men and women:
While patriarchal practices and rules in families and social networks have
persisted, through migration women and men reinterpret normative standards and creatively manipulate the rules of gender. As they do so, understandings about proper gendered behavior are reformulated and new paths
to migration are created. When exclusionary practices persist in the networks, Mexican women have devised their own systems and networks of
support. (p. 96)
Hondagneu-Sotelo found that the usual migratory scenario, in which men
leave wife and family behind to seek work in the United States, primes
both husbands and wives for greater gender-role flexibility. The husband’s absence in the family, and inadequate remittances from the United
States, push wives to take charge of family matters and to earn wages by
working. Meanwhile, husbands fending for themselves in the United
States hone domestic skills such as cooking and cleaning. Upon family reunification in the United States, gender-role expansion continues, with
wives entering the world of work, including its social dimension, and
making further gains in family decision making, division of household
responsibilities, and interests outside of the family, including local civic
involvement and even community activism (see Chapter 10 for more indepth discussion).
Hondagneu-Sotelo (1994) further noted that in cases where migrant
husbands opposed their wife’s urgency regarding reunification, many of
the wives used various strategies to undermine patriarchy, including directly challenging the decision, using their own networks to gather
money for the move, and even surprising husbands by showing up on
their U.S. doorstep, children and all. Understanding the gendered nature of Latino migration provides insights into both negative and positive aspects of the migration process for family members. Without
sufficient support and understanding, rapidly shifting gender roles can
result in family breakdown and dysfunction (e.g., domestic violence,
covered in Chapter 6); they can also result in more adaptive egalitarian
relations in Latino couples. Such flexibility and resilience in migrant
and immigrant families are strengths that can be integrated into the provision of human services.

Diversity within Latinos 105
UNDOCUMENTED LATI NOS
In his book Shadowed Lives, Chavez (1998) provides richly detailed personal case histories of undocumented Mexican and Central American individuals and families living in San Diego County. Migration is an
economically driven part of family history for a segment of Latino societies, yet Chavez notes other, less frequent yet compelling reasons for
moving, such as escaping family conflict (e.g., divorce, abandoned woman
with child, conflict with siblings), seeking adventure and to satisfy curiosity, and to escape war-related hardship and persecution on the part of
Central Americans (as noted in Chapter 1).
THE THREAT OF DEPORTATION
With regard to the dilemma of seeking a livelihood in a country where
one is contested as an illegal alien and constantly vulnerable to legal persecution and deportation, Chavez (1998) describes how undocumented
Latinos generally endure the chronic threat of apprehension, even multiple deportations, in exchange for what they are able to accomplish in the
United States. In his analysis of social, cultural, and personal incorporation in the United States, Chavez concludes:
In sum, despite lacking a guarantee of full incorporation, over time undocumented immigrants develop the kinds of ties to the local economy and society that results in their staying and settling in U.S. communities.
Experiences such as finding a job, maintaining steady employment, acquiring job responsibility, learning English, forming a family, giving birth to
children in the United States, having them attend U.S. schools and acquire
American culture, learning to navigate in the larger society, and ultimately
legalizing their immigration status incorporate undocumented immigrants
into the new society. (p. 186)
With regard to legalizing immigration status, Chavez (1998) notes that
such efforts on the part of undocumented Latinos increase with time
spent in the United States and can involve hiring lawyers to plead their
case or requesting a hearing before an immigration judge upon apprehension and refusing to sign a voluntary departure form (and being escorted
to Tijuana, Mexico). Chavez explains that recent migrants are likely to
sign a voluntary departure form because it renders the apprehension an
informal deportation and thus cannot be held against them in future applications for legal immigrant status. However, longer term migrants are
disinclined to sign voluntary departure forms because doing so erases
their years in the United States, which are helpful in mounting a case for
legal immigrant status. Thus, long-term migrants who are apprehended

106 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
are more likely to consider requesting an immigration judge to stop or
suspend their deportation and to grant them legal status on the grounds
of “noneconomic hardship.” The term refers to a compelling need to remain in the United States other than losing a job and/or assets, or not
being able to earn much money in Mexico. For example, an undocumented family with a disabled child might successfully argue that the
child would be adversely affected by a move to Mexico, where proper care
for his or her condition is less likely. Apprehended undocumented Central Americans might request a hearing for political asylum, although
proof of political persecution is typically difficult, as noted in Chapter 1.
In either case, failed appeals result in the deportation of undocumented
individuals and families. The high probability of returning to the United
States is a function of investments (jobs, schools, and communities to
which to return) and the perennial scarcity of economic opportunity in
one’s country of origin.
To Serve or Not to Serve?
Aside from the calculated risks of illegal migration, Chavez (1998) documents the considerable stress and heart-wrenching hardship of mothers
whose husbands are deported, of parents whose children are picked up
by the Immigration and Naturalization Service (INS), and of whole families deported and making multiple exhausting and dangerous attempts to
return to the United States. Yet most Americans dismiss such hardship as
the self-imposed consequence of breaking the law and entering the
United States illegally, a violation not to be reinforced in any manner. Indeed, this view was the thrust of California’s Proposition 187, which was
passed by voters in 1994 to deprive the undocumented of health care, education, and other publicly funded benefits (its unconstitutionality resulted in its quick demise).
Social policy is addressed in Chapter 10; it should be noted here that
Proposition 187 called on all California educators and human service
providers to police the citizenship of clients and to deny services accordingly. However, most refused to do the work of the INS and continued to
provide services, primarily for humanitarian reasons but perhaps also because of their awareness of the hypocrisy involved in the state’s dependence on massive Latino labor and the reluctance to respond to migrants’
basic human needs.
The central distortion in Proposition 187 was its claim that the primary
motivation of undocumented migration is to use public social services,
which of course is a natural by-product of the real reason why migrants
come: to work. This crafty proposition was never intended to stop the
flow of Mexican labor into California, or to crack down on law-breaking

Diversity within Latinos 107
corporations that routinely hire hundreds of thousands of undocumented
workers. It was intended only to drastically reduce the human service
costs of Latino laborers by inhibiting the migration of families, who are the
major consumers of basic health care and educational services (Chavez,
1998). In fact, former California Governor Pete Wilson, who spearheaded
the inflammatory “Save Our State” campaign to pass and enforce Proposition 187, consistently advocated Mexican guest worker programs, even
discouraging the immigration commissioner from raiding companies and
disrupting California businesses.
Interestingly, the nativist, anti-immigrant, and anti-Latino tone of
Proposition 187, and of more recent debates on undocumented immigration, have had the unintended consequence of galvanizing Latino political organizing and voting like never before in the state; participation in
the political process has increased dramatically and continues to this day
(addressed in Chapter 10). As long as Mexico and California and the rest
of the Untied States continue to compose interlocking economic systems
characterized by massive flows of Latino labor essential to multibilliondollar corporations, Latino migration, documented or otherwise, will
continue to be formally and informally institutionalized, as it has been
throughout the twentieth century. As such, aren’t human service
providers, as well as informed citizens of both Latino and non-Latino
backgrounds, ethically obligated to respond to the human needs of a
workforce that helps to make California the eighth most powerful economy in the entire world?
SEXUAL OR IENTATION
Scholars writing on the experience of GLBT Latinos have found some interesting links with the migration process. Diaz (1998, p. 103) describes
the frequent practice among gay Latino men of immigrating to the United
States as a “geographical pseudo-cure” to the problem of needing to escape their closeted lives in Latin America. But while immigration brings
relief, distance from one’s country (and family) of origin does not usually
end the uncomfortable double lives of many gay Latinos. As Diaz explains, familismo (i.e., the centrality of the family in the lives of Latinos) is
generally a major resource for Latino family members, but it can also
hamper the psychosocial development of Latino gay men who feel compelled to live secret sexual and romantic lives to avoid family dishonor
and rejection. In fact, Diaz underscores the link between homophobia in
Latino culture and HIV risk in Latino gay men, whose sexual lives often
become relegated to the shameful domain of secretive and impersonal
sexual encounters full of risk (see Chapter 9).

108 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Espín (1997a) surveyed 16 Cuban American lesbians and found that
though the majority identified as Latina and valued both Latina and lesbian identities, two-thirds said that if forced to choose, they would prefer
living among non-Latina lesbians with little awareness of Latino culture,
rather than live closeted among Latinos (indeed, many claimed to have already made that choice). In a more in-depth case study of two women
from that sample, both connected coming out as lesbians with coming to
the United States (Espín, 1997b).
The choice between ethnicity and sexual orientation is highly relevant
to GLBT Latinos given that their sexual orientation represents a cultural
transgression, to use Thandeka’s (2003) term, against traditional Latino
gender roles and expectations. Feeling forced to choose between one’s
Latino family and community on the one hand, and an open sexual orientation and social life on the other, can result in a painfully divided
self. Espín (1997a) notes that when a lesbian orientation is known or suspected in the family, the tendency is to silently tolerate the individual,
provided that she remain closeted, and to make excuses for her not
being married (e.g., too religious, too smart, too busy with career).
Espín also noted that 14 of the 16 lesbians interviewed reported being
Catholic, yet only three were practicing Catholics who chose to worship
at Dignity, an organization designed to meet the religious needs of gay
and lesbian Catholics who are estranged from their church.
ETHNIC VERSUS SEXUAL IDENTITY
Although GLBT Latinos face the basic racial/ethnic identity development
issues raised in Chapter 3 due to their ethnic minority status in the
United States, it could be argued that their sexual identity presents a
more pressing dilemma because it is stigmatized within Latino culture,
family, and community, in addition to the larger society. On the other
hand, Rodriguez (2004), reflecting on his clinical work with Chicano gay
men as well as the literature, claims that he is just as likely to work with
clients on sexual identity as to work on ethnic identity, or both at the
same time. To assist with such work, GLBT scholars have developed models of sexual identity development based on the logic of racial/ethnic
identity models reviewed in Chapter 3. One such model, by Cass (1990),
posits early stages of sexual identity confusion and ambivalence; middle
stages of exploration, tolerance, and pride, including resentment of homophobia; and ultimately a more advanced and integrated stage of synthesis
in which public and private lives fit in a fulfilling manner. How sexual
and ethnic identity development co-occur in GLBT Latinos warrants fur
Diversity within Latinos 109
ther research to illuminate how such individuals cope with two stigmatized identities.
Interestingly, Espín (1997b) professes faith in the power of familismo,
noting that if familismo is strong, not even homosexuality can split the
bonds between family members. Some, though certainly not all, GLBT
Latinos do enjoy family support, and Espín’s optimism speaks to the
promise of enhancing familism through public education campaigns
about the negative consequences of rejecting GLBT children and other
family members, and the need for the family to be the central buffer in
the lives of GLBT youth as they encounter heterosexism and racism.
THE TRANSGENDER CHALLENGE
Just when you think you’re beginning to understand the basic human
rights issues of gays and lesbians, along come transgender people, who
seem to “transgress” not only sex and gender roles, but biology itself! If
people are capable of relinquishing their biased socialization regarding
transgender people, and are able to recast them as fully human and thus
deserving of full human rights, figuring out the rest of the human diversity puzzle should be easy. Part of the challenge resides in the dilemma
that transgender people are not only stigmatized and rejected by heterosexuals, who frequently (mis)perceive them as homosexuals, but they
have also been historically stigmatized by gays and lesbians, who have
frequently (mis)perceived them as renouncing their homosexuality and
attempting to pass as the opposite sex in a conformist manner (Green,
2000). Not surprisingly, such multiple marginalities and major transgressions of the sexual and gender social order result in compounded vulnerabilities and unique needs.
At the core of the umbrella term transgender are transsexuals who experience a mismatch between their biological sex and their gender identity.
For example, male-to-female (MTF) and female-to-male (FTM) transsexuals feel more congruent with the gender identity, role, and appearance of
the opposite sex, whether or not they pursue hormonal treatment or reassignment surgery. Green (2000) notes that the term transgender more
broadly refers to a preponderance of characteristics of the opposite sex
(e.g., physical and/or behavioral) that cause people to question their perceptions, regardless of an individual’s gender identity.
Service providers and researchers working with transgender people believe that they may be at the greatest risk for the long list of vulnerabilities that result from pervasive oppression or transphobia (e.g., physical and
sexual abuse, harassment and hate crimes, and consequent depression

110 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
and suicidality, alcohol and substance abuse, survival sex, and HIV and
STDs). Research on HIV among MTFs is still in its infancy, but infection
rates of between 25% and 33% of fairly large San Francisco-based community samples have been reported (Clements-Nolle, Guzman, & Katz, 2001;
Nemoto, Luke, Mamo, Ching, & Patria, 1999). With regard to transgender
Latinos, extremely little research exists, although the MTF Transgender
of Color Study in San Francisco is helping to clarify some of our strongest
fears, as well as raise hopes, by revealing the transphobic context of HIV
risk in this unique population.
In the context of HIV risk, research by Nemoto, Operario, Keatley, and
Villegas (2004) based on focus groups with 48 MTFs (16 Black, 15 Asian,
12 Latinas, and 5 other) and with service providers familiar with the population documents several central contextual themes for MTFs of color.
First, significant involvement in commercial sex work emerged as an important means of economic survival, in which almost all had participated,
including about half currently, often beginning in adolescence. Transphobia-related reasons for sex work include early rejection from families and
consequent homelessness, job discrimination against transgenders, and
money needed for survival, for costly gender-maintenance medical procedures, and for drugs (including injection drugs) used to cope with all of
the above. Participants even noted that sex work and drug use were often
viewed as a right of passage among transgenders. It was also found that
sex with customers was generally regarded as a business transaction in
which to practice safe sex, whereas sex with primary partners involved
love, trust, and penetration without condoms. However, unsafe sex with
customers was reported when more money was offered for not using condoms, or when needing money for survival, medical procedures, or
drugs. The fact that transgender people are so frequently the victims of
violent hate crimes, including murder, is a tragic indicator of their degree
of stigma and oppression, so well captured by a focus group member’s
brutally honest statement:
No one’s going to kill a gay man if he finds a dick between his legs. No one’s
gonna kill a gay woman if he finds a pussy. But they will definitely put a
knife through a tranny’s throat if they see breasts and dick. (p. 729)
The recent conviction of three young men for the brutal murder of
Gwen Araujo, a young MTF transgender Latina, is significant. Following a
hung jury, the men were retried and the jury refused to buy their “transgender panic” defense, which held that they killed Araujo in a fit of panic
after discovering that they were sexually involved with an MTF transgender person.

Diversity within Latinos 111
With regard to sexual risk, Nemoto, Operario, Keatley, Han, and Soma
(2004) found the following self-reported HIV infection rates in their MTF
sample: 41% for African Americans, 23% for Latinas, and 13% for Asian/
Pacific Islanders. Both Latinas and African Americans reported lower incomes and higher rates of sex work, including unprotected receptive anal
sex (URAS), and substance use, compared to Asian/Pacific Islanders.
Participants who were HIV-positive were almost 4 times as likely as HIVnegative participants to report URAS with casual (not customer) sex partners. And although only 12% reported URAS with customers in the past
30 days, this behavior was 4.5 times more frequent in African Americans
and those with the lowest income level ($500/monthly).
A unique obstacle to condom use was noted in the finding that rates of
URAS were higher with primary partners than with casual or commercial
sex partners. In the focus groups conducted by Nemoto, Operario, Keatley, and Villegas (2004), the interpersonal context of (un)safe sex was clarified in that condoms were perceived as undermining intimacy with
primary partners as well as undermining gender validation (i.e., attention,
affection, and sex for being a woman) with casual sex partners. And although most used condoms with commercial sex clients, economic vulnerability did occasionally undermine this intention. These findings
underscore some of the unique relationship-based vulnerabilities for
MTFs that can leave them at a power disadvantage for negotiating safe sex
if it is perceived and experienced as secondary to the need for money, intimacy, and gender validation.
Among the many implications for service providers of these results are
the need for transgender-competent early intervention to curtail and prevent interpersonal abuse and the need to provide alternatives to survival
sex and substance use to cope with transphobia. A comprehensive approach should also include assisting transgender clients with work- and
housing-related discrimination, counseling aimed at preventing the need
for gender validation from becoming a risk liability, and referring clients
to transgender-sensitive health services. Such thoughtful and progressive
services, often spearheaded by transgender individuals, are sparse yet exemplify the humanism at the core of diversity-competent practice.
RACE AND SKIN COLOR
I recently met with a dark and Indian-looking Latino community outreach
worker in Oakland, California, to ask him about his impressive HIV prevention work with local Latino migrant day laborers. Shortly after ordering a spicy bowl of sopa Azteca (Aztec soup) at a local Mexican restaurant,
the outreach worker wasted no time in sizing me up by asking, “You’re

112 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
such a huero [light-skinned] Latino . . . do you think that has helped you to
become successful?” Without skipping a beat, I swallowed my spoonful of
soup and said, “In a racist society like ours? How could it not be an advantage?” He smiled knowingly at my quick, honest, and correct response
and proceeded to orient me to his excellent work with the local migrant
day laborers and to assist with access to this hard-to-reach population (see
Chapter 9).
Because Latinos can be of any racial background, there is tremendous
variety in skin color and other aspects of physicality. In our racialized
society, we should expect that phenotypic differences within Latino
groups will result in differences in social welfare. Such differences have
been studied more extensively in African Americans, yet similar research and findings are available for Latinos. Arce, Murguia, and Frisbie
(1987) examined the relation between phenotype and life chances in a
probability sample of just under 1,000 Chicanos from the southwestern
United States and Chicago. Phenotype was assessed by interviewer ratings of skin color and racial features, each of which were rated on 5-point
scales, from very light to very dark, and from very European-looking to
very Indian-looking. As predicted, results showed significantly higher
SES in light/European-looking Chicanos as compared to those rated
dark/Indian-looking. More specifically, significant differences were
found in annual income ($12,721 and $10,450, respectively), years of education (9.5 versus 7.8), occupational prestige scores (25.3 and 20.7), and
perceived discrimination ratings (25.6 and 27.2).
In a fascinating analysis of the extremely few Latinos on Fortune 1000
corporate boards, Zweigenhaft and Domhoff (1998) found that the majority were Cuban Americans from upper-class and elite backgrounds.
Analysis by two independent raters of skin color and facial features also
revealed these corporate elite Latinos to be light in skin color and more
European- than Indian-looking. Latinos constitute less than 1% of corporate directors of Fortune 1000 boards, and only 1.4% of executives at vice
presidential levels and above. Thus, factors such as social class, skin color,
and ethnic minority appearance have tangible implications for Latino life
chances and social welfare.
MIXED RACIAL AND ETHNIC HER I TAGE
Mixed racial heritage is an inherent part of being Latino, given their mestizaje, or “mixture” of Spanish and indigenous Indian heritage and the
blending of Indians with Africans during the slave trade. The term here
refers to the American usage of being from two predominant racial/ethnic parental backgrounds (e.g., African American and European Ameri
Diversity within Latinos 113
can, Latino and European American, Latino and African American).
Despite the reductionism of such a narrow social construction of racial/
ethnic background, its real consequences for psychosocial adjustment
warrant attention. For example, in a 15-family study of biracial children,
Winn and Priest (1993) found that 82% of the 34 children interviewed
claimed that they felt obligated to assume a monocultural racial designation, with many feeling like traitors to the parent with whom they did
not racially identify. These youth also consistently claimed that their
parents did not adequately prepare them for the negative reactions of
both Whites and minority peers, and a third expressed a desire to learn
about the cultures of both parents.
Interestingly, two of the three Cuban/White adolescents in the study
identified as Cuban, the other as White, and all three reported dating
both Cuban and White friends. The one Puerto Rican/Anglo participant
identified as Puerto Rican and socialized mostly with Puerto Rican
peers. This study documents many of the potential problems that mixed
youth are likely to face in a society with rigid constructions of race, and
where most people, let alone parents, are not adept at preparing such
youth for mixed racial socialization (i.e., inoculation from internalizing
society’s stereotypes and biases).
On the positive side, Winn and Priest (1993) found that most of the adolescents in the sample indicated feeling good about their racial identity
and reported socializing (e.g., dating) with a mix of friends. These researchers end their report by urging counselors and parents to help children explore their dual heritage but stop short of saying how. One obvious
key to adjustment in such youth is close ties to both parents and avoiding
the pressure to identify with only one side of their family. For example, de
Anda and Riddel (1991) studied a sample of 70 mixed adolescents (22
Asian/White, 23 Black/White, 25 Latino/White) who reported identifying as multiethnic, high comfort and acceptance by both majority and minority peers and settings, strong bonds with both sides of their family,
and a preference for ethnically diverse friends. Interestingly, of the 23
Latino/White respondents, 15 reported being perceived as White by
strangers, yet all but two identified as Latino.
de Anda and Riddel (1991) stressed the importance of not drawing samples of mixed-race individuals from clinical settings, where maladjustment is more likely. Their sample (obtained through both convenience and
snowball sampling) was characterized by a high number of intact homes
(61.4%), although with notable differences across the three groups: 81.2%
in the Asian/White group, 64% in the Latino/White group, and 39.1%
in the Black/White group. Although these three groups did not differ
on the healthy outcomes, it makes one wonder about the challenges of

114 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
integrating a dual racial/ethnic heritage if one is from a divorced background. Also, because participants in de Anda and Riddel’s study were
all “half-White,” we must also wonder how being from two stigmatized
minority backgrounds (e.g., Latino and African American) might affect
adjustment.
BLACK LATINOS
In the classic Puerto Rican coming-of-age novel, Down These Mean Streets,
author Piri Thomas (1967) describes the challenges of growing up in
Spanish Harlem as including being perceived and treated as African
American. Job discrimination and interpersonal rejections are poignantly
detailed, and there’s even a chapter titled “How to Be a Negro without
Really Trying.” Other than Thomas’s work, there is extremely little literature about the experience of Black Latinos (i.e., those who are racially
Black and culturally Latino), although it’s not hard to imagine some of
the negative consequences that could result from such a combination of
stigmatized identities in both the U.S. and Latino cultures.
Based on his professional experience as a family therapist, Baptiste
(1990) wrote one of the earliest papers on this topic. The author made
mention of some of the identity problems faced by adolescent family
members trying to figure out who they are in America’s color-conscious
society. Later, Comas-Diaz (1996) wrote about the Latinegra, or Black
Latina of Caribbean background, and the myriad potential and actual
problems reported by such women. In addition to identity issues, ComasDiaz highlights sex and class issues such as being stereotyped as sexually
exotic yet unsuitable marriage material for adelantar la raza (lifting up the
race). She notes that terms of endearment, such as negrita (little Black one)
and prieta (dark one), contain ambivalence and often mean something
like, “You’re Black and ugly but we love you anyway.” All of the problems
outlined by Comas-Diaz have roots in racismo, or Latino-style racism in
which dark family members are held in lower esteem and treated in kind
as a result of internalized oppression. Also described are ways in which
Latinegras have begun to empower themselves by forming organizations
such as the Unión de Mujeres Puertorriquenas Negras (Union of Black
Puerto Rican Women) to bring attention to this divisive intracultural
manifestation of racism.
Such writings veer close to a “tragic mulatto” portrait of Black Latinos,
but a shred of empirical support comes from a rare study by Ramos,
Jaccard, and Guilamo-Ramos (2003), who compared symptoms of depression in four groups of adolescents in grades seven through 12: AngloAmericans, African Americans, Black Latinos, and non-Black Latinos

Diversity within Latinos 115
from the National Longitudinal Study of Adolescent Health survey of
more than 20,000 students. These researchers found that Latinegra adolescents had the highest levels of depression, which was attributed not just to
their dual racial/ethnic status, but to being female and perhaps less able
than their Latinegro male counterparts to negotiate both minority group
experiences. That Latinos in this study, including Afro-Latinos, were predominantly Puerto Rican in background, further supports the writings of
Comas-Diaz (1996).
While much more research is needed on human diversity within Latino
subgroups, human service providers need to be better prepared to address
potential dilemmas in mixed racial heritage or being a Black Latino. Because traditional racial/cultural identity models were developed with single racial/ethnic groups in mind, they are limited in their application to
many Latinos. Still, familiarity with the racial/cultural and White identity
models reviewed in Chapter 3 provides a basis on which to help mixed race
and mixed ethnic individuals to resist negative social conceptions of either
side of their family backgrounds and to pursue the objective of selectively
sorting out cultural strengths from each particular background with which
to create a more integrated multiracial, multiethnic sense of self.
CONCLUSION
This chapter has barely scratched the surface regarding the immense
human diversity within U.S. Latino subgroups and of the differential impacts of oppression, as well as privilege, on various major subgroups of
Latinos categorized by society on the basis of social constructions of gender, sexual orientation, immigration status, phenotype, and mixed racial
heritage. So many other categories and their consequences should be addressed in the future (e.g., disability status), including even finer gradations and various combinations of identities and status dimensions
within the same individuals. Hopefully we will continue to connect the
many dots of oppression affecting various categories of people in the
United States in order to promote a more just society for all Americans.
REFERENCES
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problems of a neglected minority. Journal of Family Psychotherapy, 1, 15–38.
Bell, L. A. (1997). Theoretical foundations for social justice education. In M.
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courses. In M. Adams, L. A. Bell, & P. Griffin (Eds.), Teaching for diversity and
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119
CHAPTER 5
A New Practice Model for
Working with Latinos
THE THEORETICAL FRAMEWORKS presented in Chapters 1 through 4 (acculturation, social stratification, racial/ethnic identity development, subgroups
and identities) are designed to educate and sensitize readers to the social
and cultural experiences of U.S. Latinos. These specialized frameworks, constructed from pertinent social science research and theory, provide a foundation for conducting culturally sensitive assessment and culturally
competent practice across various Latino problems and subpopulations. Unfortunately, the terms cultural sensitivity and competence have been used so
repetitively in the past 30 years, often with such superficiality, that just
reading them again can evoke a kind of a cultural fatigue currently afflicting
many practitioners and the general population alike. However, if defined,
framed, and illustrated clearly, cultural sensitivity and competence become real, and
practitioners become capable of conducting assessments of proper depth and understanding to maximize the probability of effectively intervening with Latinos.
The purpose of this chapter is to present a new model of culturally and
socially competent practice with Latinos that spans both generalist and
specialized practice domains and that is solidly grounded in the literature. It should be noted that the state of the art in such model building is
still young, with plenty of room to grow. Hopefully, more research and
service attention to Latinos will ensue. The new practice model is designed to provide practitioners and service administrators with a comprehensive yet user-friendly approach that can easily be called on in service
and practice settings. Presentation of the practice model is preceded by
two major sections designed to provide the reader with conceptual background information on the potential intervention field as well as critical
thinking about cultural competence. Given the practice model’s frequent
use of the terms cultural sensitivity and competence, working definitions
of these popular constructs are provided next.

120 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Cultural sensitivity to Latinos refers to being sensitized to the cultural
and social realities of Latinos in ways that render them fully human in the
eyes of service providers, administrators, and researchers in the social sciences and services. This brand of sensitivity involves developing an increasingly keen awareness of oneself, both as a person and a professional,
and how one’s own multiple group memberships and socialization can influence relationships with others. Thus, developing cultural competence
is no small accomplishment when we ponder the ways that we as Americans have historically been socialized to view people of color, first as genetically inferior, later as culturally inferior, still mostly to blame for their
poverty and related problems, and thus undeserving of assistance. Parallel
forms of socialization around gender and sexual orientation within all
American ethnic groups similarly render women and sexual minorities less
than fully human and thus deserving of discrimination. The culturally
sensitive human service provider or social scientist is aware of the social
and interpersonal dynamics of dehumanization and is committed to not
inadvertently perpetuating them. Cultural sensitivity advances the essential need to continue to “rehumanize” Latinos and other dehumanized
groups via educational and interpersonal teaching and experiences.
Cultural competence with Latino clients presumes adequate cultural sensitivity and uses such understanding to acquire, and often create, assessment and intervention skills and abilities based on the social and cultural
realities, as well as the assets and human potential, of Latino clients. As
such, cultural competence maximizes the probability of being effective in
problem solving and minimizes the probability of insensitive and incompetent approaches that reveal and reify our biased socialization.
CONCEPT UAL BACKGROUND TO THE
POTENTIAL INTERVENTION FIELD
THE ECOLOGICAL-SYSTEMS PERSPECTIVE
Elaborate writings and discussions of the ecological-systems (E-S) perspective can help service providers develop a more comprehensive cognitive
map of human beings in the social environment (e.g., Bronfenbrenner,
1979; Germain, 1987). The bottom line of the E-S perspective is to help social and human service providers consider multiple problem levels and solutions and to think outside of the box of their traditional disciplinary
training. This is accomplished by learning to use the E-S perspective to
help visualize how multiple interactions between human systems of various sizes, over the life cycle and across biological, psychological, and social

A New Practice Model for Working with Latinos 121
Figure 5.1
Conceptualizing the Potential Practice Field
Theoretical
Framework I
I: Oppression and Social Justice
II: Acculturation and Adjustment
III: Social Stratification of Ethnicity and Power
IV: Ethnic Identity
V: Diversity within Populations
VI: What else?
Theoretical
Framework III
Theoretical
Framework II
Theoretical
Framework IV
Macro Systems
Micro Systems
(The Individual)
Psychological
System
Biological
System
Social
System
Meso Systems
Theoretical
Framework VI
Theoretical
Framework V
domains, result in varying degrees of adaptation and adjustment for individuals and groups. Using an E-S map is no small feat considering the
boundaries and confines of disciplinary training, which are narrow by design and tend to overproduce practice specialists while underproducing
generalists better able to grasp the bigger human picture.
Even in the field of social work, which subscribes to the E-S perspective
as its general practice framework, there has been a tendency to set this
perspective aside in the process of specialization in areas such as health,
mental health, gerontology, and school social work. Part of the problem is
that the E-S perspective can be detailed to a fault, overwhelming in the
practice arena, and is ultimately descriptive and not prescriptive regarding solutions to problems (Wakefield, 1996a, 1996b). This is not to say that
authors have not advocated methods for applying the E-S perspective to
diverse populations (e.g., Greene & McGuire, 1998), but even these attempts are overreaching in their attention to seemingly all aspects and
relationships in the social environment. For these reasons, only a brief
and, I hope, retainable overview of an E-S map is provided on which a
user-friendly practice model is built.
At minimum, ecosystemic experts describe a social environment such as
that depicted in Figure 5.1. The individual at the center is herself a system

122 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
of biological, psychological, and social subsystems, reminding practitioners to ask the basic question, “How much of the problem before me is a
function of this individual’s biological makeup, psychological makeup, or
social makeup?” This biopsychosocial perspective is thus a perspective
within a perspective and represents a significant advancement over being
trained to see human problems as overdetermined by any one subsystem.
For example, a former client shared that his son suffered from terrible
headaches as a toddler that baffled the family’s general medical provider,
who eventually referred the child’s parents to mental health professionals,
who attributed the headaches to marital problems. But when the painful
problem persisted after weeks of couple therapy, the client’s wife concluded that couple therapy was not the solution despite some initial buy-in
to working on marital issues. She and her husband took their son to a university hospital where it was discovered that he was suffering from a large
benign brainstem tumor. Emergency brain surgery followed and fortunately was successful in resolving the problem.
Micro-Level Systems
The story just related illustrates the semiporous boundaries between
biopsychosocial and other E-S levels. That is, a problem arising primarily
in the biological system of the child dramatically spilled over into the
child’s temperament and behavior (psychological system), and into the social system of the family, in which confused siblings and exasperated parents struggled to understand and remedy the problem. The micro system
in Figure 5.1 refers to any human system containing an individual (e.g.,
family, day care center) or containing a basic human relationship such as a
couple or family (e.g., health center, mental health center). Defining the
problem as marital and treating it at the local mental health center represents a micro system containing the couple, as does the hospital setting in
which the child was eventually correctly diagnosed and treated.
Meso-Level Systems
Meso systems refer to interactions between micro systems that contain an
individual, couple, or family (e.g., the family practitioner referring the
family to the mental health center). Theoretically, the more meso-systemic
activity on behalf of a client, family, or group, the more comprehensive the
care because more problem levels and solutions can be considered. Obviously the current example reminds us of the need to perform all of our respective jobs well within our specific domains and to strive for greater
continuity between systems of care (e.g., the family practitioner could
have done a physical work-up before referring the family to mental health

A New Practice Model for Working with Latinos 123
professionals, who in turn could have communicated more with the physician about ruling out a physical health problem).
Macro-Level Systems
Beyond meso systems are broader societal norms, values, ideologies, and
numerous institutions and organizations that influence and govern meso
and micro human systems. Macro systems include pervasive American ideologies and practices such as democracy, capitalism, and the free enterprise
economic system, and related values and narratives such as the American
dream, rugged individualism, and meritocracy. Predominant patterns of
national and cultural lifestyles are also included under macro systems;
these are the general social, political, economic, and religious lives of people. Though abstract, macro systems remind us of the power of overarching
social forces to shape specific social and human service policies, funding
streams, and the specific designs of formal and informal helping institutions. They also remind us of ways we as a society define and respond to
problems. For the most part, problem definitions and solutions have been
generated by and for mainstream Americans in an ethnocentric manner
that often ignores the problems and needs of people of color, or has attributed them to cultural or individual factors within these groups rather than
compelling external factors and forces reviewed in Chapters 1 through 4.
As the arrows in Figure 5.1 illustrate, the purpose of this book is to infuse our E-S cognitive map with several Latino-relevant social science theories and bodies of knowledge, organized in Chapters 1 through 4, to
enhance cultural sensitivity. Although not definitive, such a basic set of
frameworks lowers the probability of perpetuating past mistakes, provides a foundation on which to integrate state-of-the-art culturally competent practice with Latinos, and advances such practice by constructing
cutting-edge, social justice-oriented approaches.
THE CURR ENT STATE OF THE
ART I N CULT UR ALLY COMPE TEN T
PRACTICE AND BEYOND
THE THREE DIMENSIONS OF CULTURAL COMPETENCE
After scouring the social science literature, pioneers in the field of social
work (e.g., Lum, 1996, 1999; Manoleas, 1994) have fashioned a threedimensional model of culturally competent practice that captures the
complexity of this multidimensional concept and also nicely complements
the three major levels of the ecosystemic perspective (see Table 5.1). By
blending the three dimensions of cultural competence with the three

124 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Table 5.1
Conceptual Background for Potential Practice Field
Three Major Levels of
the Ecological-Systems Perspective
Three Major Dimensions
of Culturally Competent
Practice Micro Meso Macro
Knowledge
Formal
Informal
Skills
Assessment
Intervention
Lifelong commitment and
development
Personal
Professional
major levels of the E-S perspective, practitioners can better visualize the
vast potential intervention field. Such a 3 × 3 matrix is meant not to overwhelm practitioners and administrators but to provide them with a comprehensive cognitive map on which to build manageable practice models
in their areas of concern and interest.
Knowledge
As can be seen in Table 5.1, knowledge is the first major dimension of cultural competence. This consists of the formal kinds of knowledge, conveyed in Chapters 1 through 4, as well the informal knowledge acquired in
the daily lives of practitioners as people (e.g., in daily interactions with
people and society, experiences of popular culture). By its nature, the
dimension of knowledge refers to both the storage of pertinent information
and to increasing awareness of the social, cultural, and historical experiences of Latinos and other diverse groups, including those to which practitioners may belong. Such specialized knowledge includes a fundamental
understanding of oppression and social justice, as discussed in Chapter 4.

A New Practice Model for Working with Latinos 125
Skills
But knowledge is not enough to facilitate needed change with Latinos.
Thus the skills dimension refers to the ongoing development of assessment and intervention skills with which to address problems in a culturally competent manner. Mostly we think of such skills as formal and
disciplinary-related. But we should be open to discovering, tapping, and
building on informal, culture-based, and socially adaptive skills already
within clients and groups. Frankly, it is exactly these kinds of “indigenous” skills and natural support systems that have been primarily responsible for the survival and adaptation of ethnic minorities in the
United States (e.g., development of ethnic communities and extended
family systems that engage in mutual help, adherence to or reinvention of
cultural practices that reaffirm the humanity of group members under
dehumanizing conditions).
In his model of culturally competent practice, Lum (1999) goes into
great detail in his description of skill development, which includes the
following basic skills:
• The skill to generate profiles of the communities in which one practices that include sociodemographic data on community members
and locations of community resources that can be tapped to address
local patterns of psychosocial, health, and economic problems: Such
profiles also include awareness of local history and the community’s
struggles to empower itself, some of which may have directly involved the practitioner’s place of work! For example, a few years ago
when I approached a community Latino health center with the idea
of evaluating their HIV prevention services for farmworkers, I expected and understood the immediate reaction of staff, who
protested the number of times my university had “used them like
guinea pigs” in the past to collect data from which only the researchers benefited (called “hit and run” research by some community members). I smiled knowingly and agreed, “That’s what
universities frequently do!,” and proceeded to ask how we could
work together differently to minimize exploitation and help the
agency obtain what it needed.
• The skill to engage in culturally based relationship protocols with diverse clients that enhance initial rapport and facilitate engagement
in the helping relationship: The typical mainstream approach of beginning professional relationships by immediately addressing the
task at hand (e.g., “What seems to be the problem?” or “How can I
help you?”) is frequently misperceived by Latinos as impersonal,

126 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
even cold and rude, if a small amount of time is not taken in the beginning to personalize the relationship (e.g., introducing oneself
with some background information, expressing warmth and care by
asking clients how they are feeling, whether they are comfortable, if
they need a glass of water).
• The skill to view problems from a nonpathological perspective or as
unmet needs or ways of coping that promote survival under trying
circumstances: This idea is like the popular strengths perspective
that stresses taking inventories of client and community assets instead of seeing them only as containers of problems that need to be
fixed (e.g., Rapp, 1998). But though refreshingly positive, the
strengths perspective is a reaction to the historically biased tradition
in the social sciences of constructing minorities as defected and in
need of repair by mainstream society. It is my contention that optimal assessment skills need to be as comprehensive and balanced as
possible in identifying strengths and weaknesses, health and pathology, at both individual and larger social levels. If we do not lose sight
of the full humanity of our diverse clients, problematizing issues or
labeling serious problems as pathology need not be dehumanizing.
For example, and as discussed in Chapter 7, the pathology of gang involvement (i.e., violent deaths, major injuries, crime) should not be
minimized, but neither should the multiple unmet needs of these marginalized youth (i.e., developmental, familial, sociological) that leave
them vulnerable to the lure of street gang activity as a misdirected
way of getting basic needs met.
• At more advanced practice levels, Lum discusses the skill of designing and administrating culturally competent social services.
Taking cultural competence to administrative levels involves incorporating its major dimensions into agency mission statements,
policies, and objectives, staff training, student supervision, and
client services.
• Applying research in an informed manner to client problems involves being on top of research in one’s area to provide evidencebased treatments rather than doing merely what is familiar or what
one prefers to do. For example, many graduate students frequently
express an antimedication bias as they approach mental health services despite research evidence showing that antidepressant medications are as effective as different forms of psychotherapy. Getting
beyond such biases frees practitioners to consider more treatment
options, to educate clients about such choices, and to better match
treatments to clients with regard to their social-psychological and
cultural makeup.

A New Practice Model for Working with Latinos 127
Lifelong Professional Commitment
Lifelong development of cultural competence is a personal and professional commitment to an ongoing process of formal and informal education and skill acquisition that continues to enhance practice with
Latinos and other diverse groups. To a significant degree, mandated
continuing professional education and conferences are the formal mechanism for keeping practitioner knowledge and skills up to date in both
general and diversity-specific ways. Lum (1999) describes the culturally
competent practitioner as conscientiously keeping up with the latest in
diversity-related practice knowledge and skills, in addition to generating and passing on such expertise via supervision, program evaluation,
teaching, and consultation.
A NEW PRACTICE MODEL FOR
WOR KI NG W I TH LATI NOS
Bumper sticker wisdom urges us to “Think globally and act locally,” and
that is exactly what a viable model of culturally competent practice can
help us do. That is, all of the foregoing conceptual background information helps us to think more broadly about Latino problems and issues so
as to more effectively address local problems and clients in our domainspecific work settings. Thus, the new practice model presented here is a
2 × 4 matrix composed of 2 practice levels and 4 major dimensions of service that are essential to culturally competent practice with Latinos and
other diverse groups (see Table 5.2). This matrix is the culmination of various models of general multicultural and Latino-specific practice from
counseling and clinical psychology, from which the bulk of such literature comes, as well as from the field of social work which has proven resourceful at mining psychology and other disciplines for approaches that
can be expanded to more comprehensively address human systems in the
social environment.
GENERALIST AND SPECIALIZED PRACTICE
The fact of the matter is that most practitioners in society are trained to
be specialists in specific domains of health, mental health, education, or
social or economic services. Even social workers, whose training is generalist by design, typically develop domain-specific expertise in specific
problems and populations. Though highly desirable, true multidisciplinary service and treatment collaborations are still the exception to the
specialization rule, and our model must reflect this reality. Thus the new
practice model describes four major service dimensions discussed mainly

128 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Table 5.2
New Practice Model for Working with Latinos
Four Major Dimensions of Culturally and Socially
Competent Practice
Practice
Levels
Increase
Service
Availability
and Access
Problem
Assessment
in Social
and Cultural
Contexts
Select
Culturally
and Socially
Acceptable
Interventions
Increase
Service
Accountability
Generalist
Specialized
at the generalist level of practice (i.e., what virtually all culturally competent services need to address). How such generalist skills are applied to
specific practice domains is addressed in the practice-oriented chapters
that follow.
INCREASE SERVICE AVAILIBILITY AND ACCESS
Understanding Latino Underutilization
Way back in the 1950s and 1960s, mental health service providers concluded that Mexican Americans had better mental health than AngloAmericans because their rates of mental health service use were much
lower (Padilla, 1978). Though it was tempting for Mexican Americans to
believe that they were less crazy than Anglos, pioneering Latino mental
health experts began to challenge this assumption, citing all of the risk
factors surrounding the Chicano experience (e.g., poverty, immigration
and acculturation stress, discrimination). Indeed, some of the first prevalence studies to include Mexican Americans began to document rates of
mental disorders roughly equivalent to the general U.S. population (e.g.,
Karno et al., 1987). It was eventually concluded that the low rates of men
A New Practice Model for Working with Latinos 129
tal health service use had more to do with barriers to services than a lack
of problems.
Initially, Latino underutilization was also blamed on factors within
Latino groups, such as mistrust of Anglo professionals, reliance on the
family to solve problems, and even preferring indigenous folk healers and
medicine over formal services. It was not until the late 1970s that evidence began to accrue pointing to major barriers to service outside of
Latino groups. In 1978, President Carter’s Task Force on Minority Mental
Health published a landmark report on underutilization that attributed
the pervasive problem to four major social structural barriers (Parron,
1982). These obstacles all begin with the letter “A” and can be used as a
convenient checklist to quickly assess the degree to which an agency or
service provider is culturally competent:
• Availability: This obstacle refers to the pervasive lack of available mental health services to ethnic minority populations and communities.
• Accessibility: This obstacle refers to lack of accessible mental health
services due to clinics’ inconvenient locations and limited hours of
operation, lack of transportation to such services, and lack of health
insurance and other financial resources to pay for available services.
• Acceptability: This obstacle refers to the pervasive lack of mental
health services that are culturally acceptable to ethnically diverse
patients. Basic to this obstacle is the chronic lack of staff and practitioners who are bilingual and bicultural. Other dimensions of culturally acceptable services include the modification of conventional
treatments to include elements of the ethnic client’s culture and social experience (e.g., language, values, culture-based interpersonal
styles, ways of defining and solving problems, flexible hours, provision of child care). In a review of the literature comparing culturally
responsive to conventional mental health services, Atkinson and
Lowe (1995) found that the former were superior in increasing perceived credibility of therapists, willingness to return to treatment,
satisfaction with therapy, and depth of disclosure in therapy on the
part of ethnic minority clients.
• Accountability: This obstacle refers to a lack of accountability to the
ethnic community in terms of developing and providing desired
mental health services with multiple forms of client and community
input. Rarely are ethnic community leaders, members, and mental
health service consumers consulted about service development and
provision. There is also a pervasive lack of formal mechanisms of
practice and agency accountability, ranging from service evaluation
research to client suggestion boxes.

130 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
The Outreach Imperative
Latinos and other populations overaffected by segregation, exclusion, and
poverty require concerted efforts on the part of service providers to make
them aware of and encourage them to use available services. Service
providers need to routinely institutionalize multiple forms of outreach to
Latinos, ranging from advertisements in popular media to the use of community outreach workers who go to where Latinos live and work to educate them about services and to provide them with on-the-spot prevention
education as well as referrals. In general, Latinos at highest risk for serious problems are also the most marginal and in need of outreach efforts.
For example, poor, urban-based, IV-drug-abusing Puerto Ricans are at
highest risk for HIV/AIDS and require customized outreach efforts to decrease risk where it hits hardest (addressed in Chapter 9).
PROBLEM ASSESSMENT IN SOCIAL AND CULTURAL CONTEXTS
Imagine defining Latino client, group, community, and national problems
in ways that link them to the Latino historical experience of oppression
and its living legacies of oversegregation, poverty, and marginality. Although it is a bit abstract, Lum (1999) would begin such an endeavor with
a bias toward defining problems as unmet needs, coping efforts to survive, and as “psycho-individual reactions” (at the micro level) to environmental impacts (at the macro level). Some problems may seem more
amenable to such consideration than others (e.g., gang involvement versus diabetes), but it is a worthwhile exercise for practitioners to use the
practice background matrix in Table 5.1 to consider multiple problem levels and whether or not a specific problem may be part of a problem pattern
linked to Latino ethnicity or some other dimension of diversity. For example, although the problem of diabetes seems neatly confined to the domain of biology, why is it so disproportionately high among the poorest of
Mexican Americans and Puerto Ricans, as well as the poorest of African
and Native Americans? Further, why are diabetes risk factors, such as
obesity, poor diet, and sedentary lifestyle, also disproportionately high in
these groups? And finally, why do people of color experience more complications and die sooner from diabetes than their White counterparts? If
links between diabetes and racial/ethnic experiences can be made, this
problem should be understood and treated as such (e.g., public health
campaigns, measures to reduce poverty, further discussed in Chapter 9).
Biopsychosocial Problem Levels
As mentioned earlier, a biopsychosocial perspective allows us to consider
the possible contribution of each of these domains to a problem such as

A New Practice Model for Working with Latinos 131
diabetes. For example, in the social domain, research shows that many
Latinos with diabetes are less aware of it due to lack of effective public
health information and problematic access to health services. In the psychological domain, what Latinos think and feel about this disease bear serious consideration for optimal intervention. For those who become
diagnosed, the prospect of changing, say, a traditional Mexican diet, so
often tied to cultural lifestyle, may result in pessimism to control the
course of this serious medical problem. The bottom line is that even the
most formal medical diagnosis may require a healthy co-construction of
the disease on the part of physicians and patients in such a way that patients become knowledgeable, skilled, and motivated to manage problems
like diabetes.
Empowerment as Practice Theme
As the diabetes example illustrates, the problem assessment process
is generally improved by actively soliciting the client’s or the community’s conception of the target problem and collaborating in a process
of codefining problems, intervention goals, and methods. This is consistent with an empowerment approach to providing services to Latinos
and other groups with a history of significant disempowerment. According to Gutierrez, Parsons, and Cox (1998), empowerment practice
imbues traditional professional help with consciousness raising that
makes clients aware of the connections between personal and public
problems. That is, while immediate problems require immediate actions to relieve suffering, dialogue between practitioners and clients
about the links between problems and social and political forces should
be gradually pursued. As such, problem definition and understanding
is performed with rather than for clients, as are intervention efforts that
increasingly involve clients along the continuum from self-care to helping others affected by communitywide problem patterns. Empowerment is thus both process and outcome. Conscious effort on the part of
practitioners is required to include this theme in assessment and intervention efforts.
But how do we empower disempowered clients in an era of dwindling
and fragmented public services and privatization of social services that
emphasize cost containment and profit over entitlements, and in traditional service organizations characterized by hierarchical power structures and professionals in the roles of experts and authorities? Advocates
of empowerment practice who have studied its application at the administrative and service levels have identified a number of major obstacles and
supports, some of which are listed in Table 5.3 (Cox & Randal Joseph,
1998; Gutierrez, Glenmaye, & DeLois, 1995). Constraints to empowerment

132 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Table 5.3
Practice Theme of Empowerment
Obstacles Supports
• Expectations of funding body
• Severe/abusive clients
• Competition between agencies
• Different service approaches
• Discontinuity between services
• Difficulty measuring empowerment
• Administer vision/values/philosophy
• Broad-based flexible funding
• Teamwork to achieve goals
• Peer supervision
• Staff in-service and empowerment
training
• Delegation to action groups by
constrained administrators
• Staff self-care institutionalized
• “Personal is political” perspective
regarding client problems
• Broad-based support networks
• Revolving leadership on teams
• Advisory/decision-making groups
• Political participation and community
organizing
From “The Organizational Context of Empowerment Practice: Implications for Social Work
Administration,” by L. M. Gutierrez, L. Glenmaye, and K. DeLois, 1995, Social Work, 40(2),
pp. 249–258.
practice can be considerable, and developing supports involves a challenge to the dominant paradigm of practice in the social services. Thus,
objectives for accomplishing empowerment practice necessarily involve
both short- and long-term goals and a conscious effort to practice against
the grain of conventional service delivery.
The idea that clients, practitioners, and administrators can be empowered by developing egalitarian collaborative relationships flies in the face
of conventional human services as we know and practice it. Yet we must
strive to approximate this ideal by decreasing the obstacles and increasing
the supports listed in Table 5.3. One starting place is to openly discuss
power imbalances inherent in these different relationships and to acknowledge that there are legitimate uses of greater power, as when a client is out
of control, not capable of assuming a more collaborative role, or in danger of
hurting self or others. Attention to such Latino problem themes is illustrated throughout the second half of this book (Chapters 6 through 10).
Common Latino Problem Themes
Assessment as described earlier assumes a historical and ongoing environmental context in which most of the major problems affecting Latino

A New Practice Model for Working with Latinos 133
populations form patterns linked to their ethnic minority experience in
America. As such, there begins to emerge for culturally competent practitioners various large and overlapping patterns of problems and issues for
most U.S. Latinos: (a) immigration, acculturation, and adaptation issues;
(b) poverty, segregation, and marginalization issues; (c) breakdown of
the ethnic community and extended family systems; (d) ethnic identity
issues; and (e) the different ways these problem themes play out across
multiple status dimensions within Latino populations (e.g., for women
versus men).
SELECT CULTURALLY AND SOCIALLY
ACCEPTABLE INTERVENTIONS
Currently, little research exists that indicates the superiority of one type
of treatment approach or service over another for different Latino problems and subpopulations. This problem is partly due to the general lack
of outcome research that includes Latinos. Without empirical evidence to
guide us in the selection of best intervention strategies for Latino problems, we must strive to select, modify, and design conceptually sound intervention efforts based on the general assessment strategies outlined
earlier. The intent is to provide interventions that are congruent with the
lived reality of Latino clients, and thus experienced as relevant and helpful. This is another way of conceptualizing so-called evidence-based practice when evidence in the form of research results is missing.
Latino Client Expectations and Needs
Much has been written on the service and treatment expectations of traditionally oriented and low-income Latinos (e.g., immigrants, lower in acculturation), who continue to constitute huge portions of the major U.S.
Latino groups. Because of their social and cultural circumstances, service
expectations are likely to include immediate symptom relief, direct attention to problems of daily living, prescriptions for medications, advice on
how to remedy problems, and preferences for practitioners who are active
and directive but also warm, personable, and bien educado (well-mannered,
cultured, raised well). From this description of Latino client expectations,
it makes practical sense to begin with interventions that are short term
and that emphasize prevention, psychoeducation, and coping and problem-solving skills applied to the here and now. In the area of mental
health, for example, these expectations provide a rationale for using behavioral or cognitive-behavioral rather than psychodynamic approaches,
although ultimately which is best is an empirical question that also considers the particular client and type of problem.

134 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Practitioners should also experiment with being flexible enough to
help with needs and requests not directly a focus of professional attention (e.g., a recent immigrant client seeks the service provider’s help recovering a car that has been towed away, with a letter from the county
that she can’t understand, or with the emotional problems of a relative
back in Central America). But though it often makes sense to begin at
such a traditional starting place, service providers should gradually strive
to imbue services with the practice theme of empowerment.
Family-Centered Services
Given the centrality of the family in the lives of most Latinos, it certainly
makes sense to consider service approaches that involve members of the
extended family in the assessment and intervention processes. Family
therapy is an obvious mental health example, but virtually any human
service can involve family members who can help by providing greater
insight into problems as well as participate in concerted efforts at problem solving.
Community-Based Services
The location of most Latino families in heavily Latino-populated communities and the location of most Latino problems in ethnically linked communitywide patterns compel practitioners to provide more comprehensive
community-based services that interact with natural support systems and
community resources. Rapp and Wintersteen (1989) found that when the
strength model of case management was used by agencies caring for the
chronically mentally ill, social workers performed the majority of their
client contacts in the community and achieved client goals utilizing community resources. Gutierrez et al. (1998) similarly advocate teaching
clients to make the connection between personal and social problems and
to address them through informal and formal self-help groups, community
organizing, and political action.
The growing popularity of comprehensive school-based services for
both students and their families represents needed movement toward
community-based and family-centered efforts toward intervening at several points along the problem continuum, from private to public (described in Chapter 7).
Attention to Diverse Subgroups
Once viable treatment and service approaches have been identified for
Latinos affected by certain problems, practitioners must then engage in
the exercise of asking how such an approach would play out over different

A New Practice Model for Working with Latinos 135
subgroups within the Latino population (i.e., female versus male,
gay/lesbian versus straight, elderly versus young adults), as discussed in
Chapter 4.
Deviating from Culture of Origin?
In their classic article on culturally sensitive mental health service for
Latinos, Rogler, Malgady, Costantino, and Blumenthal (1987) note that although it makes sense to work within the culture of the client, as the literature uncritically advocates, it is in the best interests of Latino clients
to sometimes work outside of their culture of origin. This recommendation is consistent with consensus in the literature that bicultural Latinos
probably possess more adaptational skills than their monocultural counterparts. For example, nobody would question the value of monolingual
Spanish speakers learning English in the United States, right? Thus, the
frequent assertion to work within the culture can sometimes be viewed as a
well-intentioned overreaction to the historical practice of cultural imperialism on the part of social institutions, in which Latino culture was
pathologized and Latinos were pressured to abandon their culture of origin and replace it with mainstream American culture (e.g., punishing
U.S. Latinos for speaking Spanish).
Thus the delicate task of the culturally competent practitioner is to understand clients’ oppressive history and still be prepared to work outside
of traditional Latino culture, when necessary, in a nonoppressive manner.
For instance, Latinos as well as Asians are frequently stereotyped as interpersonally submissive and passive and are offered assertiveness training to decrease these deficits. That is, assertiveness is offered as a
superior substitute for traditional Latino communication protocol instead
of being introduced as a different cultural style of communication that
can be added to the client’s repertoire in the spirit of flexible biculturality
in the United States (more on this in Chapter 8).
INCREASE SERVICE ACCOUNTABILITY
As noted, federally mandated research in the area of minority mental
health has documented the pervasive lack of accountability to ethnic and
racial minorities on the part of service providers nationwide. Thus the
current model of cultural competence advocates multiple institutionalized methods and mechanisms of actively and frequently involving minority clients and their communities, as well as practitioners, in the
development, delivery, and evaluation of well-intentioned services. On
the client side, such methods range from simple suggestion boxes in waiting rooms (to which responses are posted) to exit interviews following

136 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
service use to elicit client feedback. The development of community advisory boards composed of key community players (i.e., leaders, advocates,
service consumers) is an excellent way to institutionalize Latino community input.
At the service provider and agency level, periodic staff surveys regarding service provision and agency environment are another fairly easy way
to implement accountability, as is periodic evaluation research to assess
the effectiveness of services provided. Although these recommendations
make intuitive sense, service providers sometimes dread outcome evaluations, and hence avoid them, because they are perceived as—and can be—
overly faultfinding. Such provider concerns are understandable and can
be addressed by involving providers directly and early in the planning of
evaluations (What do they want to know and why?). Implications of such
measures of service assessments range from staff trainings in areas of desired improvement, to the improvement of existing and the development
of new Latino-focused services.
CONCLUSION
We struggle to construct conceptually sound and user-friendly practice
models based on a literature still lacking in sufficient theory and empirical research on Latino populations as well as other minority groups. Nevertheless, we need to start from where we are and proceed to outline the
next best steps. In the chapters that follow, the working model of culturally competent practice with Latinos presented in this chapter is used as
a guide for reviewing and critiquing state-of-the-art and cutting-edge interventions across a wide variety of Latino problems and populations.
More specifically, practice efforts are analyzed with respect to the degree to which they increase access, assess client and community problems
in a culturally and socially informed manner, select intervention strategies that are congruent with the cultural and social reality of the target
population, deviate from Latino culture as needed, and build in multiple
mechanisms of accountability. The advantage of selectively reviewing the
best Latino practice literature from throughout the social and health sciences to teach culturally competent practice is that doing so presents
real-life examples while providing a conceptually grounded critique
rather than overwhelming readers with long and impractical wish lists of
all the things they should but so often can’t do. Further, because all psychosocial and physical health problems affecting Latinos cannot be addressed in a single text, it makes sense to carefully select and describe in
detail a few best and promising practices aimed at solving some of the
most important problems affecting Latinos today.

A New Practice Model for Working with Latinos 137
REFERENCES
Atkinson, D. R., & Lowe, S. M. (1995). The role of ethnicity, cultural knowledge,
and conventional techniques in counseling and psychology. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 387–456). Thousand Oaks, CA: Sage.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature
and design. Cambridge, MA: Harvard University Press.
Cox, E. O., & Randal Joseph, B. H. (1998). Social service delivery and empowerment: The administrator’s role. In L. M. Gutierrez, R. J. Parsons, & E. O. Cox
(Eds.), Empowerment in social work practice: A sourcebook (pp. 167–186). Pacific
Grove, CA: Brooks/Cole.
Germain, C. B. (1987). Human development in contemporary environments. Social Service Review, 61, 565–580.
Greene, R. R., & McGuire, L. (1998). Ecological perspective: Meeting the challenge
of practice with diverse populations. In R. R. Green & M. Watkins (Eds.), Serving diverse constituencies: Applying the ecological perspective (pp. 1–27). New York:
Aldine de Gruyter.
Gutierrez, L. M., Glenmaye, L., & DeLois, K. (1995). The organizational context
of empowerment practice: Implications for social work administration. Social
Work, 40(2), 249–258.
Gutierrez, L. M., Parsons, R. J., & Cox, E. O. (1998). A model for empowerment
practice. In L. M. Gutierrez, R. J. Parsons, & E. O. Cox (Eds.), Empowerment in
social work practice: A sourcebook (pp. 3–23). Pacific Grove, CA: Brooks/Cole.
Karno, M., Hough, R. L., Burnam, M. A., Escobar, J. I., Timbers, D. M., Santana,
F., et al. (1987). Lifetime prevalence of specific psychiatric disorders among
Mexican Americans and non-Hispanic Whites in Los Angeles. Archives of
General Psychiatry, 44, 695–701.
Lum, D. (1996). Social work practice with people of color: A process-stage approach. Pacific Grove, CA: Brooks/Cole.
Lum, D. (1999). Culturally competent practice: A framework for growth and action. Pacific Grove, CA: Brooks/Cole.
Manoleas, P. (1994). An outcome approach to assessing the cultural competence
of MSW students. Journal of Multicultural Social Work, 3, 43–57.
Padilla, A. M. (1978). Psychological research and the Mexican American. In C. A.
Hernandez, M. J. Haug, & N. N. Wagner (Eds.), Chicanos: Social and psychological perspectives (pp. 152–159). St. Louis, MO: Mosby.
Parron, D. L. (1982). An overview of minority group mental health needs and issues as presented to the President’s Commission on Mental Health. In F. V.
Munoz & R. Endo (Eds.), Perspectives on minority group mental health
(pp. 3–22). Washington, DC: University Press of America.
Rapp, C. (1998). The strengths model: Case management with people suffering from severe and persistent mental illness. New York: Oxford University Press.
Rapp, C. A., & Wintersteen, R. (1989). The strength model of case management:
Results from twelve demonstration projects. Psychosocial Rehabilitation Journal, 13(1), 23–32.

138 ESSENTIAL SOCIAL SCIENCE THEORIES, FRAMEWORKS, AND RESEARCH
Rogler, L. H., Malgady, R. G., Costantino, G., & Blumenthal, R. (1987). What do
culturally sensitive mental health services mean? American Psychologist,
42(6), 565–570.
Wakefield, J. C. (1996a, March). Does social work need the eco-systems perspective? Pt. 1. Is the perspective clinically useful? Social Service Review, 1–32.
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Service Review, 183–213.

139
PA R T I I
Selective Reviews of
Major Problem Areas,
Latino Groups, and Best
and Promising Practices
PART II PROVIDES DETAILED illustrations of culturally competent practice
with various groups of Latinos across a broad variety of some of the most
compelling psychosocial and physical health problems affecting U.S. Latinos today. A pair of chapters focuses on issues and interventions specific
to the Latino family and Latino youth, and remaining chapters tackle
Latino health and mental health, as well as the past and present politics of
being Latino American and how they relate to social welfare. One of the
overriding objectives of Part II is to transcend past practice rhetoric (i.e.,
wish lists of things that should be done) by using the new practice model,
introduced in Chapter 5, to guide and critique the selective presentation
of best and promising practices with Latinos. By design, the selective review of practice illustrations is intended to both address important contemporary Latino problems and issues but also to emphasize principles
and practice methods that can be generalized to other, equally important
problems not addressed given space limitations.

141
CHAPTER 6
The Latino Family
NO BOOK ON Latinos would be complete without a chapter dedicated to
the central social-psychological and cultural institution of the Latino experience: la familia. This chapter provides a descriptive and empirical
overview of the Latino family, followed by a selective review of pressing
family-related problems and issues and culturally and socially competent
responses.
Reviews of the literature on Latino families (Baca Zinn, 1982–1983;
Garcia-Preto, 1996; Ramirez & Arce, 1981; Vega, 1990) describe a variety
of organizational and functional characteristics that derive from a blend
of residual traditional Latino culture (e.g., Mexican, Cuban, Puerto
Rican) and adaptation responses to life in the United States. Descriptions
have evolved from static, stereotypic portraits of the traditional Latino
family, to more dynamic descriptions that consider heterogeneity in response to the demands of acculturation to a modern society, and across
various social subgroupings of family members.
For example, Falicov (1998) uses the term culture to refer to a community
of people that partially share the same meaning systems to describe and ascribe meaning to the world (e.g., preferred values, norms, behaviors, and
role prescriptions). Cultural similarities and differences, both between
and within group members, reflect different degrees of inclusion and exclusion across subgroups within the culture (e.g., gender, age, sexual orientation), as well as outside of it (e.g., Anglos and other ethnic groups).
Each individual member of the culture develops within a plurality of subgroups that exert multiple influences of varying degrees depending on the
salience of the subgroups to the individual across different situations as
well as across time.
Falicov (1998) further asserts that the ecological niche or unique combination of multiple contexts and partial perspectives define each individual’s and each family’s variation on major cultural themes. This
niche guides the evolution of values and behaviors (for better or worse)

142 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
given its link to the social and physical environment (e.g., social class)
and such crucial issues as access to power and resources necessary for
healthy development.
CULT UR E- AN D S O CIALLY-BASED FAM I LY
STRUCTURE, FUNCTIONS, AND CHANGES
CORE VALUES
Traditional Latino cultural values that constitute the basis of norms, behaviors, and role prescriptions, and that become modified in response to
the American social environment and personal agency, provide a convenient way of describing Latino family structures and functioning. For example, although there is an expanding variety of Latino families (i.e.,
single- and two-parent, nuclear and extended, immigrant and multigenerational, transnational, gay and lesbian), they are partially based on the
core cultural value of familismo, which refers to the central importance of
the family as manifested in strong emotional and instrumental interdependence between members, within and across generations, over the life
cycle. More modern Anglo-American norms and values generally stress
individualism, competition, independence, and even individuation from
the family in members over time; familism promotes close contact, loyalty, and even a lifelong sense of “self-in-family” that serves as a psychosocial guide for family members with regard to their values, actions,
and identity in the world.
Reviews of the empirical literature on the Latino family generally
demonstrate greater participation in family networks within and across
generations (e.g., social support) compared to their Anglo counterparts.
Sabogal, Marin, Otero-Sabogal, Marin, and Perez-Stable (1987) studied
the effects of acculturation on familism in a diverse Latino sample
(n = 452) compared to non-Latino Whites (n = 227) and found that perceptions of the family as highly supportive remained constant across
Latinos of varying levels of acculturation, and that even the most acculturated Latinos were more family-oriented than their non-Latino
White counterparts. On the other hand, other dimensions of familism,
such as sense of family obligation and use of family as behavioral and
attitudinal referents, did decrease with acculturation. Similarly, Perez
and Padilla (2000) studied a three-generation sample of 203 Chicano
adolescents and found that although Mexican cultural orientation decreased from first to third generations and American cultural orientation increased, participants retained their allegiance to Latino family
values.

The Latino Family 143
Latino families also partially share the traditional value of respeto (respect), paying deference to those of higher status in the traditional sense
(i.e., by virtue of older age or higher social position, including male gender relative to female). Related values include affiliation and cooperation,
which are traditionally stressed in family relations more than independence and assertiveness. Simpatía refers to the valuing of smooth, pleasant relationships that minimize and avoid conflict and confrontation
(even when hurt feelings and anger are aroused). Closely related is the
value of personalismo, which emphasizes the personal dimension of relationships, including task-oriented professional relationships in mental
health and other social services. The mainstream clinical practice of almost immediately focusing on the presenting problem can be perceived
as impersonal or rude by Latino patients, especially if it comes at the expense of the social lubrication needed to build confianza, or trust (Roll,
Millen, & Martinez, 1980).
Personalismo is not informality. That is, it would be a mistake for a service provider to come across too casually or overly friendly. As described
by Roll et al. (1980), culturally sensitive service providers need to find the
balance between task-oriented formality and personalized attention to
the client. To achieve such a balance, it is necessary for providers to engage
in sufficient small talk, or plática, that includes judicious self-disclosure.
CHILD REARING
Latino child-rearing practices partially reflect the traditional values just
discussed, along traditional age and gender hierarchies, in which conformity is praised and deviations are disciplined. For example, children are
expected to obey and respect parents; being right is secondary to respecting elders by not disagreeing or arguing a point. The term bien educado (well
educated) refers to children (and adults) who have been raised properly, as
reflected in their adherence to traditional values and interpersonal protocol. Mal criado (poorly raised) means the opposite. But child-rearing practices among U.S. Latinos also partially reflect modern Anglo-American
values, resulting in much bicultural variation.
The patriarchal basis of traditional Latino families can be hard to understand in mainstream America, which stresses more egalitarian and
“friendly” relations within and between generations, and increasingly
between men and women. The clash of values experienced by Latino
youth can become especially difficult when there are few if any models of
flexible bilculturality in their families or in society. The problem is exacerbated by family dysfunction and uneven levels of acculturation between members.

144 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
NATURAL SUPPORT SYSTEMS
Most discussions of natural support systems (NSS) center on the role of
the extended family and informal resources and helping networks in the
community that provide a wide range of social support that buffers stress
and boosts the enjoyment and meaningfulness of positive events (e.g.,
Delgado, 1999; Valle & Vega, 1980). Service providers are advised to learn
about and make use of the NSS of the clients and communities they serve
but should also avoid overtaxing NSS, which have partly evolved to compensate for social neglect and exclusion.
CATHOLICISM
The overwhelming majority of Latinos continue to be Catholic. Falicov
(1996) notes that the Catholic Church provides continuity to families
across generations throughout the life cycle for its central role in rites
of passage such as baptism, first Holy Communion, marriage, and funerals. The church also creates community by providing a central place
for Sunday mass, religious and Latino holiday celebrations, and community activities. Parochial school provides many Latino children with
the rare opportunity for a quality private education to enhance their
life chances.
Feagin and Booher Feagin (1999) note that, like Italian Americans, Mexican American Catholics demonstrate general allegiance to the church but
less active participation than Irish Americans. As such, Mexican Americans are able to compartmentalize religion, resulting in behaviors that do
not always conform to the church despite feelings of being very Catholic.
For example, research on contraceptive use in samples of Mexican and Mexican American Catholic women consistently reveals high use of a variety of
methods despite church teachings to the contrary (Amaro, 1988; Balls Organista, Organista, & Soloff, 1998). The expression “The Pope is not going
to take care of my children” is not uncommon among these women.
Thus, although the spiritual and supportive dimensions of Catholicism
should be assessed and utilized as needed with religious clients, we
should not assume passive conformity to the Catholic Church, nor should
we overlook progressive movement on the part of many parishes on sexand gender-related issues, or on immigration reform.
Although a major cultural resource, familism alone cannot compensate
for the Latino family’s social ecological context, in which ethnically
linked, poverty-related stressors can overtax the family system. Gomel,
Tinsley, Parke, and Clark (1998) studied coping strategies in Latino families struggling with economic hardship and found that unemployment,
perceptions of economic hardship among members, and using the family

The Latino Family 145
to cope with such hardship resulted in negative changes in family relations. In contrast, individual coping strategies resulted in more positive
relations. With regard to child mental health, Weiss, Goebel, Page, Wilson, and Warda (1999) found that emotional and behavioral symptoms in
Mexican preschool children were predicted, not by SES or acculturation,
but by family immigration status, parental dissatisfaction with family
functioning, and internal versus external coping strategies. Such research
underscores the need to expand Latino coping strategies and supports beyond overreliance on the family.
INCREASING ACCESS TO NEEDED
SERVICES: GENERAL ISSUES
Access for poor and segregated Latino families in need of services has
historically happened through the bottom-up, community-based efforts on the part of Latino-focused “ethnic agencies” designed to compensate for inadequate mainstream services (Iglehart & Becerra,
1995a). Community-based family health, mental health, and multiservice centers are examples of such efforts. In addition, some mainstream
institutions have developed Latino-focused services as part of their
usual array of services, staffed with bilingual/bicultural staff and professionals. Iglehart and Becerra (1995b) have diagramed a useful 2 × 2
model of the degree to which culturally competent services have penetrated a particular agency or ethnic community that is helpful for
thinking about different types of human service delivery systems for
Latino families and communities (Figure 6.1).
As can be seen in Figure 6.1, low agency penetration and low community penetration represent the worst-case scenario, where there is a lack
of needed services in either sphere (e.g., lack of bilingual/bicultural staff
or ethnic programs within the agency, as well as no outreach into or input
from the ethnic community). High agency penetration and low community penetration describe the existence of special ethnic-focused programs within an agency or mainstream institution. Culturally and
socially competent practice is reflected in such a program’s ideology,
technology, personnel, and structures, but not necessarily in the agency
as a whole. Such a disjunction between program and agency can be advantageous in that it allows the freedom to conduct services in ways different from the agency but that are responsive to the special needs of
clients (e.g., serving Spanish-speaking, the undocumented). The problem
with this arrangement is that there is typically little formalized input
from the community, and a change in staffing or agency organization can
jeopardize these less institutionalized programs.

146 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Figure 6.1
Overview of the Penetration of Culturally and Socially Responsive
Services into Agencies and Ethnic Communities. (Source: “Service Delivery to
Diverse Communities: Agency-Focused Obstacles and Pathways” (pp. 205–239),
by A. P. Iglehart and R. M. Becerra, in Social Services and the Ethnic
Community, A. P. Iglehart and R. M. Becerra (Eds.), 1995b, Boston:
Allyn & Bacon (Reissued, Prospect Heights, IL: Waveland Press, 2000).
Copyright by Authors. Reprinted with permission.)
Community Penetration
Specialized
Programs
Within the Agency
Ethnic Programs
in the
Community
In-Community
Training No Services
A
gency
Penetration
Low High
High
The low agency and high community scenario reflects an agency conducting programs with little input from the community and few activities
within the agency itself. The lower right quadrant of the model might be
expanded to include bottom-up grassroots efforts to develop needed services (e.g., self-help and support groups, small nonprofit agency development around an important issue). For example, in Richmond, California,

The Latino Family 147
survivors of domestic violence formed self-help groups and, with the assistance of a neighborhood center, wrote a grant and received funding for
a small nonprofit center in which to conduct self-help groups and train
group participants as lay outreach workers and group leaders. Often the
life span of such noble efforts depends heavily on connecting to larger
and better funded agencies that can incorporate the program under their
umbrella of services.
High agency penetration and high community penetration are the
ideal: An ethnic focused-agency is based in the community, provides
needed services, and has formal and consistent input from the community via community boards, employment of community members, use of
volunteers, and client exit interviews.
PROBLEM ASSESSMENT: GENERAL ISSUES
LATINO FAMILY SOCIOECONOMIC STATUS AND STABILITY
As mentioned in Chapter 2, the vast majority of Latino families is large,
urban-based, and disproportionately poor and struggles with a cluster of
risk factors related to a mix of poverty and ethnic minority status. Approximately 4 times as many Latino families live in poverty compared to
non-Latino White families (26.4% and 7.3%, respectively); 40% of Mexican American and Puerto Rican children younger than 18 live below
the poverty line compared to 10.5% of Anglo children (see Table 6.1). Further, the percentages of children below the age of 18 who live in “deep
Table 6.1
Sociodemographic Profile of Major U.S. Racial/Ethnic Groups
Median In High School College
Income Poverty Completion Graduation
Group ($) (%) (%) (%)
Latinos 23,912 26.2 53.1 9.0
Mexican 23,714 26.4 46.2 5.9
Puerto Rican 20,310 32.5 59.8 8.0
Cuban 31,015 15.4 62.1 16.5
Central/South American 23,649 27.0 62.9 15.1
Other Hispanic 28,562 21.3 68.9 15.1
Non-Latino Whites 40,420 7.3 82.0 22.9
Sources: The Hispanic Population in the United States: March, 2000 (Current Population
Reports, pp. 20–535), by M. Therrien and R. R. Ramirez, 2000, Washington DC: U.S.
Census Bureau; Hispanic Population in the United States, 1993 (Current Population Reports, pp. 20–475), by U. S. Bureau of the Census,1994, Washington, DC: U.S. Government Printing Office.

148 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
poverty,” defined by being more than 50% below the poverty line, is
12.4% for Mexican Americans and 4.2% for Anglos.
Latinos are generally younger than their Anglo counterparts (M = 26.5
and 36.5, respectively), and Chicanos are the youngest of all Latinos (M =
24.6 for Chicanos, 26.9 for Puerto Ricans, and 43.6 for Cubans; U.S. Bureau of the Census, 1994). Mexican Americans also have larger families
with more children than most other groups in the United States. Mexican
Americans are similar to Anglos with respect to rates of two-parent
households (i.e., 61 % and 58%, respectively) but have a larger average
household size (4.5 and 3.1, respectively). Mexican American women have
higher fertility rates than most other groups in America. In 1990, the
number of children born to Mexican women between the ages of 15 and
44 was 1,620 per 1,000 compared to 1,176 for Anglos and 1,461 for African
American women (Frisbie & Bean, 1995).
Given these SES data, we should expect an above-average number of
family-related problems in Latinos linked to poverty, but also to minority status and acculturation. Problem themes frequently discussed in
the Latino family literature include role reversals between members of
(especially immigrant) Latino families in which (a) women are increasingly entering the paid labor force, thereby expanding their experience
beyond traditional gender socialization, and (b) children are becoming
Americanized at faster rates than their parents, occasionally having to
assume parental responsibilities (e.g., translating for or representing
the family to social institutions) and absorbing modern American values and behaviors sometimes at odds with parental socialization.
Although most Latino families cope admirably with acculturation-related
changes and view them as part of progressing in the United States, overly
stressed and resource-poor families can have multiple maladaptive reactions. For this reason, Latino family experts have begun to take an increasingly ecosystemic view of Latino family problems and solutions. In their
classic article, Bernal and Flores-Ortiz (1982, p. 357) assert, “Where the genesis of dysfunction with Black families may be traced to the legacy of slavery, the genesis of dysfunction in Latino families (particularly Puerto Rican
and Mexican-American families) may be connected to a legacy of colonialism and neocolonialism.”
THE LATINO FAMILY IN ECOSYSTEMIC PERSPECTIVE
The overriding goal of an ecosystems approach to Latino families is to
promote family stability and adaptive functioning by addressing multiple needs, as well as promoting greater bicultural flexibility among
family members. For example, In Falicov’s (1998) multidimensional

The Latino Family 149
ecosystems comparative approach to Latino family therapy, she considers the multidimensionality of families and individual members as reflected in the plurality of cultures and subgroups to which they belong.
Rather than viewing a family member as being influenced only by the
preferred values, norms, and worldview of some monolithic Latino culture, her model considers the multiple influences of varying degrees of
inclusion and exclusion across various subgroups (e.g., age, sex, social
class, race/ethnicity, sexual orientation). Here, ecosystemic refers to the
unique combination of sociocultural contexts and related perspectives
that define each family’s culture; the term comparative refers to attending to differences both within and between families and individual
members that are relevant to stability and well-being.
With regard to family assessment, Falicov (1998) achieves problem understanding by evaluating four key generic domains: (1) family history of
migration and culture change, which includes the influence of pre- and
postmigration factors and acculturation-related changes (e.g., between
gender roles and generations); (2) ecological context, which includes the
family’s sociocultural niche, including SES, minority status, and degree
of marginalization; (3) family organization, which includes traditional
and modern influences; and (4) family life cycle, with its culturally patterned transitions (e.g., rights of passage) that are challenged and enriched in the United States.
Gender-Role Expansion
Falicov (1996) notes that although a patriarchal view of gender roles persists in Latinos, complexities and contradictions continue to evolve in such
a way that traditional family structures and functions typically coexist
with American norms and behaviors, resulting in varying degrees of biculturality across different cultural dimensions. For example, a double
standard in gender socialization and sexuality has generally persisted in
Latino families, but shared decision making between husbands and wives
increases as women enter the workforce (Ybarra, 1982). Along these lines,
Guendelman (1987) found that seasonal migration to the United States expanded the traditional roles of Mexican women to include greater
purchasing power, family decision making, division of household responsibilities with husbands, feelings of autonomy, and even less stress compared to nonworking immigrant women. Thus, in some scenarios, families
adaptively negotiate acculturation to the United States, expand their bicultural repertoires, and reap the benefits of both cultures. In other cases,
acculturation-related stressors, exacerbated by poverty and minority status, can result in various forms of family dysfunction, necessitating culturally and socially appropriate understanding and attention.

150 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Next, overarching problem themes in Latino families are reviewed
briefly, followed by a detailed analysis of such serious Latino family problems as domestic violence, sexual assault, and issues surrounding the
Latino elderly.
OVERARCHING PROBLEM THEMES IN U.S. LATINO FAMILIES
Differences
Latino families from different national-origin groups are likely to have
some relatively unique problem themes, based on their different acculturation experiences, in addition to many overlapping problem areas based on
common social and cultural experiences as Latinos in the United States. For
example, the Cuban American experience is strongly rooted in its relatively
recent “community in exile” experience, characterized by strong anti-Castro
sentiment and conservative cold war politics, combined with rapid socioeconomic success and concomitant marital assimilation into mainstream society. One way that this historical and political backdrop plays itself out
within the Cuban American community and family is through tensions that
emerge between the older generation’s expectation of loyalty to exile politics and pressure to maintain culture of origin and the younger generation’s
diminishing concern with what they see as remote history, not only less relevant to their own American lives but perhaps politically antiquated as
well. The younger generation may develop more liberal and progressive
views on lifting the embargo against Cuba, assimilation, and even about the
recent Elian Gonzales fiasco that pitted traditional Cuban American politics
against family unity and U.S. federal law (see Chapter 10).
Central American families continue to be influenced by the many dislocations and disruptions caused by their violent civil war backgrounds,
generally low SES, and adjustment to the United States with mixed formal
recognition of their refugee status. Depression and Posttraumatic Stress
Disorder related to wartime traumas and losses can be debilitating for family members, and there are frequent unresolved family reunification problems between those living in the United States and those left behind due to
lack of resources and stability. Given the pervasive denial of refugee status,
many members of Central American communities keep a low profile and
seek services less than they should for some problems. It is also worth noting that the designation Central American obscures several national origin
groups with different histories, civil war backgrounds, and experiences in
the United States. More research on each of these groups separately is
needed and is beginning to emerge.
Mexican Americans today are almost evenly divided between relatively
recent economic immigrants, who have frequently followed well-worn

The Latino Family 151
migrant streams in search of a better life, and multigenerational U.S.-born
Mexican Americans who struggle with the living legacy of discrimination and segregation, as well as the varied pressures, conflicts, and benefits inherent in the acculturation process.
Puerto Rican families continue to experience the trade-offs of “revolving door” migration between Puerto Rico and the mainland, political divisions between those favoring statehood for the island and those
favoring their current commonwealth status, and oversegregation and
poverty in the United States, where their profile is closer to that of
African Americans in terms of negative social and economic indicators
(e.g., poverty rates, female heads of household, vulnerability to psychosocial problems such as IV drug use, HIV/AIDS).
In addition to these “big four” Latino groups, other smaller, recent and
rapidly growing Latino groups are gaining visibility in the United States.
Dominicans now number over 1 million and are creating their niche on
the East Coast. In some ways they are like Puerto Ricans in their rich
African lineage, yet more similar to Cubans in their persistence in business ventures (albeit small businesses).
Similarities
In their review of 28 published reports on group therapy with Latinos,
Delgado and Humm-Delgado (1984) found that the most common problem themes centered around interpersonal conflicts regarding marriage
and family. Other common problem themes long reported in the group
therapy literature include family breakdown, acculturative stress, and
discrimination (Acosta, 1982), and in the case of depressed Puerto Rican
women, conflict with spouses/partners and children, culture shock, and
psychological distress (Comas-Diaz, 1985).
Culturally and socially competent interventions for Latino families are
discussed next, beginning with a general description of family therapy,
followed by a more detailed analysis of some timely and critical Latino
family problems that require comprehensive interventions, ranging from
group and family therapy to communitywide and even national policydirected efforts. Problems and issues more specific to Latino youth are
addressed in the subsequent chapter.
SELEC TI VE R EV IEW OF LATI NO
FAM I LY PROBLEMS AN D CULT UR ALLY
COMPETENT RESPONSES
For an impressive description of exemplary, wide-ranging programs serving Latino families, the reader is referred to Supporting Latino Families:

152 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Lessons Learned from Exemplary Programs (Resumen en Español) Volume 2: InDepth Profiles (Shartrand, 1996). Highlighted here are but a few very important Latino family-focused problems and interventions to illustrate
cultural competence in action (i.e., teaching cultural competence by examples).
ECOSYSTEMIC LATINO FAMILY THERAPY: GENERAL ISSUES
Falicov (1998) views the primary role of the family therapist to be that of
an intermediary in family conflict whose job is to reframe trouble between family members as “cultural transitions” in need of better understanding. Typically, uneven levels of acculturation between parents and
children are addressed in the context of migration history and acculturation experience and remedied by heightening mutual understanding and
appreciation as well as improving communication, negotiation, and compromise skills that promote greater flexibility, biculturality, and adjustment to the United States. Trouble between parents resulting from shifts
in gender roles, where women work outside the home and consequently
request more help from husbands with housekeeping and child care, are
similarly framed as normal acculturation problems. In addition to working with whole families and separately with individual members as
needed, Falicov notes that therapists need to be “culture brokers” who
help families obtain needed basic resources from social services, as well
as natural support systems.
Based on over 20 years of direct service and research at the Spanish
Family Guidance Center in Miami, Szapocznik and colleagues (1997) have
developed an acculturation-sensitive, structural ecosystemic approach to
family therapy with Cuban and other Latino immigrant families. Like
Falicov (1998), Szapocznik et al. attribute family problems to “acculturation gaps” that can exacerbate the normal generation gap between parents and adolescents, as well as typical problems between husbands and
wives (e.g., financial, household duties, parenting). Szapocznik and colleagues emphasize the goal of aligning family members to work together
against acculturation gaps that threaten the family. The overriding goal of
therapy is to foster cross-generational alliances within families by connecting parents to the positive aspects of more modern American values,
while connecting children to positive aspects of more traditional Latino
values. (Family therapy is covered in more detail in Chapter 7.)
Evaluation of Family Therapy
The literature on Latino family therapy is predominantly descriptive,
with the exception of the work of Szapocznik and associates, who have

The Latino Family 153
conducted considerable outcome research. For example, in Szapocznik
et al.’s (1997) summary of their research, they report that their culturespecific family approaches are as effective as more generic forms of family
therapy (e.g., structural family therapy) as well as individual psychodynamic therapy in reducing symptoms, but are superior at engaging and retaining Latino families and preserving family cohesiveness. Family
therapy was also found to be superior to group therapy. Thus, family therapy approaches to pressing Latino family problems can be a viable intervention strategy alone or, ideally, as part of a continuum of care, ranging
from micro- to macro-level efforts.
I N T I MAT E PARTNE R ( D OM E S T IC ) V I OLENCE
I N T H E L AT I NO FAM I LY
PROBLEM ASSESSMENT
The pressing and increasingly recognized problem of domestic violence
in Latino families provides an excellent example of how to begin thinking
about and responding to important family problems in a culturally and
socially competent manner. For some Latino families, the challenges discussed earlier threaten an already impoverished and strained situation,
resulting in increased rates of marital disruption and divorce, family dysfunction, and, at the extreme, domestic violence, or what is now being referred to as intimate partner violence (IPV), a term not confined to the
private realm of the home nor to heterosexual relationships. Although
much research remains to be done in this problem area, Latinos have been
included in a number of large surveys and community studies of IPV, and
researchers and practitioners have advanced ideas and models that consider the historical, cultural, and social experiences of U.S. Latinos.
PREVALENCE RATES AND THE PROBABLE ROLE OF ACCULTURATION
With regard to rates of IPV in Latinos relative to other racial/ethnic
groups in America, Sorensen (1996), a leading researcher on this topic,
noted that three major surveys provided mixed findings: Latino rates
greater than Whites’ (Straus & Smith, 1990), equivalent to Whites’
(Sorensen & Telles, 1991), and lower than Whites’ (Sorensen, Upchurch,
& Shen, 1996). However, Sorensen also astutely noted that acculturation
must be factored in to get a more accurate picture. For example, she
noted that Straus and Smith’s report from the 1985 National Family Violence Resurvey included only English-speaking Latinos, and that when
Sorensen and Telles examined the role of acculturation in their survey,
they found that rates of IPV were clearly higher in U.S.-born Mexican

154 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Americans (31%) compared to Mexico-born Mexican Americans (20%),
whose rate was equivalent to Whites’ (21.6%; percentages refer to one or
more incidents of hitting or throwing things at spouse). Exposure to the
Latino experience in America appears linked to IPV, but how?
In an effort to tease out factors related to poverty and culture, Kaufman
Kantor, Jasinski, and Aldarondo (1994) compared Latino (n = 743) and
White (n = 1,025) families from the National Alcohol and Family Violence
Survey with respect to the influence of economic stressors and cultural
norms sanctioning wife assault. Similar to Sorensen and Telles (1991),
Kaufman Kantor et al. found that wife assault was predicted by being born
in the United States for Mexican American and Puerto Rican men. Rates
for these U.S.-born Latinos were higher than for Mexican immigrants and
for the predominantly immigrant Cuban group. With respect to economic
stress, unemployment was a significant predictor of IPV. With respect to
culture, attitudinal norms sanctioning wife assault also predicted IPV but
for both Latino and White families. In fact, rates of wife assault were the
same for these two groups when controlling for economic stressors and
pro-wife assault norms. Thus, although more research is needed, social factors such as poverty play major roles in IPV, and so-called cultural factors
are not exclusive to Latinos. In fact, most of the IPV research thus far shows
that Latinos most steeped in their traditional culture of origin (i.e., immigrants low in acculturation) are those at lowest risk for IPV.
These data are noteworthy in view of the popular idea that traditional
Latino culture (e.g., machismo) is at the root of IPV. Although we should not
rule out the role of culture-based sexism, we should not view it apart from
social factors such as poverty, which is consistently linked to IPV for all
women. In Weinbaum et al.’s (2001) analysis of the 1998 California Women’s
Health Survey (N = 4,006), the major predictors of IPV were participation in
the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during the previous 2 years, unemployment, feeling overwhelmed in the previous 30 days, and smoking. Prevalence rates of IPV
during the previous year were 6% overall, but a breakdown by race/ethnicity revealed highest rates for Latinas (9.3%), followed by African American
women (8.7%), Asian women (5.4%), and White women (4.4%). Weinbaum
et al. found no differences between foreign-born and U.S.-born Latinas in
their sample; however, an analysis of survey data for the years 1999 through
2001 did reveal such a difference (Weinbaum & Thorfinnson, 2006).
TOWARD A MODEL TO UNDERSTAND LATINO INTIMATE
PARTNER VIOLENCE
In an effort to make sense of IPV in U.S. Latino families, Flores-Ortiz
(1993) has introduced the concept of “cultural freezing” to describe

The Latino Family 155
rigid and stereotyped adherence to traditional values and behaviors in
response to difficult acculturation, as well as adherence to intergenerational legacies of family violence and abuse. For example, husbands may
adhere to extreme forms of machismo but without control, or desenfrenado (without brakes), resulting in excessive drinking, aggressiveness,
and intrusive overprotection and control of wives and children. This results in a rigid boundary between the family and the outside world, and
even isolation from the Latino community. Wives may resign themselves
to martyrdom and children may become parentified and straddled with
inappropriate adult roles in the family that not only stunt healthy psychological development but serve to maintain family dysfunction (e.g.,
secrets in the family, parental communication through the child).
At the extreme, husbands may punish their wives for working and social mobility-related changes (e.g., going out with coworkers, greater assertiveness). In response, some Latinas may tolerate abuse for the sake of
family unity, to avoid the stigma related to divorce, and due to other ingrained cultural scripts. Research on a small sample of abused Latinas
does show a correlation between domestic violence and the financial contributions of wives in Latino families (Perilla, Bakeman, & Norris, 1994),
and data from sheltered abused women show that Latinas do remain
longer in abusive marriages compared to African American and White
women (Gondolf, Fisher, & McFerron, 1988).
Rodriguez, Bauer, and Flores-Ortiz (2001) advocate striking a balance
between the consideration of cultural and social factors in the dynamics
of Latino IPV. For example, they note that although traditional
values such as machismo and its submissive female counterpart, Marianismo, probably lend themselves to domestic violence in their extreme
forms, other factors need to be considered: America’s glorification and
sexualization of violence, gender-based power inequality in both mainstream and Latino cultures, barriers to IPV education and services for
women in general, lack of culturally responsive services for Latinos in
particular, and the considerable economic dependency of Latinas on
their husbands, especially among undocumented women. In fact,
Sorensen (1996) asserts that so long as federal immigration law requires
undocumented women to remain married while their citizenship applications are being processed, IPV will inadvertently be structurally built
into the system.
In her model of Latino IPV, Flores-Ortiz (1993) connects the private interpersonal realm of family violence to the public social realm of structural violence toward Latinos and other people of color. That is, life under
historical conditions of oppressive power imbalances finds its way into
family life, especially where there is alcohol and drug use by abusers, and
where Latino families face social isolation and lack traditional social

156 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
supports. Again, research supports these ideas. A study of 142 abused
women in Mexico revealed that so long as married couples lived with the
wife’s family, no abuse took place, even from previously abusive alcoholic
husbands (Finkler, 1997). The power of extended family to mitigate IPV is
diminished in the United States as immigrant Latino families transition
into more nuclear and sometimes isolated family units.
THE ROLE OF ALCOHOL
The problem of alcohol abuse in IPV families has been well documented
in the literature, and more recently with U.S. Latino couples and families. Using data from the 1995 National Alcohol Survey, Cunardi, Caetano, Clark, and Schafer (1999) examined the relation between IPV
and alcohol-related problems in African American (n = 358), Latino
(n = 527), and White (n = 555) couples. They found that in couples reporting male alcohol-related problems, rates of IPV were two times
higher in Latinos, three times higher in Whites, and seven times higher
in African Americans compared to couples without male alcohol-related
problems. Overall rates of male-to-female IPV were 23%, 17%, and 11%
for African Americans, Latinos, and Whites, respectively. A similar pattern was found for female-to-male IPV, at 30%, 21%, and 15%. Although
generally not as injurious or lethal, it is noteworthy that the latter rates
are higher than the former and deserve much more attention in all
racial/ethnic groups.
With regard to alcohol use, Cunardi et al. (1999) found that rates of
male alcohol dependency were twice as high in African Americans and
Latinos compared to Whites, and that male alcohol-related problems were
twice as high in African Americans and three times as high in Latinos
compared to Whites. The presence of male alcohol problems predicted
IPV in all three racial/ethnic groups. It should be noted that when predictor analysis controlled for sociodemographic factors, psychosocial factors (e.g., experiencing physical child abuse), and alcohol consumption,
alcohol-related problems no longer predicted male-to-female IPV in
Latino couples. Rather, sociodemographic problems such as unemployment and low family income (less than $20,000 annually) predicted IPV.
Thus, although male problem drinking is high in Latino couples and is related to higher rates of IPV, it appears to be secondary to, and perhaps a
result of, poverty-related factors.
Perilla et al. (1994) also found a relation between IPV and husband’s intoxication, as well as immigration-related stress (i.e., in the realms of
work, parenting, marriage, and family), in their small sample of 60 immigrant Latinas, half of whom were experiencing IPV. Interestingly, they

The Latino Family 157
also found that this relationship was mediated by perceived mutuality in
close relationships, as reflected in empathy, communication, respect, and
understanding. Thus, high relationship quality can attenuate the relation
between abuse and acculturative stress/drinking, but such quality is vulnerable to the problems noted earlier.
Flores-Ortiz (1993) asserts that oppression at societal and family levels
ultimately results in inauthentic human relationships because family
members isolate, disconnect from feelings, and assume a defensive stance
of stoicism and disregard for the nurturing and well-being of others. The
pain at the center of such families can result in multigenerational legacies
of violence and other problems, but intervention can transform such pain
into genuine care and resilience.
The fact that IPV exits the world over, and not just in specific cultures,
has led thinkers like Perilla (1999) to cast the problem as a broader human
rights issue. She notes that the legal status of married women, or coverture, makes it difficult for men to imagine women having separate equal
identities and freedoms apart form their traditional role of serving men.
Thus, any assertive movement toward equality can trigger threat in men
and the need to control and dominate with various degrees of force. With
respect to Latinos, Perilla notes that Latino men batter because they have
learned that violence is an effective option for which there are minimal
consequences in society and the immediate culture. She also notes that in
her own clinical work, the vast majority of battering men and battered
wives had witnessed such violence in their family of origin and that Mexican immigrants are frequently surprised that there are U.S. laws against
domestic violence.
In response to the persistent question of why abused Latinas remain
in violent relationships, Perilla (1999) reminds us that many abused
women leave their abusers only to be injured or killed. Thus, although
remaining tends to be viewed by mainstream America as a failure of
abused women, it shouldn’t be hard to imagine given issues of financial
dependence, confusion, and self-blame on the part of women socialized
by culture, including their religion, to remain married no matter what,
and the social isolation that is typically a part of the terrifying aspects
of domestic violence.
Interviews with 5,708 abused women utilizing shelters in Texas found
that, compared to White (57% of sample) and Black women (15%), Latinas
(29%) were poorer and younger, had more children, had been married
longer, and were more likely to have remained 5 years or longer in abusive marriages (31% of Latinas versus 21% of the other women; Gondolf
et al., 1988). For IPV interventions to succeed, they must be informed by
such findings and thinking.

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CULT UR ALLY AN D S O CIALLY
RESPONSIVE INTERVENTIONS WITH
INTERPERSONAL VIOLENCE
COMMUNITY-LEVEL EFFORTS
Though short on outcome data, some instructive and detailed descriptions
of community-based and even national efforts to address Latino IPV, both
in the United States and Latin America, have begun to appear in the literature. These reports convey the considerable time, care, and persistence
required to develop large-scale approaches that fit with the local historical, social, and cultural experiences of the populations involved. The results are conceptually sound community- and policy-level efforts that
address sexist macro-social values and create the infrastructure necessary
for helping affected families and communities at the micro level.
Southwestern Detroit
La Vida (Life) is a community-based partnership to prevent IPV against
women in a poor southwestern Detroit barrio of approximately 20,000
Latinos (60% Mexican American, 30% Puerto Rican). Maciak, Guzman,
Santiago, Villalobos, and Israel (1999) describe La Vida’s lengthy developmental process of establishing a broad-based coalition of key players (i.e.,
Community Based Organizations, academics, health and social service
providers, including the police and even the INS) on a community advisory board who developed a viable network, as well as an institutional
identity, and who conducted participatory, formative research to inform a
comprehensive, communitywide prevention and treatment plan.
An evaluation plan of both the collaborative process and the impact of
IPV prevention strategies is built into La Vida. Lessons learned while encountering frequent challenges (e.g., the need to balance informative research with meeting the immediate needs of clients) are described in the
form of the following recommendations: (a) Maintain ownership and control of the IPV project within the local Latino community; (b) involve
strong and stable leadership partners in the Latino community with a
long-term commitment; and (c) conduct IPV community diagnosis and
needs assessment via formative research to situate the program within
the history and social and cultural experience of the Latino community.
Efforts such as La Vida are occurring throughout Latin American, including Mexico.
Mexico City
Fawcett, Heise, Isita-Espejel, and Pick (1999) describe the use of formative
research (e.g., focus groups and interviews with key informants, IPV

The Latino Family 159
needs assessment) to assess IPV in the Iztacalo district of Mexico City.
Focus groups explored community IPV norms and beliefs, and participants were asked to identify resources in response to different IPV vignettes. In-depth interviews with women in present or past abusive
relationships were conducted to explore their experiences and responses.
Findings from the study reveal a curious mixture of traditional and modern norms and thinking about IPV used for developing local prevention efforts: (a) high community consensus regarding the attribution of IPV to
economic hardship, lack of education, past experiences of family violence on
the part of men, and alcohol problems, yet no mention of gender inequality;
(b) overattribution of responsibility for IPV to women (e.g., women not
complying with gender role; three abused women said they were unable to
change IPV when it began early in relationships); (c) descriptions of violent
men by their wives were divided between compliments (i.e., good father
and provider) and criticism; (d) views of marital separation as a solution divided between agreement and citing deterrents such as loss of income, of
family support, and of a father for the children; (e) strategies used by
abused women were both passive (patience, tolerance, avoidance, submission to requests for sex) and aggressive (i.e., withholding sex and meals, insulting man as sexual partner and provider, locking man out of home); (f)
help-seeking preferences included other women, especially mothers, rather
than formal support, and abused women expressed considerable shame and
reluctance to reach out; and (g) reluctance on the part of community members to get involved in the private lives of others, as reflected in a dicho
shared by participants, “El que mete paz, saca mas” (He who tries to make
peace, gets more than he bargains for).
Given the excellent community diagnosis of IPV, Fawcett et al. (1999)
developed an intervention plan with the overarching goal of getting
women to recognize abuse and getting family and friends to support
rather than blame the victims of abuse. More specifically, the intervention plan consisted of two interrelated communitywide components:
• A 12-session workshop to support and help actual victims of abuse,
including those participating in the workshop. Workshop content
challenged cultural norms by providing education about family violence as a community problem that is everyone’s responsibility; the
role of gender inequality; social and personal consequences of IPV;
relevant legislation and available service alternatives; the cycle of violence, including different forms of violence and their objectives;
and crisis intervention skills.
• A communitywide campaign to challenge local norms consisting of
peer outreach, popular theater, and special community events (e.g.,

160 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
conducted by workshop women) and use of local media to communicate types of violence, domestic violence laws, and where to go for
help. Organizers also developed IPV fotonovelas (comic-book-like
forms of Mexican/Latino entertainment that contain actual photos
instead of illustrations, bubble dialogue, and storylines that blend
both comedy and drama), posters, and buttons to distribute. Intimate partner violence self-assessment questionnaires were also distributed. Even the dicho mentioned earlier was challenged by a new
one: “La mujer maltratada te necesita: Acercate, apoyala, ayudala,
acompañala” (The abused woman needs you: Approach her, support
her, help her, accompany her). Unfortunately, this new positive dicho
is long, doesn’t rhyme, and is thus not as catchy as the old one. (Can
Spanish-speaking readers think of a better one?)
Nicaragua
Even from politically conservative Nicaragua, where the government has
sponsored campaigns promoting traditional culture, comes a remarkable
report of a grassroots movement of women against family violence that
not only pressed the government for the improved handling of IPV in
health care and law enforcement, but also strategically engineered the
passage of a national family violence law that protects women, includes
psychological abuse in the definition of IPV, and imposes prison sentences
for abusers in place of the previous infrequently imposed fine of $10 (Ellsberg, Liljestrand, & Winkvist, 1997). The 1996 passage of the law was the
culmination of years of organizing, which included (a) coalition building
with health centers, academic researchers, and professionals in law and
mental health; (b) an epidemiological survey revealing significant rates of
IPV; (c) a national convention to present survey results to the public and
government officials; and (d) drafting family violence legislation and lobbying the national assembly, which included a 40,000-signature petition,
testimony by legal and mental health professionals, and the results of participatory action research that conveyed information on the severity of the
problem and lack of resources. When it appeared that the poorly received
bill would stall, the women’s network took advantage of the current election year by publicizing research findings in the media, writing 21,000 letters urging legislators to act, and providing legislators with briefing
packets. The family violence law was passed unanimously a few days before the national elections.
Ellsberg et al. (1997) report that a year after passage of the domestic violence law, progress has been mixed, ranging from prosecution in a case
of psychological abuse, to reluctance to implement restraining orders on

The Latino Family 161
the part of the legal system. Thus, a “No more impunity” follow-up campaign by the women’s network was mounted.
FAMILY THERAPY FOR LATINO INTIMATE PARTNER VIOLENCE
Flores-Ortiz, Esteban, and Carrillo (1994) present a case study of IPV
Latino family therapy in which they describe three broad phases of therapy: (1) assessing legacies of intergenerational violence and presenting
them to the family as painful patterns of injustice that can be changed
(rituals are sometimes prescribed, such as making altars to abusive parents and forgiving them for their abusive shortcomings); (2) conducting
couple sessions for parents to review desired relationship, including
modeling couples whom they admire, and discussion of Latino cultural
prescriptions of a healthy family as well as Anglo-American models of
more egalitarian relationships; and (3) teaching fair argument and negotiation skills.
Immediate treatment goals address urgent issues such as the symptoms
and lethality of abuse, stopping the violence, a safety plan for the woman,
sobriety requirement for the man, psychoeducation about domestic violence, assessing the mental health needs of each family member, and reviewing steps involved in a nondestructive temporary or permanent
separation, if necessary. Multiple modes of treatment are recommended
to accomplish these goals, such as individual and group therapy for the
man and woman, couple therapy, and family therapy. If progress is made
early, treatment continues and focuses on “unfreezing” rigid cultural
scripts by increasing respect, direct and healthy communication, and
problem-solving skills and rebuilding trust and forgiveness. The couple is
also taught how their seemingly private problems are reinforced by historical and cultural patters of colonization, patriarchy, and gender oppression in both the United States and their country of origin.
The first phase of therapy typically involves constructing a family
genogram, likened to an espejo (mirror). In the case study the genogram
revealed intergenerational IPV on both sides of the couple’s families of
origin (i.e., violent fathers abused both their wives and children). The
couple married young and the man drank excessively and began hitting
the woman shortly after marriage. He also journeyed alone to the United
States, where he lived with an amante, or lover, until he was later joined by
his wife and children. After a couple of arrests (neighbors called the police) for physically assaulting his wife, the man was given the option of
jail or treatment; he participated in 18 months of group therapy for violent Latino men. The group for Latino men helped him maintain sobriety,

162 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
reduce violence, prepare for family therapy, and reflect on destructive
versus responsible male cultural scripts.
The couple was highly reinforced for their disclosures and for attending therapy. The man had an exaggerated macho self-image, and the
woman passively resigned herself to the situation, like a martyr. Therapists challenged the couple’s disbelief in the possibility of change and
their view of their behaviors as “normal.” Therapists stressed how unfair
their legacy of violence was to all family members and helped them process their emotional pain.
In the second phase, the couple’s own daughter’s marital relationship
was discussed as a happier, violence-free, and fairer relationship to emulate. The advantages of acting a little more like Anglo couples, with the
intent of “unfreezing” their rigid gender roles and increasing their bicultural repertoire, was discussed. The couple was also encouraged to go out
more alone and to function as a team where child care was concerned. Interestingly, the man had little to do with the children and sometimes felt
isolated as a result. The couple was also helped to negotiate desired
changes, which included the man helping more with household responsibilities. The third phase continued the practice of couple negotiation and
extended it to negotiations with their children and discussions of proper
child discipline, with attention to issues of acculturation.
SELF-HELP WITH INTIMATE PARTNER VIOLENCE
Zambrana (1985) wrote a thoughtful and comprehensive, bilingual selfhelp book with a pearl of wisdom title that plays off on a popular Latino
dicho: Mejor Sola que Mal Acompañada: Para la mujer golpeada (Better Off Alone
Than with Bad Company: For the Battered Latina). Several chapters define
and describe abuse scenarios for Latinas, address social and cultural reasons for abuse (e.g., traditional cultural scripts in which men are taught
to be overcontrolling and women are taught to relinquish control to men),
and help the woman consider the decision to stay or leave, followed by
how to use resources such as emergency medical and police assistance,
shelters, legal help, and support groups, even if Latina readers lack English proficiency, documentation, or money. Other chapters address creating a life and relationships without violence, and there’s even a chapter
for counselors working with Latinas.
SEXUAL ASSAULT
It is worth discussing the problem of sexual assault against Latinas in tandem with the discussion of IPV, given its community and, ultimately,

The Latino Family 163
family contexts. Latina sexual assault is even more underresearched than
Latino IPV yet has become an increasingly important topic requiring a
proper consideration of social, cultural, and familial factors to better understand, prevent, and treat.
PREVALENCE
Low and Organista (2000) reviewed the scant literature on Latina sexual
assault and found that lifetime prevalence rates of sexual assault were
consistent with national crime data: 8.1% for Latinas compared to a 19.9%
for non-Hispanic Whites (Sorenson & Seigel, 1992). However, similar to
Latino IPV patterns, U.S.-born Mexican American women were 3 times
more likely than those born in Mexico to have been sexually assaulted,
underscoring yet again the often precarious experience of Latinos in the
United States.
Koss, Gidycz, and Wisniewski (1987) were among the first to examine
rape by ethnic status in their administration of the Sexual Experiences
Survey to a national sample of 6,159 male and female college students
from 32 educational institutions. Though the findings are limited to college students, the following differences between racial/ethnic groups
were found: 16% of European American women (n = 2,655), 10% of
African American women (n = 215), 12% of Latinas (n = 106), 7% of Asian
American women (n = 106), and 40% of Native American women (n = 20),
although the latter sample was too small from which to generalize.
CULTURAL DIFFERENCES
Lefley, Scott, Liabre, and Hicks (1993) conducted a study of culture-based
beliefs about rape in a sample of 101 rape victims selected from 881 consecutive admissions to the Rape Treatment Center of the University of MiamiJackson Memorial Medical Center in Dade County, Florida. Women were
excluded if they had a prior history of rape or incest, psychiatric history, or
cognitive impairment, and the sample was almost evenly divided between
African American, Latina, and non-Hispanic White rape victims. The
Latina participants were of Cuban and Central American background and
were restricted to those whose parents were from Spanish-speaking countries and who were married to Latinos (if married).
Assessment of rape myths and their internalization was conducted by
presenting nine rape scenarios to the participants. In each it was clear
that the female was forced to have sex with the man, but the scenarios
varied in ways that the literature suggests are important to the concept of
rape, such as use of a weapon, victim-rapist relationship, social role of the

164 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
victim, and the context of the rape. Analogous to IPV reserach, results revealed that Latinas had the highest acceptance of rape myths that hold that
women contribute to rape through their dress or behavior and that women
are responsible for controlling men’s sexuality as well as their own. Latinas
also were highest in perceptions of people in their community as subscribing to rape myths and as having punitive attitudes toward victims. With regard to psychological distress, Latinas were highest, White women were
lowest, and African American women were intermediate. Further, Latinas
were most likely to employ avoidance as a coping mechanism.
These results are consistent with other studies on attitudes toward
rape that consistently reveal more traditional attitudes and greater subscription to rape myths on the part of Latinos as compared to Whites
and African Americans. For example, Williams conducted a multicultural study of both rape victims and community residents in San Antonio, Texas, and found that Mexican Americans were more likely than
both Anglo (Williams, 1985) and African American community residents (Williams & Holmes, 1981, 1982) to subscribe to rape myths. This
study used the same rape scenarios used by Lefley et al. (1993; i.e., more
victim blaming, less inclined to prosecute assailants, more antifeminist
in judgment). The community sample consisted of 335 Whites, 336
African Americans, and 340 Mexican Americans; the small female sample of rape victims consisted of 32 Whites, 11 African Americans, and 18
Mexican Americans. Compared to White and African American rape
victims, Mexican American rape victims had the highest mean scores on
the study’s crisis scale, which assessed degree of threat, inability to respond with adequate coping mechanisms, and disruption of routine
functioning.
Consistent with these studies, Fischer (1987) found that even among
bilingual and bicultural Latino college students, attitudes toward
women and forcible date rape were more traditional than those of their
White counterparts (i.e., less rejecting of date rape, less likely to blame
male perpetrators). As a group, these studies imply that Latino genderrole ideologies facilitate self-blame in Latina victims of sexual assault.
The result can be a context of shame and blame that prohibits women
from talking about their experience with their family and community.
Moreover, victim blaming following sexual assault has documented
negative effects on a woman’s healing process. For example, Ullman
(1996) found that the relation between negative social reactions to
rape and negative psychological outcome in victims was mediated by
avoidant coping. Apparently, sexism embedded in both Latino and
American gender-role systems can produce a dual dilemma for Latina
victims of sexual assault.

The Latino Family 165
SERVICE UTILIZATION AND NEEDS
With regard to postsexual assault service utilization, Sorensen and Siegel
(1992) found that both Latinas and non-Latina Whites were equally likely to
report to police, although the actual numbers are characteristically unimpressive (i.e., 9.6% and 10.8%, respectively). It was also found that Latinas
were less likely than their non-Latina White counterparts to seek any health
service regardless of need, the nature of the assault, age, and medical insurance. Further, Latinas were less likely than non-Latina Whites to see a psychologist but more likely to see a member of the clergy. When compared to
nonassaulted Latinas in the Los Angeles Epidemiologic Catchment Area
Study (the LA-ECA is a large psychiatric survey discussed in detail in Chapter 8), Latinas with a history of sexual assault were more likely to have utilized medical services in the past 6 months. Thus, underutilization of
specialized services is a problem for sexually assaulted Latinas, and outreach efforts via general medical providers and clergy would be logical
starting places. Community-based agencies specializing in Latina sexual assault are also needed; a model of such an agency is discussed next.
A MODEL SEXUAL ASSAULT AGENCY FOR LATINAS
In a cross-site analysis and case study of “exemplary” rape crisis programs funded by the National Institute of Mental Health (Harvey, 1985),
the Sexual Assault Center of San Joaquin County in Stockton, California,
was chosen as one of nine programs nationwide considered to be particularly effective in addressing the needs of victims in their community. One
of the unique aspects of this program is that its clientele corresponds proportionately to the racial and ethnic demographics of San Joaquin County,
which has a large Latino population. Some factors that might explain the
center’s success in serving the local Latino population include its multiservice orientation that incorporates comprehensive advocacy and counseling services to adult and child victims of sexual assault, and
community education and prevention services. It is housed in an accessible downtown office space, in the same building as a job program for lowincome women and an advocacy organization for abused women.
Whenever possible, Latina clients are matched with Latina staff and a
concerted effort is made to maintain a representative group of bilingual
and bicultural staff and volunteers. According to Harvey:
At all levels of programming, The Sexual Assault Center puts a special emphasis on the importance of multicultural, bilingual services. The staff is culturally and racially diverse; volunteers are recruited and services publicized

166 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
through the Spanish-speaking radio and television stations and bilingual
presentations to church groups. Materials are developed in both English and
Spanish and much consideration is given to issues facing minority communities. Client record keeping and program evaluation regularly examine the
center’s service to minority and Spanish speaking groups. (p. 73)
The agency has developed a credible reputation in the community due
to its outreach efforts and high quality of services. Unfortunately, evaluative outcome research is not a part of this program, as is generally the
case with direct services.
COGNITIVE-BEHAVIORAL THERAPY
Organista and Valdes Dwyer (1996) describe how cognitive-behavioral
group therapy (CBT) combined with clinical case management is an effective treatment strategy for Latinas suffering from depression and traumatic
experiences, including sexual assault. For example, a severely depressed
woman from Guatemala disclosed how she felt permanently “stained” for
having been sexually abused as an adolescent by her mother’s live-in
boyfriend. The problem had been exacerbated by her mother’s reaction, a
mixture of disbelief, denial, and victim blame. Group members were asked
if it was true that rape or other forms of sexual assault permanently stain
women for life, thus initiating a dialogue about traditional Latino and
more modern beliefs about sexual abuse.
Next, to begin shifting the client’s beliefs in a healthier direction, she
was asked to complete the following sentence: “Yes, it is true that I feel
stained from being sexually abused, but . . . ,” to which the woman was
able to respond, “but I was the one taken advantage of!” From such a beginning, work proceeded to place proper blame on the perpetrator and to
redefine the stained victim role to an injured survivor in need of healing
via healthy thinking, activities, social supports, and sensitive services.
Even the estranged relationship with the client’s mother was discussed,
with a focus on helping the client to better understand that such negative
reactions are problems located in the mother, family, and culture (e.g., the
role of denial, rigid gender roles), as well as the role of economic dependency. (Chapter 8 contains a more expanded description of CBT as applied
to depression in Latinas.)
ELDERLY L AT I NO I S SUE S
The intergenerational nature of familismo, combined with the significant
growth of the elderly Latino population, render problems and issues af
The Latino Family 167
fecting such family members increasingly important to conceptualize and
address. Falicov (1998) notes that elderly U.S. Latinos face physical and
psychosocial adjustment tasks similar to their Anglo-American counterparts: grandparenthood, retirement, illness, and of course death. However, she also notes a frequent “multiple jeopardy” encountered by elderly
Latinos having to do with minority status and acculturation-related issues that can exacerbate problems linked to old age. For example, elderly
Latinos lack pensions and health insurance more than their Anglo counterparts. Elderly Latino immigrants also retain varying degrees of culture-of-origin values and expectations about retirement, illness, and
death that may or may not match those of their U.S. families and local services. Falicov further notes that it is simply wrong to stereotype the Latino
family as ready to meet all of the needs of its elderly members. While
there are culture-of-origin norms prescribing extended family care of elderly parents and grandparents, such norms change with acculturation, as
does the quality of family relations.
Thus, the trick is to assess actual and potential resources of the elderly
within and beyond the family system, broker for needed resources, and
help the elderly establish mutually beneficial relationships where possible. What follows are some general and topical issues pertaining to elderly Latinos and their unique needs. Such a discussion invariably
involves health status and elderly health problems and solutions (also included in Chapter 9).
ELDERLY LATINO POVERTY, FUNCTIONING, AND SUPPORTS
Expected links between problems related to poverty, functioning, and
social-familial connectedness in the Latino elderly are borne out in reports from large-scale surveys and research. One major source of such
reports is the 1988 National Survey of Hispanic Elderly People (NSHEP;
Andrews, 1989), which included 2,299 elderly Latinos, age 65 and older,
from the East Coast, with all of the major Latino groups represented.
Comparisons of NSHEP data to national data on the elderly show lower
life satisfaction and peace of mind in elderly Latinos related to multiple
economic, health, and social problems such as higher poverty rates, medical bills, sick spouses, loneliness, and dependency on others (Andrews,
Lyons, & Rowland, 1992).
Tran and Williams (1998) used NSHEP data to examine the relation between poverty and health status and concluded that the widespread
poverty among elderly Latinos (i.e., ranging from 50% in Cubans to 63.7%
in Puerto Ricans) has an usually large negative impact on activities of
daily living such as getting in and our of bed, light housework, and

168 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
bathing. Factors that protected Latino elderly from impairment included
being married, more educated, and bilingual. Not surprisingly, elderly
Cubans were the least impaired and Puerto Ricans the most. Given such
substantial needs, what kinds of formal and informal supports are elderly
Latinos using?
FORMAL AND INFORMAL SUPPORTS
With respect to formal service use, Deitz, John, and Roy (1998) used
NSHEP data to show low use of the following formal services across all of
the major Latino groups, including Central and South Americans: little if
any use of senior center services (e.g., meals, social gatherings) and inhome services (e.g., health aide, housekeeping, meal preparation), and low
use of federal entitlement programs such as Medicaid and Medicare (e.g.,
doctor’s services and hospitalizations). Cuban Americans and Puerto Ricans were higher in use of entitlement programs, and Mexican American
and other Latinos were less integrated into such federal programs.
Deitz (1997) also compared use of formal support to family support and
found that while Latino elderly did receive some family support for activities of daily living (e.g., food shopping), their needs were not adequately
being met this way. For example, 66% of participants reported difficulty
with at least one (from a list of 11) activity of daily living, yet less than
half of these participants received family assistance. In addition, between
21% and 43% of participants paid for help with things like housework,
eating, and bathroom assistance, despite meager incomes. Dietz also
noted the following low rates of formal assistance use by participants to
supplement their low incomes: 36% used SSI, 15.4% food stamps, 12% senior centers, and only 4.1% used home health care.
Despite such low use, Latino elderly are likely to be hit hardest by
shrinking public benefits and cutbacks in federal income maintenance programs. For example, Zsembik, Drevenstedt, and McLane (1997) used data
from the 1990 Panel Study of Income Dynamics (PSID) to assess the impact
of social program cutbacks and related policies on the Latino elderly. The
PSID contains data on 2,000 Latino families, representative of Mexicans,
Cubans, and Puerto Ricans in the United States. These researchers found
that, compared to the elderly in general, Latino elderly relied more heavily
on vulnerable publicly funded health insurance (i.e., Medicaid) than private property (home ownership), insurance, and other assets. Puerto Ricans in particular were the least economically secure across all indicators
of economic status, most dependent on Medicaid health insurance, and
thus the most vulnerable to shrinking benefits in the states where they are
most numerous (e.g., New York, Florida).

The Latino Family 169
Thus, survey research on elderly Latinos documents high poverty and
functional needs exacerbated by inadequate formal and family assistance,
problems especially pronounced in the poorest Latino elderly: those
without a spouse, low in education and English fluency, and of Puerto
Rican background. From this portrait we should suspect pronounced
stress and depression in Latino elderly with less than adequate coping resources. Using the NSHEP database to examine how the elderly cope with
depression and family problems, Starrett, Todd, Decker, and Walters
(1989) found that less than 10% of participants utilized mental health
professionals or physicians, 17% used the church, and 36% indicated that
they used nothing.
BUT DON’T LATINO FAMILIES CARE FOR THEIR ELDERLY?
The answer to this question is yes and no. Reviews of the literature on
this topic do indeed show that Latino elders are more likely than their
White counterparts to live with their family and less likely to be institutionalized in long-term care facilities, including nursing homes (Johnson,
Schwiebert, Alvarado-Rosemann, Pecka, & Shirk, 1997; Zsembik, 1996).
However, the determinants for such living arrangements, as well as questions regarding how optimal this is for the elderly, have only recently
begun to be addressed. Reports from the NSHEP that examine the preferences of elderly Latinos for living alone (Zsembik, 1992) as well for living
with others (Zsembik, 1996) show that the traditional cultural norm of
caring for the elderly within the family changes with acculturation and
related factors, such as the availability and willingness of family to care
for the elderly, as well as economic resources and health status. For example, elderly Latinos with retirement incomes were much more likely to
live on their own than those with smaller and less stable incomes. Puerto
Rican elderly were found to be most likely to live alone and to prefer it
this way; this was attributed to their greater poverty, dependency on restrictive public housing, and having children less able to afford to take in
their parents.
Johnson et al. (1997) conducted a small qualitative study of 10 Mexican
American elderly to assess residential preferences and found an interesting mix of results: desire to live alone as long as possible; preference to
live with families if unable to live alone, coupled with concern about
being a burden; and a view of nursing homes as a negative last resort and
place to die. Service implications from this study, as well as the others
discussed, include working closely with families of the elderly to assess
ability and willingness to provide care and to teach them about formal
service care options, beginning with alternatives to nursing homes such

170 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
as home health care, assisted living, home nurse care, and congregate living. If a nursing home is the best option, the family should be involved
with placement and should be helped to remain involved with visits and
care decisions. The goal is to decrease fears on the part of the elderly of
being a burden, being abandoned, and even being disrespected by family
by what they may think of as a culturally incompatible option.
Writing with elderly Puerto Ricans in mind, Delgado (1995) advocates that providers of formal care for the Latino elderly should assist
them by collaborating with community-based NSS in which the elderly
are embedded. Members of the NSS can be educated about existing formal services and can be utilized as key informants, consultants, agency
board members, volunteers, and paid employees who lend their personal, cultural, and community-based expertise to the development
and improvement of elder care. Interestingly, Delgado interviewed six
academic experts on elderly Puerto Ricans who defined their NSS not
only as (in)formal support networks, but also as mechanisms of cultural
maintenance and dignity-maintaining reciprocal networks in which the elderly provide as well as receive help.
LATINO ELDER ABUSE
Elderly abuse is the most recent form of predominantly family-based violence to come to the attention of service providers and the public. Because
attention to this problem only goes back a couple of decades, information
is quite limited, even more so for Latinos and other communities of color.
For this reason, writings about elderly abuse in Latinos have had to fuse
the little we know about this problem in general with what we do know
about the (elderly) Latino experience in the United States. Vasquez and
Dinelia (1999) reviewed data from the National Elder Abuse Incidence
Survey (National Center on Elder Abuse, 1998) and reason that many risk
factors for elder abuse, such as physical and economic dependency and
cognitive impairment, coincide with poverty- and acculturation-related
stress in Latino families. These writers also note that female elderly are at
greatest risk for physical (71.4%), financial (63%), and neglect (60%)
forms of abuse at the hands of male perpetrators (e.g., husbands, male
adult children). Otiniano, Herrera, and Hardman-Muye (1997) present
such a case study, emphasizing the mutual dependence of a wheelchairbound elderly Mexican woman collecting SSI and her unemployed and alcohol abusing adult son who lives with her. Using Adult Protective
Services (APS) data from Texas, Otiniano et al. note that while Latinos
make up 28.1% of the state, they make up just under 23% of APS cases, although they attribute this rate to underreporting due to language and

The Latino Family 171
legal barriers as well as misinformation about elderly abuse in the Latino
community. These researchers also note that neglect accounts for 44% of
elderly Latino abuse cases, that adult children make up about 45% of perpetrators, and that elderly Latinas are twice as likely to suffer abuse as
their male counterparts.
Montoya (1997) echoes this line of reasoning and lists logical recommendations, such as educational campaigns about elderly abuse and APS
at community, family, and individual levels. He notes that culture-based
messages such as “No es bien disrespetar el anciano” (It’s not okay to
disrespect the elderly) can be used to combat reluctance to recognize and
disclose elder abuse in Latino families stressed by social isolation and
lack of access and resources. Obviously much more research is needed to
better understand and respond to this emerging problem area in effective ways.
DEMENTIA AND CAREGIVER BURDEN IN LATINO FAMILIES
The Alzheimer’s Association (2004) has issued special reports specifically on Latinos noting mounting evidence that elderly Latinos are at
higher than average risk for cognitive disorders for several reasons. First
of all, the Latino elderly population will triple, from 5% of all elders today
to 16% in 2050, and will continue to be disproportionately represented in
the older age groups at greatest risk for dementia. In fact, Latino life expectancy is projected to surpass all other groups in the United States by
midcentury. It is well documented that the prevalence of Alzheimer’s
doubles every 5 years beyond the age of 65, reaching an astounding 50%
for those 85 years or older. Other Latino-relevant risk factors include very
low educational levels that limit the protective benefits of formal education against Alzheimer’s disease and greater risk for Alzheimer’s and
stroke-related dementia due to diabetes, which affects 1 in 3 elderly Latinos. In the first representative, population-based study of dementia in
older Mexican Americans (N = 1,789), Haan et al. (2003) found an overall
prevalence of dementia of just under 5%, a rate comparable to similar
studies of the elderly in the United States and Canada, yet lower than
among Caribbean Latinos in New York. However, they also found that
43% of dementia in these elderly Mexican Americans was attributable to
Type 2 diabetes mellitus, stroke, or a combination of both.
Haan et al. (2003) conclude that, at a minimum, screening for dementia needs to be combined with screening for diabetes given that a third
of their sample had diabetes. Further, even though 90% of their sample
had medical insurance and 88% had a regular doctor, the vast majority
were diagnosed with dementia for the first time in the study! Thus we

172 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
must understand and address the underdetection of dementia in elderly
Latinos at both the external service level and the internal cultural level.
Ortiz and Fitten (2000) studied barriers to health care access in a sample
of 65 cognitively impaired elderly Latinos and found that participants
indicated the following three most frequent obstacles to health care access: personal beliefs about aging and illness (38%), language (33%), and
economic problems (13%). Personal beliefs that interfere with seeking
needed health care included viewing memory problems as normal in old
age, not feeling sick, and feeling too old to be helped, as well as fear of
discrimination and the effects of medication and believing that God is
more helpful than medications. These findings are rich with implications for addressing treatment obstacles beyond money and health care
access problems.
Fortunately, the Alzheimer’s Association has been active at a variety of
levels, from health policy lobbying efforts to developing a contact information center with Spanish-language capacity and organizing coalitions
of Latino-focused community and health organizations to educate and respond to Latino community needs in this specialty health area.
DEMENTIA CAREGIVER BURDEN AND SUPPORT
In response to the underuse of caregiver support groups for Latino family
members struggling to cope with parents and other elderly family members affected by Alzheimer’s disease (AD), Henderson, Gutierrez-Mayka,
Garcia, and Boyd (1993) describe a 2-year effort to involve Latinos and
African Americans in AD caregiver support groups. Though lacking formal evaluation, their report is valuable for its careful documentation of
the culturally and socially responsive efforts taken to involve more than
100 Latino and African American caregivers with no prior utilization.
The authors note that prior to their work, only Anglo-Americans attended AD caregiver groups in the two Florida cities where the study
took place. The following steps represent a careful review and synthesis
of prior pertinent literature on culturally competent service delivery.
Though effortful, this is the kind of groundwork needed to connect Latinos and other underutilizing groups with needed human services.
• Develop a community demographic profile by using census data,
local records and newspaper archives, local medical association, and
ethnic minority organization information.
• Develop a list of ethnic minority organizations (e.g., review of phone
book headings such as “Hispanic,” “Black,” “Minority,” “Government
Agencies”).

The Latino Family 173
• Identify ethnic minority media from entertainment guides from
local and ethnic minority communities and radio and TV outlets.
• Identify key community leaders from ethnic organizations, ethnic
radio and newspaper, and word of mouth.
• Interview identified key community leaders: This was done by project staff that were given the time to get out and learn about the community they were attempting to serve via semistructured interviews
viewed as data collection.
• Maintain vigilance in ongoing learning process by fine-tuning project activities following implementation.
In a companion article, Henderson and Gutierrez-Mayka (1992) present
case studies of care to AD patients in Latino families. They note that improving quality of care involved decreasing the stigma related to AD via
psychoeducation about the organic nature of this problem, encouraging
caretakers to use their “culture broker” skills to connect relatives with
AD to needed social services, and being aware of the well-documented
“female burden-barer” role in traditional Latino families and how this diminishes with acculturation (e.g., between generations).
Recently, Gallagher-Thompson et al. (2003) published the only randomized controlled evaluation of two different approaches to reducing caregiver
stress in Latinas and their Anglo counterparts caring for relatives with dementia. This study employed many of the points listed earlier to compare a
typical community-based support group intervention with a psychoeducational skill-building approach that utilized cognitive-behavioral techniques
to teach specific coping strategies. These interventions were 3 months in duration, and results showed that the skill-building approach was the most effective in reducing depressive symptoms, increasing adaptive coping
strategies, and decreasing negative coping. Latinas and Anglo women benefited similarly; this was attributed to special care taken to tailor the intervention to Latinas by addressing their language needs and by making the
cognitive-behavioral techniques compatible with Latino culture (e.g., urging
stressed caretakers to take some restorative time out for themselves as a way
to provide better care for their relative).
El Portal (the doorway or entrance) is a carefully developed and coordinated model program for Latino caregivers of AD-affected family
members (Aranda, Villa, Trejo, Ramirez, & Ranney, 2003). Based in Los
Angeles, home to the nation’s largest population of elderly Latinos, El
Portal is a community-based collaboration that uses a variety of care services by a consortium of nonprofit human services providers, program
consumers, community representatives, and government entities. Careful
attention is paid to community outreach, networking, and community

174 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
awareness, ranging from major and minor Spanish- and English-language
media outlets and campaigns to grassroots, word-of-mouth efforts by former caregivers. Fragmented services are minimized by locating educational, support, respite, and legal services within two community-based
health care agencies and by training a servidora to provide full-time service coordination.
CONCLUSION
As the central cultural institution of Latinos, la familia will continue to be
discussed and researched as a major site for understanding and responding to various family-related problems and issues. Given the immensity
of the topic, only a selective review of a few timely, complex, and increasingly important problems areas were addressed in this chapter, with the
overriding objective of illustrating how to better understand and respond
to Latino family-related problems in a culturally and socially competent
manner. These illustrations can be extrapolated to myriad other family
problems and issues of interest and importance to the reader.
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181
CHAPTER 7
Latino Youth
THE PSYCHOSOCIAL AND health problems of most Latino youth generally
result from unmet developmental needs due to the breakdown of conventional social and cultural supports and resources within the family,
ethnic community, and greater society. As such, risk in Latino youth is
evident in a cluster of inter-related problems, especially in the poorest of
barrio-dwelling youth, that need to be assessed and remedied as comprehensively as possible.
Burt, Resnick, and Novick (1998, p. 38; see Table 7.1) articulate an ecologically comprehensive approach to understanding adolescent risk that
is highly applicable to Latinos:
The presence of harmful existing conditions (antecedents) in the absence of
sufficient protective factors create vulnerabilities. These vulnerabilities,
combined with the presence of specific early signs of difficulties (system
markers), institutional inabilities to help children and youth who evidence
such markers, and the absence of positive behaviors or competencies, may
lead in time to problem behavior that will have more serious long-term consequences (negative outcomes).
For many Latino youth, antecedents include excessive poverty, family
dysfunction, deficient community institutions (e.g., schools), and problems linked to minority status and the process of acculturation. Risk in
Latino adolescents is generally higher in more acculturated youth experiencing family breakdown and disconnections from traditionally stabilizing social institutions such as school, church, prosocial peer groups and
activities, and work. Psychosocial and health problems are most evident
for Mexican American (i.e., Chicano) and Puerto Rican youth, from the

Table 7.1
Risk Antecedents, Markers, Behaviors, and Outcomes: A Conceptual Framework for Thinking about Youth
Antecedents
Protective
Factors
System
Markers
Problem
Behaviors
Positive
Behaviors
Negative
Outcomes
Family dysfunction Individual competencies/abilities Poor school performance School-related problem behaviors
(truancy, absenteeism, violence)
Good school attendance, attachment
to school, good
performance
Dropping out of school, poor
credentials for economic
self-sufficiency
Parental
competencies/
resources
Child protection/
out-of-home
placement
Early sexual
behavior
Postponing sexual
behavior
Pregnancy, too-early parenthood, poor pregnancy outcomes
Sexually transmitted diseases, including chlamydia
and AIDS
Poverty Use of tobacco,
alcohol, other
drugs
Abuse of or addiction to
alcohol or other drugs, and
associated health problems
Neighborhood and
local institutions
Other adults
Neighborhood
resources
Effective schools and
other institutions
with responsibility for
children and youth
Running away from
home, foster home
Associating with
delinquent peers
Positive interactions
with family
Participation in
community and
religious institutions
Social, problemsolving, and peer
skills
High self-esteem
and achievement
motivation
Homelessness
Physical abuse, battering
Prostitution
Sexual abuse, rape, incest
Death or permanent injury
from guns, knives, and other
violent behavior; automobile
accidents; other accidents
Other morbidity/mortality
outcomes (e.g., hepatitis,
tuberculosis, pneumonia,
AIDS complications)
Depression, suicide
Criminal convictions
Source: Building Supportive Communities for At-risk Adolescents: It Takes More Than Services, by M. R. Burt, G. Resnick, and E. R. Novick,
1998, Washington, DC: American Psychological Association.
182

oldest and largest of U.S. Latino groups whose histories reveal significant
tension with mainstream society and consequent acculturative stress
(e.g., segregation, poverty). Although the literature is scarce, there appear to be parallel problem patterns for Central American and Dominican youth, who usually live alongside predominantly urban-based
Mexican American and Puerto Rican youth. And although Cuban American youth are hardly immune to psychosocial problems, the literature reveals generally better levels of adjustment given their unique history and
generally better socioeconomic status (SES). For example, a study by Gil
and Vega (1996) showed greater acculturative stress in Nicaraguan as
compared to Cuban adolescents in Miami, given the latter’s integration
into the highly successful Cuban enclave.
Protective factors include individual, family, and community strengths;
however, as noted in Burt et al.’s (1998) framework, such protective factors are frequently undermined by the very risk factors listed in that
framework. As a result, early system markers (e.g., records of school failure, police records) are disproportionately high for Latino youth, as are
more serious and long-term problem behaviors. The most prominent cluster of problem behaviors affecting Latino youth includes depression and
suicidality, substance abuse, delinquency and gang involvement, school
failure, and risky sexual behavior. To address such a cluster of problems,
O. Rodriguez and Zayas (1990) argue for family therapy and family
preservation efforts for adolescent status offenders, community-based
groups for adolescents, and school-based interventions that emphasize
family and ethnic pride. Certainly the overlapping nature of Latino youth
problems and needed multilevel intervention strategies warrant addressing several problem areas simultaneously through comprehensive familycentered and community-based approaches.
CLUSTER OF PSYCHOSOCIAL AND HEALTH
PROBLEMS AFFEC TI NG LATI NO YOUTH
THE CENTRALITY OF SCHOOL FAILURE
The historically entrenched problem of school failure for significant numbers of Mexican American and Puerto Rican youth, and more recently for
Central American and Dominican youth, merits special attention for its
central role in the development and exacerbation of related psychosocial
and health problems, and for the potential role of the school as an optimal
location for intervention.
In a review of the literature by Rumberger (1998), data covey the following scholastic profile for Latino youth: (a) 17% of Latino students have
dropped out by ninth grade; (b) fewer than 50% of Latinos at ninth grade
Latino Youth 183

184 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
have earned enough credits to be on track for graduation; and (c) by the
end of the 10th grade, 31% of Latino students have dropped out and fewer
than 21% have earned enough credits to be on track to graduate. Such
data are particularly pronounced for Puerto Rican youth, who have the
highest rates of dropout among Latino youth. A. Rodriguez (1992) highlighted the following factors in his brief review of the literature on
dropout in Puerto Rican youth: (a) dropout rates between 45% and 65% in
most cities, and a staggering 70% in New York; (b) those who came to the
mainland as adolescents are twice as likely to dropout as those born on
the mainland; (c) two-thirds are from single-parent households; (d) youth
with limited English proficiency youth are at higher risk than Englishproficient youth if not provided with appropriate bilingual education programs; and (e) students placed in special education programs are at
higher risk of dropping out than those not in special education programs.
Rumberger and Larson (1994) assert that Mexican American high
school dropouts are like non-Latino dropouts in many respects (i.e., dislike for school, low educational aspiration, discipline problems), but
they are more likely to drop out before high school and to receive a generally inferior education up to that point. In Solórzano and Solórzano’s
(1995) review of the literature, they found that at both elementary and
secondary school levels, Mexican American youth are more likely to attend segregated schools with low-quality curricula, less qualified
teachers, greater teacher turnover, overemphasis on remedial studies,
rigid ability placements and tracking into non-college-preparatory
courses, low-quality programs for students with limited English proficiency, and curricula with little relevancy to the Chicano experience.
Thus, theories of Chicano and Latino school failure in general need to
focus on the role of school structure, resources, and processes as opposed to the traditional bias of looking for cultural defects within the
Latino student, family, and community (Rumberger & Larson, 1994).
It is still a fairly common misconception that poor Latino parents don’t
place a high value on education, as if any group could do without such an
essential need. What research does show is that Latino students and parents are similar to their Anglo counterparts in their educational values
and aspirations, but the former have less instrumental knowledge regarding scholastic requirements for college and what type of education is
needed to prepare for desired professional careers and are less aware of
where to obtain such information (Behnke, Piercy, & Diversi, 2004; Garcia, 2001). Further, poor Latino parents are less able than their Anglo
counterparts to provide direct guidance to help their children with homework and vocational aspirations (Azmitia, Cooper, Garcia, & Dunbar,
1996). Lack of English proficiency plays a major role in this problem area.

Latino Youth 185
As with other families, the more Latino parents are involved in school
activities (Qian & Blair, 1999), as well as homework and monitoring their
children (Plunkett & Bamaca-Gomez, 2003), the higher their children’s
school motivation. Thus, it is imperative that schools step up their ability
to help Latino students and their parents realize their healthy educational
values and aspirations through competency-building strategies. Without
the knowledge, resources, and skills to realize educational dreams, it is
no surprise that so many young Latinos disconnect from school, as reflected in apathy and even resistant, anti-authority and antischool postures (Matute-Bianci, 1986).
DEPRESSION AND SUICIDALITY
The bulk of mental health research on Latino youth centers on Mexican
Americans and shows that these youth, who constitute the majority of
Latino youth, are at greater risk for depression and suicidality than
Anglo and African American youth. Roberts, Roberts, and Chen (1997)
assessed diagnosable Major Depression and related impairment in a survey of 5,423 students from five middle schools in Houston, Texas. They
found rates of Major Depression that ranged from under 2% for Chinese
American students to over 6% for Mexican American students, with
Anglo students in the middle (3.9%). African American students also had
higher rates of depression than Anglos, but only Mexican Americans had
higher rates of Major Depression with impairment (i.e., problems functioning at home, school, and with peers), even after controlling for the effects of SES, sex, and age.
A national survey of adolescents (Roberts & Sobhan, 1992), a household
area probability sample of Los Angeles County (Siegel, Aneshensel, Taub,
Cantwell, & Driscoll, 1998), a survey of high school students (Emslie,
Weinberg, Rush, Adams, & Rintelmann, 1990; Weinberg & Emslie, 1987),
and a comparison of Chicano and Anglo middle school students (Roberts
& Chen, 1995) all found consistently higher rates of depression symptoms
in Mexican American adolescents compared to Anglo-Americans and
African Americans. With the exception of the Roberts and Chen study,
Chicano youth rates remained highest even after controlling for SES, sex,
and age. Thus, factors in addition to poverty influence depression in Chicano youth and need to be understood.
The breakdown of traditional stabilizing forces, and not poverty per se,
leaves Latino adolescents vulnerable to depression and related problems.
Swanson, Linskey, Quintero-Salinas, Pumariega, and Holzer (1992) found
higher rates of depression, suicidality, and drug use in 1,775 Chicano
high school students compared to 2,383 poorer high school students from

186 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Mexico. Research suggests that the breakdown of the Latino family is central in the relation between acculturative stress and mental health problems. Hovey and King (1996) studied the relation between acculturative
stress and depression in poor Latino high school students and found that
depression and suicidality were predicted by high acculturative stress and
low family cohesion (i.e., low support, tension). In turn, acculturative
stress was predicted by low family cohesion and adolescent pessimism
about the future. Further, suicidality was predicted by depression and low
expectations of the future.
Research on Latino families in Miami found greater acculturative
stress in Nicaraguan adolescents compared to their Cuban counterparts,
given the latter’s easier integration into the maturing Cuban enclave versus the recent refugee status of Nicaraguan youth (Gil & Vega, 1996).
Nicaraguan adolescents had the highest rates of suicide attempts in
Miami (Vega, Gil, Warheit, Apospori, & Zimmerman, 1993), and their
early tobacco and alcohol use was related to language conflicts and suicide attempts (Vega, Gil, Zimmerman, & Warheit, 1993). Deterioration of
family cohesion was evident in both of these Latino groups, but only for
Nicaraguan adolescents was acculturative stress related to parent-child
conflict, injured self-esteem, and perceptions of teacher derogation (Gil &
Vega, 1996).
Indeed, family breakdown can impair the ability of parents to guide
their children safely through the risk-filled environments encountered
by most Latino youth. For instance, in their sample of 121 low-income
Chicana mothers of fourth-grade children, Dumka, Roosa, and Jackson
(1997) found that maternal support and discipline (protective factors)
mediated the impact of poverty and family conflict (risk factors) on child
symptoms of depression and Conduct Disorder. That is, when support
and discipline were high, there was no relation between risk factors and
symptoms in children, and vice versa. Unfortunately, the risk factors contributed to inconsistent maternal discipline and low support for children
or undermined protective factors.
Seidman, Chesir-Teran, and Friedman (1999) assessed multiple risk and
protective factors in both family and peer micro systems and their relation
to depression and antisocial behavior in poor, urban adolescents of color.
Results revealed a variety of ways in which poverty and family and peer
systems are related to depression and acting out: (a) The most
depressed and antisocial adolescents came from family relationships characterized by dysfunction (i.e., high conflict, low support, and medium parentchild involvement), enmeshment (medium-high conflict, medium-low
support, and high parent-child involvement), and conflict (high conflict,
medium support and involvement); (b) the most depressed students also
came from peer relationships characterized by rejection; and (c) the most

Latino Youth 187
antisocial adolescents had peer relationships with engaging but antisocial
friends. Such results underscore the need for intervention programs that
include prosocial peers and strategies to improve family functioning.
ALCOHOL AND SUBSTANCE ABUSE
As with depression, risk for substance abuse also increases with acculturation, family breakdown, school failure, and overinvolvement with
risky peers, and varies by Latino groups based on their varied acculturation histories and SES profiles, as discussed in Chapters 1 and 2. Systematic attention to such variables helps us to unravel the sometimes
confusing and contradictory findings in the literature. For example,
major national surveys such as the Youth Risk Behavior Surveillance
Study (Centers for Disease Control, 1996) and the 1998 National Household Survey on Drug Abuse (U.S. Department of Health and Human
Services, 2000) tell us that adolescent substance use is generally greater
in Latinos than in Anglo- and African Americans. However, by lumping
all Latino groups together, important group differences are obscured
under the label “Hispanic.” We can assume, however, that Puerto Rican
and Chicano youth account for the higher rates of Latino substance use
reported in these surveys given the SES profiles of these groups. SokolKatz and Ulbrich (1992) compared alcohol and substance use in a sample of Chicano (n = 794), Puerto Rican (n = 299), and Cuban (n = 144)
adolescents and found that Chicano and Puerto Rican rates of drug use
were twice as high (30% and 28%, respectively) as among Cubans adolescents (15%), although the three groups did not differ in alcohol use
(15%, 12%, and 16%, respectively). Interestingly, Sokol-Katz and Ulbrich also found that although being from a single-parent home predicted alcohol and substance use for both Chicano and Puerto Rican
adolescents, it failed to predict for Cubans. These researchers concluded
that Cubans from single-parent homes are most likely protected by their
higher SES advantages (e.g., better support networks).
While national surveys suggests greater substance use in Latino youth,
reviews of the literature have concluded that Chicanos have lower lifetime
prevalence of illicit substance use than Anglo-Americans (Booth, Castro,
& Anglin, 1990; De La Rosa, Khalsa, & Rouse, 1990). However, contradictory findings have also begun to emerge in large survey research. For instance, results from the National American Drug and Alcohol Survey
showed greater current and lifetime substance use in Anglo (n = 2,243)
than in Chicano (n = 1,837) 12th-grade students; however, rates for Chicano eighth-grade students (n = 2,530) were higher than for their Anglo
counterparts (n = 1,547) in both current and lifetime substance use, as
well as related risk behaviors such as using substances alone, using two

188 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
drugs at same time, and sharing needles (Chavez, Randall, & Swaim,
1992). Sampling high school seniors misses dropouts, who are overrepresented among Latino drug users.
On a related note, results from the California Substance Use Survey
(Boles, Casas, Furlong, Gonzales, & Morison, 1994) found equal rates of
alcohol and drug use in Chicano and Anglo high school students, and
within-group analysis showed greater substance use in U.S.-born versus
Mexico-born Chicanos. Such studies underscore the need for more careful research that disaggregates Latinos, considers acculturation effects,
and does not bias surveys toward high school completers.
Family and Peer Factors
In addition to the factors already noted, it is well-known in the literature
that peer and family factors greatly influence youth substance use. But
how do risk and protective factors within these two major domains of
adolescence play out for Latinos? With regard to the role of peers, Flannery, Vazsonyi, Torquati, and Fridrich (1994) found that peer variables
were more powerful than parent variables in predicting substance use in
a sample of 1,170 middle school children in Tucson, Arizona (24% Chicano and 64% Anglo). That is, peer substance use and pressure to engage
in antisocial behaviors were the strongest predictors of lifetime alcohol
and drug use, compared to parent-child closeness, involvement in activities, and parental monitoring. Poorer adjustment to school also predicted
substance use for Chicanos.
Coombs, Paulson, and Richardson (1991) similarly reported that peer
marijuana use was the most consistent predictor of substance use in a
sample of 230 Chicano and 216 White students, ages 9 to 17. However, a
closer look at their findings reveals a pattern in which substance use in
Chicanos was predicted by both peer and parent factors, whereas use
among Anglo students was predicted almost entirely by peer variables.
That is, Chicano students were more likely than Anglo students to choose
parents over peers when asked whose ideas they respected more and to
whom they would turn during times of trouble. Chicano students also reported that they were more likely to obey their parents in the event of
parent requests to keep away from peers whom their parents perceived as
a bad influence.
Another study of Chicano middle school children found that only low
family cohesion predicted substance use in male adolescents, as compared to peer substance use, peer relations, adjustment to school, family
substance use, and level of acculturation (Brooks, Stuewig, & LeCroy,
1998). In this study, family cohesion was defined as low conflict, high
parental monitoring, intact family, and spending time together. Interest
Latino Youth 189
ingly, family cohesion did not predict substance use in female students,
consistent with the findings of Flannery et al. (1994), who found that substance abuse in Chicanas was predicted by poor adjustment to school but
not by family variables. Taken together, these results appear to reflect
greater familism in Latino youth, although more research is needed on
sex differences.
Risk and Protective Factors
In one of the most comprehensive studies of substance use in Latino
youth, Felix-Ortiz and Newcomb (1999) studied the separate and combined impact of risk and protective factors across multiple adolescent domains in a sample of 516 predominantly Chicano high school students
from Los Angeles. Risk and protective factor indices were constructed
from a wide variety of well-substantiated correlates of adolescent substance abuse: family variables (e.g., parental support and substance use),
peer and community variables (e.g., peer substance use, availability of
substances, tolerance for substances in the community), educational adjustment (e.g., grades, aspirations), conventionality (i.e., obeying the law,
religiosity), emotional health (i.e., psychological distress, history of physical/sexual abuse and suicidality), and beliefs about self and drugs (e.g.,
self-acceptance, perceived harmfulness of substances). Dependent variables assessed were frequency of cocaine/crack, PCP, marijuana, inhalants, beer/wine/liquor, and cigarette use during the prior 6 months.
A pattern of results emerged that are very important for sharpening
our understanding of the complexity of substance use in Latino youth in
general and high-risk youth in general: It was found that risk factors predicted substance use more strongly than did protective factors, but that
protective factors mediated the relation between risk and substance use
for both boys and girls. That is, at high levels of risk, protective factors
predicted less substance use, whereas at low levels of risk they did not.
Thus, protective factors protect Chicano youth from substance abuse
when risk factors are substantial. Frauenglass, Routh, Pantin, and Mason
(1997) found a similar pattern of results with regard to tobacco use in
poor Latino adolescents in Miami: When peer tobacco use was high, family support predicted lower tobacco use in participants, but at low levels
of peer use family support did not predict use. Thus, developing and reinforcing individual, family, peer, and community protective factors is
likely to help adolescents coping with high-risk environments.
More attention to Latina youth is also warranted in view of findings by
Felix-Ortiz and Newcomb (1999) that alcohol and inhalants were the most
commonly used substances among girls as well as boys, and that rates of
alcohol use were actually higher for girls. Because two of the studies just

190 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
reviewed found that poor school adjustment but not family factors predicted substance use for Chicanas (Brooks et al., 1998; Flannery et al.,
1994), it certainly makes sense to enhance academic and extracurricular
school adjustment as a way of preventing substance use in Latinas.
LATINO YOUTH GANGS
Latino-Sensitive Gang Theory
Most of what we know about Latino gangs comes from literature on Mexican American juvenile street gangs that date back to at least the 1930s.
Puerto Rican youth gangs also have a long and notorious history in the
United States, but major texts such as Youth Gangs in American Society
(Shelden, Tracy, & Brown, 2004) and Gangs in America (Huff, 1996) contain
almost no information on this important population. Even less information is available on those newer Latino youth (i.e., Central Americans and
Dominicans) who fall into gang membership patterns.
Although only a minority of Chicano youth become cholos, or gang
members, this historically entrenched phenomenon has been a painful
and destructive part of the Chicano experience throughout most of the
twentieth century, sometimes occurring in multigenerations of the same,
barrio-dwelling families. Goldstein and Soriano (1994) note that gang
data are imprecise because no national-level agency has assumed responsibility for their systematic collection and dissemination. Using mostly
local police and other criminal justice agency records, Goldstein and Soriano estimate the existence of 2,000 gangs in the United States with about
20,000 members. They note that the age range for membership has expanded from 12–21 to 9–30, and that the ratio of boy gangs to girl gangs
has decreased from 201 to 151, with increasing autonomy in the latter.
There are an estimated 600 Black and Chicano gangs in Los Angeles
and 100,000 gang members, and there were 770 gang-related murders in
1991 (Harris, 1994). Yablonsky (1997) notes that four recent trends have
made gangs in America more violent and problematic than ever before:
(1) access to more lethal weapons; (2) greater availability of drugs; (3) increasing interracial violence; and (4) an increase in the multipurposes
and sophistication of gang organization and structure.
The foundations for a social and culturally sensitive understanding of
Latino gangs were developed in the pioneering works of Vigil (1988) and
Morales (1992), who conceptualized gang membership as an extreme response to the extreme failure of family, community, and traditional social
systems to meet the developmental needs of Latino adolescents struggling with poverty-related risks and minority status in the United States.
Such “multiple marginalities” were viewed as resulting in compromised
or
Latino Youth 191
development and struggles with distorted cognitive maps of the self, family, culture, social systems, and society.
Belitz and Valdez (1994, 1997) build on these classic works by focusing
on the context of family dysfunction and the psychological crisis of adolescent and ethnic identity development as responses to family marginality and adolescent alienation from family and society. These authors note
that in immigrant families, parent and child role reversals (e.g., negotiating in English) and the low-prestige jobs of parents can create images of
parents as weak in contrast to neighborhood gang members who appear
powerful, confident, defiant, and aware of what’s going on. In multigenerational Latino families, the long-term effects of poverty can erode
healthy family functioning needed to guide adolescents through the developmental task of healthy identity development, including issues of
Latino ethnic identity.
Family dysfunction pushes youth outside of the family to struggle
with exceedingly complex issues of identity, purpose, role, and power on
the streets. The pull of urban gang culture, with its rigidly defined hierarchy, prescribed member roles and activities, and symbols of group and
cultural identity, can be particularly alluring for vulnerable youth. Chicano gang members invariably refer to their gang as their familia, to gang
members as carnales, or blood brothers, and to the respeto and protection
they are accorded as members. They also adopt or are given gang names
(e.g., Payaso [clown], Sleepy) as well as roles (e.g., fighter, artist, leader)
and use a mix of gang and Mexican symbols and images to express and
project their individual and collective identities (e.g., tattoos, graffiti,
hand signs). Thus, the use of gangs to achieve personal and social goals
is considerable for these otherwise marginalized outsiders and suggests
interventions that redirect such basic human motivations.
But while gang members claim their “homies” as family, their distorted
maps of familism and friendship limit healthy relationships. For example,
in a rare empirical study of incarcerated Chicano and Anglo gang members, Lyon, Henggeler, and Hall (1992) found that members’ peer relationships were characterized by more aggressiveness and social immaturity
than the relationships of nongang incarcerated youth. Chicano gang members also had more extensive criminal records and reported greater hard
drug use than nongang incarcerated Chicanos.
Belitz and Valdez (1997) note that the following family dysfunction factors are typically related to gang membership: substance abuse, domestic
violence, and physical or sexual abuse of children and adolescents. The
pent-up rage and violence frequently manifested (and valued) by gang
members has many roots, including modeling and identifying with an aggressive and abusive parent or street models such as veterano (veteran)

192 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
gang members. The fact that Latino gang member violence is mostly directed at rival Latino gang members, who mirror each other in almost all
respects, reflects a deep-seated self-hate linked to negative images of self
and ethnic culture. Violence is also a way of creating real consequences to
the gang realities that members construct from their limited environments and resources. For example, although the job of protecting one’s
turf or barrio is at odds with lacking any property ownership, the price to
be paid for crossing the imaginary line is quite real.
To illustrate their theorizing, Belitz and Valdez (1994, pp. 67–69) offer
the illustrative case study of 17-year-old Benito from an urban, barriodwelling, three-generation Chicano gang-involved family.
Benito’s father was dominating, aggressive, and physically abusive toward his wife and children. Growing up, Benito avoided, helplessly tolerated, and eventually imitated his father’s violence. Benito loved his
mother but saw her as weak and unable to protect him. School failure and
disciplinary action at school resulted in hanging out with gang members
and eventually joining a local gang of similar others. Benito took on the
role of an extremely crazy or locote gang member with regard to alcohol
and drug use, run-ins with the law, fighting, and so on. Multiple legal
and mental health contacts followed with frequent incarceration where
Benito would be victimized by stronger, and would himself victimize
weaker, incarcerated youth. Despite the costs, Benito considered his gang
his real family and professed his lifelong loyalty and willingness to die
for it. ¡Mi barrio primero! [My barrio-gang above all!] is a frequent claim of
gang members professing their loyalty to their gang above all. For Benito,
the gang was also a location in which he could claim his Chicano identity,
albeit a distorted one characterized by a crazy, violent, defiant, high risktaking male macho image.
Unfortunately, schools generally exacerbate the Chicano gang problem
by responding only with disciplinary actions such as detention and suspensions, as well as academic tracking, remedial courses, and alternative
continuation schools, which all serve to further stigmatize and alienate
gang members from school and positive peers (Vigil, 1999). Outside of
school, the simple criminalizing of gangs and suppression activities by
police further push gangs to the margins of society.
Latina Gangs
Females have always been active in Latino gangs, but primarily as girlfriends of male gang members. However, tough and autonomous Latina
gangs have begun to form with potential for destructive acts similar to
male gangs. Interviews with cholas from southern California (Felkenes &
Becker, 1995; Harris, 1994) found them to be very similar to cholos in
terms of why they join gangs, involvement in substance use, violence (e.g.,

Latino Youth 193
feuds with rival gangs), and other prized loca behavior. These girls had
weak ties to family, school, and society, and many had experienced abuse in
their family. Felkenes and Becker found that 41.2% of the 40 Los Angelesbased cholas interviewed had dropped out of school and that fewer than
25% were employed either full time or part time. Detention centers for
these girls were often viewed more as safe havens than a deterrent to
gang involvement.
A qualitative study of female Puerto Rican gang members in New York
concluded that their gang identity was almost a default identity resulting
from the rejection of major aspects of their social and ethnic roles as poor
Puerto Rican women (Campbell, 1987). Although they identified as
Puerto Rican, they considered themselves more American and modern
than old-fashioned Puerto Ricans but without much integration into mainstream society. Similarly, although they were aware of themselves as female and poor, they rejected both passive and promiscuous female roles
and placed a high value on wearing designer clothes.
RISKY SEXUAL BEHAVIORS
Teen Pregnancy
Adolescent sexual behavior has been a long-standing public health priority for its connection to teen pregnancy and sexually transmitted diseases (STDs). National surveys indicate a continual rise in teen
pregnancies, live births, and consequent problems, including greater
health risks for mother and child, less education and fewer career choices
for teen mothers, higher poverty and divorce rates for teen parents, and
the potential for interpersonal violence and child abuse (Berry, Shillington, Peak, & Hohman, 2000; Franklin & Corcoran, 2000). The live birth
rate for Latina adolescents (100 per 1,000 pregnancies) is quickly approaching that of African Americans (109 per 1,000), both of which are
more than double the rate of Anglo-American adolescents (43 per 1,000).
The majority of research on Latino adolescent teen pregnancy has been
conducted among Mexican Americans and shows two consistent patterns: (1) Those higher in acculturation are at greater risk for sexual activity and single motherhood than those lower in acculturation (Becerra
& de Anda, 1984; Darabi & Ortiz, 1986; Reynoso, Felice, & Shragg, 1993);
and (2) Mexican American adolescents have higher live birth rates than
Anglo-American teenage girls despite similar rates of pregnancy and
lower rates of sexual intercourse (Aneshensel, Becerra, Fielder, & Schuler,
1990; Aneshensel, Fielder, & Becerra, 1989). The latter finding is most
likely due to the Mexican American girls’ lack of knowledge about sex
and contraceptives, less contraceptive use, and less communication with

194 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
parents about sexual matters (Baumeister, Flores, & VanOss Marin, 1995;
Holck, Warren, Morris, & Rochat, 1982), factors also prominent in other
Latino groups (DuRant, Pendergrast, & Seymore, 1990).
Sexually Transmitted Diseases and HIV/AIDS
In Los Angeles County, rates of gonorrhea and syphilis are low for both
Latino and Anglo adolescents, but rates of chlamydia were twice as high
for Latinos (483.2 versus 234 per 100,000, respectively; Nuno, Dorrington,
& Alvarez, 1998). More alarming, although adolescent AIDS cases are
only 1% of L.A. County cases, Latinos constituted almost half of these
cases, as compared to 27.2% for African Americans and 21.9% for Anglos.
A rare survey of HIV risk in just under 600 mostly Puerto Rican adolescents in New England found that over 40% were at high or moderate risk
for HIV because of frequent unprotected sex with multiple partners during the prior 6 months (Smith, McGraw, Crawford, Costa, & McKinlay,
1993). Interestingly, girls were at considerably higher risk than boys in
the study.
Risky sexual behavior in Latino adolescents increases with acculturation to the United States because ties to traditionally stabilizing forces
such as the family and traditional community institutions break down.
Research on teenage Latinas shows that avoiding sexual activity is predicted by remaining in school, frequent church activity, and family stability (DuRant et al., 1990), and that not being pregnant is predicted by
intact family, positive school attitudes, and getting information about
sexual matters directly from parents (Baumeister et al., 1995). Felice,
Shragg, James, and Hollingsworth (1987) found that dropping out of
school was a greater precipitant of pregnancy for Mexican American than
for Anglo or African American girls.
So where are the Latino adolescent boys in all of this? Citing the work
of Perez and Duany (1992), Kiselica (1995) reports the following percentages of sexual activity, by the age of 19, on the part of Latino (81%), Anglo
(76%), and African American (96%) male adolescents: Latino adolescent
males were found to have lower rates of effective contraceptive use (50%)
compared to Anglos and African Americans (60% each).
Preventing Risky Sexual Behavior
A review of teen pregnancy programs serving mostly Latino and African
American youth found that programs that provided contraceptive knowledge and access were superior in increasing contraceptive use and decreasing rates of pregnancy, even though they had no effect on sexual
activity (Franklin & Corcoran, 2000). Despite such results, only one in
five of 32 programs reviewed provided contraceptives to adolescents. Fur
Latino Youth 195
ther, programs designed to delay sexual activity were effective but only for
young adolescents. This point is important if we want to avoid the common
mistake of advocating one-size-fits-all, abstinence-only approaches to diverse adolescents, as currently advocated by the Bush administration.
Risky sex prevention programs for Latinos need to be integrated into
schools, churches, and families, given that research showing that stability
in these domains is related to less sexual activity (DuRant et al., 1990)
and lower rates of pregnancy (Baumeister et al., 1995) in teenage Latinas.
Mounting such programs will be difficult in view of the Catholic
Church’s hard line on premarital sex and contraceptives and the traditional tendency for Latino parents and children not to discuss sexual
matters. Such conservative systems need to better understand the current
reality of risky sex in Latino youth and creative ways to address it. For example, churches could advocate delaying sexual activity in younger adolescents and more traditional immigrant adolescents, but need to be more
realistic about the social experiences of older and more acculturated
Latino adolescents if they wish to be effective. Further, given that research shows that Mexican American girls who discuss sexual matters
with their parents are less likely to become pregnant, interventions that
help parents with this challenging task are needed, especially considering the discomfort that such parents express about this task and their tendency to not discuss contraceptives (Baumeister et al., 1995).
ADDRESSING THE CLUSTER OF PROBLEMS
CUR R EN TLY AF F EC T I NG L AT I NO YOU T H
SCHOOL- AND COMMUNITY-BASED INTERVENTION STRATEGIES
Comprehensive, family-centered, and community-based strategies at
multiple ecological levels are badly needed to address the cluster of psychosocial and health problems endangering the lives of Latino youth,
families, and communities. Fortunately, trends in this direction have
been pursued, complete with models, demonstration projects, and occasional outcome data on which to build (e.g., Burt et al., 1998; Dryfoos,
1994b; Flaherty, Weist, & Warner, 1996). An excellent example is the Houston Communities in School (CIS) project, which coordinates a broad range
of child and family services in 21 schools with the ambitious goal of curbing dropout, improving academic skills, decreasing delinquency, and
preparing students for adult work roles (Burt et al., 1998).
The CIS service configurations are tailored to the needs of different
schools but generally include personal and preemployment counseling
for students and comprehensive social services for families. High-risk
students are identified and referred to the CIS caseload; lower risk

196 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
students are invited to participate in school enrichment activities as a
way of decreasing program stigma and promoting more needed interaction between risky and positive peers. The program functions as a broker for local county and community-based services that seek partnership
on behalf of students. Continuity is enhanced by vertical teams that follow students through school feeder programs from elementary through
high school. A complex set of public and private sources provide funding
for CIS; because sources shift with political administrations and corporate mergers, funding requires ample administrative infrastructure to
manage. As of 1996, more than 18,000 students had been served by CIS,
with school retention rates remarkably between 89% and 100%.
There is a CIS program at Edison Middle School in a community known
as “Little Mexico,” where a club approach was used to attract Mexican
American students to modeling, mariachi (traditional popular Mexican
string and brass band), and English-as-a-second-language clubs (Burt
et al., 1998). These clubs were particularly attractive to Chicana gang
members. The CIS program employs 40 tutors from the University of
Houston, two caseworkers, a drug counselor, and a community youth service crisis worker. Padres con Poder (Parents with Power) is a program for
parents that teaches them parenting skills with special attention to
Latino family themes, as well as substance use and violence prevention.
Burt et al. also described a collaboration between CIS and county juvenile
probation in which staff from both provide intensive student and family
services to adjudicated youth.
Greenberg Garrison, Roy, and Azar (1999) describe a community-based
program in Washington, DC, designed to enhance the personal, social,
and school functioning of Central American youth with dual attention to
family adjustment to the United States. Program development began with
a needs assessment via meetings with youth and families, community
leaders, service providers, school administrators, and county government
personnel. Student referrals were based on input from parents, teachers,
principals, and school councils; student assessment included observation
in school and unstructured settings and meetings with parents. Family
assessment included a full evaluation of psychosocial needs.
A comprehensive array of innovative programs was developed for
Latino students and their families: in-home and crisis intervention services; individual, group, and family therapy; case management to address
subsistence needs and community-based parent education and support
(with child care as needed); consultation to school personnel regarding
student behavior; and interagency collaboration to address family psychosocial needs. Examples of program innovations include a newcomer
program for immigrant students, with a buddy system to facilitate adjust
Latino Youth 197
ment to new schools, and group therapy focusing on refugee-related
themes of loss and grief.
A preliminary evaluation of the program found that 90% of parents’
and about 66% of teachers’ ratings indicated improvement in general student functioning. One-third of students improved in reading, and twothirds either improved or remained at appropriate grade-level math and
study skills. With regard to school attendance, 90% of students attended
80% of the time, and 70% attended 90% of the time during the prior year.
Both of these broad school programs bear a resemblance to what are
called “full-service schools,” which are designed to address local children
and families in their communities by consolidating multiple services
within the school setting.
FULL-SERVICE SCHOOLS IN LATINO COMMUNITIES
In her book Full-Service Schools: A Revolution in Health and Social Services for
Children, Youth, and Families, Dryfoos (1994a) defines full-service schools
as school centers where physical health, mental health, and social and
family services are located, depending on local school and community
needs. Dryfoos (1994b) describes an impressive pair of full-service
schools in very different Latino communities that exemplify just what is
possible to do on behalf of Latino students, families, and communities.
A Full-Service School for the Dominican American Community
Dryfoos (1994b) describes IS 218, a predominantly Dominican middle
school in New York City’s Washington Heights, as a “settlement house”
in a school, given this full-service school’s unique development and spectrum of school-based services tailored to the Dominican community. The
development of IS 218 began with an extraordinary collaboration between
New York City schools and the Children’s Aid Society (CAS), one of the
city’s oldest and largest nonprofit social services, whose budget of over
$30 million was being used to operate 26 social service agencies (e.g.,
community centers, adoption services and foster care, housing for the
homeless, medical and dental care, job programs).
In the late 1980s, CAS began to address the social service needs of
Washington Heights. During consultations with local school officials, the
idea of school-based community services arose. The timing was auspicious because the city was planning to replace outdated school buildings
and the new collaboration worked on an architectural plan to create a
full-service school that would be open 7 days a week, from early morning
to late evening, as well as during the summer. The Children’s Aid Society
simultaneously partnered with the community organization Alianza

198 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Dominicana (Dominican Alliance) by securing grants to train staff to
work in afterschool programs in the new “beacon school” (schools linked
with community agencies). Grants were also obtained to address a number of issues articulated by staff and community members (e.g., mobile
medical and dental care, program for disabled).
After 4 years of planning, IS 218 opened in 1992 complete with a family
resource center, medical suite, and security guards. Social workers and
community volunteers at the family center help with public assistance
and housing, immigration and citizenship needs, crisis intervention,
drug prevention, and adult education; for example, parents can earn certificates in dental assistance. The school was named after a Latino poet,
Salome Urena Middle Academies, and houses 1,200 students who are enrolled in one of four academic academies: math, science, and technology;
business; expressive arts; or community service. Each academy consists of
five classes and five team teachers who meet frequently with advisory
groups of 15 students to discuss career plans, school, and family problems
and issues. Afterschool programs build on the academies (e.g., business
students develop and operate a school store that can involve family members and family business plans). There’s even a Spanish class for local police taught by students and family members! Regular meetings between
the school principal, the CAS director, and the superintendent of schools
are essential in the administrative management of such a complex and
ambitious venture. Interestingly, Dryfoos (1994b) noted that the school
cost about $800,000 a year to run, and that the annual cost per student of
$7,500 was actually below what is spent on suburban school students.
A Full-Service School for the Mexican American Community
In Modesto, California, the predominantly Chicano Hanshaw Middle
School is managed by the Interagency Children’s Service Coordination
Council, which is composed of representatives from the city school district, several county government child agencies, and major nonprofit organizations. The council’s mission is to build community-responsive
schools in poor neighborhoods. Hanshaw provides on-site medical and
dental screenings, mental health care, substance use prevention and treatment, and family support and education. Students are divided into seven
“communities,” each tied to local California state universities (e.g., California State Stanislaus, Fresno, Sacramento, etc.) that provide tutoring (as
well as university T-shirts!). Team teaching and cooperative learning are
practiced throughout the curriculum and local businesses assist with employment preparation activities. The 1991 Healthy Start Support Services
for Children Act provides funding for interagency case management
services to minimize fragmented services to students and families. Al
Latino Youth 199
though more program evaluation is needed, school attendance is 98%,
and test scores are reported to be rising (Dryfoos, 1994b).
FOCUSED SCHOOL-BASED INTERVENTIONS
PREVENTING SCHOOL FAILURE
Although it is optimal to address Latino school failure as part of the comprehensive programs described earlier, there are specific programs worth
mentioning given their creative, culturally competent approaches.
Achieving Latinos through Academic Success (ALAS) was designed for
high-risk Chicano middle school students with disciplinary problems,
poor grades, and chronic truancy (Rumberger & Larson, 1994). Alas
means “wings” in Spanish. The program interrupts school failure by implementing empirically based strategies at multiple ecological levels: (a)
increasing student problem-solving skills in academics and family matters; (b) providing continuous feedback to students and parents (i.e.,
daily, weekly) regarding school performance and behavior; (c) “hot seat
attendance monitoring” of students on a period-by-period basis, expectation to make up truancies, and quick notification of parents about students’ problems; (d) extracurricular school activities with positive peers
and adults at school; and (e) parent training regarding parenting issues as
well as how to best interact with the school on students’ behalf.
A report by Rumberger and Larson (1994) based on 2 years of program
implementation with 2,000 predominantly Chicano students found that
ALAS students had better school attendance, higher grades, and lower
dropout rates by the end of eighth grade, as compared to no-program control students. Only 5% of ALAS students were chronically truant during
the program’s 2-year period, as compared to 21% of control students. Students in ALAS also demonstrated lower failure rates than control students in English (29% and 45%, respectively) and math (37% and 59%,
respectively). By the end of ninth grade, ALAS students continued to outperform controls (e.g., 80% on track to graduate versus fewer than 50%;
Rumberger, 1998).
The Theme Project is another school failure prevention program for
Chicano middle school children that involved a collaboration between
teachers and university researchers. The program offered intensive
teacher training and enhancement of student learning through collaborative learning groups in which basic school subjects were integrated and
taught through themes of relevance and high interest to Chicano students
(e.g., the Olympics, ethnic identity, cultural differences, crime and nonviolence; Garcia, 2001). Findings showed that student involvement in the
Theme Project improved school attendance, academic preparation, and

200 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
achievement compared to a matched control group. The superiority of the
Theme Program over the school’s regular curriculum was also apparent
on standard achievement tests (e.g., reading, writing, and language subtests), and bilingual as well as English-only students performed equally
well in the program.
Unfortunately, the overrepresentation of Latino youth in resource-poor
schools means that innovative schools and programs are still the rare exception and not the rule. This will continue to be the case until Latino
communities achieve enough power to effectively assert their basic need
for quality education and family support services.
PREVENTING SUBSTANCE ABUSE
A meta-analysis of 143 adolescence drug prevention programs found that
(a) the majority of programs are school-based and delivered to White
middle-class youth; (b) only 12.6% of programs were delivered to at-risk
youth, defined as ethnic minority or substance-using or maladjusted to
school; (c) peer programs (i.e., positive peer influence plus drug refusal
skills training) were far superior in decreasing drug use than drug
knowledge programs, affective programs (that increase self-esteem, communication, decision-making skills, etc.), and combinations of knowledge
and affective programs; and (d) at-risk youth benefited most from alternative programs that included remedial tutoring, job skills training, community volunteering, and one-to-one relationships with positive role
models (Tobler, 1986). Implications of this important review for Latino
youth include the need to provide culturally competent peer and alternative programs to prevent and limit substance use.
A study by Forgey, Schinke, and Cole (1997) comes close to implementing these suggestions with auspicious results in a sample of more
than 600 seventh graders from six New York City schools. Half of the
sample was African American and just under 40% were Latino. These
researchers involved students in their Culturally Tailored Intervention
(CTI) program, a psychosocial program that includes culturally sensitive approaches to teaching skills and involves prosocial peer leaders to
deliver parts of the curriculum. Rap videos and cultural stories based on
historical and contemporary African American and Latino heroes are
used to teach ways of coping with poverty and discrimination. Forgey
et al. compared their CTI to a psychosocial program called Life Skills
Training (LST) and found that at posttest, both CTI and LST were effective, and superior to a no-treatment control condition, in decreasing
intention to drink and use drugs in the future. Further, at 2-year followup, students in both the CTI and LST conditions maintained gains, but

Latino Youth 201
only CTI students actually drank less often and intended to drink less
in the future.
INTERVENTIONS WITH GANGS
For years, Vigil (1999) has recommended use of the school as a base
of prevention and intervention work with Chicano youth at risk for
gang membership and their families. Branch (1997) adds that gang interventions should consider the results of a meta-analysis of interventions for juvenile offenders which found that tightly structured,
skills-oriented behavioral programs are the most successful at decreasing delinquent behavior. School-based gang programs are scarce and
rarely based on the literature; however, a couple of noteworthy programs exist.
Gang Mediation Program
RESPECT (Respect Encourages Student Participation in Empowering
Communication Techniques) is a school-based mediation program for
preventing and decreasing violence among inner-city, barrio-dwelling,
multigenerational gang members (Tabish & Orell, 1996). Gang members
are contacted by school staff and gang interventionists, who develop
personalized relationships that are based on mutual respect, recognition of dignity, and understanding. The school was the scene of many
long-standing turf battles between members of three rival gangs with a
history of multigenerational animosity. A gang leadership council, consisting of representatives from each gang, was formed to monitor conflicts on a bimonthly basis. Formal mediation includes explanation of
the process by staff and selection of one representative and an alternate
from each gang. A formal and neutral setting is selected with clearly
posted ground rules (e.g., honesty, mutual respect, confidentiality, and
no name calling, insults, interruptions, threats, or weapons).
The objectives of RESPECT are to take adolescent realities seriously, respecting adolescents but not gang behavior, and modeling mature conflict
resolution. The program lasts 1 to 3 hours a day for 3 to 5 days. Mediation
begins by reviewing purpose and process and defining the problem.
As feelings escalate, mediators rephrase and redirect communication.
Subsequent meetings include review, calling witnesses to clarify disagreements and to redefine problems if necessary, and eventually brainstorming to generate solutions. The feasibility of solutions is tested and
discussed until consensus is achieved. Agreements are typed up and
signed by each gang representative, who meet the following week to
review plan implementation. Although RESPECT lacks evaluation, it

202 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
conveys the need to conduct outreach to gang members and to involve
them in a school-based violence prevention program that emphasizes
Latino values and models appropriate alternatives to violent behavior.
Experimental School for Gang Members
In a fascinating book titled Peace in the Streets, Hernandez (1998) describes
his evolution from a truant officer in Los Angeles to a teacher, guidance
counselor, and founder of two experimental schools for Chicano gang
members. The schools created badly needed spaces for chronically truant
gang members who spent their days hanging out in abandoned homes
and condemned buildings, doing drugs, and frequently exploiting and
abusing each other (i.e., fighting, rapes of female members). At these
schools, volunteer teachers, counselors, and clinicians provided needed
tutoring, vocational counseling, and individual and group therapy.
Lessons were embedded in Chicano stories and taught in group formats
in which even the slightest participation was rewarded. Neglectful and
abusive life histories were common in these youth, and the book sensitively reaffirms the child developmental needs of Chicano gang youth
coping with immense problems with few, if any, supports.
With regard to macro-level factors, the creation of more jobs for Chicano youth is likely to be an effective way of reducing the gang problem.
For example, Gertz, Bedard, and Persons (1995) surveyed 702 Mexican
American adults about gangs and heard the following solutions to preventing gangs: more jobs (46%), youth centers (23%), stiffer sentences
(18%), improved security (8%), and other (5%). A full 75% of the sample
considered Latino youth gangs a serious problem. The high endorsement
of jobs and youth centers by two-thirds of the sample is worth considering in the creation of community-based gang prevention strategies.
FAM I LY-FO CUSED I N TERV EN T IONS
Given the central role of familismo in Latino culture, as well as family dysfunction in the psychosocial adjustment problems of Latino youth, family
therapy represents a logical treatment option, whether alone or in conjunction with other interventions (e.g., individual and/or group therapy
for youth, family case management). As mentioned in Chapter 6, Latino
family therapists emphasize an ecosystems approach with the overriding
goal of restoring family stability and adaptive functioning by addressing
the needs of different family members and promoting bicultural flexibility with regard to understanding and responding to youth and family
mental health problems.

Latino Youth 203
FAMILY THERAPY
Falicov (1998) views the family therapist as an intermediary of family
conflict whose role is to reframe troubled youth as “nervous” instead of
bad, and family problems as “cultural transitions” in need of better understanding. Uneven levels of acculturation between parents and children, Latino migration histories, and the process of acculturation form a
context for youth and family problems that can be remedied through
greater mutual understanding and appreciation and improving communication skills.
Falicov (1998) describes a Mexican immigrant family in which a U.S.-
born 15-year-old daughter makes a suicide attempt precipitated by her
overprotective father’s refusal to let her take a cross-town bus to visit a
friend who has moved. Therapy focused on helping the parents to understand their daughter’s struggle for greater autonomy in the United States
while trying to be a good Latina daughter, and negative consequences
that can be prevented. Simultaneously, the daughter was helped to see the
positive intentions behind her father’s strictness (i.e., protection from
their high-crime urban environment). Father and daughter were guided
through a series of increasingly larger negotiations and compromises,
such as permission to stay out a little later providing that the daughter
call home to check in and permission for the daughter to express her disagreement provided she does so in a respectful manner.
Falicov’s (1998) approach to family therapy is consistent with that of
the Spanish Family Guidance Center in Miami, where Szapocznik and
colleagues (1997) have developed acculturation-sensitive models of family therapy with Cuban and other Latino immigrant families, with an
emphasis on drug-abusing and delinquent adolescents. Like Falicov, Szapocznik attributes adolescent problems to the “acculturation gap” that
often exacerbates the normal generation gap between parents and adolescents. For example, in their Bicultural Effectiveness Training, Szapocznik, Santisteban, Kurtines, Perez-Vidal, and Hervis (1984) emphasize
the goal of aligning family members to work together against acculturation gaps that threaten family stability (see Figure 7.1). By fostering
cross-generational alliances within families, parents are connected to
the positive aspects of modern American values and youth are connected to the positive aspects of more traditional Latino values.
Falicov (1998) also argues for therapists to take on the role of “culture
brokers” to help families obtain needed social services and natural support
systems. The East Little Havana Parent Leadership Program (Szapocznik
et al., 1997) is designed for the families of Latino children at risk for joining
gangs. Parents are convened and taught leadership and resource-seeking

Figure 7.1
The Bicultural Effectiveness Training Approach to Latino Family Therapy.
(Source: “Bicultural Effectiveness Training (BET): A Treatment Intervention
for Enhancing Intercultural Adjustment in Cuban American Families,” by
J. Szapocznik, D. Santisteban, W. Kurtines, A. Perez-Vidal, and
O. Hervis, 1984, Hispanic Journal of Behavioral Sciences, 6(4),
pp. 317–344. Reprinted with permission.)
Hispanic Values-Parents Youth/Acculturated Values
1) Detouring
(a) Creating an IP: value conflict placed in IP role, blamed for the familyís ailment. The intergenerational
conflict is reframed by attributing all negative consequences to the cultural conflict.
2) Establishing crossed alliances
(a) Family boundaries are made more permeable at this time to foment crossed alliances and
encourage Parent/Acculturated Value and Youth/Hispanic Value relationships. Crossed alliances
are expected to further weaken existing generational cultural alliances.
(b) Reframing: intergenerational relationship is attributed positive consequences (enrichment available
from differences), and the family is encouraged to perceive culture conflict as a common foe.
Intergenerational cultural conflict between generations are detoured through culture conflict.
(b) By viewing culture conflict as a common foe and by weakening existing generational-cultural
alliances new crossed alliances are fostered, the overall level of biculturalism in families is
enhanced, and parents and youth strengthen their relationship vis-a-vis cultural alliances.
Parents Youth
Hispanic Values Acculturated Values
Parents Youth
Culture Conflict
Hispanic Values Acculturated Values
Parents Youth
Hispanic Values Acculturated Values
Parents Youth
Legend
Conflict
Communication
Direction of communication
Permeable boundaries
Firm boundaries around alliances
or relationships
204

skills, which are then used to implement supervised activities for their
children and their children’s friends (e.g., field trips, team sports). With regard to evaluation, Szapocznik et al.’s summary of their research shows
that their ecosystemic, culture-based family therapies are as effective as
more generic forms of family therapy (e.g., structural family therapy) in reducing symptoms but are superior at engaging and retaining Latino families and preserving family cohesiveness.
Consistent with Szapocznik et al.’s (1997) model, Belitz and Valdez
(1997) begin family therapy for Chicano gang members by reviewing each
family member’s unmet needs and trauma history. The goal is to decrease
blaming and increase understanding of each family member’s behaviors.
Culture brokering by the therapist attempts to meet the family’s social
service needs, including out-of-home placement for gang youth as
needed. Family therapy with immigrant families emphasizes disempowered yet overprotective parents and overempowered youth by virtue of
their greater acculturation and premature autonomy.
PRIMARY PREVENTION WITH LATINO FAMILIES
Johnson and Walker (1987) conducted a rare empirical and longitudinal
study on the primary prevention of behavior problems in young Mexican
American children from low-SES backgrounds in Texas. When their children were between the ages of 1 and 3, parents were provided with inhome and clinic-based parenting and family decision-making skills and
education about basic child development. Mother and child interactions
were also observed, and services were provided in Spanish as needed.
Comparisons of experimental and control families over a 5- through 8-
year period showed dramatic differences in parenting skills and child development, intelligence, and adjustment. Mothers in the experimental
condition used less criticism and restrictive control and more encouragement and praise; experimental children scored higher on standard tests
of development and intelligence; and experimental boys were less destructive, overactive, negative attention seeking, and emotionally sensitive, as compared to control boys ages 4 to 7.
GROUP TR EATMENT
Whether in combination with individual or family therapy or schoolbased mental health services, group therapy is a promising way of addressing Latino youth problems, especially given the overimportance
of peers and urban street culture in response to family breakdown and
dysfunction and loss of other prosocial controls. De Las Fuentes (2000)
Latino Youth 205

206 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
describes school-based groups she has conducted with urban immigrant
Latino adolescents that address acculturation challenges faced by older
adolescent immigrants who frequently experience lengthy separations
from parents and other family members prior to migration.
Baca and Koss-Chioino (1997) describe a group treatment for Chicano
adolescents experiencing behavioral problems, substance abuse, and gang
involvement. Group therapy is offered as a “fourth space” away from home,
school, and the street, where participants can look at lives in a setting that
re-creates positive features of the home (e.g., living room furniture,
snacks). Treatment goals include promoting adjustment by improving the
expression of feelings, clarifying and affirming healthy ethnic identity, and
expanding life choices. Participants are asked to lead relevant discussions
stimulated by clips from Chicano/Latino movies (e.g., El Norte, Mi Familia),
documentaries, art, or poetry.
Gang involvement is discussed by decreasing its glorification and focusing on alternative ways of meeting the real need for familia, belonging, respeto, and a visible and viable role in the world. Preliminary results
reveal improvement in educational problems and family interactions and
in decreasing symptoms of depression, Conduct Disorder, and Oppositional Defiant Disorder.
Belitz and Valdez (1997) also recommend group treatment for Chicano
gang members, usually in combination with family therapy. The goal is to
reduce the gang member component of identity by teaching group members about ethnic identity development within the Chicano experience.
For example, members learn that alienation from both Mexican and American cultures can push individuals toward gangs as a way of addressing
their legitimate need for family and belonging and ethnic identity. In addition to examining the personal and social consequences of gang membership, members are also involved in healthy activities and affiliations
designed to replace the positive functions of gangs (e.g., pro-community
organizations, education programs at school, probation plans).
Belitz and Valdez (1994) discuss a case study in which 2 years of group,
family, and individual therapy were used to help a Chicano gang member
named Chris, who joined a gang at 12 years of age following years of neglect by a substance-abusing mother, sexual abuse by a stepfather, and
being shuffled between the homes of mother and grandparents. At 15
years of age, Chris attempted suicide after threatening to kill his pregnant girlfriend for breaking up with him. Individual therapy focused on
processing childhood traumas, related vulnerability and rage, and behavioral consequences (substance abuse, gang involvement, suicidal and
homicidal impulses). Group therapy with other gang members focused
on exploring adolescent, “gang banger,” and Chicano identities. Members

Latino Youth 207
were helped to critically examine how their cholo identities, vato loco
(crazy guy) role models, and gang activities were used to cope with inadequate families, roles, and identities, as well as venting pent-up rage.
Consistent with an ecological model, members were helped to distinguish the positive and negative aspects of gang membership and to move
into more adaptive roles and identities outside of the gang (e.g., acquiring
a job, being a responsible father, helping the community). Chris did not
quit the gang for some time but increasingly felt permission to move into
other fulfilling roles. Family therapy included helping Chris to express
his highly ambivalent feelings toward his mother (resentment for lack of
protection yet fantasy of being properly mothered by her), helping his
mother to apologize while expressing appropriate concern about Chris’s
gang involvement, and involving extended family in treatment to construct a more cohesive and traditional Chicano family.
Belitz and Valdez (1997) note that individual therapy with a gang member involves tolerating the youth’s strong impulse to test limits and act
out, as well as monitoring the therapist’s countertransference (e.g., seeing
gang members as criminal, not treatable). Knowledge about Chicano
gangs (local as well as general) is a basic requirement for sensitive treatment. The role of therapist blends micro and macro levels by assuming an
advocacy and brokering role with respect to accessing resources from educational, vocational, court, and probation-related agencies and supports
from the community’s natural support systems, including healthy extended family relations.
I NDI V IDUAL THERAPY
In a rare comparison of individual cognitive-behavioral therapy (CBT)
and interpersonal psychotherapy (IPT) in the treatment of 71 clinically
depressed Island Puerto Rican adolescents, Rossello and Bernal (1999)
found that both therapies reduced symptoms better than a waiting-list
control condition, and that IPT was also superior to the control condition
in increasing self-esteem and social adaptation. Interestingly, the authors
concluded that though both culturally adapted treatments are efficacious
for Puerto Rican youth, IPT may be especially congruent with Latino cultural values. Treatment manuals for both therapies included values such
as respeto and familismo, but IPT may have more directly emphasized such
values, as well as personalismo, given its main objective of reducing symptoms in interpersonal relations and contexts.
Though only preliminary, these results support IPT, as well as several
writings on the appropriateness of CBT, for Latinos and other people of
color, given this treatment’s emphasis on particular client circumstances,

208 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
using self-change skills to empower, attention to specific behaviors and
conscious process, emphasis on action versus just verbal expression, and
a didactic approach (Hays, 1995; Organista & Muñoz, 1996).
CONCLUSION
The pernicious cluster of problems affecting large numbers of Latino
youth is unlikely to abate soon considering the persistent parallel clusters of risk factors and undermined protective factors, which have their
roots in historical legacies of racism and subordination, poverty and
segregation. Emerging trends toward ecosystemically comprehensive,
community- and school-based, child- and family-centered prevention
and intervention programs represent a viable way of beginning to address formidable challenges.
Comprehensive community-based approaches are a partial solution to
traditionally fragmented social and human services for adolescents, each
with their different rules, requirements, administrative procedures, and
lack of coordination. Indeed, the term “categorical” program reflects the
ways that most grant programs fund single agencies or coalitions to address narrowly defined adolescent problems such as dropout, teen pregnancy, and juvenile delinquency. Integrating services at federal, state,
and local levels can be facilitated by changing the focus of funding
sources toward collaborative efforts. This is beginning to happen (e.g.,
Healthy Families Act). Human service providers must continue to inform
themselves about relevant funding mechanisms and social policies for
pursuing integrated service projects.
Burt et al. (1998) refer to comprehensive, integrated youth and family
services as “an idea whose time has come” and make several recommendations based on their study of actual programs. At the individual program level, the best programs were those that worked with community
stakeholders to identify gaps in the local service delivery network. These
agencies also evolved to broker services, often by working in the gray
areas between service boundaries that defined catchment areas, clients
served, and problems addressed. Burt et al. note that key players in this
arena were successful coalition builders who often mirrored the ethnic
and racial characteristics of the communities they represented.
At the local system level, service collaborators must develop a common
set of long-term goals and exercise flexibility in their roles. Commitment
and longevity can be promoted by pooling a portion of each agency’s
funding to support integrative activities and by establishing interagency
advisory group chaired by someone from a different agency each year. At
the policy system level, evidence supporting the treatment outcome and

Latino Youth 209
cost effectiveness of integrated services must be generated to persuade
policymakers to fund such efforts.
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CHAPTER 8
Latino Mental Health
SO WHAT DO we know about Latino mental health in America? Until recently, the answer to this question used to be “Nothing conclusive” because research consisted mainly of local community studies conducted on
different subgroups of Latinos, focusing on different mental health problems, and employing different research methods. Fortunately, U.S. Latinos
have become increasingly included in large psychiatric prevalence studies
during the past 25 years and informative patterns of mental health problems are beginning to emerge. But even before reviewing these data, we
should make a couple of educated guesses about Latino mental health in
America based on the theoretical frameworks presented in Chapters 1
through 4. For example, we could expect to find a relation between acculturation and mental health such that the more stressful the acculturation
experience for a Latino group, the more distress and consequent mental
health problems. That is, we should expect to find important differences
between major Latino groups as well as within them. On a related note,
the well-substantiated link between poverty and mental health problems
should be in evidence for Latinos overaffected by poverty.
ACCULT URATI VE STR E SS, POVERT Y, AND R I SK
With regard to adjustment to acculturation, Puerto Ricans are the poorest
and most segregated Latinos in America, and Cuban Americans have attained SES levels approaching their non-Hispanic White counter parts.
Mexican Americans are midway between Puerto Ricans and Cubans with
respect to SES, and less segregated than Puerto Ricans. Like Cubans, Central Americans are largely recent refugees but largely without the official
sanction and support of the U.S. government. They also lack the predominant professional background of Cuban Americans. As a result, Central
Americans live mostly in poor, segregated, and working-class urban communities, an experience resembling that of Mexican Americans. Given

216 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
these general conditions regarding acculturation, it is fairly easy to rank
the major Latino populations with respect to level of acculturative stress,
as in Chapter 1, and consequent risk for stress and mental health problems. So, what does the literature say?
Rogler, Cortes, and Malgady (1991) published the seminal review of the
literature on acculturation and Latino mental health based on 30 empirical studies published between 1967 and 1989. Not surprisingly, Rogler
et al. discovered that they could not integrate the studies because of a
general lack of methodological uniformity. That is, this group of studies
utilized different measures of acculturation (from scales to single items)
and mental health (from diagnoses based on the Diagnostic and Statistical
Manual of Mental Disorders [DSM] to psychological symptoms) and studied different groups of Latinos, thereby disallowing meaningful comparisons. Indeed, 12 of the studies demonstrated a positive relation between
acculturation and mental health, but 13 studies demonstrated a negative
relation. Of the remaining five studies, three reported curvilinear relations, and two reported mixed findings on different dependent variables.
THE SOCIAL STRESS HYPOTHESIS
Rogler et al. (1991) concluded that future research must be conducted
with greater methodological uniformity; this has begun to happen. In addition, they noted that while acculturation can be stressful in an external
sense (i.e., migration, loss of supports, adaptation to new country), there
are also internal perceptions of acculturation to consider. For example, although new immigrants and refugees experience migration-related
stress, they may also feel safe, hopeful, and better off than they were in
their country of origin. However, Rogler et al. further note that although
new immigrants may make positive social comparisons to their countryof-origin counterparts, second- and later generation Latinos may soon
come to make negative social comparisons to mainstream American society given the different ways that prejudice, discrimination, and devalued
ethnic minority status limit their once optimistic aspirations. Better designed studies are needed to test the social stress hypothesis of mental
health problems in Latinos; this also has begun to happen.
T H E PR E VALENCE OF M EN TAL
DI SORDER S I N U.S. LATI NOS
There is a small but growing number of epidemiological, populationbased prevalence studies of Latino mental health. Consistent with recom
Latino Mental Health 217
Table 8.1
Mental Health Comparisons of the Three Major U.S.
Latino Groups on HHANES*
Mainland Mexican Cuban
Puerto Rican American American
Prevalence of Major Depression Disorder (%)
Lifetime 8.9 4.2 3.9
Six months 5.8 2.3 2.4
One month 4.8 1.8 1.4
Rates of Past Heavy Drinking (%)
Male 35.0 36.0 17.0
Female 17.0 15.0 05.0
*Hispanic Health and Nutrition Examination Survey
mendations by Rogler et al. (1991), this collection of surveys is more
methodologically uniform with respect to epidemiological survey methods, DSM-based diagnoses, use of large representative samples of Latinos,
careful translations and adaptations of assessment instruments, and the
inclusion of acculturation measures.
THE HISPANIC HEALTH AND NUTRITION EXAMINATION SURVEY
The Hispanic Health and Nutrition Examination Survey (HHANES) was
the first major prevalence study of Latino health in America; it was conducted between 1982 and 1984 and included the following large samples
of Latinos: 7,462 Mexican Americans in the five southwestern states;
2,834 Puerto Ricans in the New York Area; and 1,357 Cubans in Miami,
Florida. The HHANES primarily consisted of a medical history examination, but it also included a DSM-III-based measure of Major Depression
and the well-known Center for Epidemiologic Studies Depression (CESD) scale to measure recent symptoms of depression (Radloff, 1977). Assessment instruments were fully translated and administered in Spanish
and English as needed.
Consistent with earlier predictions, results form the HHANES do indeed show the highest rates of Major Depression in Puerto Ricans and the
lowest in Cuban Americans, but Mexican Americans’ rates are similarly
low (Moscicki, Rae, Regier, & Locke, 1987). As can be seen in Table 8.1,
current, 6-month, and lifetime prevalence of Major Depression rates for
Puerto Ricans are all more than double the rates of Cuban and Mexican
Americans’. The fact that rates for Mexican and Cuban Americans do not
differ can be explained by acculturation differences within Mexican
Americans that must be taken into account.

218 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
A follow-up study on the Mexican American sample found that “caseness” of depression, based on CES-D cutoff scores of 16 or higher, was predicted by an “Anglo orientation,” as assessed by being born in the United
States, preference for English versus Spanish, and self-identification as
Mexican American or Anglo versus Chicano or Mexicano, even after controlling for SES (Moscicki, Locke, Rae, & Boyd, 1989). Kaplan and Marks
(1990) similarly found a positive relation between acculturation and depression in the Mexican American sample but only for younger (20 to 30
years of age) and not older participants, even after controlling for SES.
They concluded that younger Latinos are more actively acculturating than
their elders.
Thus, more acculturated Mexican Americans appear to have rates of
depression closer to those Puerto Ricans. But then why don’t we see acculturation differences among Puerto Ricans? This question was addressed by Vera et al. (1991), who compared the HHANES U.S. Puerto
Rican sample to a probability sample of Island Puerto Ricans and found
comparable rates of CES-D caseness or cutoff scores above 16 (28.1% and
28.6%). Although an acculturation perspective might predict higher distress for more acculturated mainland Puerto Ricans, it is important to understand that the distinction between mainland and Island Puerto
Ricans has been blurred by decades of unrestricted circular migration
and the fact that all Puerto Ricans are U.S. citizens. Moreover, as a U.S.
colony, Puerto Rico has undergone dramatic Americanization during the
twentieth century, including transition from a rural agrarian society to a
more urban and industrial one. In fact, the only Puerto Rico islandwide
prevalence study, conducted in 1984, showed overall prevalence rates of
mental disorders comparable to those in the U.S. general population (G. J.
Canino et al., 1987). However, it is worth noting that when Vera et al. compared U.S. and Island Puerto Ricans at the lowest income level (i.e., less
than $15,000 annual income), U.S. Puerto Ricans did indeed have higher
levels of depression symptoms than Island Puerto Ricans.
The relation between depression and self-reported health in the
HHANES was investigated by Angel and Guarnaccia (1989), who found
an inverse relation for both Puerto Ricans and Mexican Americans. However, self-reported health and depression were worse in Puerto Ricans,
and medical doctors rated Puerto Ricans less healthy than they rated
Mexican Americans. Other reports comparing Mexican Americans to Island Puerto Ricans show higher rates of somatic symptoms (I. A. Canino,
Rubio-Stipec, Canino, & Escobar, 1992) and Somatization Disorder
(Shrout et al., 1992) in Puerto Ricans. The latter study also found higher
rates of alcohol abuse/dependence and affective disorders in Mexican
Americans, but again this was true only for U.S.-born and not immigrant
Mexican Americans.

Latino Mental Health 219
More recently, Lee, Markides, and Ray (1997) used the HHANES to
compare patterns of heavy drinking (i.e., in excess of guidelines for safe
alcohol consumption). Not surprisingly, they found greater prevalence of
past heavy drinking in Mexican American (36%) and Puerto Rican (35%)
males compared to Cuban American males (17%); the same pattern, albeit
lesser rates, was found for women (15%, 17%, and 5%, respectively; See
Table 8.1). Puerto Rican men and women had the longest periods of past
heavy drinking (Ms = 6.2 and 4.4 years, respectively) as compared to
Mexican American men and women (Ms = 4.6 and 2.8 years, respectively)
and Cuban American men (M = 4.4 years; there were not enough Cuban
women to calculate years). Further, past heavy drinking was related to
current heavy drinking and various health risk factors and chronic medical conditions. For example, Mexican American females who were past
heavy drinkers had higher rates of smoking, depression symptoms, and
chronic medical conditions compared to Mexican American women with
no history of heavy drinking. This same pattern was found for Puerto
Rican men for smoking and chronic medical conditions, and for Mexican
American men for smoking.
In sum, the HHANES survey allows for rare comparisons between the
three major Latino groups in America. These comparisons form a pattern
of mental health problems that is consistent with the different acculturation histories of these three groups: Puerto Ricans appear to be at highest
risk and Cubans lowest, with Mexican Americans’ risk closer to Puerto
Ricans but also evidencing a clear positive relation between acculturation
and mental health problems.
THE EPIDEMIOLOGIC CATCHMENT AREAS STUDY
Also during the 1980s, the National Institute of Mental Health sponsored
the largest psychiatric prevalence study in America (L. N. Robins &
Regier, 1991). The Epidemiologic Catchment Areas (ECA) study was conducted with population-based probability sampling, stratified by catchment areas, in five major Americans cities, and conducted DSM-III-based
diagnoses. The ECA included a large sample of Mexican Americans from
Los Angeles (n = 1,244), but Puerto Ricans composed only 2% of the New
Haven ECA site. No other Latino groups were included.
Reports comparing Mexican American and non-Latino White mental
health are based on the Los Angeles ECA (LA-ECA) study that was conducted in 1983 to 1984. Although LA-ECA reports reveal comparable lifetime (Karno et al., 1987) and 6-month (Burnam, Hough, Escobar, et al.,
1987) prevalence of mental disorder in Mexican Americans and their
White counterparts, an examination of these rates reveals important acculturation differences within the Mexican American sample. Immigrant

220 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Mexican Americans have lower overall lifetime prevalence than nonLatino Whites (i.e., less Major Depression, Obsessive-Compulsive Disorder, and drug abuse/dependence), but U.S.-born Mexican Americans
have higher lifetime prevalence (i.e., more alcohol abuse/dependence,
dysthymia, and phobia; Burnam, Hough, Karno, Escobar, & Telles, 1987).
Burnam, Hough, Karno, et al. (1987) utilized a multidimensional scale
of acculturation and found that acculturation was positively associated
with higher lifetime prevalence of several mental disorders (i.e., alcohol
abuse and dependence, substance abuse and dependence, and phobia),
even after controlling for age, sex, and marital status. More specifically
U.S.-born Mexican Americans (who had higher acculturation scores) had
higher rates of all of these disorders, with the addition of Major Depressive Disorder and dysthymia.
THE SELECTIVE MIGRATION HYPOTHESIS
The fact that immigrant Mexican Americans have far lower prevalence
rates of mental disorder than their U.S.-born counterparts is intriguing
given their generally lower SES and supposed stress from migration. One
popular explanation for this finding is the “selective migration hypothesis,” which holds that perhaps those Mexicans who immigrate to America
are especially healthy compared to those who do not immigrate. The selective migration hypothesis is the opposite of the social stress hypothesis, which holds that the lower mental health of native-born Mexican
Americans has to do with their stressful experience in America as a devalued and discriminated ethnic minority group. This latter hypothesis
is more consistent with earlier predictions and is supported by a study by
Vega et al. (1998), reviewed shortly in the chapter.
NATIONAL COMORBIDITY SURVEY
Not as large as the ECA, the National Comorbidity Survey (NCS) is the
first mental health prevalence study based on a national probability sample of adults (N = 8,098), including representative percentages of Latinos
(9.7%) and African Americans (11.5%) in addition to non-Latino Whites
(75.3%; other = 3.5%), and DSM-III-R-based diagnoses. Results published
by Kessler et al. (1994) reveal generally comparable mental health profiles
across ethnic groups, although Latinos have higher levels of current affective disorders and comorbidity, which refers to simultaneous diagnoses of three or more mental disorders. Thus the NCS is helpful in
indicating higher risk in Latinos for comorbidity and affective disorders
such as depression.
Unfortunately, the NCS represents a step backward with regard to understanding Latino mental health and its relation to acculturation. That

Latino Mental Health 221
is, the NCS lumped together Latinos of various national-origin backgrounds and interviewed only English-speaking Latinos. The fact that
about half of Latinos participating in prevalence studies elect to do interviews in Spanish underscores the enormity of this omission. Employing
such culturally insensitive research methods in view of the ECA findings
is difficult to understand. Fortunately, a recent prevalence study on Mexican American mental health has greatly advanced our understanding of
the relation between acculturation and Latino mental health.
THE MEXICAN AMERICAN PREVALENCE AND SERVICES SURVEY
Vega et al. (1998) surveyed a stratified random sample of 3,012 noninstitutionalized adults of Mexican background in Fresno County, California.
As in the NCS, DSM-III-R-based diagnoses were made. But to better understand the relation between acculturation and mental health, Vega
et al. compared U.S.-born Mexican Americans to short-term (less than 13
years in the United States) and long-term (13 years or more in the United
States) immigrants. Further, findings from the Mexican American Prevalence and Services Survey (MAPSS) were compared to those of the NCS
as well as a Mexico City prevalence study. Thus, this study is extremely
helpful in expanding on the prevalence studies reviewed earlier.
Like the NCS and ECA, initial findings from the MAPSS reveal comparable prevalence rates between Mexican Americans and the general U.S.
population (i.e., a lifetime prevalence rate of nearly 50% for any disorder
assessed). However, further analyses of MAPSS data reveal that these
comparable prevalence rates are found only for U.S.-born Mexican Americans. In contrast, rates among immigrant Mexican Americans are only half
those of the general prevalence of U.S.-born Mexican Americans, comparable to rates of mental disorder found in the Mexico City survey. Table
8.2 reveals the dramatic positive relation between acculturation and mental illness by comparing short- and long-term immigrants and U.S.-born
Mexican Americans across virtually all major mental disorders assessed.
Super Mexicans or Stressed Mexicans?
With regard to understanding the relation between acculturation and
Mexican American mental health, Vega et al. (1998) conclude that their
findings do not support the selective migration hypothesis, given the
comparable prevalence rates for immigrants in the MAPSS and their
counterparts in the Mexico City survey. Instead, these researchers conclude, “Mexican immigrants share the lower risk status of their national
origin, but acculturation has deleterious effects on many aspects of their
health at the population level” (p. 777). In other words, acculturation may
be hazardous to Latino mental health!

Table 8.2
Lifetime Prevalence of Mental Disorders in MAPSS, Mexico City, and NCS Surveys
MAPSS
Immigrants Immigrants NCS
<13 years >13 years U.S. Born Mexico City Latinos Total
(n = 884) (n = 851) (n = 1,145) (n = 1,733) (n = 305) (N = 5,384)
(%) (%) (%) (%) (%) (%)
Major Depression 3.2 7.9 14.4 7.8 18.3 17.2
Manic Depression 1.3 1.6 2.7 1.3 0.5 0.4
Dysthymia 1.6 1.6 5.2 1.5 8.6 6.8
Any affective disorder 5.9 10.8 18.5 9.0 20.4 19.5
Panic Disorder 1.0 2.6 1.8 0.4 1.8 3.5
Agoraphobia without history of panic 3.0 7.5 11.8 3.8 6.8 5.0
Social phobia 3.8 5.7 11.8 2.2 19.0 13.4
Simple phobia 2.6 7.9 12.0 3.0 16.4 11.1
Generalized Anxiety Disorder 0.0 0.0 0.0 1.1 6.2 5.4
Any anxiety disorder 7.6 17.1 24.1 8.3 28.0 25.0
Alcohol abuse 0.5 2.2 5.2 3.1 6.6 9.9
Alcohol dependency 8.6 10.4 18.0 8.2 14.2 15.1
Substance abuse 0.0 1.8 3.4 0.3 3.3 4.7
Substance dependency 3.0 5.3 13.8 0.8 7.0 7.9
Any abuse/dependency 9.7 14.3 29.3 11.8 24.7 28.2
Any mental disorder 18.4 32.3 48.7 23.4 51.4 48.6
Note: MAPSS = Mexican American Prevalence and Services Survey; NCS = National Comorbidity Survey.
Source: “Lifetime Prevalence of DSM-III-R Psychiatric Disorders among Urban and Rural Mexican Americans in California,” by W. A. Vega
et al., 1998, Archives of General Psychiatry, 55, pp. 771–782. Reprinted with permission.
222

Vega et al. (1998) end their report with a series of questions, including
two that are entertained here. The first question is “Why does socialization into American culture and society increase susceptibility to psychiatric disorders so markedly, what are the risk factors, and is this process
generalizable to other ethnic groups?” (p. 777). Obviously this is a complex question requiring long and qualified answers based on new and improved research. However, the short answer is that the acculturation
histories of different U.S. Latino groups predispose them to varying degrees of exclusion and poverty, which are related to above-average stress,
below-average resources, and thus risk for mental disorders. This application of an acculturation framework appears to be supported by the studies reviewed, which reveal highest risk in Puerto Ricans and lowest risk
in Cuban Americans for disorders such as Major Depression, Somatization Disorder, alcohol abuse/dependence, and related chronic medical
conditions. Further, the literature on Mexican Americans clearly shows a
positive relation between acculturation and mental disorder due mostly
to the stress of being Mexican American in America as opposed to the selective migration of “Super Mexicans” from Mexico.
With regard to the second question, “What components of Mexican
culture are protective against mental health problems, and can these be
conserved?” (Vega et al., 1998, p. 777), much has been written about
healthy and protective aspects of traditional Mexican culture, such as
close and supportive extended family systems. As a core characteristic of
Latino culture, familismo is likely to be an important buffer of acculturative stress and the effects of poverty but is also probably weakened by
such challenges.
Interestingly, the idea of slowly diminishing protective cultural factors
may help to explain why U.S.-born Mexican Americans and Island Puerto
Ricans do not have overall prevalence rates that greatly exceed those in
the general U.S. population. That is, considering the much higher poverty
rates of Island Puerto Ricans (60%) and Mexican Americans (31%) compared to non-Latino Whites (8.6%), it’s nothing short of amazing that
their mental health profiles are roughly comparable to Anglo-Americans
with regard to prevalence at the population level.
A NOTE ON CENTRAL AND SOUTH AMERICAN MENTAL HEALTH
As mentioned in Chapter 1, most Central Americans report fleeing their
country of origin under war-related duress (Cordova, 1998), but their
adaptation to the United States has been hampered by a general denial of
refugee status (including entitlements to social services) due to limited
ability to prove direct evidence of political persecution (Ferris, 1987). The
Latino Mental Health 223

224 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
denial of political asylum leads to inhibited social and community life,
mistrust, and perceptions of the U.S. government as supporting repressive
governments in Latin America (Farias, 1991). This Central American
predicament is unfortunate because studies of community samples report
elevated symptom levels of depression, anxiety, somatization, and interpersonal sensitivity compared to American norms (Plante, Manuel,
Menendez, & Marcotte, 1995). In addition, rates for Central Americans
are higher than for Mexican immigrants in symptoms of depression and
migration-related stress (Salgado de Snyder, Cervantes, & Padilla, 1990)
and in Posttraumatic Stress Disorder (PTSD; Cervantes, Salgado de Snyder, & Padilla, 1989).
With regard to South Americans, mental health studies are almost nonexistent. The main reasons for immigration are similar for South American groups as for other Latinos, namely, economic hardships and, at
times, internal armed conflicts that place people in danger of torture or
death (Gonsalves, 1990). As such, themes of loss and trauma are likely in
this population, as well as the stress of acculturation and poverty. An additional stress is the greater geographical distance from their country of
origin, which makes periodic contact with their families much less likely
than most other Latinos. Having fewer neighbors from their country of
origin results in fewer chances to share meaningful memories and customs, such as national celebrations (e.g., Independence Day), and national
songs, foods, and folk knowledge. Much more research on Central and
South Americans is needed to better understand their experience in the
United States and related mental health profiles.
I NCR EASI NG ACCE SS TO MENTAL
HEALTH SERVICES
It is now well-known that Latinos underutilize mental health services despite mental health needs that are at least equivalent to those of the general U.S. population. It is also well-known that underutilization is due
mostly to external structural obstacles, reviewed briefly in Chapter 5, as
opposed to internal cultural obstacles (e.g., culture-related attitudes and
practices). Excessive emphasis in the past has been placed on the latter,
but it is worth exploring and understanding any such obstacles from a
culturally sensitive perspective.
UNDERUTILIZATION
For more than 25 years, reviews of the literature have repeatedly documented that members of ethnic minority groups underutilize mental

Latino Mental Health 225
Table 8.3
Mental Health Service Utilization Patterns for Los Angeles
County by Major Ethnic/Racial Groups
Percentage of Percent of County
Group Los Angeles County Patient Population
Latino Americans (n = 3,000) 34 26
Asian Americans (n = 3,000) 9 3
Anglo Americans (n = 3,000) 43 44
African Americans (n = 3,000) 13 21
Source: “Community Mental Health Services for Ethnic Minority Groups: A Test of the Cultural Responsiveness Hypothesis,” by S. Sue, D. C. Fujino, L. Hu, D. T. Takeuchi, and N. W.
S. Zane, 1991, Journal of Consulting and Clinical Psychology, 59, pp. 533–540. Reprinted
with permission.
health services despite their considerable needs (Atkinson & Lowe, 1995;
Sue, 1977; Sue & Zane, 1987). Underutilization appears to be especially
true for language minority groups such as Latinos and Asian Americans.
For example, Sue, Fujino, Hu, Takeuchi, and Zane (1991) conducted a
major study of the Los Angeles County Mental Health System and found
that Latinos and Asians were underrepresented in proportion to their
population sizes, Whites were proportionately represented, and Blacks
were overrepresented (see Table 8.3). The same pattern of results was
found in an earlier study of L.A. County (Flaskerud, 1986), as well as a
study of nearly 14,000 mental health charts from 17 community mental
health centers in King County, Seattle (Sue, 1977). The latter study also
found that when ethnic minorities did use county mental health services,
about half dropped out of treatment after one session of therapy, as compared to 30% of Anglo-American clients.
STRUCTURAL OBSTACLES: DOES ETHNIC AND LINGUISTIC MATCHING
MAKE A DIFFERENCE?
In addition to low service availability and accessibility, the low number of
bilingual/bicultural mental health professionals continues to be a major
problem, especially in view of research showing that they do make a difference for language minorities such as Latinos. For example, Sue et al.
(1991) studied the impact of linguistic and ethnic matching of therapists
and clients by reviewing the mental health charts of 12,000 L.A. County
mental health patients. More specifically, these researchers examined the
charts of 3,000 Latino, 3,000 Asian, 3,000 African American, and 3,000
Anglo-American mental health patients. Results revealed that linguistic
and/or ethnic matching improved treatment outcome, decreased dropout

226 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
from therapy, and increased the total number of therapy sessions but only for
Latinos and Asians who were low in acculturation (i.e., recent immigrants, less
likely to speak English, and less familiar with the mental health system).
Thus, the presence of bilingual and/or bicultural mental health professionals is imperative for the huge numbers of Latinos low in acculturation who
need such matching the most as they confront increasing mental health
problems during the acculturation process.
CULTURAL OBSTACLES
Somatization
There is empirical support for the widespread belief that Latinos and
other traditionally oriented groups tend to express emotional problems
through their bodies (i.e., somatization) and thus seek help from medical rather than mental health providers (Padilla, Carlos, & Keefe, 1976).
The tendency for Latinos to somaticize is especially true for those lower
in acculturation and for females. Escobar et al. (1987) used the Los Angeles ECA data to compare Somatization Disorder in Mexican Americans (n = 1,242) and non-Hispanic Whites (n = 1,309) and found that
whereas men’s prevalence did not differ, the rate among Mexican American women over 40 years of age was higher than for their non-Latino
White counter-parts. Somatization in Mexican American women was
also found to be positively correlated with age and negatively correlated
with level of acculturation. Further, looking just at women who met criteria for depression or dysthymia, Escobar et al. found that about 50% of
Mexican American women also met criteria for Somatization Disorder,
as compared to 20% of non-Latino White women. Thus, medical staff
need to be actively involved in mental health outreach and referral to
better serve Latino patients.
It should also be noted that the diagnosis of Somatization Disorder is
extremely rare (e.g., prevalence of 0.1% in the ECA study), partly because
of the complex criteria required in the DSM. Thus, to better capture somatic symptoms in community and clinical settings, Escobar et al. (1987)
developed an abridged index of the most common somatic symptoms, requiring only six or more symptoms for women and four or more for men.
Using the abridged index, they found a prevalence of 4.4% in the LAECA data in addition to the results just enumerated on Mexican American women.
It is worth mentioning the historically negative bias against somatization. It has been conceptualized by Freudians as a primitive defense
mechanism used by those who are not psychologically minded and thus not
amenable to psychotherapy. Here’s where cultural sensitivity in mental

Latino Mental Health 227
health should compel us to be critical of any perspective that pathologizes
what may be a cultural difference. For example, some researchers have
forwarded the idea that somatization can also be viewed as a culturally
adaptive idiom of distress, of which the culture-bound syndromes nervios
(nerves) and ataque de nervios (nerves attack) are examples among Latinos
(Hulme, 1996). As idioms of distress, somatic symptoms communicate
emotional distress in a cultural context, rather than defend against it, but
such meanings are lost on and even devalued by insensitive practitioners.
In my mental health work with somatic Latino patients, I emphasize that
pain is pain and that the distinction between mental and physical distress
is a convention of the modern Western world that insists on dividing
physical, mental, and even spiritual domains within people for the sake
of specialization. As such, it may be just as (un)fair to accuse modern U.S.
and European culture of “psychologizing” physical pain as it is to accuse
less modern cultures of “somaticizing” mental pain.
Folk Healer Utilization: Fact or Fiction?
The Latino mental health literature is very insistent that we consider the
supposed importance of folk healers and practices such as Curanderismo
in the case of Mexican people and Santería in the case of Puerto Ricans
and other Caribbean peoples. Although more research is needed, that
which has been conducted largely fails to support any widespread use of
folk healers among Latinos and clearly does not support its use to the exclusion of much needed conventional health services. For example, in the
MAPPS survey, Vega, Kolody, Aguilar-Gaxiola, and Catalano (1998) assessed mental health service utilization in their epidemiological survey
of 3,012 Mexican Americans in Fresno County, California, and found that
only 3% of the 508 participants who met criteria for one or more psychiatric diagnoses during the prior year had used “informal help,” including
curanderos (Mexican folk healers). Similarly, Higginbotham, Treviño, and
Ray (1990) found that only 4.2% of 3,623 southwestern Chicanos reported
consulting a curandero, herbalist, or other folk practitioner during the
prior year. Folk doctor use by this small percentage was predicted by low
income and dissatisfaction with modern medical services recently received, indicating use of curanderos as a last resort. Finally, an early survey of 666 Chicanos from Los Angeles found that only 2% had consulted a
folk healer or curandero for emotional problems during the prior year, and
that only 8% had ever done so in their entire life (Padilla et al., 1976).
When these participants were asked who is the first person they would
recommend to someone with an emotional problem, 0% indicated a curandero as opposed to doctor (25%), relative or compadre (20%), priest
(17%), friend (14%), mental health clinic (14%), or psychiatrist or counselor (9%).

228 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Despite such data, the Latino mental health literature continues to
push the idea of pervasive folk healer use in Latinos as a valid culturebased alternative to conventional medicine, without any evidence or critical examination of such culture-based practices (e.g., Harris, Velasquez,
White, & Renteria, 2004). It just may be that folk healer use in Latinos is
similar to the utilization of astrologists, fortune tellers, and witchcraft on
the part of a few Anglo-Americans: a real yet small and insignificant endeavor. If so, Latinos would be much better served if we concentrated our
efforts on promoting accessible, affordable, and culturally acceptable
modern health and mental health services.
Hopefully more scholarly research will continue to clarify this popular
area of discussion in the Latino mental health literature. For example, Becerra and Iglehart (1995) conducted a fascinating study of folk medicine
and home remedy use in an urban Los Angeles sample of nearly 500 participants from public housing projects and the Chinatown area. The sample was almost evenly divided among Mexican, African, Anglo-, and
Chinese Americans. Results revealed that (a) all racial/ethnic groups
used such practices; (b) such practices were used in addition to, and not in
place of, conventional health care; and (c) folk medicine remedies were
used primarily for minor illnesses or to prevent major illnesses, but not to
treat chronic illnesses. Further, compared to nonusers, folk medicine
users were found to use more self-care strategies in general, suggesting
that rather than viewing folk medicine as something exotic, it may simply
reflect part of a larger picture of better health behaviors.
Unfortunately, comparable survey data on Puerto Rican and Cuban use
of Caribbean folk doctors do not appear to exist, although we should expect low use of Santeros (Caribbean folk healers practicing Santería) in
Cuban Americans whose higher SES affords them rapid acculturation
and high levels of health insurance and access to professional medical
services. With regard to Puerto Ricans, much descriptive literature has
been written on their use of Santería, but with little critical inquiry.
A SELEC T I V E R EV I EW OF CULT UR ALLY
COMPETENT MENTAL HEALTH
I NTERVENTIONS W I TH LATI NOS
The preceding review of the prevalence of mental disorders in Latinos
makes clear the rather compelling link between historical acculturative
stress, poverty, risk for mental disorders, and the need for culturally competent mental health services. Unfortunately, there continues to be extremely little empirical research on best intervention approaches for
Latinos. The few studies that do exist are not methodologically uniform

Latino Mental Health 229
enough to suggest which treatments are best for specific mental health
problems and Latino subgroups. Thus, we need to strive for conceptually
sound approaches based on the working practice model presented in
Chapter 5, with sufficient attention to ecosystemic levels that blend
macro, meso, and micro practice approaches. The services and other interventions reviewed in this section range from comprehensive communitybased approaches to individual therapy. Family therapy was covered in
Chapter 6 and thus is not covered here.
COMMUNITY MENTAL HEALTH APPROACHES
Aponte and Morrow (1995) assert that community mental health approaches are ideal for ethnic minority groups such as Latinos because of
their focus on decreasing stress in the community versus individuals
through the provision of services that are community-based and comprehensive, that emphasize continuity between services as well as disease
prevention and health promotion, that strive to be innovative in response
to community needs, that tap natural resources and supports such as
paraprofessionals, and that attempt to empower communities by sharing
control over services through active community board leadership.
All of this sounds great, but it is a radical departure from institutionalized mental health business as usual, with its predominant top-down
medical model of practice, “power over versus power with” clients, categorical funding streams for specific problems or populations, and the recent industrialization of services emphasizing cost savings (Manning,
1999). Thus, “alternative community delivery systems” and “ethnic agencies” are in the best position to deliver progressive services to Latinos.
Iglehart and Becerra (1995) describe ethnic-focused agencies as consisting primarily of ethnic staff serving predominantly ethnic clients, resulting from local community initiatives (e.g., grassroots, bottom-up),
committed to social change on behalf of special populations, frequently
small and resource-poor but not always. According to Aponte and Morrow (1995), the major elements of alternative community service delivery
systems include the following:
• Ecological validity: This term refers to congruence between services
and the community ecosystem and between how community members experience their environment and how it is perceived by service
providers. Thus, services are less prepackaged and more tailored to
community needs.
• Multiproblem approach to services: Mental health services need to
address a broad range of community needs through multiple service
provider roles (e.g., advocate, teacher, consultant, therapist, case

230 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
manager, organizer). With the exception of clinical social work, this is
a significant departure from professional mental health training.
• Commitment to interagency collaboration and coordination: The quality of
mental health care is enhanced by activities ranging from regular
staff in-services between as well as within agencies to informal links
with community institutions such as churches, groups, and leaders.
• Employment of bilingual/bicultural staff: The importance of this factor
has already been stressed for promoting rapport and the cultural acceptability of mental health services.
• Utilization of paraprofessionals: This involves the utilization of informal community helpers, some of whom are former mental health
clients, in the provision of community mental health services. In a
study of 54 agencies serving ethnic minority communities, Jenkins
(1981) noted quite a few years ago a large trend toward utilizing paraprofessionals (i.e., 43% of 574 workers had less than a BA degree).
• Development of community competence with social services: This factor
emphasizes the need to increase the ability of community members
to negotiate formal mainstream services via information, modeling,
organizing, and political participation.
• Strengthening social support networks: From extended family to the
community and beyond, alternative community service delivery systems promote existing social networks.
• Prevention and consultation strategies: Here the emphasis is on prevention of mental health problems and provision of technical assistance
and resources needed to address mental health and other community problems.
The literature frequently describes projects, agencies, and centers that
address many of these goals in a wide variety of settings, ranging from
community-based multiservice centers to special ethnic-focused units
within traditional mental health institutions. Unfortunately, outcome evaluations of such community interventions are almost always lacking given
their lack of research arms. The following are illustrations of communitybased mental health interventions with Latinos with an emphasis on outcome studies when possible and adherence to the elements of alternative
community delivery systems just outlined.
Proyecto Bienestar and the Prevention of Depression in the
Latino Community
Proyecto Bienestar (Wellness Project) appears to be the only large randomized, controlled, clinical mental health trial conducted in the Latino
community (Vega, Valle, & Kolody, 1994). The goal of Proyecto was to prevent depression symptoms in low-SES immigrant Mexican women in San

Latino Mental Health 231
Diego County by identifying, training, and supervising natural female
helpers in the community, known as servidoras (servants). In addition to a
no-treatment control condition, 655 women were randomized into two
other experimental conditions, each of which involved weekly 90-minute
meetings for 12 weeks: a servidora-facilitated merienda (afternoon get-together) group and a link-person condition in which servidoras met individually with participants. In both experimental conditions, the
intervention consisted of teaching participants how to modify unsupportive environments, increase effectiveness in interpersonal relationships, and improve coping with expected and unexpected life stressors.
One-year posttreatment results comparing experimental and control conditions revealed that the project was successful in preventing depression
symptoms in those women with the fewest pretreatment symptoms of depression, and this was especially true for those women who completed
more than half of the 12 intervention sessions. However, for women with
moderate symptoms at baseline or higher, there was no intervention effect. The authors concluded that Proyecto Bienestar was successful in its
goal of preventing depression in a high-risk group not yet evidencing
symptoms, but was least helpful to those already evidencing symptoms.
They recommend adapting these types of prevention programs to Latino
communities, but it is evident that more intensive treatment programs are
needed for Latinas evidencing serious symptoms of depression. One such
program is described in the “Group Treatment” section that follows.
GROUP INTERVENTIONS
There has been consensus for some time in the psychotherapy literature
that group treatment is an especially viable modality for Latino patients
(e.g., Delgado & Humm-Delgado, 1984). Though descriptive, these reports discuss how group therapy is particularly well suited to Latino patients struggling with migration- and acculturation-related stress and
isolation, the breakdown of the extended family, the difficulty of not
speaking English, and the experience of discrimination. Following are
some brief illustrations of Latino group therapy that are consistent with
the components of culturally responsive community interventions outlined earlier, as well as with the working model of practice with Latinos
presented in Chapter 5.
Group Therapy with Puerto Ricans
Lilian Comas-Diaz and associates have generated much helpful literature
on group work with Puerto Ricans that emphasizes the creative incorporation of what they call “drama” by way of Puerto Rican music, poetry, literature, and Espiritismo (Spiritism, Caribbean-based folk healing beliefs

232 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
and practices) as a more effective alternative to conventional forms of
group therapy such as gestalt and rational emotive therapy. For example,
Comas-Diaz (1986) designed a grupo de mujeres (women’s group) specifically for alcoholic Puerto Rican women; she describes initial aggressive
outreach to emergency rooms, police, schools, and churches, followed by
group therapy that addresses alcoholism in the context of cultural adaptation and conflicts created by shifting gender roles. The cultural stigma
and protection attached to female alcoholics are addressed, and older
women are used to communicate their experiences to younger group participants. In a rare (and too short) note on the utilization of folk healers,
Comas-Diaz mentions a psychologically charged session led by espiritistas
(Spiritualists, or folk healers) who relay messages to group members
while supposedly being inhabited by spirits.
Puerto Rican salsa and bolero music conveying emotions and struggles
similar to those of group members are carefully selected and played as a
way of facilitating the group process. Because so many Latinas follow
novelas (soap operas) on Spanish television, Puerto Rican plays that mirror the struggles of the people are also used to facilitate self-examination.
Such media were also found to be helpful in getting Puerto Rican male
group members to discuss their problems and issues.
With regard to more conventional approaches, Comas-Diaz (1981) also
documented the equal effectiveness of cognitive therapy and behavioral
therapy over a no-treatment control condition in the treatment of depression in Puerto Rican women. Cognitive and behavioral therapies do appear consistent with the expectations of traditional clients that include
immediate symptom relief, guidance and advice, and a problem-centered
approach (M. R. Miranda, 1976). Such short-term, directive, problemsolving therapies are also more consistent with the expectations of lowincome groups, whose pressing life circumstances frequently demand
immediate attention and interfere with long-term treatment (TorresMatrullo, 1982).
Treating Major Depression in Latinos
The Cognitive-Behavioral Depression Clinic (CBDC) at the San Francisco
General Hospital is an example of a needed service for Latinos located
within a traditional mental health system. Obstacles to services are minimized by providing free or low-fee (affordable) hospital-based (available,
accessible) services by linguistically and ethnically matched therapists
(acceptability). In terms of outreach, medical staff have been trained to
recognize and refer patients presenting with sad affect and/or multiple
somatic complaints. Patients are offered an evaluation for depression
based on their physician’s recommendation that facilitates the acceptance

Latino Mental Health 233
of mental health services. The clinic receives about 300 referrals a year,
and about half of these are Spanish-speaking Latino primary care patients, predominantly first-generation immigrants from Mexico and Central American refugees.
Outpatient group CBT is offered to patients who meet criteria for
Major Depression without psychotic features. Persons with active substance abuse, cognitive disorders, or other Axis I psychiatric diagnoses are
referred out for appropriate services. However, patients with concomitant
anxiety disorders (e.g., Generalized Anxiety Disorder, Panic Disorder,
PTSD) or Somatization Disorder are not excluded. Also, persons currently in treatment for their substance abuse problems are allowed to
enter group CBT. Patients are offered 16 weeks of standardized, manualdriven, group CBT provided by bilingual, bicultural Latino therapists.
Groups meet weekly for 2 hours for 16 weeks, and the treatment protocol
addresses three major areas (Muñoz, Ghost Ippen, Rao, Le, & Valdes
Dwyer, 2000): (1) activity schedules designed to break the vicious cycle of
depression leading to low activities and vice versa; (2) assertiveness training to increase interpersonal effectiveness; and (3) cognitive restructuring designed to identify and change depression-related thinking and core
beliefs.
The psychoeducational style of CBT quickly orients patients to treatment by educating them about the diagnosis of Major Depression and
how CBT is used to conceptualize and treat their problems. The use of
therapy manuals, homework assignments, and chalkboard-aided teaching
results in patients referring to therapy as la clase de depresión, which further helps to alleviate stigma attached to therapy. Each participant is
given a copy of the manual, which includes outlines of each of the sessions and weekly homework assignments consisting primarily of daily
mood monitoring in relation to activities, interpersonal contacts, and
thoughts. Homework is reviewed at each session to teach patients the relations between thoughts, behaviors, and mood.
Pretreatment Preparation. To reduce the incidence of dropout, patients
are invited to a pretreatment orientation session in which they meet
bilingual, bicultural Latino staff and therapists and learn about the
structure and process of group therapy over coffee and cookies. This
type of role preparation is highly recommended for decreasing dropout in
low-income (Orlinsky & Howard, 1986), ethnic minority (Acosta, Yamamoto, & Evans, 1983), and Latino (Delgado, 1983) patients.
Personalized Engagement. Engagement is further enhanced during the
first group therapy session by incorporating the salient Latino value of

234 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
personalismo into a culturally sensitive relationship protocol. Hence, during the first session, time is allotted for presentaciones in which therapists
and patients share personal background information about where they
are from, their families, work that they have done, personal interests, and
so on. The similarities among patients in terms of countries of origin,
types of work, and interests naturally elicit questions and small talk, or
plática. Following the presentations, therapists educate patients about the
diagnosis of Major Depression and the CBT model.
As a preliminary assessment of depressed thinking, patients are asked
to speculate about the causes of their depression. For example, a middleaged Central American woman attributed her depression to the death of
her son, who had been killed years earlier in El Salvador, where young
men were frequently the targets of either government or guerrilla forces
during that country’s civil war. The woman recalled the trauma of having
to identify her son’s bullet-riddled body in the city morgue. After ample
empathy was expressed, the woman was asked what about her son’s death
had made her so depressed. Interestingly, she blamed herself because the
two of them had an argument on the morning of his death and he stormed
out of the house, never to return (“If I had not argued with him, he would
not have been killed”). This case illustrates the difference between normal bereavement and guilt-ridden self-blame that can result in Major Depression. It also illustrates the kinds of traumas that Central American
refugees often bring into therapy.
Cognitive Restructuring. In the preceding case, it was imperative to eventually challenge the woman’s belief that she was responsible for forces
outside of her control. She eventually learned to think, “Yes, it’s true that
my son and I argued and that he left the house in anger on the day of his
death, but that doesn’t mean that his death was my fault.” The woman
was also reminded that her son’s life included more than his tragic death,
and she was asked to recall some pleasant memories of him. She was
eventually able to share that her son had been quite a joker and recalled a
few of his pranks, which made her laugh for the first time in a long time.
This is an example of a streamlined approach to cognitive restructuring
by teaching clients what I refer to as the “Yes, but . . . technique,” in
which clients are taught that much problematic thinking amounts to
“half-truths” about problems that need to be made into “whole truths.”
Rather than provoking defensiveness by labeling patient beliefs as irrational, à la Albert Ellis (Ellis & Grieger, 1977), or distorted, à la Aaron
Beck (Beck, Rush, Shaw, & Emery, 1979), patients feel understood when
therapists communicate that their thoughts are understandable in view of
their circumstances. This approach is also helpful in addressing another

Latino Mental Health 235
common problem in middle-aged Latinas, who frequently have to stop
working because of chronic medical problems, disabilities, and depression; for example, in a sample of 176 CBDC patients, 52% had chronic
medical conditions (Organista, Muñoz, & Gonzalez, 1994). A common
conclusion among these women was “¡
No sirvo para nada!” (I’m good for
nothing!) because self-worth is frequently overinvested in providing tangible support to their family. Again, we teach cognitive restructuring by
asking patients to complete such statements as “Yes, my health problems
do limit what I can do, but . . . ,” to which patients respond with something like “but that doesn’t mean I’m worthless” or “but there are still
some things I can do for my family.”
Restructuring Prayer? Because the majority of Latino patients are
Catholics, religion is regarded as a relevant domain in which practitioners
need to work. For example, churchgoing and prayer are reinforced as behavioral and cognitive activities, respectively, that help patients cope
with negative mood states. However, it is often necessary to assess and
even challenge forms of prayer that may lessen active problem solving.
For example, when patients report that they “just prayed” as a way of coping, they are asked to share their prayers during group. They often reply
that they simply asked god to alleviate their suffering or to solve their
problems. In such cases, patients are helped to shift prayers in a more active direction by discussing relevant Latino dichos, or sayings, such as
“Ayudate, que Dios te ayudará” (God helps those who help themselves).
Therapists also model for patients, asking them to recite prayers in which
god is asked for support in trying out new behaviors (e.g., “God, please
give me the strength to increase my daily activities” or “learn how to be
more assertive”).
Activity Schedules. Activity schedules and behavioral contracts to increase reinforcing activities are used to break the vicious cycle of depression and loss of interest in things, leading to low activity levels that in
turn maintain depression. Activity schedules are also helpful in countering Agoraphobia related to Panic Disorder affecting some patients (Organista, 1995).
When applying cognitive-behavioral techniques, it is important to be
aware of underlying mainstream American cultural assumptions. For example, an implicit assumption underlying activity schedules emphasizes
the need to take time out for oneself, based on the value that one must
take care of oneself before others. Although such an assumption is undoubtedly adaptive in our individually oriented society, it can run
counter to the emphasis in Latino culture, especially for women, to put

236 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
the needs of family members ahead of one’s own. This cultural contradiction is further complicated by the fact that although traditional Latino female gender-role expectations may be more realistic within intact
extended families and community systems (with their many compensating resources), such expectations become unrealistic in the United States,
where Latino families have become more nuclear, with fewer traditional
resources.
Consider, for example, the excessiveness of one of our female clients
who had the bulk of homemaker and parenting responsibilities in her
family, in addition to working full time outside of the home. For this
client it was important to balance her responsibilities with some time for
pleasant relaxation, but how? It was also important to teach her how to set
limits with her husband and other family members regarding excessive
housework and child care.
Naturally, Latino patients can be persuaded to do pleasant activities
with family members. The woman in this example began increasing
pleasant activities by taking her children to the park after work and by
visiting a coworker who also had children. The two women talked about
work over coffee while their children played together.
Interestingly, depression clinic patients frequently express a willing to
increase pleasurable activities in order to distraerse or distract themselves
from problems. This view of pleasant activities as a way of temporarily
escaping problems provides practitioners with an opening for encouraging this effective intervention strategy. In addition, because Latino patients are disproportionately poor, lists of local activities costing little or
no money (e.g., free admission to museums and the zoo on the first
Wednesday of the month, crocheting, preparing favorite meals) can be
generated by group members. Next, obstacles to doing such activities are
addressed (e.g., falta de ganas [loss of desire] due to depression). Because
Latino patients are so fond of dichos, we discuss sayings such as “You can
lead a horse to water but you can’t make him drink” as a way of increasing motivation.
Finally, teaching patients to assertively set limits on excessive demands
from family members is another helpful way of decreasing obstacles to
doing activities. For instance, the woman in the current example practiced how to ask her husband to spend more time with the children after
school while she shopped. Getting a traditionally oriented Latina to make
such assertive requests requires a culturally sensitive approach to assertiveness training.
Assertiveness Training. In traditional Latino culture, communication is
strongly governed by traditional institutions such as the extended family,
the community, and the church, as well as by values such as deference to

Latino Mental Health 237
those of higher status based on age, sex, and social position. As such, assertive communication can run contrary to the culture’s emphasis on
communication that is polite, nonconfrontational, deferential, and even
intentionally indirect (e.g., asking one relative to speak to another on
one’s behalf). Such communication is especially true for women, who are
taught to defer to and obey men and to subordinate their needs to those
of the family (Comas-Diaz, 1985). Unfortunately, such a traditional system of communication is subject to breakdown in modern society, where
the mediating functions of traditional institutions are rapidly deteriorating. As such, the need for members of our society to assertively convey
their needs and desires is imperative for optimal adaptation.
Despite the dilemma of teaching a modern, Western, and particularly
American style of communication to traditionally oriented individuals
(Rakos, 1991), the argument to do so with Latino patients is compelling.
For example, Soto and Shaver (1982) studied a sample of nearly 300
Puerto Rican women and found that those rating highest in gender-role
traditionalism were the least assertive and the most psychologically distressed. But how can practitioners conduct assertiveness training in a culturally sensitive manner?
Encouraging descriptions of assertiveness training with Latinos have
been reported (e.g., Torres-Matrullo, 1982), as well as culturally sensitive
training guidelines for ethnic minorities in general (Wood & Mallinckrodt,
1990) and with Latinas in particular (Comas-Diaz & Duncan, 1985). Such
guidelines de-emphasize the concept of “personal rights” as a way of motivating assertiveness because it can seem foreign to the nondemocratic,
nonegalitarian family and friendship systems of traditional Latinos.
The trick is to sensitively deviate from traditional Latino culture by encouraging patients to expand their bicultural capabilities by adding assertive communication skills to their traditional communication style.
That is, we biculturate patients by describing assertiveness as an effective
communication skill in mainstream American society. The emphasis on
biculturation is based on an additive model of therapy, in which the task is
to add mainstream communication skills to the patient’s current repertoire rather than devaluing and attempting to subtract traditional communication styles.
Care is taken to stress culturally compatible aspects of assertiveness
such as the emphasis on communication that is not only direct but also
honest, respectful, a way of cultivating family relationships, and a good
way of teaching one’s children how to be socially competent in mainstream society. Based on Comas-Diaz and Duncan’s (1985) guidelines,
Latino cultural factors that mitigate against developing assertiveness are
discussed during group as well as strategies for dealing with predictable
negative reactions from spouses and other high-status individuals. For

238 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
example, Comas-Diaz and Duncan taught Puerto Rican women to preface
assertive expressions with phrases like “Con todo respeto” (With all due
respect) and “¿Me permite expresar mis sentimientos?” (Would you permit me to express my feelings?). In addition, patients are taught to respond to negative reactions to their assertiveness with explanations such
as “Expressing my feelings makes me less upset and better able to handle
things.”
One seemingly passive woman in our group learned how to respond
more assertively toward her overly critical mother. On one occasion, the
patient was hurt because when she had shared with her mother the possibility of starting a job, her mother responded by saying, “And just how do
you expect to work a job when you can’t even speak English!” When the
patient was asked why she did not express her hurt feelings to her
mother, she said that she did not want to be disrespectful. This point is
noteworthy because, although Latinos are as likely as anybody else to be
passive, the patient’s reason for enduring her mother’s insensitivity
stemmed from her culture-based practice of respectful behavior toward
one’s parents and not passivity per se.
With the help of modeling by therapists and role-play, the woman was
finally able to say to her mother, “With all due respect, Mamá, could you
please be more supportive in my efforts to get a job? It hurts my feelings
when you are so critical and discouraging.” Both surprised and angered,
the patient’s mother quickly accused her daughter of “talking back” and
called her a mal criada, or “badly raised” child without manners. But roleplaying and group discussion had prepared our patient for this assertionmitigating response, to which she replied, “Would you permit me to say
something about that?” Her mother could hardly say no, and the patient
continued, “If you don’t let me express my feelings to you I’m going to
feel bad and resentful toward you, which I really don’t want to do.” In
this case, group discussion was extremely helpful in differentiating an
honest and respectful assertive communication from the rude, disrespectful, and aggressive expressions of a mal criada.
Another way of motivating Latino patients to consider assertiveness is
to ask them what happens when they hold in negative feelings. Almost
without exception, patients describe the exacerbation of existing physical
illness such as high blood pressure, diabetes, heart disease, and gastrointestinal symptoms. This approach is important because Latino patients
commonly report a tendency to aguantar (tolerate) or guardar (hold in)
anger rather than express it to those with whom they are upset. The tendency to guardar can be viewed as part of a larger culture-based style
known as controlarse, which refers to the disciplined self-control of negative thoughts and feelings leading to either resignation or efforts to overcome hardship (Cohen, 1985).

Latino Mental Health 239
Evaluation. A randomized clinical trial comparing group CBT with and
without social work case management was conducted at the CBDC (J. Miranda, Azocar, Organista, Valdes Dwyer, & Areán, 2003). Clinical case
management (CCM) was employed to enhance treatment by addressing
the multiple needs of depression clinic patients. Case managers also cofacilitated CBT groups and reinforced clinical work during individual case
management sessions. Participants in this study were 199 patients (77
Spanish-speaking Latinos, 112 mostly non-Latino Whites, and a few
African American clients). Results showed less dropout in the CBT +
CCM condition than in CBT alone for all patients. The combined condition was also more effective in decreasing depression and improving
functioning but only for Spanish-speaking Latino clients. This latter finding is
consistent with the aforementioned work by Sue et al. (1991), which
showed that linguistic and ethnic matching in therapy improved retention
and outcome but only for Latinos and Asians low in acculturation and not
for their higher acculturated counterparts nor for Anglo- or African
Americans. J. Miranda et al. concluded that Latino clients were most responsive to group CBT + CCM because of their special linguistic- and acculturation-related needs, which were directly addressed in treatment.
INDIVIDUAL APPROACHES
Hays (1995) argues that CBT is well suited for people of color for many reasons, including its emphasis on tailoring treatment to the client’s particular circumstances, the way it empowers clients through self-change skills,
and its attention to conscious process and specific behaviors. On the same
topic, Casas (1988) notes that CBT emphasizes action, not just verbal expression, and can be used to change environmental factors causing psychological distress, and that explanations of problems are more plausible and
less abstract than in other therapies. Although these are sound arguments,
others have argued that psychodynamic therapy can also be adapted to ethnic minority clients (Wohl, 1995). In Martinez’s (1994) review of the treatment outcome literature on Latinos, nothing definitive could be concluded
about individual therapy. Thus, at this point in time, nothing conclusive
can be said about individual treatment with Latinos other than that service
should be consistent with the new practice model presented in this book as
well as with lessons learned from the literature discussed earlier.
CONCLUSION
The purpose of this chapter was to review Latino mental health and its
links to acculturative stress and poverty, and to apply the book’s working
model of culturally and socially competent practice with Latinos to a
review of noteworthy mental health interventions. Generalist practice

240 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
issues were spelled out and followed up with domain-specific illustrations (e.g., prevention and treatment of depression). In the illustrations,
examples were provided on how practitioners can work both within as
well as outside of traditional Latino culture in a culturally sensitive and
competent manner. Although outcome evaluations are scarce, those that
exist are informative and should encourage us to pursue better research
in this important area for Latinos.
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245
CHAPTER 9
Latino Health
AFTER YEARS OF neglect, and a glaring lack of baseline data, the study of
Latino health in the United States is beginning to pick up considerable
speed with the production of numerous research publications, including
major book compilations (e.g., Aguirre-Molina, Molina, & Zambrana,
2001) and inclusion of Latinos in large surveys just in time to address the
growing and complex health needs of the diverse Latino population. Reviews of the literature in this area (e.g., Carter-Porkas & Zambrana, 2001;
Vega & Amaro, 1994) concur that, though much more research is needed,
Latino health is sometimes characterized as a paradox in that U.S. Latinos
often manifest surprisingly good health on a variety of indicators in spite
of being overly affected by poverty and legacies of exclusion and discrimination. This chapter provides an overview of Latino health in the United
States, followed by a selective review of major health problems and issues
across different Latino groups and disease states in order to situate this
immense topic within the context of culturally and socially competent
health care.
OVERV IEW OF LATI NO HEALTH I N THE UNI TED
STATE S: MORTALI T Y AND MORBIDI T Y
Despite the consistent inverse relation between health and SES all over
the world, Latinos appear to be as healthy, and sometimes even healthier,
than their non-Latino White counterparts on some major indicators. A review of overall mortality rates reveals equivalent rates in children between the ages of 1 and 14 (about 30 deaths per 100,000 for both) and
lower death rates for middle-aged (45 to 65) and older (65 and over) Latinos (609 and 790 per 100,000, respectively; Vega & Amaro, 1994). However, mortality rates are higher for Latinos than Whites between the
active ages of 15 and 44, and an examination of the leading causes of
death for Latinos helps us begin to understand why.

246 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Table 9.1 lists the top 10 leading causes of death for Latinos, Whites,
and African Americans (Carter-Pokras & Zambrana, 2001). As can be
seen, many of these causes of death overaffect Latinos between the ages of
15 and 44 (e.g., homicide, accidents). It should also be noted that although
heart disease and cancer are the top two leading causes of death for all
major U.S. groups listed, age-adjusted rates show lower overall risk in
Latinos. However, Latinos are at greater risk for certain types of cancer
(i.e., cervical, stomach), as well as for diabetes, homicide, chronic liver
disease, hypertension, and HIV/AIDS.
Comparisons between Whites and different Latino groups further help
to clarify health disparities, contextual factors, and needs. For example,
although Latinos have lower overall cancer rates than Whites (i.e., lung,
prostate, breast), Mexican Americans and Puerto Ricans have higher rates
of stomach cancer (Cubans’ rates are lower than Whites’) and 2 to 3 times
more cervical cancer (Carter-Pokras & Zambrana, 2001; Vega & Amaro,
1994). Further, tuberculosis, long associated with poverty, is twice as high
in Latinos compared to Whites and is concentrated primarily among
Puerto Ricans in New York City and Mexicans in the Southwest.
Rates of sexually transmitted diseases (STDs) are also generally higher
in Latinos than Whites, and the rate of HIV/AIDS is 3 times greater in
Latinos, concentrated mostly among Puerto Ricans, where it is an alarming 7 times greater than for Whites. The AIDS problem also translates to
an overrepresentation of Latinos, especially Puerto Ricans, among pediatric cases (23%) and among women (20%). Not surprisingly, Puerto Ricans have higher all-cause mortality (406 per 100,000) compared to Cubans
(300 per 100,000) and Mexican Americans (348 per 100,000; Carter-Pokras
& Zambrana, 2001).
MATERNAL-INFANT HEALTH
With regard to maternal-infant reproductive health outcomes, Latinos
and Whites differ little in terms of infant mortality (5.6 and 6 per 100,000
births, respectively), with the exception of Puerto Ricans (8.6 per 100,000
births). This same pattern holds for low birth weight (6.4, 6.6, and 9.7 per
100,000 births, respectively; Carter-Pokras & Zambrana, 2001). Latinos’
rates are slightly higher than Whites’ on preterm births (11.4 and 10.2 per
100,000, respectively), as well as maternal mortality rates (5.2 and 4 per
100,000, respectively).
A Mexican Health Paradox?
Guendelman and associates (Guendelman, Chavez, & Christianson, 1994;
Guendelman & English, 1995; Guendelman, English, & Chavez, 1995)

247
Table 9.1
The 10 Leading Causes of Death in the United States among Latinos, Whites,
and African Americans, Both Sexes, All Ages (1998)
Total Population Latinos Whites African Americans
Cause of Death Number Rank Number Rank Number Rank Number Rank
All causes (age adjusted) 2,337,256 — 98,406 — 1,912,802 — 275,264 —
Heart disease 724,859 1 24,596 1 609,256 1 77,434 1
Cancer 541,532 2 19,528 2 449,785 2 60,642 2
Stroke 158,448 3 5,587 4 131,039 3 18,067 3
Chronic obstructive pulmonary disease 112,584 4 2,528 9 101,274 4 7,131 8
Accidents 97,835 5 8,248 3 73,669 6 12,617 4
Pneumonia and influenza 91,871 6 3,277 6 78,174 5 8,246 7
Diabetes 64,751 7 4,741 5 46,884 7 11,278 5
Suicide 30,575 8 — — 25,846 8 — —
Kidney disease 26,182 9 — — 20,372 10 — —
Chronic liver disease 25,192 10 2,845 8 ————
Alzheimer’s disease ———— 20,834 9 — —
Homicide — — 2,978 7 — — 8,282 6
HIV/AIDS — — — — — —7,055 9
Perinatal conditions — — 1,987 10 — — 4,674 10
From “Latino Health Status” (pp. 23–54), by O. Carter-Pokras and E. Zambrana, Health Issues in the Latino Community, in M. Aguirre-Molina,
C. W. Molina, and R. E. Zambrana (Eds.), 2001, San Francisco: Jossey-Bass. Adapted with permission.

248 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
have documented surprisingly healthy birth outcomes for Mexican immigrant women in California, comparable to their non-Hispanic White
counterparts (i.e., low rates of fetal death and low birth weight). However,
these researchers also report a decline in good birth outcomes with increasing acculturation. For example, Guendelman and English found
that, compared to newcomers, Mexican immigrants living in the United
States for as little as 5 years were more likely to deliver preterm and low
birth weight infants, had more pregnancy complications and fewer
planned pregnancies, and were more likely to smoke. Infant health also
appears to deteriorate with acculturation, as indicated by a study of more
than 700 healthy infants of Mexican immigrants born in San Diego
County. Guendelman et al. (1995) found that a quarter of these infants
succumbed to serious infectious disease due to negative social conditions
such as large households, barriers to care, and mothers who smoked.
Comparisons of the health behaviors of Mexican American women
and their White counterparts show that Mexican American women report lower consumption of tobacco, alcohol, diet soda, and caffeine, especially during pregnancy and lactation (Guendelman & Abrams,
1995a). Unfortunately, Guendelman and Abrams (1995b) also found that
second-generation Mexican Americans have diets that resemble their
White counterparts. Thus, acculturation to the United States appears to
have a negative impact on the maternal-infant health of Mexican Americans because of negative social conditions and a decline in healthy immigrant behavior.
OBSTACLE S TO LATI NO DI SEASE PR EVENTION
AND HEALTH PROMOTION
There appear to be two overriding tasks in promoting health and preventing disease in Latino communities. The first involves studying possible
culture-based protective factors (e.g., healthy diet, low rates of smoking
and drinking) to better understand and reinforce such behaviors. The
second task is to promote culturally and socially competent health care
for Latinos that involves micro- through macro-level systemic changes,
beginning with improving basic access to health care.
THE PERVASIVE PROBLEM OF LOW HEALTH CARE ACCESS FOR LATINOS
The fact that many Latinos are likely to lack health insurance clearly has a
major impact on their overall health outcomes. It is difficult to imagine how
a patient without insurance can get the necessary battery of preventive examinations such as mammography, pap smears, and screening for diabetes

Latino Health 249
and colon and prostate cancer, among others; or how a patient with hypertension can be examined and treated regularly to prevent any cardiovascular complications that result from this condition. (Carillo, Treviño,
Betancourt, & Coustasse, 2001, p. 65)
Carter-Pokras and Zambrana (2001) report the following percentages of
uninsured Americans: 14% of Whites, 20% of African Americans, and
33% of Latinos. Among Latinos, the percentages are 19% for Puerto Ricans, 21% for Cubans, and an alarming 39% for Mexican Americans. With
regard to health consequences, Carillo et al. (2001) report that half of
uninsured Latinos (a) had not seen a doctor when last sick; (b) had gone
without a prescription for needed medication; and (c) had gone without
recommended medical tests and treatments; two-thirds reported having
trouble paying bills or being contacted by collection agencies for medical
expenses. Reasons for lack of insurance center on a pervasive lack of
health coverage through employment because of high concentrations in
non-white-collar occupations such as construction, small firms, agriculture, and mining. Lack of citizenship is also a significant reason. It is a
cruel irony that the United States employs a predominantly Mexican
farmworker labor force that is mostly undocumented and that generally
lacks any form of health care in spite of working in what many consider to
be the most dangerous occupation in America in terms of annual number
of injuries and deaths (Organista, 2004).
Primary Barriers
Carillo et al. (2001) describe various macro-level or primary barriers to
health care faced by Latinos in the United States that threaten to worsen
an already unhealthy situation. For example, the Balanced Budget Act of
1997, which called for decreasing Medicare expenditures by $116 billion
over a 5-year period, may succeed by balancing the budget on the backs of
the poor given that “safety net” providers, such as community health centers, are the hardest hit because of the types of clients they serve: 41%
uninsured, 33% Medicare, 31% Latino, 65% below the poverty level, 20%
at the poverty level or just above it, and 25% nonreimbursable. The same
is true for academic medical centers, which tend to serve poor communities of color, often in general hospital type settings.
Carillo et al. (2001) note that recent welfare reform, the Personal Responsibility and Work Reconciliation and Opportunity Act of 1996, severed the link between public assistance and Medicaid and prepares
welfare recipients for work in sectors without health insurance. Many
who remain eligible for Medicaid may not even be aware of it. Similarly,

250 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Latino families 200% below the poverty line that are documented but not
Medicaid eligible may be unaware of safety net programs for which their
children are eligible, such as the recent State Children’s Health Insurance
Program.
Secondary and Tertiary Barriers
Secondary barriers to health care include lack of Latino and Spanishspeaking medical staff and interpreters and excessively complex HMOrelated intake procedures, all of which ultimately translate into poor
health for Latino patients. Carillo et al. (2001) note that although Latino
physicians are more likely than their White counterparts to provide services to Medicaid patients and the uninsured, they constitute only 2% of
medical doctors.
Tertiary barriers include low-quality communication between patients
and their doctors and other medical staff and relations that compromise
Latino health. For example, Giacomini (1996) reports that Latino patients
with health care equivalent to that of Whites undergo fewer of the following medical procedures: coronary artery bypass graft, angioplasty, and
kidney transplants. Even among ischemic heart disease patients in L.A.
County, Latinos’ rates of coronary artery bypass graft and angiography
were lower compared to Whites.
Thus, culturally and socially competent health care for Latinos is
dependent on multiple levels of reform needed to connect eligible Latinos to the services for which they are entitled, maintain and improve
safety net services for poverty-stricken Latinos who are ineligible
for Medicaid, and provide accessible health care for undocumented
Latinos who continue to live and work in the United States. What follows are illustrations of ways to conceptualize and respond to major
health problems and issues that continue to compromise the health of
U.S. Latinos.
A SELEC T I V E R EV I EW OF CULT UR ALLY
COMPETENT APPROACHE S TO LATI NO HEALTH
Given the immensity of Latino health problems and issues in the United
States, the remainder of this chapter illustrates needed approaches to
Latino health promotion and disease prevention by selectively reviewing
published reports of various campaigns and programs that are conceptually tight, involve multiple intervention levels, and present auspicious results. Priority is granted to some of the most grave and pervasive health
problems currently affecting U.S. Latinos.

Latino Health 251
DIABETES AND HEART DISEASE
Adult-onset Type II diabetes (90% to 95% of all cases of diabetes) increasingly exacts a major toll on the American public. This is especially
true for Mexican Americans and Puerto Ricans, whose rates of this disease are twice that of Whites and Cuban Americans. Over the past 50
years, diagnoses of diabetes in the United States have increased 10-fold,
from 1.5 million in 1958 to 10.5 million in 1998, and it is now the seventh
leading cause of death (sixth leading cause for Latino men and fourth
leading for Latinas; Luchsinger, 2001). Latinos also evidence greater
complications from diabetes than Whites, including amputations, retinitis, dementia associated with stroke, end-stage renal failure, and
even tuberculosis. Such complications appear to be related to documented late detection of diabetes and lack of health care that can help to
prevent and minimize complications.
Because rates of diabetes are lowest among Euro-Americans and highest among American Indians, with intermediate rates for Mexican Americans and Puerto Ricans, there is much conjecture about genetic loading
given that these Latino groups come from an admixture of indigenous
and European genetic backgrounds, as well as African ancestry in the
case of Puerto Ricans. Although more genetic research is needed, the
role of weight, diet, and exercise in the risk for diabetes is clear, as are
implications for Latino-focused interventions. National data show a
strong and clear positive relation between diabetes and weight, with risk
ranging from 2 times greater prevalence in overweight Americans to 6.5
times greater risk in obese Americans. Unfortunately, Americans show a
steady trend in weight gain and decline in physical activity; this is especially pronounced for Mexican Americans (for whom we have the most
Latino data). Survey data from the Hispanic Health and Nutrition Examination Survey (HHANES, collected in 1982 to 1984) and the National
Hispanic Health and Nutrition Examination Survey (NHANES; collected in 1988 to 1992) show that the rate of overweight Mexican American men went from 31% to 40%, and from 41% to 48% for Mexican
American women (Luchsinger, 2001). Further, rates of overweight and
obese children ages 2 months to 5 years are also higher for Mexican
Americans than for Whites.
With regard to diet and exercise, data from the HHANES III show that
15.6% of men and 27% of women in the United States report no leisure
time physical activity; these rates are 29% and 43.8% for Mexican American men and women, respectively. Among 4-year-old children, Mexican
Americans are reported to have less home- and school-related physical
activity. Various investigations of diet in Mexican American children

252 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
show excessive meat and milk, too few servings of fruits and vegetables
(HHANES), and greater general intake of fat among Mexican Americans
than among Cubans and Puerto Ricans (HHANES and HHANES II).
These diet and exercise data are also highly relevant to heart disease.
Clearly, diabetes prevention depends on early detection, improving
diet and physical exercise, and testing high-risk groups: Mexican Americans and Puerto Ricans, those over 45 years of age, those with diabetic
first-degree relatives, women with past and current diagnosis of gestational diabetes (i.e., during pregnancy), and babies heavier than 9 pounds
at birth (Luchsinger, 2001). Such interventions are few, but promising
community-based and family-focused efforts have documented success
in the Latino community. Work in related areas such as prevention of
coronary vascular disease (CVD) and cancer prevention and control also
offer comprehensive models of macro-level public health campaigns
through micro-level education and problem solving.
PREVENTING DIABETES AND HEART DISEASE
Holcomb and associates (1998) reported on a rare, school-based, diabetes
prevention program aimed at poor fifth-grade Mexican American students residing in the U.S.-Mexico border region. Thirty teachers at 13
schools received a day of training regarding diabetes and how to deliver
the Jump into Action curriculum to their students. A comparison group
of nine teachers from six schools also volunteered to use the curriculum,
but without training. Jump into Action was designed to teach children
about the causes of diabetes and the role of diet and exercise and to build
self-efficacy regarding prevention. More than 800 students completed
pre- and postintervention assessment, as well as a 1-month follow-up.
Promising results showed that, regardless of teacher condition, significant gains were made on all areas assessed and that the majority of these
gains were maintained at follow-up. Teachers overwhelmingly rated the
program effective and clear and said that they would recommend it to
other teachers.
Holcomb et al. (1998) did note that there was less improvement in the
dietary-related behaviors of students compared to gains in knowledge and
self-efficacy, and that interventions need to better impact the home environment. Clearly elementary school children are limited in their
power to influence family dietary habits, making the involvement of
parents, especially mothers, key to making diabetes prevention-related
changes in diet.
Communitywide campaigns are also needed to pave the way for familyfocused interventions. A pair of studies designed to prevent CVD in Lati
Latino Health 253
nos are very instructive with regard to how Latino families and communities can be engaged in such disease prevention efforts.
Foreyt, Ramirez, and Cousins (1991) compared a family-oriented approach to long-term weight loss to a group intervention for individuals,
as well as to an information-only control condition. The project was called
Cuidando el Corazón (Taking Care of the Heart) and was aimed at lowincome, married Mexican American women who were 20% above ideal
body weight and who had one or more children between the ages of 3 and
6. Women in the control group were provided with a manual on preventing CVD through behavior change, nutrition, exercise, and modifying the
fat content of traditional Mexican recipes. Women in the group condition
received the same manual but also attended 24 90-minute, weekly meetings throughout the course of a year. The groups also included extended
behavioral education, food demonstrations, and six monthly maintenance
classes designed to enhance compliance by teaching problem-solving
strategies aimed at slips and high-risk situations such as holidays and socials. It is important to note that child care was made available for the
women attending the groups.
Corazón’s family-oriented condition was the same as the group condition except that groups were composed of married couples and included
techniques for supporting the efforts of spouses, as well as for promoting
healthy habits in children (for whom separate groups were held). Culturally appropriate weight reduction strategies began with brisk couple
and/or family walks and framing mother’s weight loss as beneficial to la
familia rather than just to her individually. Participants were assessed
every 3 months throughout a 1-year period for weight loss and other measures. A little more than half of the 168 Latinas who participated completed the multiple assessments. Results showed that participants in both
the family and the group condition lost significantly more weight than
those in the information-only control group.
Cuidando el Corazón is impressive for facilitating actual weight loss in
overweight Latina mothers, and one could imagine combining elements
of its family-focused condition with the child-focused efforts of Holcomb
et al. (1998), as well as with more communitywide efforts to raise awareness about major preventable diseases overaffecting Latinos.
At the community level, Alcalay, Alvarado, Balcazar, Newman, and
Huerta (1999) reported on the development, implementation, and evaluation of Salud para Su Corazón (Health for Your Heart), which was successful in increasing awareness of CVD risk factors and ways to prevent
them in a sample of 344 adult Latinos in Washington, DC. When the vast
majority of these individuals were assessed at six different locations results showed that although only 50% could name three or more ways to

254 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
prevent CVD at pretest, 70% could do so at posttest. Although no
changes in behaviors were found (and this should be explored), this
study is noteworthy for its methodical and comprehensive attention to
building a Latino community-based alliance of key players, ranging
from health care providers and community leaders to business and
media professionals, who used a consensus-building approach to develop, test, revise, implement, and evaluate multiple CVD prevention efforts. Such efforts included a needs assessment via generation of a
community profile and conducting six focus groups with community
residents at high risk for CVD, followed by developing and testing Spanish TV and radio media campaigns and sorely missing Spanishlanguage materials and conducting charlas (informal talks) on the topic
with participants. Through the involvement of media professionals, a
21-part, 5-minute series, called A Month of Prevention against Heart Disease, was created and aired three times daily on Radio Borinquen
(Puerto Rican Radio). Also two 24-minute telenovelas (novellas for television) entitled For the Love of Your Heart and Cooking with Your Heart
in Mind were created and were aired 2,000 times by Univisión, the national Latino television network. Such efforts support the overarching
goals of this program: to maximize reach into the Latino community
and to promote program sustainability and transferability (e.g., Spanishlanguage materials have been packaged and are frequently disseminated throughout the country).
Addressing Latino Diet
Because diet and eating habits can be central to social, cultural, and
developmental experiences, they can be resistant to change even if
the goal is to prevent and control numerous chronic diseases. Thus, a
deeper understanding of how to address problems in bicultural Latino
diets is warranted, and there is some insightful research to assist with
this task.
Buena Alimentación, Buena Salud (Good Nutrition, Good Health) is
the name of an auspicious program that was successful in improving the
diet of overweight Latino diabetics (Vasquez, Millen, Bissett, Levenson, &
Chipkin, 1998). At 3-months postintervention, the 18 participants in the
experimental condition had reduced total and saturated fats and increased fiber and carbohydrates. Each of the 12 intervention sessions contained three components: active discussion to clarify health information,
behavioral skills acquisition, and demonstrations of how to shop for and
prepare healthier meals (e.g., in-session cooking and tasting, trips to supermarket, how to read food labels). The overall intervention framework
used a social learning theory analysis of the antecedents and conse
Latino Health 255
quences of food/eating behavior, with emphasis on identifying high-risk
situations (e.g., holidays, eating out) and healthy alternative behaviors,
sustaining healthy behaviors, and how to problem-solve around relapses.
Table 9.2 lists the program contents, skill objectives, and methods of
Buena Alimentación, Buena Salud, which were carefully developed from
three phases of background research: (1) assembling a local consultative
multidisciplinary team; (2) developing and implementing a patient population survey to assess knowledge and attitudes related to diabetes management; and (3) conducting focus groups to discuss major obstacles
encountered when attempting to manage diabetes. This background research revealed widespread lack of compliance with diabetes management, high rates of poverty, the belief in nearly half of participants that
they were not overweight, and high daily consumption of traditional
foods. At the same time, over 90% of participants surveyed agreed that
complications of diabetes could be avoided.
Not discussed explicitly in the report are the specific kinds of beliefs
and attitudes among diabetics in general, and Latino diabetics in particular, that compete with diabetes management. For example, Hunt, Pugh,
and Valenzuela (1998) conducted lengthy qualitative interviews with 51
Mexican American diabetics which showed that although all participants
practiced self-care and expressed concerned about their diabetes, none
fully complied with recommended management because of the following
competing beliefs and behaviors:
• Overestimation of the power of medications to compensate for poor diet:
Half of participants reported using their diabetes medications in
place of exercise and improved diet; some viewed medications as a
safety valve to be used when eating poorly.
• Strong desire to feel normal: Almost 80% of participants found it hard
to accept “never eating/drinking normally again.” Men found it distressing to give up favorite fatty dishes such as tamales and enchiladas and claimed that low-fat foods were too light and not filling.
Men also generally continued to drink alcohol, discounting it as a
problem. Women said it was difficult to both diet and prepare meals
for the family, and that taking care of family members left no time
for exercise. Some women tried to eat smaller portions of normal
family foods, but then found it difficult to resist eating more.
• Problems dieting during social events: Participants either ignored their
diet during social events or avoided such events.
• Misconceptions about blood glucose levels and desire to avoid side effects of
medication: Medication side effects (e.g., acute dizziness, disorientation, sweating, palpitations) sometimes scared patients and

Table 9.2
Diabetes Prevention Program Objectives
Week Content Skills Demonstration
1. Program goals, diabetes risk in Latinos Identify realistic outcomes from program
participation.
Prepare and taste low-fat recipe.*
2. Diabetes and complications Identify factors that contribute to diabetes
complications.
Evaluate food records for fat content.
Prepare and taste low-fat recipe.*
3. Dietary fat and cholesterol Examine the amount and type of fat in
traditional foods.
Analyze low-fat menu.
4. The role of portion control in diabetes
management
Describe appropriate portion sizes of different
foods.
Practice measuring portions in a
variety of foods.
5. Label reading Analyze food labels for fat and calorie content. Practice reading labels.
6. Inexpensive and healthy low-fat foods at
the market
Identify barriers to low-fat food selection. Attend supermarket tour.
7. Review label reading and supermarket
idea
Examine food labels. Prepare and taste low-fat recipe.*
8. Role of weight reduction in NIDDM Identify problem eating behavior. Problem-solve in
situations of high risk for inappropriate eating.
Prepare and taste low-fat recipe.*
9. Psychological lesson—relationship between
food, emotions, thoughts, and behaviors
Analyze impact of stress on food choices and
eating habits.
Prepare and taste low-fat recipe.*
10. Psychological lesson—stress management Examine sources of stress. Develop coping
strategies for dealing with stress.
Practice relaxation techniques.
11. Importance of exercise for weight
management
Develop realistic exercise plan. Practice exercising. Monitor glucose
before and after activity.
12. Planning for holidays and vacations Develop and implement coping strategies. Work on problem-solving situations
during holidays.
* A traditional low-fat recipe was prepared and taste-tested in every class.
From “Buena Alimentaciøón, Buena Salud [Good Nutrition, Good Health]: A Preventive Nutrition Intervention in Caribbean Latinos with Type 2 Diabetes,” by I. M.
Vazquez, B. Millen, L. Bissett, S. M. Levenson, and S. R. Chipkin, 1998, American Journal of Health Promotion, 13(2), pp. 116–119. Adapted with permission.
256

caused them to discontinue medications and to eat sweet and heavy
foods. Some patients actually expressed fear of low blood glucose.
• Limited economic resources: Many low-SES participants said that recommended diet and exercise are expensive (i.e., price of blood glucose strips, syringes; preparing separate meals for self and family;
needing to eat what’s available when finances are low).
• Poor recognition of the relation between glucose control and the previous
factors: None of the above beliefs and behaviors were seen as impacting control of blood glucose levels!
Related studies by Hunt and colleagues also found that some Mexican
American diabetic patients lost motivation to comply with diabetes management when inconsistencies arose between their efforts and health outcomes (Hunt, Valenzuela, & Pugh, 1998), that is, when careful diabetes
management did not result in controlled glucose levels and vice versa.
Such patients need to be taught about the process of chronic disease management, including the need for consistent diabetes management despite
occasional counterintuitive outcomes.
One final note on work by Hunt and colleagues (Hunt, Hamdi Arar, &
Akana, 2000): These researchers examined the use of culture-based alternative treatments (e.g., herbs, prayer, fatalistic religious beliefs) as possible
competitors to the biomedical management of diabetes in 43 low-income
Mexican Americans with Type 2 diabetes. They found that use of such alternatives was infrequent and did not interfere with standard medical care.
None of the participants used curanderos (Mexican folk healers) for diabetes,
use of herbs was infrequent and only supplemental to medical treatments,
and prayer was viewed as enhancing medicines but not as a substitute.
Regarding the last point, I recall one Latino diabetic patient with whom I
worked who stopped his diabetes management and, when asked about it,
replied that if it was god’s will for him to die, then he would. I challenged
the patient’s fatalistic thinking by asking him if he felt that it was his right to
challenge god. When the patient expressed confusion at the question, I explained that it was as if he were putting a single bullet into a pistol, holding
the gun to his head, and saying, “Let’s see if god wants me to live or die.”
It remains unclear how beliefs about the management of diabetes differ
between Latinos and non-Latinos (given the lack of a comparison group in
the studies just reviewed); still, these beliefs and related behaviors are
noteworthy for the kinds of culturally related phenomena that need to be
specifically targeted in interventions designed to enhance healthy disease
management. The growing focus on cancer prevention and control with
Latinos offers further illustrations of increasingly culturally and socially
Latino Health 257

258 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
competent primary and secondary prevention strategies and multiple levels of intervention.
CANCER
Reviews of the literature on cancer among Latinos point out that although
national surveillance data are improving, there continue to be limitations
(Gutierrez-Ramirez & Carter-Pokras, 1994; Ramirez & Suarez, 2001). Nevertheless, such reviews conclude that Latinos have lower overall rates of cancer compared to non-Latino Whites (e.g., less lung, colorectal, breast, and
prostate cancer). Cancer disparities favoring Latinos are attributed to
healthy diets that are high in fiber and low in fat, as compared to the diets
of Anglos and African Americans. Nevertheless, Latinos do have higher
rates of certain types of cancer (i.e., stomach, cervical, gallbladder, esophagus, and liver). Recognizing lower cancer risk in Latinos, Gutierrez-Ramirez
and Carter-Pokras caution that “there are indications that this situation
could change” (p. 230). For example, they note trends in the literature that
the following cancers may be increasing among Latinos: leukemia and cancers of the breast, colon and rectum, lung, prostate, bladder, kidney, and
brain. The most common forms of cancer for both Latino and White men are
prostate, colon, and lung; the most common for both Latinas and White
women are breast and colon cancer. The third most common cancer for Latinas is cancer of the cervix, whereas for white women it is lung cancer.
Despite the primal fear evoked in Latinos and Whites alike by the diagnosis of cáncer, Gutierrez-Ramirez and Carter-Pokras (1994) are quick to note
that there is substantial room for primary and secondary prevention given
the significant roles of diet, lifestyle, and access to preventive care. The most
obvious example is lung cancer, 80% of which could be prevented by avoiding smoking. The authors note that although Latinas smoke less than their
White counterparts, smoking rates continue to increase for Latinos living in
the United States. In fact, rates of smoking in Latino and White men is now
about the same at around 30%, and the rate is even higher for Puerto Rican
men, at 37%. Gutierrez-Ramirez and Carter-Pokras cite the many documented associations between being overweight and eating a Western diet
rich in animal products and fats and a variety of cancers, including colon
and rectal, prostate, ovary, uterus, breast, and testicular; links between alcohol consumption and liver cancer; and links between exposure to pesticides among farmworkers and malignant lymphoma, GI tract cancer, cancer
of testes, and clusters of childhood cancers found in farmworker-filled
towns such as Delano and McFarland in California. Thus, there is considerable work to be done in the area of Latino cancer prevention and control.
In addition to the usual disease-related recommendations (i.e., more
research, more funding, more Latino participation), the First North

Latino Health 259
American Conference on Cancer in Hispanics (Modiano, 1992) asserted
that the process and development of “culturally tailored” interventions
need to be adequately explained. Hopefully this important recommendation can be addressed here by reviewing some auspicious cancer prevention interventions.
CANCER PREVENTION EN ACCIÓN
One of the most impressive efforts at rigorous, comprehensive, culturally
and socially appropriate, and communitywide cancer prevention with
Latinos has been conducted through En Acción: the National Hispanic
Leadership Initiative on Cancer (NHLIC). The NHLIC is a program for
both research and action to prevent and control cancer in major U.S.
Latino groups (i.e., Mexican, Puerto Rican, Cuban, Central American) in
eight major Latino urban centers: San Francisco, San Diego, Houston, San
Antonio, Laredo, Brownsville, Brooklyn, and Miami. The three major
components of En Acción are (1) conducting a large-scale survey to assess
cancer screening behaviors and related background and risk factors; (2)
promoting cancer prevention and control at the community level by connecting national and regional experts with grassroots groups to mount
media campaigns and peer network support efforts; and (3) evaluating
prevention intervention efforts (Ramirez et al., 1998). A series of published reports by the NHLIC research team documents ethnoregional differences in cancer risk and correlates, as well as evaluations of NHLIC’s
culturally and socially appropriate prevention intervention model. These
three components are highlighted next.
The Cancer Risk Survey
To generate cancer risk data, the NHLIC survey was conducted in the
early 1990s and consisted of 1,200 completed telephone interviews in each
of the eight city sites, stratified by sex and age groups (under and over 40;
Ramirez et al., 1999). Areas assessed included level of health care, consumption of fruit and vegetables, smoking, various forms of cancer
screening for women (i.e., history of pap smears and mammograms) and
men (i.e., digital rectal exams for screening prostate cancer), and other
background variables related to risk. Reports from this database provide
insights into many of the dynamics of cancer risk in Latino communities
across the country, and also provide the basis for implementing NHLIC’s
prevention intervention model.
The Cancer Prevention Model
Education and advocacy are based on a social modeling approach in
which behavioral journalism is used to create local “role model” stories of

260 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
real Latinos preventing and controlling cancer. These are disseminated
through mass media (i.e., television news, radio, newspapers) and small
local media (e.g., print material distributed by grassroots volunteers).
Stories relate how the role models acquired information, changed attitudes, and picked up the skills needed for optimal cancer prevention or
control. Following the media campaign, local peer networks of natural
helpers, composed primarily of volunteer housewives and in some places
promotores (nonprofessional community health promoters), are identified
and trained to reinforce media messages with friends, neighbors, and
others in the community.
PREVENTING CERVICAL AND BREAST CANCER IN LATINAS
It has been documented that Latinas have twice the rate of invasive cervical cancer as non-Latino White women (16.2 and 7.9 per 100,000, respectively) yet are less likely than all other groups of women in the United
States to receive pap smear screening (Gutierrez-Ramirez & CarterPokras, 1994). This means that Latinas are dying needlessly: Cervical cancer screening can save the lives of women of childbearing age who get
regular pap smears so that precancerous lesions can be quickly treated
(Ramirez & Suarez, 2001). Breast cancer screening rates are also lower for
Latinas than for White and African American women, and this is even
the case for Latinas without financial barriers to health care (Ramirez,
Suarez, et al., 2000). Although Latinas’ rate of breast cancer is about 40%
lower than the rate for White women, presumably because of Latinas’
greater number of earlier and multiple births, breast cancer continues to
be the most common form of cancer among Latinas in the United States
(Ramirez & Suarez, 2001).
Ethnoregional Differences in Latina Cancer Screening
Data from the NHLIC show considerable ethnoregional differences in
Latina cancer screening. Screening for cervical (Ramirez, Talavera, et al.,
2000) and breast (Ramirez, Suarez, et al., 2000) cancer was found to be
consistently lower for Mexican American women in Texas (especially in
the South Texas border region) and was highest among Central Americans in San Francisco and Cuban Americans in Miami. For Latinas over
the age of 40, pap smear screening during the past 3 years was lowest in
Texas (from about 48% in Laredo to 60% in Houston), as compared to between 63% (Puerto Ricans in New York) and 74% (Central Americans in
San Francisco) for all other Latina groups. The same pattern was found
for mammogram screening during the past 2 years for Latinas over 40:
lowest in Texas (from approximately 42% in Laredo to 59% in San Anto
Latino Health 261
nio) compared to between 60% (Mexican American women in San Diego)
and 83% (Central American women in San Francisco) for all other Latina
groups. Armed with these data, the NHLIC conducted analysis to better
understand the social and cultural contexts of cancer prevention screening in Latino communities and to test their conceptually tight prevention
intervention model.
Social Integration and Cancer Screening
The NHLIC team investigated the relation between cancer screening and
social integration for Latinas over the age of 40 (Suarez et al., 2000) and
found that Latinas with higher numbers of friends and relatives, higher
frequency of social contacts, and higher church membership and attendance were almost twice as likely to have had a recent pap smear than
Latinas low in these markers of social integration. Church involvement
emerged as the strongest predictor of cervical cancer screening. Social networks were generally large and active for these middle-aged and older
Latinas. The impressive link between social integration and cancer screening was strongest for Mexican American and weakest for Puerto Rican
women. In fact, there was no relation between social integration and
screening for Puerto Ricans, whose social networks were smallest, indicating greater isolation in these women. The results support the NHLIC’s
prevention intervention model that is designed to mobilize naturally occurring peer support networks in Latino communities to prevent disease.
Using the Model to Prevent Cervical Cancer
Given the data on cervical cancer screening, the NHLIC team decided to
promote cervical cancer screening where it was needed most by implementing their prevention intervention model in the U.S.-Mexico border
region of South Texas (Ramirez et al., 1999). Salud en Acción (Health in
Action) is the name of the Brownsville-based intervention, which consisted of a predominantly Spanish-speaking media blitz that included
more than 80 TV segments, more than 60 newspaper stories, and nearly
50 radio programs featuring local role model stories. Embedded in these
personalized accounts of cervical cancer prevention were the knowledge,
attitudes, and skills involved with acquiring pap smears, as well as ways
that spouses and family members can be instrumental in supporting such
behavior for the sake of the entire family. Following the media blitz, natural peer networks were mobilized by identifying and training 175 predominantly homemaker volunteers to incorporate cancer prevention into
their communications with community residents.
To evaluate Salud en Acción, a panel of just over a 100 Brownsville women
who had participated in the NHLIC baseline survey were reinterviewed

262 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Table 9.3
Percentages of Mexican American Women in Highest
and Lowest Pap Smear Adherence Levels by Intervention
(Brownsville) and Control (Laredo) Sites
Baseline Follow-Up
Site Adherence (1994) (1996)
Brownsville Highesta 54.2 60.7
(Program) Lowestb 23.4 13.1
Laredo Highesta 46.8 47.1
(Campaign) Lowestb 27.6 25.0
a Within past year or 2 years (at baseline) and strong intentions (at follow-up).
b Never or more than 3 years ago and no intentions (at follow-up).
Source: “Cervical Cancer Screening in Regional Hispanic Populations,” by A. G.
Ramirez et al., 2000, American Journal of Health Behavior, 24(3), pp. 181–192.
Reprinted with permission.
following several months of the intervention. Their data were compared to
the baseline Brownsville data, as well as to data of a comparison panel of
more than 100 women from Laredo, where no Salud en Acción intervention
was implemented (i.e., control site). As can be seen in Table 9.3, impressive
intervention effects were reported only in Brownsville, where the percentage of women in the highest pap smear adherence condition increased from
a little over half at baseline to nearly two-thirds. Further, the percentage of
Brownsville women in the lowest adherence condition decreased from almost a quarter at baseline to 13%. In contrast, no such positive changes in
cancer screening rates were evident at the Laredo site.
Using the Model to Prevent Smoking
McAlister et al. (1992) also used the NHLIC model to prevent smoking in
a Texas-Mexico border community, with auspicious results. Over a period
of 5 years, these researchers implemented four smoking cessation campaigns, advertised as Programa a Su Salud (Program for Your Health), in
the South Texas city of Eagle Pass. The nearby town of Del Rio was selected as the no-intervention comparison town. To evaluate Programa, a
panel of 135 participants from Del Rio was compared to a panel of 160 residents from Eagle Pass. The Eagle Pass panel also included a subsample of
70 residents who received intensive counseling for smoking cessation in
addition to the communitywide intervention. That is, 70 Eagle Pass residents accepted an additional offer of more individualized counseling for
quitting smoking, which ranged from telephone consultations to face-toface meetings with outreach workers, as well as enrollment in the Ameri
Latino Health 263
can Cancer Society’s Latino-focused telephone-based smoking prevention intervention.
With regard to results, self-reported rates of smoking cessation for
Eagle Pass were 17%; 8% were verified though breath samples into a
portable carbon monoxide analyzer. In comparison, only 8% of the Del
Rio panel self-reported cessation and only 1.5% were verified through
carbon monoxide analysis. Interestingly, no differences were found between Eagle Pass participants who received intensive counseling and
those exposed only to the campaign. Thus, use of the NHLIC model to
prevent smoking appears to result in moderate reductions in smoking for
border-area Mexican Americans and appears to be as effective as more intensive counseling to prevent smoking.
L AT I NO S AT R I SK F OR H I V/AI DS
HIV/AIDS has been called a disease that knows no borders (geographical or human), and that exploits human vulnerability on a global scale.
For these reasons, it should not be surprising that rates of HIV/AIDS are
disproportionately high for U.S. Latinos, and highest among the poorest
of Latinos (i.e., Puerto Ricans) and the most stigmatized sexual minorities within both U.S. and Latino cultures (i.e., men who have sex with
men). My own research also shows that HIV/AIDS poses a significant
threat to Mexican/Latino migrant workers whose immense poverty
pushes them across the U.S.-Mexico border to work in a country that depends on their labor yet marginalizes them. Given the very different realities for each of these Latino groups, similar as well as different factors
need to be considered for effective HIV/AIDS prevention. Before reviewing viable prevention interventions, a brief overview of HIV/AIDS and
U.S. Latinos is provided.
U.S. LATINOS AND HIV/AIDS
The most recent government data show that although Latinos make up
about 14% of the U.S. population, they compose 18% of cumulative AIDS
cases and 19% of both new AIDS and HIV cases reported in 2001 and 2002,
respectively (S. Ruiz, Kates, & Pontius, 2003). Latinos currently make up
20% of those living with AIDS, as compared to 37% for Whites and 42% for
African Americans. A breakdown of data shows interesting patterns of
HIV/AIDS by sex, exposure category, and geographic location. Newly reported AIDS cases among Latinos are primarily in men (77%) but include
a sizable number of Latinas (23%). In fact, Latinas compose a growing

264 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
proportion of AIDS cases, which increased from 15% in 1991 to 23% of all
female AIDS cases in 2001. On a related note, while pediatric AIDS cases
have declined dramatically during the 1990s due to treatments that can
prevent HIV transmission from mother to infant, Latinos still made up
15% of pediatric AIDS cases in 2001.
HIV exposure categories for Latino and White men reveal considerable
differences: sex between men (48% and 73%, respectively), injection drug
use (29% and 13%, respectively), and heterosexual contact (16% and 5%,
respectively). Analyses of Latino AIDS cases by place of birth and exposure categories are depicted in Figure 9.1. As can be seen, sex between
men is a major exposure category yet varies between 14% for mainland
Puerto Ricans to 47% for Latinos born in Mexico. Conversely, 43% of
mainland Puerto Ricans were infected through injection drugs, as compared to 17% of other U.S.-born Latinos and less than 10% of Latinos born
in Mexico, Cuba, and Central/South America. The percentage of risk “not
reported” is lowest for Puerto Ricans but remarkably high for all other
groups.
Although the AIDS case rate is 31.4 per 100,000 for U.S. Latinos in
general, case rates are much higher in the northeastern states, where
Puerto Ricans predominate: Massachusetts (103.8 per 100,000), Washington, DC (102.6), Connecticut (98.7), New York (92.7), Pennsylvania
(77.6 per 100,000), and Delaware (64.6). An analysis of all registered
Latino AIDS cases in Chicago showed that Puerto Ricans had the highest annual AIDS cases in the city since 1987, and that the major mode of
transmission for men was injection drug use (Murphy, Mueller, & Whitman, 1996). For all Latinas in the Chicago study, heterosexual contact
was the predominant mode of transmission, with the largest proportion
being sex partners of injection drug users. Thus, national and regional
data show considerable variability between and within national-origin
Latino groups. However, Puerto Ricans clearly stand out as the highest
risk group among U.S. Latinos.
THE PUERTO RICAN HIV/AIDS CRISIS
HIV/AIDS thrives in groups most impacted by poverty and social marginality given the frequently lethal combination of high social problems
and low resources that plays a central role in the transmission of HIV
through injection drug use, prostitution, and sex with high-risk partners.
In 2000, the Latino Commission on AIDS in New York held a press conference to declare a state of emergency regarding HIV/AIDS in the Latino
community (http://www.latinosaids.org). Among many important points
raised, the commission noted the following: (a) While New York Latinos

Latino Health 265
Figure 9.1
Percentage of AIDS cases reported among Latinos by place of birth and risk
behavior, 2001. (Note: Includes reported cases among those 13 years of age
and older. May not total 100% due to rounding. Source: Key Facts: Latinos
and HIV/AIDS (#6088), The Henry J. Kaiser Foundation, July 2003, Menlo
Park, CA: Author. Reprinted with permission.)
25% 17% 11% 42%
14% 43% 29% 10%
47% 6% 16% 29%
35% 5% 19% 39% 2%
2%
4%
3%
3%
1%
1%
0%
0%
0%
34% 7% 10% 46%
MSM IDU Heterosexual
Contact
Risk Not
Reported
Hemophilia/
Transfusion
IDU/
MSM
0% 100%
U.S. – 50 states
and DC
U.S. – Puerto Rico
Mexico
Central/South
America
Cuba
represent only 9% of U.S. Latinos, they make up 30% of all Latino AIDS
cases in the United States; (b) over half of all Puerto Rican AIDS cases
can be traced directly to intravenous drug use, 40% of Puerto Rican
women became infected through sex with male injection drug users, and
virtually all pediatric cases are attributable to the direct or indirect IV
drug use of parents; and (c) gay, bisexual, and transgender men make up
30% of male Latino AIDS cases. The commission went on to point out that
few services are available to New York Latinos, and even fewer services

266 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
are geared toward women and stigmatized groups such as IV drug users
and gay, bisexual, and transgender individuals. In fact, they note that
New York has the highest rate of HIV infection and AIDS cases of any
prison population in the United States because over 90% of those incarcerated for drug-related offenses are Latino and African American.
Kottiri, Friedman, Neaigus, Curtis, and Des Jarlais (2002) note that
the higher rates of HIV/AIDS in Puerto Ricans and Blacks in New York
City were established early in the epidemic, during the late 1970s and
early 1980s. In their study of 662 intravenous drug users (IDUs) from
New York City, these researchers found that almost half of Puerto Rican
and Black IDUs were HIV positive, as compared to a third of White
IDUs. They also found that sexual- and drug-related risk taking was
highest in Puerto Ricans, and that risk taking in these IDU groups generally occurred within their own racial/ethnic social networks. Thus,
community-based collaborative efforts are urgently needed to study and
respond to the racially and ethnically linked mixture of poverty and
culture that contribute to IV drug and HIV/AIDS risk in the Puerto
Rican community.
PREVENTING HIV/AIDS IN THE PUERTO RICAN COMMUNITY
Colon, Sahai, Robles, and Matos (1995) describe an HIV prevention effort
aimed straight at the heart of the Puerto Rican AIDS crisis. Ex-addicts
were trained to conduct extensive HIV prevention outreach education to
more than 1,100 IDUs in San Juan, Puerto Rico. These individuals were
actively injecting drugs and not enrolled in drug treatment programs.
They were approached at shooting galleries, “copping areas” where drugs
are scored, and on the street corners of 10 different neighborhoods; 80%
were male, almost half were HIV positive, and they had been injecting
drugs for an average of 13 years. Outreach included education about sex
and IV-related transmission and demonstrations of proper condom use
and how to clean needles with bleach. Outreach workers spent an average
of 12 weeks in the community and successfully posttested almost 90% of
participants.
Results revealed significant decreases in sharing cookers and increased
needle cleaning with bleach. There were no effects on needle sharing,
which was low to begin with and which probably requires needle exchange programs to reduce further. There was also a lack of impact on
risky sexual behaviors. The authors note that specialized interventions
need to be designed for female partners who do not inject drugs and who
make up the majority of the sex partners of IV-drug-using men. The authors also report non-intervention-related reductions in IDU risk behav
Latino Health 267
iors such as less injecting in galleries, borrowing or renting needles, and
sharing cookers, which could be a promising reflection of IDUs receiving
risk reduction messages in their environment.
LATINO GAY MEN
Sex between men remains the highest risk factor for acquiring HIV in the
United States generally, for both U.S.-born and immigrant Latinos, and
this is true in many Latino countries of origin such as Mexico and Puerto
Rico. For this reason, it is important to focus prevention efforts on Latino
men who have sex with men, whether gay-identified or other, and to promote detailed prevention efforts that consider the environmental, social,
cultural, and sexual contexts of HIV risk. Rafael Diaz’s HIV prevention
work with Latino gay men stands out for its careful attention to theory,
research, and practice.
Oppression versus Self-Regulation
Diaz (1998) believes that while Latino gay men neither wish nor intend to
engage in unsafe sex, underdeveloped self-regulatory processes are vulnerable to breakdown during sex, where they become undermined by the
internalization of oppressive social factors such as homophobia, racism,
and poverty, as well as cultural factors such as familismo and machismo,
which contain elements oppressive to nonheterosexual family members.
For example, while familism is generally considered to be the central cultural strength among Latinos, it may actually work to put Latino gay
males at greater risk for HIV because it is generally rejecting of deviations from the traditional heterosexual norm. Gay Latino men are too
often faced with the dilemma of having to choose between la familia and
living their life openly. For those who remain in the family by concealing
their sexual orientation, Diaz believes that their sexuality can become
confined to a forbidden domain of secrecy and shame. Thus there can be
a splitting off or dissociation from their sexuality that can leave many
Latino gay males with too little opportunity during their early psychosocial development to have the kinds of normative experiences that are
needed to develop a healthy and meaningful sense of self, especially with
respect to sexual and gender roles. An unfortunate consequence of this
cultural predicament is seeking release of sexual impulses and feelings in
limited, secretive, and unpredictable ways that render Latino gay males
vulnerable to risk (e.g., being vulnerable to sexual manipulation and
abuse, cruising for anonymous sex).
This is not to say that traditional family members can’t be supportive
of sexually different family members. Indeed, such support frequently

268 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
happens among various members (e.g., a mother or sister), but because
it isn’t normative at the traditional end of the family continuum, it’s not
probable. This is unfortunate given the potentially powerful role of family acceptance to help sexually different family members deal with potential societywide rejection and discrimination. Latino family support
probably increases with acculturation, modernization, and a loosening
of traditional gender and sexual norms and expectations.
Machismo is another traditional cultural value that gay Latino men
often internalize early in maladaptive ways. Diaz (1998) notes that because Latino culture has traditionally confused gender with sexuality,
gay men are popularly likened to women in men’s bodies. Thus, some gay
men who internalize this stereotype may be prone to think of themselves
as inadequate or “failed men,” resulting in either submissive or overly
macho gay men with something to prove in the bedroom (e.g., prioritizing sexual prowess over affection and communication and over safer sex
strategies such as condom use).
Racism and poverty can also overinfluence the sexual and interpersonal
lives of gay Latino men in the United States, who are frequently stereotyped as sexually exotic in the predominantly White gay community, and
because Latino gay men are frequently at a vulnerable economic disadvantage relative to Whites. Rather than risk rejection, some gay Latino
men may feel the pressure to live up to sexual stereotypes, or not to disappoint partners on whom they are economically dependent.
The bottom line in Diaz’s (1998) psychocultural theoretical framework
is that healthy self-regulation becomes undermined in challenging sexual
situations where scripted and automatized behaviors, stemming from
oppressive social and cultural variables, take over in unconscious and
emotionally charged ways. Repeated experiences of failure to implement
intentions to practice safe sex can lead to hopelessness and even fatalism
about contracting el premio gordo (the grand prize), as some gay men refer
to HIV/AIDS.
Thus, oppressive social and cultural regulators of interpersonal behavior become internalized psychological regulators of sexual behavior that
is experienced not simply as risky and unsafe but as socially and culturally meaningful scripts. Such a bold theory is not without its critics (e.g.,
pathologizing gay Latino men), but it is a well-thought-out attempt to tie
public oppressive conditions to the personal experiences and lives of individuals who frequently lack the kinds of supports needed to develop a
healthy sense of self under dehumanizing conditions. Service providers
hoping to respond to the special needs of Latino gay men need to be able
to think on these two levels of psychosocial analysis.

Latino Health 269
Evidence-Based Practice
Diaz (1998) has conducted research to support his theory by connecting
HIV risk in a large and diverse urban sample of gay Latino men to their
personal experiences of homophobia (operationalized as verbal and
physical harassment during childhood for being homosexual), racism
(i.e., rude treatment and police harassment linked to race/ethnicity), and
poverty (i.e., running out of money for basic necessities, having to borrow money, having to look for work). Based on a probability sample of
912 gay Latino men recruited from Latino and gay-identified bars, clubs,
and social events in Los Angeles (n = 301), New York (n = 309), and
Miami (n = 302), Diaz and Ayala (2000) found that men with high levels
of HIV risk (i.e., reporting unprotected sex with a recent nonmonogamous partner) reported more oppressive experiences than their counterparts with lower sexual risk taking. Such research and theorizing have
led to a well-conceived HIV prevention program for Latino gay men,
based in San Francisco, that has received national attention; the Centers
for Disease Control recognizes this program and provides technical assistance and financial support for its implementation for gay Latino men
in community service agencies across the country.
PREVENTING HIV IN LATINO GAY MEN
The Hermanos de Luna y del Sol (HLS; Brothers of the Moon and Sun)
program was designed by Diaz (1998) and Latino gay health educators in
San Francisco’s Latino Mission District based on Diaz’s adaptation of
Bandura’s (1994) theory of self-regulation and Freire’s (1993) principles of
empowerment education. Developers of HLS believe that HIV prevention
programs for gay Latino men can be effective if they can (a) break the sexual silence by providing safe venues for serious communication about sex;
(b) provide an experience of commonality and pride in which men can
feel part of a larger supportive gay Latino community; (c) provide opportunities for critical self-reflection and self-observation about factors that
regulate sexual and other behaviors; (d) collaborate in the construction of
group, dyadic, and individual strategies to address perceived barriers to
safer sex; and (e) create opportunities for social activism.
Outreach
Participants are recruited into HLS groups by outreach workers who visit
Latino and gay-identified social venues and distribute attractive calling
cards advertising encuentros de comunicación y amistad (friendship and
communication encounters) para hombres Latinos de ambiente. The latter

270 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
term literally means “for Latino men of the ambience,” which, according
to Diaz (1998, p. 162), “is a popular Latino expression referring collectively to all those who are homosexually active or self-identify as homosexual, even though perhaps only privately so.” He goes on to say, “De
Ambiente is thus a code phrase that denotes (in-group) knowledge about
sexual orientation and behavior, but does so in a private, self-referenced
way, without the implications of being out publicly within a viable gay
community” (p. 162).
The carefully designed calling cards also feature an attractive logo composed of the HLS name around a composite drawing of a Latino man’s
face, partially eclipsed by a crescent moon on one side, both of which are
encircled by the corona of the sun. On the card’s backside is a carefully
worded description of the program above a photo of smiling Latino men,
with contact information and a list of incentives ($10 and dinner per
meeting, a T-shirt). Consistent with personalismo, the invitation is direct
yet warm; phrases include “La cena ya esta servida” (Dinner is already
served) and “Solo faltas tu!” (The only thing that’s missing is you!).
HIV Prevention Groups
Interested participants are invited to four group sessions with the following goals: (a) to facilitate communication resulting in self-observation
and critical self-reflection; (b) to create a sense of community and gay
pride; and (c) to facilitate the co-construction of strategies to combat social and cultural oppressors and to promote safer sex behaviors. Methods
to achieve these goals include discussions guided by the following key
questions: “What’s the most difficult thing about being a Latino Gay
man?”; “How have you been affected by the HIV/AIDS epidemic?”; and
“What makes safe sex difficult for you?”
Ensuing discussions help participants to connect social and cultural
factors with psychosocial problems that interfere with self-care (e.g.,
low self-esteem, low sex regulation, social isolation, fatalism regarding
HIV). Participants also keep a safe sex journal guided by questions they
are asked to answer within 24 hours of a sexual episode. For example,
participants are asked to rate how positive or negative the sexual encounter was and why. Answers are discussed in group to help participants understand the personal and situational factors that hinder or
facilitate safer sex, how personal self-regulation is enhanced by sex
journal discourse, and how having a healthy sex life is a heroic struggle
against oppression.
A preliminary evaluation of 78 HLS participants revealed promising
findings: Most of the men felt better about themselves and more connected to the Latino gay community, better able to understand their sexu
Latino Health 271
ality and risk for HIV, and more capable of practicing safer sex and of
avoiding situations that make it difficult to practice safer sex (Diaz, 1998).
MEXICAN/LATINO MIGRANT LABORERS IN THE UNITED STATES
I have dedicated more than 15 years to studying the problem of HIV risk
in predominantly Mexican migrant laborers who live and work in the
United States for extended periods of time providing essential labor to lucrative American businesses and industry sectors such as construction,
the pervasive service sector, domestic labor, agricultural labor, meat
packing and poultry preparation. HIV prevalence and prevention research on this unique population of Latinos consists mainly of a number
of small studies in different regions of the country, but reviews of the literature (Organista & Balls Organista, 1997; Organista, Carrillo, & Ayala,
2004) indicate considerable HIV risk warranting prompt attention.
Migratory labor systems all over the world are involved with the geographical spread of HIV because they are composed primarily of young
male migrants away from home for extended periods of time, resulting in
family breakdown, increased number of sex partners (including sex with
commercial sex workers and sex between men), and the consequent risks
to wives and other sex partners of such migrant men. Documented risk
factors for Mexican migrant laborers are high numbers of sex partners,
including sex between men and between men and female sex workers,
high rates of STDs, needle sharing following injections of illegal drugs
and “therapeutic” injections of vitamins and antibiotics, sex with IDUs
on the part of female migrants (Organista & Balls Organista, 1997), and a
high prevalence of alcohol and substance dependency and depression
(Alderete, Vega, Kolody, and Aguilar-Gaxiola, 2000). A screening of 151
drug-using farmworkers in the DelMarVa Peninsula of Delaware revealed
six men who were HIV positive (Inciardi, Surratt, Colon, Chitwood, &
Rivers, 1999), four of whom were Mexican who each had a history of trading sex for money or drugs. It has also been documented that Mexican
farmworkers report lower perceived risk than Black and Anglo farmworkers (McBride, Weatherby, Inciardi, & Gillespie, 1999).
All of the risk factors just enumerated are exacerbated by the nature of
migratory labor in the United States, which is typically difficult, dangerous, inconsistent, low-paying, exploitive, lonely, and disruptive of social,
familial, romantic, and sexual relations in one’s country of origin. Background characteristics of Latino migrants that also influence risk include
low formal education and literacy, limited English, high rates of undocumented status, low access to health and social services, and traditional
gender roles.

272 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Sex between Men
Because sex between men remains the highest risk factor for acquiring
HIV in both the United States and Mexico, it is an imperative exposure
category to assess. Yet, self-reported rates of sex between men in surveys
of Mexican/Latino migrant laborers are unexpectedly low, between 2%
and 4%. These rates probably reflect difficulty detecting actual prevalence with the survey method, even if done anonymously. Thus, qualitative research methods, such as private, anonymous interviews with key
informants, are needed to render more visible this sensitive and important HIV exposure category (Organista, 2004; Parker, Herdt, & Carballo,
1991).
Women at Risk
Organista, Balls Organista, Garcia de Alba, Castillo Moran, and Ureta
Carrillo (1997) found that married migrant men were just as likely as single migrants to have sex with female prostitutes while in the United
States, yet were less likely to use condoms. It has also been documented
that married Mexican migrant men, unaccompanied by their wives while
working in the United States, report more lifetime sexual partners, more
partners in the previous 2 years, more extramarital affairs, and more sex
with prostitutes, as compared to men accompanied by their wives (Viadro
& Earp, 2000). The fact that guest-worker contracts typically contain provisions preventing wives from joining their migrant husbands during seasonal work (Chang, 2000) is an example of how structural factors in the
form of labor policies can create risky environments for migrant laborers.
Cultural factors that place the female sex partners of migrant men at
risk for HIV include traditional Latino gender roles in which sex with
husbands is rarely discussed, let alone negotiated, resulting in low levels
of safer sex. For example, in a study of 100 rural women in Mexico who
were the wives of Mexican migrants working in the United States, Salgado de Snyder, Diaz Perez, and Maldonado (1996) found that two-thirds
did not practice safer sex when having sex with their husband during his
visits to Mexico, despite being knowledgeable about HIV transmission
and despite suspecting the husband’s infidelity. This latter point is not
surprising in view of research showing that such women believe it is
promiscuous to carry and suggest use of condoms, and thus rely primarily on nonbarrier contraceptive methods such as the pill and IUD for family planning and not disease prevention (Balls Organista, Organista, &
Soloff, 1998; Organista et al., 1997; Salgado de Snyder et al., 1996).
Interestingly, a follow-up study by Salgado de Snyder, Acevedo, DiazPerez, and Saldivar-Garduno (2000) compared the sample of 100 rural
wives of migrant laborers left behind in Mexico to 100 wives currently

Latino Health 273
living with their husbands in rural Mexico, and to 100 wives of migrant
men currently living with their migrant husbands in Los Angeles. The results of this study indicate a clear acculturation trend in that the L.A.-
based wives reported more lifetime sex partners, experience with a wider
variety of sexual behaviors, greater condom use during sexual episodes
with husbands, and a higher frequency of asking husbands to use condoms. Such findings suggest that Latina-focused interventions promoting sexual negotiation and safer sex may be viable, especially for more
acculturated Latinas.
HIV PREVENTION INTERVENTIONS WITH MIGRANT LABORERS
In a review of 187 community-based agencies providing HIV prevention
services to Latinos in the state of California, Castañeda and Collins
(1997) found that community based organizations (CBOs) were considerably more effective in reaching Latinos than federal and state agencies
because of their greater number of bilingual staff and volunteers
and their culturally sensitive approaches to service delivery. Further, although the Latino-focused CBOs in the study were fewer and smaller
than non-Latino-focused agencies, they had more bilingual/bicultural
staff and less staff turnover, made greater use of education videos and
Spanish media, provided more one-on-one services, stressed outreach more often, and provided more services to sex workers. Despite
the dedicated effort of these Latino CBOs, they typically lack the capacity to evaluate services or to take their services beyond basics such as
teaching about HIV transmission, promoting safer sex (e.g., condom
use), and providing HIV testing and related counseling for those testing
positive.
Collaborative Approaches
There are two major ways of expediting HIV prevention with Latinos in
general and Mexican migrants in particular. The first is through topdown governmental and bottom-up community collaborations that combine governmental financial resources and technical assistance with
community-based agency and resident knowledge of local problems and
high-risk groups and how to access them. The second way is through university-community collaborations that combine research expertise with
community-level service expertise. Both of these collaborative strategies
have resulted in a few promising HIV prevention approaches with Mexican migrant laborers and related groups (e.g., Mexican immigrants).
A review of the literature by Organista et al. (2004) revealed only
a handful of published studies on HIV prevention interventions with

274 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Mexican/Latino migrant laborers, or closely related groups (see
Table 9.4). Though only a beginning, this small set of studies is instructive for the inclusion of culturally competent approaches at either a basic
(e.g., bilingual and bicultural personnel, outreach) or more advanced
level that creatively incorporate Mexican culture-based elements into
interventions that address local realities. These studies also demonstrate the tremendous advantages of community-based collaborative
approaches.
Increasing HIV/AIDS Knowledge in Farmworkers
On behalf of the California State Office of AIDS, Ruiz and Molitor (1997)
conducted a community-based intervention designed to improve knowledge
of HIV transmission in 142 predominantly Mexican, Spanish-speaking migrant farmworkers in northern California. The intervention relied primarily
on local outreach workers who conducted one-to-one contacts in which they
educated participants about HIV/AIDS and promoted and distributed condoms. HIV/AIDS information was also disseminated through community
festivals and on local Spanish-language radio and TV programs. The results
of pre- and postintervention assessments showed significantly improved
knowledge of HIV transmission. Yet although this study validates the effectiveness of “HIV 101” educational approaches, the mainstay of Latino AIDS
service organizations, it addresses few of the complex issues raised in the
literature review just discussed.
Though theirs is not a migrant-focused study, Maxwell, Bastani, and
Warda (2002) conducted a noteworthy single-session HIV prevention intervention with young Spanish-speaking Latinos recruited at an HIV
testing clinic in Los Angeles that primarily serves Latino immigrants.
The idea was to enforce behavior changes advocated during HIV testing
and counseling sessions by offering a single follow-up weekend session.
The intervention went beyond the usual HIV 101 information to include
proper condom use demonstration and practice, discussion and role-plays
of negotiating condom use with a partner, and the distribution of a Mexican style fotonovela entitled Flirting with Danger.
As mentioned in Chapter 6, fotonovelas are comic-book-like forms of
Mexican/Latino entertainment that contain actual photos instead of illustrations, bubble dialogue, and storylines that blend comedy and
drama. Of the 106 participants recruited for the baseline pretest, about
half agreed to participate in the workshop; 81% of workshop participants
were available for a 4-week posttest, as were 54% of the nonintervention
participants. Interestingly, participants were almost evenly divided between Mexican and Central American and between male and female,
and the intervention session was designed for both men and women to

275
Table 9.4
Summary of HIV Prevention Outcome Evaluations with Mexican Migrant Laborers and Related Groups
Authors of Study Intervention Description Sample Description Major Findings
J. Ruiz & Molitor (1997) Community-based HIV education;
mostly one-on-one contacts by outreach workers plus educational talks
and activities at community venues
142 Mexican migrant farmworkers Improved pre- to postintervention HIV
knowledge
Mishra & Conner (1996) Condom promotion via fotonovelas
and radionovelas depicting scenarios with female prostitutes
193 Mexican male migrant farmworkers Increased condom use with prostitutes
Sanudo (1999) More rigorous replication of Mishra
& Conner (1992)
175 Mexican male farmworkers (85
in experimental and 90 in control
conditions)
Same pattern of results as Mishra &
Conner (1996)
Organista, Alvarado,
Balbutin-Burnham,
Worby, & Martinez
(2006)
Community-based HIV prevention
groups for predominantly Mexican
migrant day laborers
23 predominantly Mexican male
migrant day laborers
Preliminary results indicate pre- to
postintervention increases in condom use with female sex partners,
carrying condoms, and knowledge
of correct condom use.
Maxwell, Bastani, &
Warda (2002)
90-minute single-session AIDS prevention workshop 106 Latino immigrants (55 male and 43 female) recruited and pretested at
an AIDS testing clinic; 54 attended
workshop and 81% posttested; 54%
of nonworkshop participants were
posttested
Two-thirds of the sample received
4-week posttest that showed increase
in “always” carrying condoms, in male
workshop participants, from 18%
pretest to 42%.
From “HIV Prevention with Mexican Migrants: Review, Critique, and Recommendations,” by K. C. Organista, H. Carrillo, and G. Ayala, 2004,
Journal of Acquired Immune Deficiency Syndrome, 37(Suppl. 4), pp. S227–S239. Adapted with permission.

276 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
enhance discussions of condom negotiation. With regard to results, the
proportion of participants who “always” carrying condoms increased
from 18% to 42% among those who responded to this item at both baseline and posttest, and this was true only for those who attended the workshop and for male participants. These are meaningful results given the
importance of carrying condoms as a predictor of actual condom use with
both occasional and regular sex partners in Mexican migrants (Organista
et al., 2000). However, these results also support past research showing
that most Mexican migrant women do not carry condoms because doing
so is associated with promiscuity.
Increasing Condom Use by Male Farmworkers
A collaboration between researchers at the University of California, Irvine,
and a health clinic in northern San Diego County with experience serving
farmworkers resulted in an intervention designed to increase condom use
with female sex workers by 193 Mexican male farmworkers (Mishra & Conner, 1996). HIV prevention information was provided to participants in the
culture-friendly form of fotonovelas and radionovelas (radio broadcast novellas), with the latter broadcast daily on a local Spanish-language station
(participants were given radios and program times and encouraged to tune
in). Like much of Mexican entertainment, the Tres hombres sin fronteras
(Three Men without Borders) novelas were both funny and dramatic and
depicted three scenarios in which a male farmworker either (a) decides to
use a condom with a prostitute; (b) abstains from sex with the prostitute;
or (c) infects his wife with HIV, who gives birth to an HIV-positive baby, as
a result of unprotected sex with the prostitute.
All participants were pre- and posttested and results showed significant gains in HIV/AIDS knowledge and related attitudes, and in reported condom use with prostitutes. Of those men who used prostitutes
during the course of the study, 20 of 37 reported condom use after participation in the study, compared to 1 of 32 prior to participation. This study
demonstrates the promising use of an intervention that is sensitive to both
Mexican culture and the migrant farmworker to target a particular subgroup (adult men), risk factor (unprotected sex), and situation (sex with
female prostitute).
A more rigorous replication of this study was conducted by Sanudo
(1999) with the same pattern of promising results: 20 of 85 male farmworkers reported sex with prostitutes at baseline, and only 4 of the 20 reported having used condoms. At postintervention, 24 reported sex with
prostitutes and 16 of them reported condom use. Further, in the nonintervention control group, 22 of 90 male farmworkers reported sex with
prostitutes at baseline, 26 of 90 reported using prostitutes at postinter
Latino Health 277
vention, and none of these men reported any condom use. Further replications of the intervention are highly warranted and could be expanded
to address more situational factors common to migrants, such as the role
of excessive drinking in unprotected sex, sex between men, and sex with
transgender individuals.
HIV Prevention with Migrant Day Laborers
A collaboration by the author at the University of California, Berkeley, and
the city of Berkeley HIV/AIDS Program, which conducts outreach to migrant day laborers (MDLs), resulted in a convenience sample survey of risk
in 102 predominantly Mexican migrant day laborers (Organista & Kubo,
2005), followed by the development, implementation, and evaluation of a
pilot HIV prevention group (Organista, Alvardo, Balbutin-Burnham,
Worby, & Martinez, 2006). Survey results indicated many of the usual risk
factors in Mexican migrant men (e.g., unprotected sex with prostitutes, excessive drinking), and a follow-up focus group explored the context of risk
for these day laborers, which included sexual risk taking while intoxicated
and when feeling what the men called desesperación (desperation) due to
lack of work and money, boredom, and missing family. Sex between men
was discussed by an openly gay MDL in the focus group, as well as by heterosexual-identified men, one of whom reported being propositioned
while performing day labor work for an informal employer.
The pilot intervention group was conducted twice with a total of 23
MDLs, all of whom were pretested and 12 of whom were located for a 1-
month postintervention evaluation. The intervention focused primarily
on (a) asking participants to share their personal goals in seeking work in
the United States, including obstacles that interfere with such goals; (b)
asking participants to discuss HIV risk for MDLs in general, and for each
participant personally, following a review of HIV/STD transmission and
a hands-on condom use demonstration and exercise with phallic replicas;
and (c) facilitating a discussion of various risk reduction strategies.
Group process was meant to facilitate participatory learning health circles, as described by Magaña, Ferreira-Pinto, Blair, and Mata (1992), who
advocate the use of círculos de salud (health circles) for HIV prevention
with Latinos based on the empowering and progressive work of Brazilian
educator Paulo Freire. Such health circles provide participants with basic
information about HIV transmission and prevention, but aim at involving
participants in active problem-solving discussion after posing risky situations and questions directly relevant to their lives.
HIV-related discussion with the MDLs was facilitated by the creation
of poster-size Mexican lottery game cards depicting relevant aspects of
the MDL experience. Lotería is a Mexican card game like Bingo, but the

278 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
numbered cards also contain funny and dramatic Mexican images. For example, the card for El Borracho (the drunk) depicts a hunched-over intoxicated Mexican man, the card for La Muerte (death) depicts the Grim
Reaper, and the card for La Escalera (the ladder) depicts a ladder symbolizing progress. The research team copied these images from actual barajas
de lotería (lottery cards) but also created their own to depict HIV/AIDS issues commonly raised by Mexican migrants: La Prostituta (the prostitute), La Amante (the lover), and Sexo entre Hombres (sex between men).
As with fotonovelas, the use of Mexican lottery cards is meant to facilitate HIV/AIDS-related discussion and self-reflection in ways consistent
with expectations of the nature of Mexican social life and the spontaneity
and humor that characterize social interactions (Carrillo, 2002). While
preliminary results must be interpreted with caution given the very small
sample of convenience and the loss of approximately half of the sample by
follow-up evaluation, results are auspicious in that they indicate higher
knowledge of correct condom use, increased levels of carrying condoms,
and increased condom use with female sex partners. Such findings pave
the way for taking this intervention beyond the pilot phase to a sufficiently funded, broader, and more rigorous application of culturally competent methods that evolved over the course of a rewarding, albeit
challenging, 2-year collaboration between university and community.
CONCLUSION
In 1994, Vega and Amaro reported a mixed health prognosis for U.S. Latinos, noting various health issues and disease states for which Latinos
were at higher and lower risk. Many of these major health problems and
issues were reviewed in the current chapter with an eye toward situating
them within the historical and current experiences of U.S. Latinos. This
chapter also sought to illustrate many creative, promising, and effective
approaches to socially and culturally competent health care with Latinos.
Pervasive poverty for too many Latinos alongside a far too pervasive lack
of health care insurance will continue to depress the negative side of the
Latino health paradox, while a growing body of research will hopefully
illuminate and build on the positive side in instructive ways.
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283
C H A P T E R 10
Latino Power
Political Participation, Policy Benefit,
and the Role of Service Providers
THE OVERRIDING PREMISE of this book is that huge percentages of U.S. Latinos suffer disproportionately low rates of SES and compromised social
welfare as a result of historical and current experiences of oppression on
the basis of race, ethnicity, culture, immigration status, and other factors.
In Chapter 1, the analysis of Latino acculturation histories showed that
those groups with the most stressful acculturation experiences (e.g., Mexican Americans and Puerto Ricans), as reflected in protracted historical
conflict with mainstream society and consequent oversegregation,
poverty, and social marginality, continue to live out legacies of vulnerability to psychosocial and health problems.
In Chapter 2, the analysis of social stratification of Latino ethnicity
and power in the United States described how Latino inequality has
been historically institutionalized by macro-social arrangements and
standard ways of operating, frequently codified in laws and social policies and justified by dominant national narratives, ideologies, values,
and cherished myths. The review of core SES data for Latinos (i.e., educational and occupational indicators) clearly shows an unacceptably
slow rate of progress for those Latinos overly affected by poverty and
low levels of political power. Yet, mainstream media and politicians insist on emphasizing the spectacular growth rate of Latinos and some
sort of imminent rise to power and equality à la European immigrants.
But such optimism is based on a half-truth, the false side of which requires macro-level economic, political, and cultural solutions to advance
Latino social welfare.

284 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Chapter 3 described ways in which living under circumstances of
stressful acculturation and social stratification can negatively affect the
racial/cultural identity development of Latinos, as well as distort the
race-related perceptions of Anglo-Americans. One of the pernicious consequences of socialization within a democratic social matrix tainted by
oppression is to overattribute Latino social welfare to individual-level factors such as intelligence, ability, effort, merit, values, and culture. Such
mainstream attributions serve to justify and stabilize Latino inequality
and suggest minimal interventions designed mostly to fix Latinos. But
with greater awareness of historical and current social forces, we can
more accurately see Latino inequality as powerfully shaped by the uneven Latino experience in America. As such, implications for practice
should expand to include working at various macro levels to change
Latino welfare compromising social structures and environments, social
policies and laws, and unfair business as usual standard ways of operating.
These suggestions may at times sound abstract to the academic and
professional training of social workers, educators, and medical and mental health professionals, but some basic grounding in Latino politics helps
to demystify a social justice approach to service delivery and paves the
way for political arena involvement and macro-level changes. Hopefully
some of the meso- and macro-level interventions reviewed in Chapters 6
through 9 (e.g., full-service schools in Dominican and Chicano communities, communitywide cancer prevention and control on the Texas-Mexico
border by the National Hispanic Leadership Initiative in Cancer) illustrate urgently needed, policy-relevant ways to promote Latino well-being
that depart from inadequate, institutionalized care or lack thereof. This
chapter emphasizes Latino-relevant policy issues and ways that service
providers can be more involved at this level.
LATI NO POWER? WELL, YE S AND NO
In her seemingly mistitled book, Out of the Barrio: Toward a New Politics of
Hispanic Assimilation, Linda Chavez (1991) claims diminished discrimination aimed at Latinos, criticizes Latino leaders’ civil rights agenda, and
overfocuses on positive indicators of Latino upward mobility in America.
Latinos have indeed progressed in many of the ways described in
Chavez’s selective review of the literature, but it is the unacceptably slow
pace of progress for America’s most oppressed Latinos that continues to
exact massive tolls on Latino youth, families, and communities, as carefully documented in Chapters 6 through 9. Chavez’s lack of sufficient
problem emphasis (or politically savvy omission?) was undoubtedly instrumental in her presidential cabinet nomination by George W. Bush to

Latino Power 285
head the U.S. Department of Labor in 2000. But like her writings, her appointment was strongly attacked by Latino and labor leadership, who
publicized enough incriminating evidence to have the nomination overturned (e.g., like many middle-class Americans, she had a history of hiring undocumented Latino laborers to help out at home). Such actions
reflect how almost unbearable it is for those that truly represent impoverished Latinos to listen to Chavez’s (1989) rhetoric about Latinos rising to
the top of society like a “Tequila Sunrise”! Perhaps a more fitting title for
her book would be Out of (Touch with) the Barrio. In addition to the trite
remedies offered by Chavez (i.e., learn English, get an education, apply
for citizenship, and vote), socially and culturally informed macro-level
policy analysis and interventions are imperative for advancing Latino
SES, political and cultural power, social capital, and even national image
in truly significant ways.
HUMAN SERVICE PROVIDERS AND THE POLITICAL ARENA
A basic understanding of Latino political participation and incorporation,
and how service providers can play important political roles, is key to promoting Latino social welfare on a broad scale. Yet the idea of political support, advocacy, and activism on behalf of a client group is too infrequently
a part of academic, professional, and research training. Indeed, political
involvement might even be discouraged and looked down upon at the
agency level, leaving most service providers to experience a disconnect between political involvement and their seemingly “neutral” professional
roles. This doesn’t mean that national professional organizations, such as
the National Association of Social Workers (NASW) or the American Psychological Association (APA), don’t weigh in on important political matters relevant to the profession; it means that the average practitioner has
but a vague sense of how to become involved at the local level on behalf of
client groups such as Latinos.
In their book Affecting Change: Social Workers in the Political Arena, sixth
edition, Haynes and Mickelson (2006a) remind social and human service
professionals that though they may lack background training in politics,
they do possess a variety of skills and talents for operating in the political
arena on behalf of clients. At a minimum, such skills include acquired expertise on specific client and community problems, knowledge about service gaps, and which service elements constitute best practices. Service
providers also possess access to agency records and data that can be very
relevant to policy development and advocacy.
Mindful of vague legal restrictions on the political activities of human
service professionals, Haynes and Mickelson (2006b) summarize what’s

286 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Table 10.1
Limits on Partisan Political Participation of Federal Government Employees
Allowable Not Allowable
Register people to vote Register voters for only one party
Assist in voter registration drives Campaign for/against candidates in
partisan elections
Express opinions about candidates and
issues
Collect contributions, sell tickets for
political fund raising
Contribute funds to political
organizations
Join campaign activities to elect
partisan candidates
Sign nomination petitions Distribute campaign materials in
partisan election
Wear political buttons and political
messages while off duty; support
nonpartisan organizations
Organize or manage political rallies
Campaign on referenda, constitutional
amendments, and municipal petitions
Circulate nomination petitions
Be a candidate for nonpartisan elections (e.g., independent party candidate), or local offices such as school
board or city council, which do not
involve fund raising
Be a candidate in partisan elections
allowed while on the job and what isn’t according to the Hatch Act, which
was enacted in 1939 and updated in 1993 to limit the partisan political activities of government employees (i.e., those employed by the federal executive branch and state and local executive agencies). Table 10.1
specifies these restrictions.
Haynes and Mickelson (2006b) admit that exactly whom the Hatch Act
covers is not always clear and that service providers should seek out such
information (e.g., from their professional organizations, agency administrators). For example, service providers working for a nonprofit, taxexempt organization are still subject to the restrictions, given their
agency’s government-related funding streams (Thompson, 1994). Of
course, as citizens, service providers have the same rights as others to involve themselves in partisan politics while off duty.
From “The Practitioners Influence on Policy” (pp. 82–95), by K. S. Haynes and
J. S. Mickelson, in Affecting Change: Social Workers in the Political Arena, sixth edition, K. S. Haynes and J. S. Mickelson (Eds.), 2006, New York: Longman.

Latino Power 287
THE DYNAMICS OF LATINO POLITICAL POWER
Determinants of Political Participation
Political involvement in Latino-relevant social issues depends on a basic
understanding of central historical and ongoing issues. In J. A. Garcia’s
(2003a) analysis of Latino politics in America, he notes that political participation, or actions to influence the policy-making process, depends
heavily on a group’s resources and recruitment into the political process.
Not surprisingly, SES and related resources (e.g., time, money, and skills
that transfer to the political arena) are the most powerful determinants of
political participation. Other determinants include socialization into the
political process (e.g., parental role models) and a positive psychological
disposition toward politics. With regard to recruitment, elected officials
and their representatives engage in efforts to mobilize different groups in
society and must consider issues such as timing and degree of nonparticipation in a group (e.g., youth voting age, ineligible noncitizens and
felons, those uninterested in politics).
These disadvantages translate into the problematic political profile
that was sketched out in Chapter 2 (Table 2.6), where it was noted that
Latino political participation and representation continue to be very low
in America, with the exception of Cuban Americans, and that the majority of Latinos are ineligible to vote either because they are too young or
are noncitizens. It should also be noted that far too many eligible Latinos
are not registered to vote. The net effect of such background characteristics is a Latino electorate that is only a fraction of what it could be
based on the population size of U.S. Latinos. Such a pervasive lack of political participation means little to no role in social policy development
and benefit.
Public Policy Done to Latinos
Consistent with the theme of Latino subordination running throughout
this book, Hero (1992) has developed a model of Latinos in the U.S. political system that he refers to as “two-tiered pluralism.” This model describes the condition of Latino citizens as characterized by equal legal
rights to participate in the political process, coupled with lower social
and political status due to social structural and historical subordination.
Thus, whereas conventional pluralism presumes relative equal opportunity for different groups in society to compete for resources and power
(i.e., to become politically active in a variety of ways), two-tiered pluralism acknowledges historical conditions of racism and discrimination that
have marginalized certain groups and set into motion entrenched legacies of unequal power and opportunity and limited political clout.

288 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Figure 10.1
Two-tiered political participation for Latinos. (Source: “Latinos and the Political
System: Two-Tiered Pluralism” (pp. 189–206), by R. Hero, in Latinos and the
U.S. Political System: Two-Tiered Pluralism, R. Hero (Ed.), 1992, Philadelphia:
Temple University Press. Reprinted with permission.)
Policy Arena Stage of Policy Process
Agenda Setting
Anglo (white)
Blacks Latinos
Redistributive
Developmental
Allocational
First Tier
Second
Tier
Policy Formulation
ìFloor” of Individual Rights
Policy Legitimation
Policy Implementation
Threshold (minorities as
recipients of policies)
In Figure 10.1, the first diamond-shaped tier, which actually contains
the second tier, illustrates the healthy distribution of wealth for AngloAmericans; most are in the middle, with smaller proportions at the top
and bottom. In sharp contrast, Latinos are concentrated predominantly in
the less powerful second tier due to historical constraints on equality and
continuing informal and institutionalized discrimination. The unhealthy
triangular-shaped distribution of Latino (and African American) wealth
conveys that relatively few have achieved even middle-class status. The
position of Latinos as predominantly in the second tier underscores the
well-known connection between low SES and low political clout.

Latino Power 289
One of the results of the political predicament of Latinos is that their
political demands have historically been those of a disadvantaged ethnic
minority group striving for increased equality, primarily responded to by
mediating institutions such as meager government assistance programs,
welfare bureaucracies, nonprofit organizations, and political task forces
charged with studying the status of minority groups. From a conventional pluralist perspective, the demands of ethnic minorities tend to be
viewed as undeserving complaints because it is widely presumed that
equality already exists, which of course is technically but not actually
true (Hero, 1992).
In contrast, the demands of first-tier occupants are rarely viewed as complaints because the politically powerful can more easily meet their needs
through direct access to the political system and have little need for overt
political activity to demand equality. It should also be noted in Figure 10.1
that being concentrated in the second tier means that Latinos have little
power to set agenda, formulate and legitimate policy, or exercise political
power in any broad sense. As a result, top-down public policy is generally
done to Latinos because they are rarely its creators, despite being in the best
position to understand and solve their own social problems. Only through
increased political participation and representation can Latinos become
more centrally involved with agenda setting and policy formation, legitimation and implementation, as depicted in Figure 10.1. Understanding the
links between the dynamics of Latino voting and political representation,
capable of influencing social policy, can help service providers to more
clearly imagine different places in the political incorporation process in
which they can participate to advance Latino social welfare.
T OWARD POLICY BENEF I T F OR U.S. L AT I NO S
Using the state of California as a major example of Latino political incorporation, Fraga and Ramirez (2003) provide a framework and a decade’s
worth of data to illuminate the complex dynamics of growing political
power and remaining problems and issues. They begin by noting that between 1992 and 2000, Latinos doubled their percentage of the California
electorate, from 7% to 14% of state voters, and that this increase significantly affected state politics:
From 1990 to 2000, 11 elections were held [in California] for governor, U.S.
senator, and president. Democrats have won nine of these races. In seven of
these nine (78%) Latino voters were significant contributors to the winning
Democratic candidates. Three of these nine successful Democratic candidates (i.e., one third) would not have won without the Latino vote. . . . Latino

290 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
voters utilized their growing percentage of the California electorate to vote
consistently as a majority block in favor of Democratic candidates. (p. 316)
But Fraga and Ramirez (2003) also note that influencing the policy benefit for Latinos is not simply a function of the increasing Latino electorate or
voters, but also the degree to which Latinos become elected to office—
that is, Latino representation—and the degree to which such Latino representation can influence policy making by playing key roles in local
government and state legislature. Such policy influence ranges from seats
on local city councils and school boards to becoming partisan leaders,
committee chairs, and assembly speakers at the state level. Thus all three
dimensions—voting, representation, and policy making—are critical for
service providers and others to understand in order to enhance Latino
political incorporation, which Fraga and Ramirez define as “the extent to
which self-identified group interests are articulated, represented, and
met in public policymaking” (p. 304).
ENHANCING THE LATINO ELECTORATE
Of course, growing Latino numbers all around the country eventually
translate into an increase in voting power. However, service providers
and others can significantly expedite this process by doing four basic, yet
essential things:
1. Assist unregistered eligible Latinos with registration. For example, although the number of eligible Latinos registered to vote in California increased from 52% in 1990 to 62% in 1996, recent data show that
of the more than 4.5 million eligible Latino citizens, only about half
are registered (Fraga & Ramirez, 2003)! Thus, making Latino clients
and community groups aware of such sobering numbers and of their
potential influence on local, state, and national issues pertinent to
Latino welfare represents one of the most viable direct strategies to
enhance Latino political power. Service providers can push for
same-day registration opportunities at voting sites. Piven and
Cloward (1988, p. 13) made the strong case for public agency-based
voter registration years ago, arguing that “if people could register in
the course of using services in agencies as diverse as welfare, Social
Security, nutrition, employment, agriculture, education, and day
care, the United Sates would have universalized access to the electoral system.” They also reported on the success of an organization
called Human SERVE that implemented agency-based voter registration in 16 states and 15 major cities.

Latino Power 291
2. Involve Latino youth in the political process, with their huge numbers and
potential imminent political power. Alvarez and Butterfield (1998) studied Latino population growth in California from 1990 to 1995 and
found that nearly 90% of the state’s net increase in Latinos
(1,414,112) was due, not to migration, as popularly believed, but to a
natural increase from U.S. births. Thus, well over a million Latino
youth could possess significant voter influence by the time they
reach 18, somewhere around 2015, but this will depend on how well
we involve them in the political process. History and government
classes represent viable school-based sites for integrating such a relevant lesson into the general curriculum. Service providers working
with delinquent and gang-involved Latinos could integrate prosocial political involvement as a way of redirecting youths’ misspent
time and energy to relevant youth and community issues.
3. Assist immigrant Latinos with applications for naturalization and consequent voting privileges. Even legal immigrants cannot vote unless they
apply for citizenship through the process known as naturalization.
J. A. Garcia (2003b) reports that fewer than half of all permanent residents in the United States have been naturalized, and that rates for
Latinos have been the lowest of all immigrant groups, especially for
Mexicans. Results from the National Latino Immigrant Survey found
that while between 82% and 95% of respondents planned to apply for
citizenship, only between 38% and 51% had only begun the process
(DeSipio, 1997). Thus, service providers should be familiar with the
criteria for naturalization in order to motivate eligible Latino immigrants to apply. Applicants must be 18 years of age or older; living as
a legal permanent resident in the United States for at least 5 years;
able to read, write, speak, and understand commonly used words in
the English language; and able to demonstrate a basic knowledge of
U.S. history and government. Fraga and Ramirez (2003) suggest that
adult education and English classes are ideal sites for teaching immigrants about the naturalization process and its link to voting, citizenship, and civic duty. Mexicans, who constitute the majority of all U.S.
immigrants, should also be informed that naturalization no longer
means losing Mexican citizenship, now that Mexico honors dual citizenship. And though there will always be a few immigrants unwilling to pursue citizenship, data from the National Latino Immigrant
Survey indicate that between 82% and 95% intend to do so.
4. Assist undocumented Latinos with citizenship applications. This is tricky
business, given that failed applications can mean deportation, yet undocumented migrants with several years and investments in the
United States, as well as with noneconomic hardships, may qualify

292 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
(L. R. Chavez, 1998). As mentioned in Chapter 4, such hardship refers
to a compelling need to remain in the United States other than losing
one’s job or not being able to attain comparable earnings in Mexico.
Examples include family members with pressing problems (e.g., children or elderly with disabilities or chronic illnesses requiring services) who would suffer in Mexico due to inadequate services.
Undocumented Central Americans can be urged to request sponsorship from employers to whom they are close (e.g., as in the case of domestic workers). However, requests for political asylum still rest on
providing proof of political persecution, which is difficult for most.
ENHANCING LATINO REPRESENTATION
All of these recommendations will enhance the Latino electorate in
America, but it remains necessary to have social policies in place designed to empower Latino voters by reducing institutionalized barriers to
political representation. In their study of Latino incorporation in California, Fraga and Ramirez (2003) note small but impressive trends in the
election of Latino state officials that are directly attributable to attaining
Latino registration percentages at 40% and above in Latino-majority districts, which were created by the legislature to help Latinos elect candidates of their choice. Despite the controversial nature of creating
majority-minority voting districts, the method clearly advances minority
representation. In California, for example, Fraga and Ramirez note that
all nine such Latino-majority districts elected Latino state officials in
1998. Further, between 1990 and 1998, the number of Latino state assemblypersons increased from 4 to 17, and Latino senators increased from 3
to 7. Fraga and Ramirez further note that the majority of these Latino
state officials have been Democrats, thereby concentrating partisan political power, and that a large proportion have been women (e.g., almost a
third of Latinos in the assembly and over half in the senate in 2000).
The Endangered Voting Rights Act
Latino-majority districts guarantee not only the election of Latinos, but
also the long-term institutionalization of Latino political leadership. As
such, the bipartisan practice of using census data to create such districts,
allowable under the Voting Rights Act (VRA), needs to be defended. The
VRA was enacted in 1965 to enhance the voting power of African Americans, who, like other ethnic minorities, have been historically unable to
elect local officials in White-majority districts. Indeed, where Blacks and
Latinos have been historically numerous (e.g., the South and Southwest,
respectively), voting districts were purposefully created to disallow

Latino Power 293
Table 10.2
Anti-immigrant, Antibilingual, and Anti-Affirmative
Action Referenda in California
Latino-Relevant
Referenda in California Purpose and Outcome
Proposition 187 The so-called Save Our State proposition passed
in 1994. Denied undocumented people access to
publicly funded health, education, and social services, and even denied permanent resident aliens
access to social welfare programs. Proposition 187
was immediately ruled unconstitutional for its
multiple violations of federal and state laws
governing basic human rights.
Proposition 227 The “English Language Initiative for Immigrant
Children,” passed in 1998, replaced bilingual
education programs in public schools (K–12) with
one-year English-immersion programs.
Proposition 209 Removed state affirmative action provisions for
both employment and higher education.
Proposition 54 The so-called Racial Privacy Act, defeated in 2003,
would have prohibited state and local government
from collecting information that includes reference
to race and ethnicity.
racial and ethnic minority voting blocks in what is known as gerrymandering (this odd term derives from eighteenth-century Massachusetts Governor Elbridge Gerry, who created a salamander-shaped voting district). The
VRA was amended in the early 1970s to include language minorities and
has had a significant impact on Latino representation ever since. For example, J. A. Garcia (2003c) notes that there were only 5 Latinos elected to
the U.S. Congress before the VRA amendments and that the number grew
to 21 by the 1990s. He also notes that the VRA’s largest impact on Latino
representation has been at the local level, where more than 10,000 such officials have been elected to school boards, city councils, and county
boards of supervisors.
But even with these gains, it is important to keep in mind that Latinos
still compose only about 1% of all elected officials in America. Even in
California, Whites still make up 75% of voters, which, if united, can easily overwhelm Latino voters, as was evident in the White block votes
that passed anti-immigrant, antibilingual, and anti-affirmative action
statewide referenda during the past 20 years (outlined in Table 10.2).

294 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Interestingly, the combined agenda of these backlash referenda can be
viewed as seeking to disempower Latinos by rolling back previous political gains won in areas central to Latino social welfare in the United
States. However, it should also be noted that one of the great ironies of
such polarizing propositions is that they resulted in the greatest surge
of Latino voter registration and turnout, including immigrant applications for naturalization, in the history of California (J. A. Garcia, 2003c;
Fraga & Ramirez, 2003).
To some degree, propositions have also alerted racial and ethnic minorities in California and progressive Whites of their common agenda,
which probably helped to defeat Proposition 54 in 2003, the so-called
Racial Privacy Initiative, which was designed to amend the California
constitution by restricting state and local governments from collecting
and using race and ethnic identifiers in public heath, schools, crime prevention, and civil rights enforcement. The author of Proposition 54 (and
of Proposition 209), University of California Regent Ward Connerly,
viewed it as a step toward a color-blind California; however, such a
proposition would make it nearly impossible to address the deep and
numerous health and racial disparities in California and the rest of society. Such superficial fixes to entrenched racial problems in America are
naively premature at best and downright regressive at worse.
In spite of continuing minority political disadvantage, there has been
a predictable backlash against the VRA in states such as Texas,
Louisiana, Georgia, North Carolina, New York, Illinois, and Florida,
where it is frequently disparaged as “reverse gerrymandering.” Such a
backlash ignores the racist institutional barriers that made the VRA necessary in the first place, and it generally comes from those with enough
political power to render minority gains short-lived anyway. For example, in the North Carolina case of Shaw v. Reno in 1993, the constitutionality of using race to draw voting district boundaries to enhance the
representation of ethnic and racial minority interests was strongly questioned by the U.S. Supreme Court, which outlawed the use of race as the
predominant factor in drawing such districts. Thus, other factors such
as poverty and community cohesiveness need to be considered. Fraga
and Ramirez (2003) proactively urge elected Latinos to practice more inclusive politics by building coalitions and addressing issues that may include but go beyond Latino benefits. For example, California’s 1998
Healthy Families Initiative extends the availability of low-cost health insurance to the state’s 7 million uninsured, 50% of whom are Latino. Although this health policy does not cover a third of Latino children
because of various eligibility criteria (e.g., restricted to citizens, documented residents in California before August 1996), it is an example of a

Latino Power 295
policy beneficial to the poor in general and Latinos in particular (Burciaga Valdez, 2003).
Interestingly, in California, where Latinos have finally established a
foothold in representative state politics, Governor Arnold Schwarzenegger launched a vigorous campaign in the fall of 2005 to redraw voting districts, complaining about their odd shapes (remember the salamander?),
rather than simply awaiting the official voting district review period that
happens with each new census. Not only would the governor’s off-cycle
proposal have cost millions of unnecessary dollars, but it also appeared
aimed at disempowering heavily minority and Democratic voting districts. Fortunately for Latinos, the measure was defeated at the polls, but
it will predictably resurface throughout the United States.
ENHANCING LATINO POLICY BENEFIT
To what degree does increasing Latino representation result in the elusive
prize of social welfare-enhancing policy benefit? Is influence at this
macro level, especially in the priority areas of poverty, employment,
health, education, and immigration reform, beginning to occur in ways
that would be predicted by the political gains outlined earlier? Unfortunately, Fraga and Ramirez (2003) note that there is no existing research on
the policy accomplishments of Latino legislators, whether in terms of policy interest articulation, agenda setting, or legislative enactment. However, these researchers conclude that the small but unprecedented growth
of Latino representation in California can be influential. For example, in
1998, Latino Democrats constituted 54% of the majority in both the assembly and senate necessary to elect party leaders, including Antonio
Villaraigosa as the second Latino speaker of the assembly, the first being
Cruz Bustamante, who subsequently was elected to lieutenant governor,
the first Latino statewide elected official in over 100 years! Though unsuccessful, Villaraigosa’s strong bid for mayor of Los Angeles in 2002 and
Bustamante’s bid for governor of California in 2004 symbolize the growing confidence of Latino representatives to directly influence policy on
city- and statewide levels. As noted in Chapter 2, such confidence and accruing political savvy resulted in the historic election in 2006 of Villaraigosa as the first Latino mayor of Los Angeles in 133 years!
To the degree that policy development is advanced by Latino or Latinointerested officials, service providers can help by keeping abreast of the
issues (local, statewide, national) and by offering their direct assistance
to the process. Haynes and Mickelson (1997b) recommend that social
workers volunteer to provide testimony, either alone or with clients,
which is an essential and influential part of legislative deliberation on

296 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
senate bills. Such testimony can include presentations of case studies and
relevant agency data, as well as speculation on policy implementation scenarios. These actions can be taken by individual service providers locally
and by their professional organizations (e.g., NASW, APA) at regional,
statewide, and national levels. Other potential areas of involvement are
grassroots movements and formal Latino political organizations.
R EV I SI TI NG THE LATI NO POLICY AGENDA:
THE PERSISTENCE OF
SOCIOECONOMIC VULNERABILITY
ECONOMIC DEVELOPMENT AND REFORM
In a more functional model, social welfare policy would provide support
for the tangible survival and instrumental needs of the populations whose
participation in the market system has been most limited by societal factors, including Hispanics and their families. It would also be organized to
support their socioemotional needs, intervene in crises, and deliver longterm support. There would be validation of the membership and capability
of the Hispanic community to build upon its own strengths. There would
be participation by those community members, creation or expansion of
neighborhood-based services, and increasing control by the community itself. (McDonough & Korte, 2002, p. 245)
The functional model of social welfare suggested in this excerpt could
be better supported by the slowly growing political power of Latinos, if
not for powerful and well-orchestrated backlashes that frequently unravel
the hard-won victories of Latino movements. For instance, although significant gains in Latino political power began to happen in the 1970s, the
simultaneous disappearance of community based organizations (CBOs)
in the Latino community undermined such gains, as well as advances
made by Latino movements and the War on Poverty during the 1960s. In
their economic analysis of Chicano communities in southern California,
Moore and Vigil (1993) conclude that despite massive federal spending on
CBOs, which spearheaded significant improvements in Latino education,
medical and mental health care, and relations with the police, the criminal justice system, and the INS, funding rapidly dried up during the
1970s and 1980s due principally to the growing political momentum to
shrink the welfare state, economic recession, and a few scandals in young
and inexperienced Latino CBOs.
The loss of Latino-focused CBOs left hundreds of thousands of community members without adequate safety nets for coping with the continued
disappearance of core sector jobs in unionized industrial plants (i.e., eco
Latino Power 297
nomic restructuring). Since then, there have been few alternatives but to
join the ranks of the working poor as part of the dramatic rise in service
sector work, or what Moore and Vigil (1993, p. 33) refer to as “low wage
reindustrialization.” Thus, while lower and working-class Americans
have generally been hurt by economic restructuring during the second
half of the twentieth century (e.g., downsizing industry, corporate outsourcing of jobs abroad, sharp increase in dead-end service sector work),
Latinos have been especially vulnerable given the short half-life of their
meager policy benefits.
President Reagan’s Blueprint for Today’s Ultraconservativism
The election of President Reagan during the 1980s and his administration’s New Federalism legislative agenda drastically slashed federal
government spending on social welfare programs for the poor, forming
the blueprint for today’s hyperconservative ideology toward poverty,
or the belief that poverty is a moral failure not to be subsidized by
government. Yet by the end of Reagan’s second term as president, instead of the “trickle-down economics” promised, the national debt had
doubled, the stock market had crashed, and homelessness in America
had surged.
As noted by De La Rosa (2000), Reaganomics was further solidified in
the 1990s with huge Republican wins in the 1994 congressional elections
and their Contract with America legislative agenda, which was codified
into law with the passage of the 1996 Personal Responsibility and Work
Opportunity Act. The fact that less than 25% of poor Americans can actually escape poverty (Rothman, 2002), and that little “work opportunity” or living wages exist beyond the service sector jobs of the working
poor, somehow seems to elude self-proclaimed “compassionate conservatives” in their mission to shrink big government (and its safety nets for
the poor) while expanding the corporate sector through corporate welfare, or the use of taxpayer money to supplement the expenses and losses
of big business.
The result has been a continuously widening gap between rich and
poor, paid for by the working and middle classes. If the average American was more aware of how relatively little tax money goes to the poor
and to basic public facilities (i.e., public schools, parks and recreation,
waterworks), and how many billions in taxes subsidize rich corporations that return almost nothing to the people (e.g., jobs, cheaper products and services) or to the government (tax revenue), there would be a
renewed commitment toward lifting Americans out of poverty while
stemming corporate greed. In-depth discussion of this topic is beyond
the scope of this book; awareness of corporate welfare is detailed by

298 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
writers and organizations such as Barlett and Steele (1998), Citizens for
Tax Justice (2002), and Nader (2000), which are briefly outlined next to
put welfare for the poor into proper perspective.
CORPORATE RECIPIENTS OF WELFARE
Under the guise of misnomers such as “public-private partnership” and
even “economic development,” corporate welfare costs taxpayers billions annually in higher prices and lost revenue. Rothman (2002) writes
that such welfare for the rich and corporate business class has been estimated at $60 billion in industry-specific tax breaks annually, and another $75 billion in government spending that directly benefits
business. He notes that the government contributes about $100 million
every year to help major U.S. corporations advertise their products
abroad. Corporate welfare recipients such as McDonald’s, Mars candy,
Campbell’s soup, Miller beer, and Gallo wine defend government subsidies on the basis of remaining competitive in the global economy and
thus better able to provide cheap products and job opportunities. But
how likely is it that Mexican farmworkers picking grapes for Gallo will
experience any benefit from their tax contribution to this form of corporate welfare?
No average American taxpayer, or small business for that matter, has
the economic and political clout to directly influence politicians and economic policies or to coerce state and local governments to provide millions of dollars in tax exemptions or building project grants simply for
deciding to start or expand a business or for merely threatening to move
a business out of state. Yet entitled corporations routinely pit states
against each other in giant welfare package bidding wars for precisely
such reasons. For example, Marriot of Maryland claimed that its offices
had grown too small for its 3,800 employees and threatened to move these
jobs out of state. When the state of Virginia offered a multimillion-dollar
welfare package to lure Marriot, Maryland counteroffered with a package
estimated at between $31 and $47 million and won the bid (Nader, 2000).
It was later revealed that Marriot had decided not to move before Maryland’s offer! Similarly, when the Stock Exchange threatened to leave New
York a few years ago if tax breaks were not granted, Mayor Giuliani came
up with an estimated $900 million in tax relief (which worked out to
about $200,000 for each job retained).
There is a long list of such uses of taxpayer money resulting in little if
any real job gain for states, and in many cases actual job losses. For example, after the relatively poor city of Toledo, Ohio, came up with a $300
million welfare package to keep Chrysler’s Jeep plant in the city, the cor
Latino Power 299
poration announced that it would decrease its workforce from 5,600 to
4,900 and would try not to go below 4,200 (Nader, 2000).
In addition to a lack of jobs, most U.S. citizens are also having their tax
money diverted from the major domains of public life, which continue to
deteriorate and undermine the quality of life for most Americans. According to Nader (2000):
• A third of schools are in need of extensive repair or replacement ($113 billion needed over 3 years to remedy). For example, a quarter of schools in
Cleveland need replacement. Yet the city phased out athletic programs to
save money, while $300 million in taxpayer money was used to build basketball and baseball arenas for multimillionaire team owners who do little to make tickets affordable to the city residents whose tax dollars built
the stadiums.
• About $9 billion in services are needed to restore and upgrade public
parks in the United States.
• The U.S. Department of Transportation estimates that just under $10 billion is needed to maintain public transportation at its current mediocre
level. Another $4 billion would result in an upgrade of the public transportation system to “good.”
• The Centers for Disease Control estimates that $140 billion over the next
20 years are needed to prevent 900 deaths and 1 million people from getting sick each year from bad public water. In an eight-part series on corporate welfare, Time magazine (Barlett & Steele, 1998) profiled Evansville,
Arkansas, a town unable to secure a mere $750,000 from the state to remedy the problem of undrinkable water (due to sulfur, natural gas, and
other petroleum products and E. coli contamination). Yet, Arkansas spent
$7 million for a water and sewage treatment plant in nearby Jonesboro to
lure Frito-Lay to the state. And this was only a small part of the total corporate welfare package of over $100 million in tax credits, industrial development grants, a 140-acre plant site, and a 20% discount on sewer bills
for 15 years. As a subsidiary of Pepsi-Cola, which generates profits of over
$20 billion annually, why would Frito-Lay need Arkansas taxpayer
money, especially in return for a little over 150 new jobs?
Given what appear to be some obviously bad investments of taxpayer
money, why do such forms of corporate welfare persist and even flourish?
The answers are many but center around the tremendous political clout of
large corporations, characterized by national organizations, millions of
dollars in annual campaign contributions, and powerful lobbyists advocating for the maintenance and expansion of corporate welfare-related
tax codes and various business and economic policies.
Thus, the definition of corporate welfare is fairly straightforward. According to Nader (2000, p. 31):

300 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
If a program involves the government giving more to private companies
than it gets back—that is, where it is engaging in a transaction that cannot
be justified as a fair market value exchange—then it should be considered
corporate welfare.
According to Nader, the welfare double standard for the rich and
poor in America is characterized by an absence of public campaigns
against corporate “welfare kings” versus imaginary “welfare queens”
(the latter term popularized by President Reagan), no time limits on or
regular reporting of corporate welfare versus the current 5-year time
limits on welfare for the poor, and no welfare restrictions on foreign corporations like those repeatedly imposed on immigrants. All the conservative rhetoric about success through merit and rugged individualism
simply does not apply to the most powerful of American businesses,
while it is consistently used to portray the poor as unworthy of government investment.
Perhaps corporate welfare would be worthwhile if corporations generating billions of dollars in profits annually simply paid their fair share of
taxes. Imagine if they paid the 25% to 30% tax rate typically paid by the average middle-class American. Yet one of the greatest ironies of corporate
welfare is that corporate recipients have made an art form out of paying
back little to nothing in taxes into the very government that subsidizes
them. For example:
• The Citizens for Tax Justice (CTJ; 2002) report that current surges in
corporate welfare, including those enacted by the Bush administration’s so-called Stimulus Bill, will cost ordinary Americans over
$170 billion while driving corporate income tax down to a mere 1.3%
of the gross domestic product by 2004, or the second lowest level in
the past 6 decades. The CTJ goes on to profile 10 large profitable corporations (e.g., Microsoft, General Electric, Ford, IBM, GM, Worldcom), noting that while they received $29 billion in corporate welfare
over the 2-year period from 2002 to 2003, they paid only 5.9% of their
profits (approximately $135 billion) in federal income tax. During
the 5-year period studied by CTJ prior to their report, it was found
that during some years, many corporations paid less than 2% in
taxes (e.g., Microsoft, WorldCom) and some paid no taxes at all (e.g.,
Enron, Colgate-Palmolive), despite profits in the billions.
• In a 2003 Frontline television story, “Catch Us If You Can,” the Fortune 500 corporation Union Bank was featured for its clever tax
break scheme, in which it would use client money to lease the entire
rail transportation system of a small German town for billions of dol
Latino Power 301
lars only to cancel the lease the very next day, so that it could be
listed as a tax-deductible business venture (the German town received a few million for cooperating). It took years for the underfunded and understaffed IRS to bring Union Bank to a congressional
hearing and to close the tax loophole. But once the IRS had succeeded, Union Bank went back to the same German town and leased
its sewer system, canceling the transaction the next day.
• In his book Perfectly Legal, Johnston (2003) describes a variety of complex ways that the superrich pay little to nothing in taxes, frequently
consulting elite law firms and banks that have become experts at creatively manipulating tax codes and shelters (e.g., tax-exempt offshore business addresses).
That billion-dollar corporations can wind up with a tax rate of less than
6%, thereby shifting the disproportionately unfair tax burden onto American workers and taxpayers while receiving billions in corporate welfare
and returning nothing to taxpayers in the way of good jobs with living
wages and benefits, is the real welfare problem in America—not the pittance begrudgingly meted out to the working poor trapped in the deadend service sector because American big business would rather maximize
profits by outsourcing jobs abroad rather than pay working-class Americans a decent living wage and basic benefits.
UNDERSTANDING LATINO POVERTY
The socioeconomic vulnerability of most U.S. Latinos will continue to require multiple strategies, ranging from enhancing the Latino policy benefit to continued grassroots movements at the local level and the ongoing
efforts of various formal Latino organizations. Without Latino input,
policies designed to combat poverty will continue to miss their targets in
the Latino community. The Urban Institute (1995) asserts that antipoverty policies aimed at the dislocated, unemployed, and “underclass”
(e.g., poor African Americans) continue to miss the fact that most Latinos
are working poor, and that even pro-immigrant policies miss the twothirds of Latinos who are U.S.-born. In their book In the Barrios: Latinos and
the Underclass Debate, Moore and Pinderhughes (1993) present a series of
reports demonstrating how Latino poverty is different from African
American poverty (with the exception of Puerto Ricans): Among Latinos,
both work participation and marriage rates are higher than the national
average (because of continuous immigration), there has been less of an exodus of middle-class Latinos (because of family ties to the barrios), and
the sale of illegal drugs has occurred on a much smaller scale. Thus,

302 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
viable solutions to Latino poverty need to be based on the characteristics
of Latino economic vulnerability.
In De La Rosa’s (2000) plan of action to combat Latino poverty, he advocates a pair of ideas to stimulate economic development in the barrio
and to subsidize working poor Latinos. First, the federal government
should implement the 1992 Enterprise Zone Act in all Latino barrios
where the poverty rate exceeds 20% (not 45%, as currently prescribed).
This Act provides tax breaks in exchange for businesses locating within
impoverished communities and agreeing to hire at least 30% of their
workforce locally. De La Rosa’s adjustment to the Act would broaden its
application beyond underclass to working poor communities. The second recommendation is to provide monthly cash transfer payments to all
working poor persons equal to 150% (not 100%) of the poverty threshold
established annually by the government. For example, based on the 1998
poverty threshold of $16,450 for a family of four in which parents are
not currently working, annual cash assistance would amount to $24,675
or 150% of $16,450. In the case where working parents earn $12,000 annually, then the federal government would subsidize the difference of
$12,675 to achieve 150% of the poverty threshold of $16,450. Americans
have been conditioned to recoil at the idea of cash incentives for the taxpaying working poor; however, such incentives should be viewed in contrast to corporate recipients of welfare, as discussed earlier. Lifting
taxpaying citizens out of poverty is a good investment for the country.
De La Rosa imagines reaching this lofty goal through the development
of a political action committee or coalition of professional and political
Latino organizations (such as those outlined later in the chapter), including professional service organizations, that can prioritize and publicize Latino poverty (e.g., raise money, conduct a major rally in DC,
lobby the White House to appointment poverty-focused officials).
IMMIGRATION AND WELFARE POLICY REFORM
With over half of all U.S. immigrants coming from Mexico, including significant numbers of undocumented, immigration-related policy making
during the 1990s concentrated on decreasing annual numbers, curtailing
the use of public and social services, and making illegal immigration
more difficult (DeSipio, 1997). The 1996 Personal Responsibility and
Work Opportunity Reconciliation Act (PRWORA) denies Social Security
and food stamps to immigrants, including legal permanent residents; requires the sponsors of immigrants to be legally responsible for those unable to support themselves; mandates the INS to verify the eligibility of
immigrants applying for public benefits; and authorizes deportation for

Latino Power 303
ineligible applicants. Criticism of PRWORA has influenced how the Balanced Budget Act of 1997 restored Social Security and Medicaid benefits
to pre-PRWORA-eligible immigrants whose benefits had been terminated, and how eligibility was extended to those in the country as of 1996
who had become disabled. The Agricultural Research Act of 1998 restored food stamp benefits to pre-PRWORA-qualified immigrant children, those that were receiving disability assistance, and the elderly
(Kilty & Vidal de Haymes, 2000). Thus, criticism of policies that deny the
most basic help to the most vulnerable members of society (e.g., children,
elderly, disabled) can temper extreme and insensitive measures.
Militarization of the U.S.-Mexico Border
With the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, increased militarization of the U.S.-Mexico border continued to be a high policy priority to curb illegal immigration.
The Act built on 1994s “Operation Gatekeeper” by erecting a 14-milelong steel wall, increasing the number of border patrol agents and providing them with paramilitary training, and authorizing 5,000 soldiers
for border patrol duty in 1989 (Kilty & Vidal de Haymes, 2000). A tragic
outcome of these policies has been the continuously mounting deaths—
more than 2,000 so far—of Mexicans who attempted to cross in less
guarded but more dangerous border areas (e.g., precarious mountainous
and desert areas beyond the fence).
U.S. dependence on essential Mexican labor makes such lethal immigration policies a cruel contradiction in urgent need of reform (e.g., some
form of regulating the crossing of laborers to meet worker and corporate
needs). Instead, Congress drafted an inflammatory bill in spring 2006 advocating not just the criminalization of an estimated 11 million undocumented migrants, composing 5% of the U.S. workforce, but making the
crime a felony, sealing the U.S.-Mexico border, and deporting massive
numbers of immigrants (as was done to Mexican immigrants in 1929
when the economy collapsed and they made handy scapegoats with very
little power). A far more immigrant-friendly counterbill soon emerged in
addition to an unprecedented grassroots movement of Latinos across the
country expressing moral outrage at the first bill as well as galvanized political voice and power.
The absurdity of Mexico-related immigration policies, or perhaps the
cold logic in allowing U.S. corporations and capitalists to manipulate a
huge, cheap, and exploitable workforce, partly through the historical
legal production of illegal workers (De Genova, 2004), has been discussed
by various immigration scholars who study the uniqueness of the Mexican case. For example, Sassen (1990, pp. 382–383) concludes:

304 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
The implications for the Mexican case are clear. Migrations are produced.
The mere fact of a shared border and inequality in wages between the two
countries is not sufficient in itself to account for immigration. The construction of railroads in the 1800s, the development of commercial agriculture, and now the development of the Border Industrialization Program are
all processes that created a labor market. The fact that this labor market
was eventually divided by a patrolled border led to contradictions in the
legislation covering both halves. Secondly, if the United States through its
economic activities, has incorporated Mexican workers and Mexican areas
into a broader international organization of production, and if, furthermore, these activities promote the formation of migrations, then the
United States must assume some responsibility for immigration of Mexicans into North America.
LANGUAGE AND EDUCATION POLICY REFORM
For a brief moment in the 1960s and 1970s, it seemed as though the educational crisis of Latinos, as well as their anemic political participation,
would be partially remedied when the U.S. Congress adopted the Bilingual Education Act of 1968 and when the VRA was extended to language
minorities in the 1970s, eliminating linguistic barriers to voting (e.g.,
bilingual ballots). But as early as 1981, backlash campaigns to make English the official language were introduced into Congress every year. They
finally began to succeed in as many as 17 states by 1990, either through
initiative or legislative action.
According to Schmidt (1997), proponents of English-only movements not
only viewed English as essential to social mobility, but also feared national
disunity based on a perception of Latinos as more interested in maintaining
their culture of origin. Linda Chavez, former executive director of U.S. English, went as far as attributing the bilingual movement to selfish Latino
leaders, whom she views as motivated by political self-interest, and insisting
that Latinos should be free to embrace individualism through English rather
than from government-imposed homogenization through culture maintenance. This is why, for example, critics of bilingual education advocate rapid
transition to English programs over maintenance programs designed to support Spanish language and Latino culture while promoting English acquisition. Maintenance programs represent a pluralistic approach to bilingual
education based not on a rejection of English and its obvious advantages, but
on the right to linguistic nondiscrimination and cultural maintenance. While
the assimilationist position of Linda Chavez imagines liberal individualism
without barriers, pluralists recognize the historical role of English as the language of power and oppression in the United States. Thus they value cultural maintenance partly as protection against the marginality that results

Latino Power 305
when people of color are forced to assimilate without being provided with
equal access, opportunity, and power (i.e., marginality).
Results of the National Latino Political Survey (NLPS) strongly support
a pluralist approach that places value on both English/American culture
and Spanish/Latino culture. For example, NLPS results reveal that over
90% of U.S. Latinos agree that English should be learned, over 80% support bilingual education, over 70% favor bilingual education in which both
languages are learned, and over 50% of Latinos disagree that English
should be the official language, as compared to 80% of Anglos who also
participated in the NLPS (Schmidt, 1997). Thus, politically powerful opponents of bilingual education are dismantling such programs against the
will of Latinos on the basis of inaccurate perceptions of Latinos. For example, fears of Latino nationalism are hardly supported by the results
form the National Latino Immigrant Survey, which tells us that over 95%
of Latino immigrants intend to stay in the United States, that between
82% and 95% plan to become citizens, and that the majority either
strongly or very strongly love the United States (DeSipio, 1997)! Service
providers genuinely interested in empowering Latinos should find ways
to promote bilingual education and other forms of linguistic access, freedom, and equality in democratic America.
Not relinquishing the ideal of bilingual education is consistent with the
recommendations of both researchers and government reports that have
addressed the educational crisis of Latinos for decades. In his summary of
this literature, Eugene E. Garcia (2003), dean of education at Arizona
State University and former dean of education at U.C. Berkeley, concludes
that there is simply no substitute for quality teaching, sensitive to Latino
culture and linguistic needs, in addition to adequate school resources.
Citing the 1998 U.S. Department of Education Report No More Excuses:
Final Report of U.S. Hispanic Dropout Project, Garcia reiterates documented
factors that reliably predict school success for Latinos and all children:
preschool attendance, small class size in the early grades, more money
spent per child, lower teacher turnover, and higher teacher satisfaction
with school resources. Garcia is understandably critical of the current era
of so-called educational reform, in which school accountability is mistakenly equated with high-stakes state testing, which results in the closing
of poorly performing public schools or the reconstitution of such schools
with new leadership, staff, and plans. Garcia concludes:
Beyond the lack of evidence that supports the belief that these remedies will
solve the problem of failing schools, the trouble with all of them is that they
focus on changing governance and structure, rather than on improving teaching and learning in schools. For 30 years, research has shown what makes an

306 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
effective school where teaching and learning takes place; high expectations
and standards for all students, curricula that mirror the standards, appropriate methods of standards-based assessment, strong principals, a safe and orderly environment, a high degree of parental involvement, teachers who are
well-prepared in content and pedagogy, ongoing professional development
for all teachers, and accountability throughout the school. As E. E. Garcia
(1999) discusses in Student Cultural Diversity: Understanding and Meeting the
Challenge, these characteristics can be found in the best schools, be they public, private, religious, charter, or reconstituted. (p. 81)
Thus, at the heart of the issue is the continuing inferior education of
poor Latino children in the public schools. As an example, E. E. Garcia
(2003) states that the 2000 case of Williams et al. v. The State of California
et al., which charged that poor Latino and African American children are
being given a public education far inferior to that provided their more
privileged White counterparts throughout the state. The Mexican American Legal Defense Fund (MALDEF), which joined in the filing of this
suit, was pleased with the state’s settlement of the case in summer 2004
because it agreed to abolish shorter school calendars that disproportionately affected poor students of color.
One could easily imagine school social worker actions to support cases
like Williams, such as providing testimony at hearings or local school data
on structural and resource-related school deficiencies. Other sites for social worker advocacy exist all along the educational pipeline, where ruptures at each major junction decrease academic achievement. This is
vividly illustrated in Figure 10.2 using the work of Solórzano and associates (Yosso & Solórzano, 2006), who analyzed data from the 2000 U.S. census, the National Center for Educational Statistics, and the National
Survey on Earned Doctorates to show just how dramatically schools are
failing Latino youth. Policy recommendations by these researchers include
the following: (a) Make basic college entrance requirements the default
curriculum for all students; (b) increase access to academic enrichment
programs such as elementary school gifted and talented education programs and high school advanced placement courses that underenroll Latinos; (c) make Latino parents aware of their right to opt out of vocational
programs and inappropriate standardized testing and to opt in to Englishlanguage learner support and academic enrichment programs; and (d) decrease reliance on high-stakes and inappropriate testing and assessment.
HEALTH CARE POLICY REFORM
All of the Latino policy areas under discussion constitute different dimensions of the same old problem: SES vulnerability. Policy advances in the

307
Figure 10.2
Mexican Americans attain low academic outcomes at each point
along the educational pipeline (2000). (Source: “Leaks in the Chicana and
Chicano Educational Pipeline,” by T. J. Yosso and D. G. Solórzano, 2006, Latino
Policy and Issues Brief, 13, pp. 1–3. Reprinted with permission.)
100
Elementary School
Students
46
Graduate from
High School
26
Enroll in College
8
Graduate with a
B.A. Degree
2
Earn a Graduate or
Professional Degree
0.2
Graduate with a
Doctoral Degree
17
Go to a
Community College
1
Transfers to a
4-Year College
9
Go to a 4-Year
College

308 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
educational achievement of Latinos will also improve health, given the
strong association between SES and health. But because educational reform and educating a population are long-term goals, policy makers need
to extend and not limit health care benefits to Latinos as a way of saving
the country massive expenses that will eventually result from neglecting
the health of millions of U.S. Latinos and other poor populations. In her
summary of the recommendations of Latino health professionals and researchers, Suarez (2002) highlights the following: (a) federal legislation to
appropriate funds for the development and evaluation of health promotion
and disease prevention programs for Latinos; (b) such programs should
integrate Latino community lay leaders and promotoras in development,
implementation, and evaluation; (c) educational campaigns to raise Latino
awareness through large and small local media and community networks;
and (d) mass media marketing targeting Spanish-speaking Latinos regarding issues of health access and eligibility. Hayes-Bautista (2003) adds
to this list the urgent need to increase the number of Latino medical doctors, noting that in California, for example, Latinos make up over 30% of
the state population yet less than 5% of physicians. This amounts to a
Latino-patient-to-Latino-physician ratio of 2,8931, as compared to a nonLatino-patient-to-non-Latino-physician ratio of 3351.
De La Rosa (2000) concludes that we must revisit President Clinton’s ideas
of universal health care for all Americans. This is consistent with Cornelius
(2000), who advocates promoting health care as a human right and not a class
privilege. At the least, De La Rosa suggests extending Medicaid programs
to those at 150% (not 100%) above the current poverty threshold to better
meet the health needs of working poor Americans. Burciaga Valdez (2003)
recommends federal subsidies to enable small businesses to provide health
insurance, given that they do not have the clout to extract corporate welfare
from the government. This suggestion is based on the fact that about a third
of Latinos are employed by small firms with fewer than 25 workers that
can’t afford to provide health care benefits. In fact, three-quarters of all
firms employ fewer than 10 employees and are thus in the same position.
But government subsidies could easily make health care insurance available
by dividing the cost among government, employer, and employee (i.e., small
business welfare that enables both small businesses and workers).
Health Policy for the Undocumented
With regard to the health of the undocumented in America, Kullgren
(2003, p. 1630) concludes:
Intended to serve as a tool for reducing illegal immigration and protecting
public resources, federal restrictions [PRWORA] on undocumented immior
Latino Power 309
grants’ access to publicly financed health services unduly burden health
care providers and threaten the public’s health. These deleterious effects
warrant the public health community’s support of strategies to both repeal
these restrictions and sustain the provision of health services irrespective
of immigration status.
Although PRWORA does make a few exceptions in the case of emergency treatment, immunization, and health care for the children of undocumented born in United States, confusion about such minor
exceptions inhibits undocumented parents from seeking family health
care. Other compelling reasons for serving the undocumented include
controlling communicable diseases in the general population, reducing
the ethical dilemma of health professionals who are being told not to
deliver the needed heath services that they were trained to provide,
and the lack of cost effectiveness in using taxpayers’ money to provide
emergency treatment but not the preventive services that would decrease such emergency care. But how can health care providers circumvent the PRWORA while avoiding legal challenge? Kullgren (2003)
recommends that we introduce congressional bills at the state level to
amend PRWORA to include primary and preventive care among the list
of health services exempted from restriction, as was done by Texas representatives in the 107th congress.
Until Latino political power can sufficiently marshal policy benefit to
begin to remedy the long-standing policy agenda of U.S. Latinos, the
work of grassroots political organizing and movements, in concert with
the various types of formal Latino organizations, will need to continue
the struggle to lift Latino social welfare.
GRASSROOTS POLITICS AS A
BASE OF LATI NO EMPOWERMENT
While the Latino policy agenda struggles forward in fits and starts,
spurts and setbacks, those who experience firsthand and on a daily basis
the consequences that compromise social welfare will also continue to
struggle, sometimes succumbing to vulnerabilities and sometimes surmounting them through personal and community agency. In spite of formal political underinvolvement, there has been a long, rich, and
persistent history of Latino activism, primarily at the local level aimed at
specific issues. Examples of past and ongoing Latino social justice movements provide insight into Latino initiative, agency, and resilience.
Latino political activism, largely neglected by mainstream historians,
is increasingly documented by Latino-interested scholars. The sample

310 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
offered in this section exemplifies what is still possible, and indeed necessary, in U.S. Latino communities, as Latino needs continue to be overlooked by mainstream social policy and politics.
THE MOTHERS OF EAST LOS ANGELES
Pardo (1998) has documented the community activism of the Mothers of
East Los Angeles (MELA), formed in the mid-1980s to defeat the first
state prison planned for an urban setting. The prison proposal infuriated
Gloria Molina, the first Latina assemblywoman, because 75% of L.A.
County prisons were already located in her East Los Angeles district. But
when her objections were dismissed by the California Department of
Corrections and Governor Dukmejian, Molina, a seasoned Chicana feminist, took the fight to the grassroots level, where 8 years of marches, rallies, and litigation by the MELA eventually defeated the state. It is worth
noting that Molina later became the first Latina elected to the Los Angeles City Council (1987–1991) and the first woman and first Mexican American elected to the Los Angeles Board of Supervisors, which oversees an
annual budget of $13 billion (Pardo, 1998). Molina’s vacated assembly seat
was won in 1986 by fellow Latina community activist Lucille RoybalAllard, who also worked to defeat the prison plan and was elected to Congress in 1992 (J. A. Garcia, 2003d).
Subsequent MELA activism prevented the construction of a toxic waste
incinerator, also planned for East Los Angeles. A branch of MELA incorporated in 1990 as a nonprofit organization that has promoted water conservation, lead poisoning abatement, immunization awareness, and
scholarships for college. Pardo’s (1998) research helps to tell the larger
story of emerging Latino power by focusing on local community mothers
sparked to action by locally elected Latina representatives and supported
by Catholic parish priests, who defeat powerful state officials and corporations to protect their community. The fact that the pioneering elections
of Molina and Roybal-Allard resulted from Latino-majority voting districts created under the VRA, which was expanded to include Latinos as a
result of litigation on the part of MALDEF, helps us to connect the many
dots of Latino political power.
One particularly amusing MELA story comes from its defeat of a proposal by oil companies to construct a shallow oil pipeline from offshore
rigs in Santa Barbara to Long Beach through the heart of East Los Angeles. This route would bypass affluent and predominantly White coastal
cities such as Pacific Palisades. At one meeting, community members
asked oil representatives why they didn’t run the pipeline along the coast,

Latino Power 311
to which one official replied, “Oh no! If it burst, it would endanger the
marine life!” (Pardo, 1998, p. 132).
Gendered Latino Politics
As Pardo (1998) underscores, MELA is also the story of ordinary women
doing extraordinary political things because they view their activism
not as a violation, but as an extension of the traditional Mexican gender
role to protect their families. Given this perspective, and extra measures
to meet family obligations (e.g., early cooking and cleaning to free up
time for meetings and marches), husbands were generally supportive,
often driving their wives to political activities and occasionally participating themselves. Pardo’s analysis thus eliminates the commonly presumed boundary between public political and private domestic work for
Latinas and reinserts women back into the center of their long history in
Latino politics.
Two Latino Thumbs Up for Salt of the Earth
The 1953 movie Salt of the Earth portrays a dramatic reenactment of the Empire
Zinc mining strike in New Mexico during the 1950s, in which the wives of Mexican
miners replaced their husbands on the picket line when legal harassment and intimidation prevented the men from continuing their union-supported strike. Far ahead of
its time, the film depicts how these strong Mexican women contested subordination
by their husbands, who were initially unsupportive of their political involvement. The
film includes leading Mexican actors in inspiring roles and was the only blacklisted
film in America; director Herbert J. Biberman was sent to federal prison by the U.S.
House Un-American Activities Committee as part of the red scare of the 1950s. This
makes it a remarkable testament to the agency of those oppressed on the basis of social class, race, gender, and culture against powerfully oppressive corporate and
legal systems. Such past and ongoing stories should inspire service providers and
others not to underestimate the history and potential of Latinas to care for their families and communities by successfully blending political activism and Latino culture.
(CATHOLIC) CHURCH-BASED ACTIVISM
The new role of the Catholic Church as a culture-based foundation for
community activism continues to unfold in the aftermath of harsh criticism from Latino activists during the 1960s and 1970s for neglecting
Latino social justice issues. Also, the fact that Latino immigration continues to revitalize and expand Catholic congregations throughout the
United States has raised the Church’s accountability to the Latino community. Thus, service providers working with Latinos should make
themselves aware of local Catholic Church community activism in order

312 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
to collaborate on ongoing campaigns and programs, involve clients where
appropriate, and introduce new issues to Church coalitions.
The Resurrection Project
A particularly striking example of Catholic Church-driven community organizing and social justice work comes from the predominantly Mexican
Latino community of Pilsen on Chicago’s Lower West Side. What is noteworthy about the Resurrection Project (TRP) is the Church’s leadership
in empowering community residents to pursue central needs in nonpartisan ways. As reported by Grossman et al. (2000), TRP emerged in 1994,
after years of coalition building among eight local Catholic churches,
community organizations, and businesses, complete with by-laws requiring two-thirds community residents on the board of directors. With a
budget of $25 million, four major programs are directed at some of the
most pressing community needs: (a) community organizing to institutionalize local power by identifying and training indigenous community
leaders to advocate for local issues (e.g., community policing, voter registration); (b) family support services ranging from Head Start, day care, and
parenting skills to housing programs for homeless women and children;
(c) home ownership and financial services to develop low-income housing to
replace inadequate housing and increase savings and loans options for
residents; and (d) real estate and assets management to develop and renovate
community-owned real estate to increase sustainability and affordability,
increase tenant management of church-owned properties, and support a
cooperative of minority-owned construction companies to participate.
The Project’s United Power for Justice coalition of churches, residents,
and nonprofit organizations aims to hold elected officials accountable to
the needs of the Latino community. Further, general training classes offered to parishioners stress “the prophetic teachings of Jesus, the role of
the church in seeking justice, and the importance of building people
power for justice” (p. 141).
FORMAL LATI NO POLI TICAL ORGANIZATIONS
The history of the Latino political organization is as old as anti-Latino
discrimination in the United States and Latino countermovements designed to promote survival and civil and human rights under often hostile conditions (outlined in Chapters 1 and 2). Many of the organizations
profiled in Table 10.3 continue to prosper and enhance Latino social justice in America. They offer a wide variety of sites and specialties in
which service providers and others can promote Latino social justice
and welfare at the macro level by lending their professional skills,

Latino Power 313
Table 10.3
Latino Political Organizations
Organization History and Scope
La Alianza Hispano Americano (Hispanic
American Alliance), Orden de Los Hijos de
America (Order of the Children of America)
Nineteenth-century mutual aid societies
that combated segregation and discrimination by providing basic, survivaloriented resources such as credit, burial
insurance, and social services, especially
to immigrants.
Mexican American Legal Defense Fund
(MALDEF)
Los Angeles-based MALDEF, founded in
San Antonio, Texas, in 1968, is a litigation
organization with a $6.5 million annual
budget, with additional offices in San
Antonio, Atlanta, Chicago, Houston,
Sacramento, and Washington, DC. Its
staff of 75 employees includes 22 attorneys, 10 legislative and policy analysts,
and outreach staff to promote community
education and leadership. MALDEF
focuses on the central Latino program
areas of education, employment, immigrant rights, political participation, and
public resource equity (fair share of government services) and access to justice.
MALDEF was instrumental in litigation
that expanded the VRA to include Latinos
and other language minorities. In Tyler v.
Phloe, MALDEF won free access to public
education for undocumented children living in the United States.
League of United Latin American Citizens
(LULAC)
Founded in Texas in 1927 as a nonpartisan organization of Latino citizens
designed to promote assimilation, LULAC
eventually fought the segregation of Mexican students in Texas and California. Now
a DC-based, inclusive, Latino multi-issue
membership organization.
Puerto Rican Legal Defense and Education
Fund (PRLDEF)
Like MALDEF, a litigation organization
founded in the 1970s that assisted with
expansion of the VRA to language minorities. In Aspira v. New York, PRLDEF litigated for bilingual education and service
rights for Puerto Rican and other languageminority students.
(continued)

314 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
Table 10.3 (Continued)
Organization History and Scope
Cuban American National Foundation
(CANF)
Founded in 1981 as an anti-Castro, anticommunist exile organization, CANF has
been successful in winning asylum status
for Cuban refugees and support for their
adaptation and promoting foreign policy
that isolates Cuba (e.g., trade blockade).
Southwest Voter Registration Project
(SVRP), Midwestern Voter Registration
Project (MVRP)
SVRP and MVRP have conducted campaigns to register eligible Latinos to vote
for over 25 years, often timing their efforts
to coincide with local elections.
Dominican American National Roundtable
(DANR)
A recent civic organization, serving as an
umbrella for over 60 local Dominican
groups to promote adaptation in the United
States.
Congressional Hispanic Caucus (CHC) From 5 Latino Congress members in 1976
to currently over 20, the CHC is designed
to promote collective Latino agendas at
the federal level (e.g., developing a pool of
Latino candidates for Supreme Court
vacancies). CHC efforts are limited by its
generally Mexican American membership
and Democratic politics, avoided by the
few Latino Republicans in Congress.
National Association of Latino Elected and
Appointed Officials (NALEO)
Nonprofit, nonpartisan organization
founded in 1976 to enhance the effectiveness of all Latino representatives through
assistance and training, networking,
research reports, assistance with policy
matters, and establishing Latino-inclusive
priorities (e.g., its major campaign beginning in 1985 was to promote naturalization
of Latino immigrants in order to vote).
making financial donations, and involving Latino community members.
The few profiled here come from the work of J. A. Garcia (1993d) and
feature some of the major historical and current political organizations,
now spanning three centuries.
TOWARD PAN-LATINO POLITICAL POWER?
In 2000, 6-year-old Elian Gonzales was rescued by the U.S. Coast Guard
after his mother and her boyfriend drowned at sea while trying to escape Cuba by sailing to Florida on a small boat. His story provided a

Latino Power 315
glimpse into some of the impediments to pan-Latino political power in
the United States. While the boy’s uncle in Miami sought political asylum for Elian, the fact that he was taken without the permission of his
father in Cuba sparked a national debate and an international political
incident involving no less than Fidel Castro, the INS and Department of
Justice, the Cuban American community, and even the Office of the
President. The event climaxed with an INS raid of the home at which
Elian was living after the family, backed by the Cuban community, refused to surrender the boy for return to Cuba. The position of the Cuban
exile community in Miami is understandable, given their anti-Castro
politics, but most other Latino groups, and most of America for that
matter, placed the importance of reuniting the boy with his family
above local and international politics.
As can be seen in Table 10.3, national Latino political organizations
such as the National Association of Latino Elected and Appointed Officials work to promote networking among all elected Latino politicians
and appointed representatives, with the objective of identifying Latinowide priorities (e.g., naturalizing immigrants as citizens, language
rights), building coalitions and thus consolidating nationwide Latino
political power and impact. Although the Congressional Hispanic Caucus aims to do the same at the U.S. congressional level, it’s telling that
Republican Latino congresspersons currently refuse to participate in
the predominantly Mexican American and Democratic organization.
Huge differences of opinion on Castro and the Cuban blockade make the
inclusion of Cuban Republican congresspersons on the caucus highly
unlikely, again underscoring major differences between Latino nationalorigin groups.
Indeed, J. A. Garcia (2003e) has advanced a number of pan-Latino political scenarios, one of which depicts Cuban Americans as an “outlier,”
whose predominant Republican political agenda and higher SES have separated them from most other U.S. Latinos. But even among the remaining
U.S. Latino groups, Garcia acknowledges that pan-Latino politics may
take on merely a symbolic form, in which groups such as Mexican Americans, Puerto Ricans, and Central Americans continue to pursue their own
group-specific issues while occasionally invoking the term Hispanic or
Latino as a device to enhance the perception of such issues at the national
level. Still, Garcia is sticking to his chief scenario of growing pan-Latino
political power based on what he terms a “community of interests.” With
commonalities in culture, language, and history (including minority
status, discrimination, and negative public image) as a basis, pan-Latino
politics can simultaneously address Latino subgroup concerns and crosscutting concerns such as those brought up in this chapter (i.e., language

316 SELECTIVE REVIEWS OF MAJOR PROBLEM AREAS
needs versus English-only movement, immigration reform, political participation needs, affirmative action). Garcia reports findings from the
Latino National Political Survey (LNPS, de la Garza, DeSipio, García,
García, & Falcón, 1993) to support his vision. The data, however, seem to
convey a mixed picture.
INTER-LATINO GROUP PERCEPTIONS, INTERACTION, AND AFFINITY
The LNPS (de la Garza et al., 1993) data used to analyze Latino intergroup
perceptions and behaviors, essential to pan-ethnicity, reveal low panethnic identification (i.e., as Hispanic or Latino) versus high nationalorigin identification (i.e., as Mexican, Puerto Rican, or Cuban), and
generally low contact between groups, yet fairly positive intergroup
affinity. For example, when asked the degree to which participants have
contact with members of the three major U.S. Latino groups, less than
10% of respondents indicate “a lot” of such contact. However, when
asked to rate how warmly they felt about other group members, using a
“feeling thermometer” with a neutral midpoint of 50, ratings ranged
from 53 to 67, indicating moderate affinity. When asked about similarity in cultural practices across Latino groups, over 50% of respondents
perceived them to be “somewhat similar,” 20% said “very similar,” and
yet a full 25% perceived “none”! When asked about similarities in political and economic interests, less than 10% of respondents perceived
such interests to be “very similar,” and between a 25% and 42% said
they were “somewhat similar.” Based on these data, we should not expect Latino pan-ethnic political clout on a national level any time soon.
At the same time, we should confidently expect and facilitate growing
Latino political participation, representation, and, hopefully, policy
benefit on a group-by-group, issue-by-issue basis, which may be able to
focus on many of the social welfare-enhancing issues of paramount importance to most U.S. Latinos. Service providers should not underestimate their own past and potential contributions to Latino political
power in America.
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321
Epilogue
Adelante—Proceeding Forward
THIS BOOK HAS been a challenging yet exciting opportunity to deepen our
understanding of Latino psychosocial and health problems and to describe in sufficient detail a number of real-life best and promising practices aimed at solving some of the most important and difficult problems
and issues affecting various Latino populations in the United States
today. Because no single book can address all of the important problems
affecting Latinos, a major objective was to demonstrate general principles
of cultural competence by concentrating on a few very important specific
areas, and hence teaching practice by example and illustration. Hopefully
such general principles of culturally competent practice can be transferred to the reader’s local area of practice and expertise in the spirit of
thinking globally and acting locally.
The illustrations and critiques of best and promising practices were
guided by a comprehensive yet pragmatic new practice model for working
with Latinos that spells out the four major practice dimensions that need
to be included if we are to continue addressing multiple problem levels
and solutions, from micro individual to meso community to macro social
institutional. The integrative approach used throughout this book, applied to different Latino populations, theoretical frameworks, and problem areas, was intended to address the kinds of nonrandom problem
patterns that affect racial and ethnic minority groups given the links of
such problems to historical and current issues of injustice, marginality,
and social injustice.
During its development, this book was extensively reviewed by a number of thoughtful experts in the social sciences whose commentary and
recommendations were used to strengthen the book’s content. These reviewers also underscored the continuing dilemma of needing to include
more coverage of other important Latino groups (e.g., Dominicans,
South and Central Americans) and problem areas (e.g., juvenile justice

322 EPILOGUE
and prison systems, child abuse) that increasingly demand our concern
and attention. I hope to remain informed of the growing research and
writing in such areas and to integrate such work into future editions of
this book, an opportunity I would welcome con mucho gusto. Similarly,
books such as this need to remain in tune with topical political and cultural issues, activities, and events directly affecting Latinos, such as the
current bitter and divisive debate on undocumented immigration and
the U.S.-Mexico border policies. Clearly such issues could benefit from
an integrative social science approach that describes their complex history and broader context.
A social constructivist perspective teaches us that there is little if any
neutrality in the social sciences and that it can be occasionally refreshing
to have writers and thinkers be more up front about their biases. Although I made great efforts to offer balanced perspectives in this work—
as much as was humanly possible—I also had to make peace with what I
needed to say. How could I not be biased from my own Chicano experience of being born and raised in East Lost Angeles during the eventful
1960s and 1970s? I believe we still need to hear from voices throughout
the Latino experience in America, as well as from Latino interested
scholars and practitioners, to better understand and help ourselves and
each other. I sincerely hope this book serves to promote such understanding and action.

A
Abrams, B., 248
Acevedo, A., 272
Acharya, A., 171
Acosta, F. X., 151, 233
Acuña, R., 14, 15, 18
Adams, R. M., 185
Aguilar-Gaxiola, S., 220, 221, 222, 223,
227, 271
Aguirre-Molina, M., 245
Akana, L. L., 257
Alcalay, R., 253
Aldarondo, E., 154
Alegria, M., 218
Alipuria, L., 78
Alvarado, M., 253
Alvarado, N. J., 275, 277
Alvarado-Rosemann, P., 169
Alvarez, I., 194
Alvarez, M., 291
Amaro, H., 144, 245, 246, 278
Ambler, C., 173
Amezcua, C., 262
Andrews, J. W., 167
Aneshensel, C. S., 185, 193
Angel, R., 218
Anglin, M. D., 187
Annis, R. C., 7
Aponte, J. F., 229
Apospori, E., 186
Aranda, M. P., 173
Arce, C. H., 112, 141
Areán, P., 239
Arnalde, M. A., 102, 103
Aronson, J., 84
Atkinson, D. R., 71, 129, 225
Ayala, G., 269, 271, 273, 275
Azar, V., 196
Azmitia, M., 184
Azocar, F., 239
B
Baca, L. M., 206
Baca Zinn, M., 141
Bakeman, R., 155, 156
Balbutin-Burnham, A., 275, 277
Balcazar, H., 253
Balls Organista, P., 144, 271, 272, 276
Bamaca-Gomez, M. Y., 185
Bandura, A., 269
Baptiste, D., 114
Barlett, D. L., 298, 299
Barrera, N., 154
Bastani, R., 274, 275
Bauer, H. M., 155
Baumeister, L. M., 194, 195
Bean, F. D., 20, 27, 51, 54, 55, 56, 148
Becerra, R. M., 145, 146, 193, 228, 229
Beck, A. T., 234
Becker, H. K., 192
Bedard, L., 202
Behnke, A. O., 184
Belanger, G., 312
Belitz, J., 191, 192, 205, 206, 207
Bell, L. A., 97
Belski, J., 312
Berlin, J. A., 101
Bernal, G., 148, 207
Berry, E. H., 193
Berry, J. W., 5, 6, 7, 9
Betancourt, J. R., 249, 250
Bird, H. R., 218
Bissett, L., 254, 256
Blair, M., 277
Blair, S. L., 185
323
Author Index

Blumenthal, R., xiv, 135
Bola, J. R., 276
Boles, S., 188
Booher Feagin, C., 16, 17, 18, 21, 22,
23, 24, 25, 26, 27, 28, 29, 30, 31, 32,
50, 57, 144
Booth, M. W., 187
Boswell, T. D., 54
Boyd, J. H., 218
Boyd, S., 172
Branch, C. W., 201
Bravo, M., 218
Bronfenbrenner, U., 120
Brooks, A. J., 188, 190
Brown, W. B., 190
Burciaga Valdez, R., 295, 308
Burnam, M. A., 128, 218, 219, 220, 226
Burt, M. R., 181, 182, 183, 195, 196, 208
Butterfield, T. L., 291
C
Caetano, R., 156
Campbell, A., 193
Canino, G., 218
Canino, I. A., 218
Cantwell, D. P., 185
Caraveo-Anduaga, J., 220, 221, 222,
223, 227
Carballo, M., 272
Cardoso, R. M., 312
Carillo, J. E., 249, 250
Carlos, M. L., 226, 227
Carrillo, H., 271, 273, 275, 278
Carrillo, R. A., 161
Carter-Pokras, O., 245, 246, 247, 249,
258, 260
Casas, J. M., 239
Casas, M. J., 188
Cass, V. C., 108
Castañeda, A., 72
Castañeda, D., 273
Castillo Moran, M. A., 272, 276
Castro, F. G., 187
Catalano, R., 220, 221, 222, 223, 227
Cervantes, R. C., 35, 224
Chang, G., 272
Chavez, E. L., 188
Chavez, G., 154, 246, 248
Chavez, L., 18, 20, 105, 106, 107, 284,
285, 292, 304
Chavous, T. M., 82, 83, 84
Chelala, C. A., 34
Chen, Y. C., 185
Chen, Y. R., 185
Chesir-Teran, D., 186
Ching, A., 110
Chipkin, S. R., 254, 256
Chitwood, D. D., 271
Christianson, R., 246
Clark, C. L., 156
Clark, K. M., 144
Clements-Nolle, K., 110
Cloward, R. A., 290
Cohen, L. M., 238
Cole, K., 200
Collins, B. E., 273
Colon, H. M., 266, 271
Comas-Diaz, L., 114, 115, 151, 232,
237
Conner, R. F., 276
Cooke, D. Y., 82, 83, 84
Coombs, R. H., 188
Coon, D. W., 173
Cooper, C. R., 184
Corcoran, J., 193, 194
Cordova, C. B., 223
Cordova, R., 34, 40
Corethers, T. C., 312
Cornelius, L. J., 308
Cortes, D. E., 216, 217
Costa, L. A., 194
Costantino, G., xiv, 135
Courtney, J. G., 154
Cousins, J. H., 253
Coustasse, A., 249, 250
Cox, E. O., 131, 134
Crawford, S. L., 194
Cross, H. G., 53
Cross, W., 71
324 AUTHOR INDEX

Cunardi, C. B., 156
Curtis, R., 266
D
Darabi, K. F., 193
de Anda, D., 113, 193
Decker, J. T., 169
De Genova, N., 303
Deitz, T. L., 168
de la Garza, R., 316
De La Rosa, M., 187, 297, 302, 308
de las Fuentes, C., 205
De La Torre, A. C., 52, 54
del Castillo, R. G., 15
Delgado, M., 144, 151, 170, 231, 233
DeLois, K., 131, 132
Denton, N. A., 27
DeSipio, L., 291, 302, 305, 316
Des Jarlais, D. C., 266
Diaz, R. M., 107, 267, 268, 269, 270, 271
Diaz-Perez, M. J., 272
Dinelia, R., 170
Diversi, M., 184
Domhoff, W. D., 53
Domhoff, W., 112
Dorrington, C., 34, 35, 194
Drevenstedt, G. L., 168
Driscoll, A. K., 185
Dryfoos, J., 195, 197, 198, 199
Duany, L. A., 194
Dumka, L. E., 186
Dunbar, N. D., 184
Duncan, J. W., 237
DuRant, R. H., 194, 195
E
Earp, J. L., 272
Ehrenberg, R., 52
Ellis, A., 234
Ellsberg, M., 160
Emery, G., 234
Emslie, G. J., 185
English, P., 248
English, P. B., 246
Escobar, J. I., 128, 218, 219, 220, 226
Eshleman, S., 220
Espín, O. M., 103, 108, 109
Esteban, M., 161
Evans, L. A., 233
F
Falcón, A., 316
Falicov, C. J., 141, 144, 148, 149, 152,
167, 203
Farias, P. J., 34, 224
Fawcett, G. M., 158, 159
Feagin, J. R., 16, 17, 18, 21, 22, 23, 24, 25,
26, 27, 28, 29, 30, 31, 32, 50, 57, 144
Felice, M. E., 193, 194
Felix-Ortiz, M., 189
Felkenes, G. T., 192
Ferreira-Pinto, J. B., 277
Ferris, E. G., 33, 34, 35, 40, 223
Fielder, E. P., 193
Figueroa, J. B., 48, 52
Finkler, K., 156
Fischer, G. J., 164
Fisher, E., 155, 157
Fitten, L. J., 172
Flaherty, L. T., 195
Flannery, D. J., 188, 189, 190
Flaskerud, J. H., 225
Flores, E., 194, 195
Flores-Ortiz, Y., 148, 154, 155, 157, 161
Foreyt, J. P., 253
Forgey, M. A., 200
Fraga, L. R., 289, 290, 291, 292, 294, 295
Frankenberg, R., 86
Franklin, C., 193, 194
Frauenglass, S., 189
Freeman, D., 218
Freire, P., 269
Fridrich, A., 188, 189, 190
Friedman, J. C., 186
Friedman, S. R., 266
Frisbie, W. P., 112, 148
Author Index 325

Fujino, D. C., 225, 239
Furlong, M., 188
G
Gallagher-Thompson, D., 173
Gallion, K. J., 259, 261
Garcia, E., 184, 199, 305, 306
García, F. C., 316
Garcia, J., 172, 287, 291, 293, 294, 310,
314, 315
Garcia, J. A., 60, 61, 316
Garcia, M. C., 29, 30, 31, 32
Garcia, M. T., 20
Garcia, R. E., 35
Garcia de Alba, G. J. E., 272, 276
Garcia-Preto, N., 141
Garcia Vasquez, J. J., 34
Germain, C. B., 120
Gersh, B. J., 101
Gertz, M., 202
Ghost Ippen, C., 233
Giacomini, M. K., 250
Gidycz, C. A., 163
Gil, A. G., 183, 186
Gillespie, S. A., 271
Glenmaye, L., 131, 132
Goebel, P., 145
Golding, J. M., 226
Gomel, J. N., 144
Gomez, P., 259, 261
Gondolf, E. W., 155, 157
Gonsalez, G., 235
Gonsalves, C. J., 224
Gonzales, G., 188
Gonzales, J. L., Jr., 5, 33
Gonzalez, H. M., 171
Gonzalez Baker, S., 9, 12, 15, 17, 19, 20,
44
Goodway, J., 252, 253
Green, J., 109
Greenberg Garrison, E., 196
Greene, R. R., 121
Grieger, R., 234
Grossman, S. F., 312
Guarnaccia, P. J., 218
Guendelman, S., 103, 149, 246, 248
Guilamo-Ramos, V., 114
Gutierrez, L. M., 131, 132, 134
Gutierrez-Mayka, M., 172, 173
Gutierrez-Ramirez, A., 258, 260
Guzman, R., 110, 158
H
Haan, M. N., 171
Hakuta, K., 57, 59
Hall, J. A., 191
Hamdi Arar, N., 257
Han, L., 111
Hardiman, R., 97
Hardman-Muye, M., 170
Harless, W., 101
Harris, M., 190, 192, 228
Harrison, B., 52
Harvey, M., 165
Hayes-Bautista, D., 308
Haynes, K. S., 285, 286, 295
Hays, P. A., 208, 239
Healey, J. H., 19
Heise, L. L., 158, 159
Helms, J., 71
Henderson, J. N., 172, 173
Henggeler, S., 191
Herdt, G., 272
Hernandez, A., 202
Hero, R., 287, 288, 289
Herrera, C. R., 170
Herskovits, M. J., 4
Hervis, O., 203, 204
Hicks, D., 163, 164
Higginbotham, J. C., 227
Hohman, M. M., 193
Holck, S. E., 194
Holcomb, J. D., 252, 253
Hollinger, D. A., 78
Hollingsworth, D. R., 194
Holmes, K. A., 164
Holzer, C. E., III, 185
Hondagneu-Sotelo, P., 103, 104
Hough, R. L., 128, 219, 220, 226
Hovey, J. D., 186
326 AUTHOR INDEX

Howard, K. I., 233
Hu, L., 225, 239
Huerta, E., 253
Huff, C. R., 190
Hughes, M., 220
Hulme, P. A., 227
Humm-Delgado, D., 151, 231
Hunt, L. M., 255, 257
Hurtado, A., 101
I
Iglehart, A. P., 145, 146, 228, 229
Inciardi, J. A., 271
Isita-Espejel, L., 158, 159
Israel, B. A., 158
Iwata, E., 73, 74
J
Jaccard, J., 114
Jackson, B. W., 97
Jackson, K. M., 186
Jacobs, P., 17
Jagust, W. J., 171
James, M., 194
Jasinski, J. L., 154
Jenkins, S., 230
John, R., 168
Johnson, A. G., 86
Johnson, D. L., 205
Johnson, R. A., 169
Johnston, D. C., 55, 301
K
Kaplan, M. S., 218
Karno, M., 128, 219, 220, 226
Kates, J., 263
Katz, M., 110
Kaufman Kantor, G., 154
Keatley, J., 110, 111
Keefe, S. E., 79, 80, 81, 82, 226, 227
Kerner, J., 101
Kessler, R. C., 220
Khalsa, J. H., 187
Kilty, K., 303
King, C. A., 186
Kingery, P. M., 252, 253
Kiselica, M. S., 194
Kolody, B., 220, 221, 222, 223, 227,
230, 271
Korte, A., 296
Koss, M. P., 163
Koss-Chioino, J. D., 206
Kottiri, B. J., 266
Kubo, A., 277
Kullgren, J. T., 308, 309
Kurtines, W., 102, 103, 152, 153,
203, 204, 205
L
Landau, S., 17
Lane, D., 252, 253
Larson, K. A., 184, 199
Le, H., 233
LeCroy, C. W., 188, 190
Lee, D. J., 219
Lefley, H., 163, 164
Lenski, G., 41, 42, 43
Leslie, L. A., 34, 35
Levenson, S. M., 254, 256
Li, J., 52
Liabre, M., 163, 164
Lietch, M. L., 34, 35
Liljestrand, J., 160
Linskey, A. O., 185
Linton, R., 4
Lira, J., 252, 253
Locke, B. Z., 217, 218
Low, G., 163
Lowe, S. M., 129, 225
Luchsinger, J. A., 251, 252
Luke, D., 110
Lum, D., xiv, xix, 123, 125, 127,
130
Lyon, J. M., 191
Lyons, B., 167
Author Index 327

M
Maciak, B. J., 158
Magaña, J. R., 277
Maldonado, M., 35, 272
Malgady, R. G., xiv, 135, 216, 217
Mallinckrodt, B., 237
Mamo, L., 110
Mancilla, Y., 152, 153, 203, 205
Manning, S. S., 229
Manoleas, P., 123
Manuel, G. M., 35, 224
Marcotte, D., 35, 224
Marger, N. N., 39, 41, 42, 48, 54, 59, 61,
94
Marin, B. V., 142
Marin, G., 142
Markides, K. S., 219
Marks, G., 218
Marti, J., 261
Martinez, C., 239
Martinez, R., 143, 218
Martinez, S. R., 275, 277
Mason, C. A., 189
Massey, D. S., 27
Mata, A., Jr., 277
Matos, T. D., 266
Matute-Bianci, M. E., 185
Maxwell, A. E., 274, 275
Mazon, M., 18
McAlister, A., 259, 260, 261, 262
McBride, D. C., 271
McDonough, K., 296
McFerron, R., 155, 157
McGonagle, K. A., 220
McGraw, S. A., 194
McGuire, L., 121
McIntosh, P., 46, 85, 86
McKinlay, J. B., 194
McLane, C. P., 168
McLemore, S. D., 9, 12, 15, 17, 19,
20, 44
McWilliams, C., 14, 15
Melendez, E., 48, 52
Mell, K. G., 53
Menendez, A. V., 35, 224
Mercado, S., 262
Mickelson, J. S., 285, 286, 295
Millen, B., 254, 256
Millen, L., 143
Miranda, J., 239
Miranda, M. R., 232
Mishra, S. I., 275, 276
Modiano, M. R., 259
Molina, C. W., 245
Molitor, F., 274, 275
Montejano, D., 20
Montes Mozo, S. M., 34
Montoya, V., 171
Moore, J., 296, 297, 301
Moquin, W., 16
Morales, A. T., 190
Moran, C. E., 57
Morison, G., 188
Morris, L., 194
Morrow, C. A., 229
Morten, G., 71
Moscicki, E. K., 217, 218
Motylewski-Link, C., 154
Mueller, G., 264
Mungas, D. M., 171
Muñoz, R. F., 208, 233, 235
Murguia, E., 53, 112
Murphy, H. B. M., 8
Murphy, J., 264
Murphy, S. L., 281
N
Nader, R., 298, 299
Neaigus, A., 266
Nelson, C. B., 220
Nemoto, T., 110, 111
Newcomb, M. D., 189
Newman, E., 253
Norris, F. H., 155, 156
Novick, E. R., 181, 182, 183, 195, 196,
208
Nuno, T., 194
328 AUTHOR INDEX

O
Operario, D., 110, 111
Orell, L. H., 201
Orfield, G., 20
Organista, K. C., 144, 163, 166, 208,
235, 239, 249, 271, 272, 273, 275,
276, 277
Orlinsky, D. E., 233
Ortiz, F., 172
Ortiz, T. A., 171
Ortiz, V., 193
Otero-Sabogal, R., 142
Otiniano, M. E., 170
P
Padilla, A., 35, 79, 80, 81, 82, 128, 142,
224, 226, 227
Page, A., 145
Pantin, H., 152, 153, 189, 203, 205
Pardo, M. S., 310, 311
Parham, T., 71
Parke, R. D., 144
Parker, R. G., 272
Parron, D. L., 129
Parsons, R. J., 131, 134
Patria, J., 110
Paulson, M. J., 188
Peak, T., 193
Pecka, G., 169
Pell, E., 17
Pendergrast, R. E., 194, 195
Perez, S. M., 194
Perez, W., 142
Pérez-Stable, E. J., 142, 259
Perez-Vidal, A., 203, 204
Perilla, J. L., 155, 156, 157
Persons, W., 202
Pettinelli, M. E., 312
Phinney, J. S., 65, 70, 78
Pick, S., 158, 159
Piercy, K. W., 184
Pinderehughes, R., 301
Piven, F. F., 290
Plante, T. G., 35, 224
Plunkett, S. W., 185
Pontius, C. O., 263
Priest, R., 113
Pugh, J., 255, 257
Pulley, L., 262
Pumariega, A. J., 185
Q
Qian, Z., 185
Quintero-Salinas, R., 185
R
Rabinowitz, Y., 173
Radloff, L. S., 217
Rae, D. S., 217, 218
Rakos, R. F., 237
Ramirez, A. G., 253, 258, 259, 260,
261, 262
Ramirez, M., III, 72
Ramirez, O., 141
Ramirez, R., 173, 290, 291, 292, 294,
295
Ramirez, R. R., 147
Ramos, B., 114
Randal Joseph, B. H., 131
Randall, C., 188
Ranney, M., 173
Rao, S., 233
Rapp, C., 126, 134
Ray, L. A., 219, 227
Redfield, R., 4
Regier, D. A., 217, 219
Renteria, T., 228
Resnick, G., 181, 182, 183, 195, 196, 208
Reynoso, T. C., 193
Richardson, M. A., 188
Riddel, V. A., 113
Rintelmann, J. W., 185
Rios, C., 218
Rios, R., 218
Author Index 329

Rivers, J. E., 271
Roberts, C. R., 185
Roberts, R. E., 185
Robins, L. N., 219
Robles, R. R., 218, 266
Rochat, R. W., 194
Rodriguez, A., Jr., 184
Rodriguez, C. E., 27, 48, 52
Rodriguez, M. A., 155
Rodriguez, N., 34
Rodriguez, O., 183
Rodriguez, R., 77, 78, 108
Rogler, L. H., xiv, 135, 216, 217
Roll, S., 143
Romo, H., 9, 12, 15, 17, 19, 20, 44
Ronstrom, A., 35
Roosa, M. W., 186
Rosenberg, M., 69, 72
Rosenberg, P., 52
Rossello, J., 207
Rothman, R. A., 40, 41, 51, 53, 298
Rouse, B. A., 187
Routh, D. K., 189
Rowland, D., 167
Roy, I. S., 196
Roy, L. C., 168
Rubio-Stipec, M., 218
Ruiz, J. D., 274, 275
Ruiz, S., 263
Rumberger, R. W., 183, 184, 199
Rush, A. J., 185, 234
S
Sabogal, F., 142
Sahai, H., 266
Saldivar-Garduno, A., 272
Salgado de Snyder, V. N., 224, 272
Santana, F., 128, 219
Santiago, A., 158
Santisteban, D., 152, 153, 203, 204,
205
Sanudo, F., 275, 276
Sassen, S., 303
Schafer, J., 156
Schinke, S., 200
Schmidt, R., Sr., 304, 305
Schuler, R. H., 193
Schulman, K. A., 101
Schwiebert, V., 169
Scopetta, M., 102, 103, 152, 153, 203,
205
Scott, C., 163, 164
Seidman, E., 186
Sellers, R. M., 82, 83, 84
Seymore, C., 194, 195
Shartrand, A., 152
Shaver, P., 237
Shaw, B. F., 234
Shelden, R. G., 190
Shen, H., 153
Shillington, A. M., 193
Shirk, N., 169
Shragg, G. P., 193, 194
Shrout, P. E., 218
Siegel, J., 163, 165, 185
Sistrunk, S., 101
Smith, C., 153
Smith, D. W., 252, 253
Smith, K. W., 194
Sobhan, M., 185
Sokol-Katz, J. S., 187
Solano, N., 173
Soloff, P., 144, 272
Solórzano, D. G., 184, 306, 307
Solórzano, R. W., 184
Soma, T., 111
Sorensen, S. B., 153, 154, 155
Sorenson, S., 163, 165
Soto, E., 237
Stalvey, L. M., 88
Starrett, R. A., 169
Steele, C. M., 84
Steele, J. B., 298, 299
Stern, M. P., 262
Stratton, T. L., 154
Straus, M. A., 153
Stuewig, J., 188, 190
Suarez, L., 258, 259, 260, 261, 262
Suarez, Z. E., 308
Sue, D., 70, 71, 83, 87, 88
330 AUTHOR INDEX

Sue, D. R., 71
Sue, D. W., 70, 71, 83, 87, 88
Sue, S., 225, 239
Surratt, H. L., 271
Swaim, R. C., 188
Swanson, J. W., 185
Szapocznik, J., 102, 103, 152, 153, 203,
204, 205
T
Tabish, K. R., 201
Takeuchi, D. T., 225, 239
Talavera, G., 259, 260, 261, 262
Tatum, B. D., 46, 86, 87, 88, 89, 90
Taub, B., 185
Telles, C. A., 153, 154, 219, 220
Telles, E. R., 53
Thandeka, 99, 100, 101, 108
Therrien, M., 147
Thomas, P., 114
Thompson, J. J., 286
Thompson, L. W., 173
Thorfinnson, T., 154
Tienda, M., 20, 27, 51, 54, 55, 56
Timbers, D. M., 128, 219, 220
Tinsley, B. J., 144
Tobler, N. S., 200
Todd, A. M., 169
Torquati, J., 188, 189, 190
Torres, R. D., 52, 54
Torres-Matrullo, C., 232, 237
Tracy, S. K., 190
Tran, T. V., 167
Trapido, E., 260, 262
Trejo, L., 173
Treviño, F. M., 227, 249, 250
U
Ulbrich, P. M., 187
Ullman, S., 164
Upchurch, D. M., 153
Ureta Carrillo, L. E., 272
V
Valdes Dwyer, E., 166, 233, 239
Valdez, D., 191, 192, 205, 206, 207
Valenzuela, M., 255, 257
Valle, R., 144, 230
Van Doren, C., 16
VanOss Marin, B., 194, 195
Vasquez, C. I., 170
Vazquez, I. M., 254, 256
Vazsonyi, A. T., 188, 189, 190
Vega, W., 141, 144, 183, 186, 220, 221,
222, 223, 227, 230, 245, 246, 271,
278
Velasquez, R. J., 228
Vera, M., 218
Viadro, C. I., 272
Vidal de Haymes, M., 303
Vigil, J. D., 190, 192, 201, 296, 297
Villa, V. M., 173
Villalobos, G., 158
Villarreal, R., 259, 260, 261, 262
Villegas, D., 110, 111
Vlach, N., 35
W
Wakefield, J. C., xv, 121
Walker, T., 205
Walters, G., 169
Warda, M., 145
Warda, U. S., 274, 275
Warheit, J. G., 186
Warner, B. S., 195
Warren, C. W., 194
Weatherby, N. L., 271
Weinbaum, Z., 154
Weinberg, W. A., 185
Weiss, S. J., 145
Weist, M. D., 195
Wells, K. B., 226
West, C., 75
White, J., 228
Whitman, S., 264
Author Index 331

Williams, J. E., 164
Williams, L. F., 167
Wilson, P., 145
Winkvist, A., 160
Winn, N. N., 113
Wintersteen, R., 134
Wisniewski, N., 163
Wohl, J., 239
Wood, P. S., 237
Worby, P., 275, 277
Wylie, R. C., 8, 70 Y
Yablonsky, L., 190
Yamamoto, J., 233
Ybarra, L., 149
Yosso, T. J., 306, 307
Yun, J. T., 20 Z
Zambrana, R. E., 245, 246, 247,
249
Zambrana, M. M., 162
Zane, N. W., 225, 239
Zayas, L. H., 183
Zhao, S., 220
Zhou, M., 53
Zimmerman, R. S., 186
Zimmerman, W., 53
Zsembik, B. A., 168, 169
Zweigenhaft, R. L., 45, 53, 112
332 AUTHOR
INDEX

A
Abuse, elder, 170–171
Acceptability, service, 129
Access, service, 128–130, 145–147
Accidents, 246
Accountability, service, 129, 135–136
Acculturation, 101–102
of Central Americans, 33–36
concept of, 4–11
of Cuban Americans, 27–33, 215
defined, 4–5
and depression, 218
gap, 152, 203
and gender, 102–103
and intimate partner violence,
153–154
and maternal-infant health, 248
and mental health, 219, 220, 221
of Mexican Americans, 11–21
patterns of, 3–38
of Puerto Ricans, 21–27, 215
and risky sexual behavior, 194
as three-phase process, 5
versus assimilation, 5, 101–102
Acculturative stress, 7–11, 149,
215–216
and depression and suicide, 186
and familismo, 223
and social welfare, 10–11
Achieving Latinos through Academic
Success (ALAS), 199
Activity schedules, 235–236
Adaptation to United States, 5–7, 135
and Central Americans, 35–36
and Cuban Americans, 33
and Mexican Americans, 6–7, 20
and Puerto Ricans, 26–27
Adolescents. See also Youth
and depression, 114–115
and pregnancy, 193–194
Affiliation, 143
Affirmative action, 47, 86–87
Agoraphobia, 235
Agricultural Research Act, 303
AIDS, 194. See also HIV/AIDS
Alamo, The (1960, 2004), 13–15
ALAS (Achieving Latinos through
Academic Success), 199
Alcohol, 258. See also Substance abuse
and Cuban Americans, 219
group therapy for women, 232
and intimate partner violence,
156–157
and Mexican Americans, 219
and Puerto Ricans, 219
use among Latinas, 189–190
use among Latino youths, 187–190
Alianza Dominicana, 197–198
Alternative community delivery
systems, 229–230
Alzheimer’s Disease, 171–174
Assault, sexual, 162–166
model agency, 165–166
service utilization and needs, 165
Assertiveness training, 236–239
Assessment, 147–151
skills, 125, 126
in social and cultural contexts, 130–133
Assimilation, 5, 72, 101–102
Asylum, political, 34
Availability, service, 129
Awareness:
cultural, 79–81
integrative, 76–77
White, 89–90
333
Subject Index

B
Bay of Pigs, 29
Behavior, problem, 183
Bicultural Effectiveness Training, 203,
204
Biculturation, 237
Bilingual education, 57–59, 184,
304–306
Bilingual Education Act, 304
Biopsychosocial perspective, 122,
130–131
Black Latinos, 114–115
Border, U.S.-Mexico, 303–304
Bracero Program, 18
Breast cancer, 260–263
Brown Berets, 75
Buena Alimentación, Buena Salud,
254–255
C
California, 57, 106–107, 289–290
California Substance Use Survey,
188
Cancer, 246, 258–263. See also specific
cancer
Caregiver burden, 171–174
Case management, 134
Castro, Fidel, 28–29
Catholic Church, 144–145, 235,
311–312
Center for Epidemiologic Studies
Depression (CES-D) scale, 217
Central Americans:
acculturation, 33–36, 215
adaptation, 35–36
community-based intervention
strategies for youth,
196–197
conflict, 34–35
contact, 34
and mental health, 223–224
problem themes, 150
Cervical cancer, 260–263
Chavez, Cesar, 19
Chicanos, 19–20
cultural awareness and ethnic
loyalty, 79–81
defined, 12
ethnicity, 79–82
and gangs, 190, 191
group therapy for adolescents, 206
jobs for youths, 202
and school failure, 184, 199–200
substance use among youths,
185–186, 187
youth, 181
Child mental health, 145
Child rearing, 143
Church involvement, 261
Círculos de salud, 277
Citizenship, 291
Client expectations, 133–134
Cognitive-Behavioral Depression
Clinic, 232–234
Cognitive-behavioral therapy (CBT),
166, 207, 232
Cognitive disorders, 171
Cognitive restructuring, 234–235
Cognitive structures, 83
Collaborative prevention programs,
273–274
Commitment, professional, 127
Communication, 236–237
Community-based services, 134,
296–297
disease prevention, 253
for elderly Latinos, 170
for HIV/AIDS prevention, 273–274
for intimate partner violence, 158–161
for Latino youth, 195–197
and mental health, 229–231
Community penetration, 146
Competence, cultural, 96
and approaches to physical health,
250–263
current practice, 123–127
developing, 120
new practice model for working
with Latinos, 119–138
responses to family problems, 151–153
three dimensions of, 123–127
Condoms, 111, 272, 273, 274, 276–277
334 SUBJECT INDEX

Confianza, 143
Conflict with United States, 5
and Central Americans, 34–35
and Cuban Americans, 28–33
and Mexican Americans, 12–20
and Puerto Ricans, 22–26
Conflict resolution, 201
Conformity, 72–74, 87
Congressional Hispanic Caucus
(CHC), 314, 315
Constructionism, social, 93–95
Contact with United States, 5
Central Americans, 34
Cuban Americans, 27–28
Mexican Americans, 12
Puerto Ricans, 21–22
Continuing education, 127
Contraception, 144, 193, 194–195
Contract with America, 297
Cooperation, 143
Coping strategies, 144–145
Corporate America, 53
Corporate welfare, 298–301
Critical White studies, 85
Cross-fire refugees, 33
Cross-generational alliances, 152
Cuban American National Foundation
(CANF), 314
Cuban Americans:
acculturation, 27–33, 102–103,
215
adaptation, 33
and alcohol use, 219
and bilingual education, 58–59
conflict, 28–33
contact, 27–28
and depression, 217
and education, 55
employment of, 54
as exiles, 29–30, 31–32
problem themes, 150
socioeconomic status, 3
substance abuse, 187–190
youth, 183
Cuban Missile Crisis, 30
Cuban Refugee Program, 31
Cuidando el Corazón, 253
Cultural awareness, 79–81
Cultural competence, 96
approaches to physical health, 250–263
current practice, 123–127
developing, 120
new practice model for working
with Latinos, 119–138
responses to family problems, 151–153
three dimensions of, 123–127
Cultural identity, 85–89
Culturally Tailored Intervention
(CTI) program, 200–201
Cultural sensitivity, 4, 120
Culture, 141
Culture of origin, 6, 135
Curanderismo, 227
Curandero, 227
D
Date rape, 164
Death, causes of, 246, 247
Delinquency, 183
Dementia, 171–174
Deportation, 105–107
Depression:
and acculturation, 186, 218
and adolescents, 114–115, 183, 185–187
and Central Americans, 224
and cognitive-behavioral therapy
(CBT), 166
and Cuban Americans, 217
and elderly Latinos, 169
and Mexican Americans, 217, 218
prevention of, 230–231
and Puerto Ricans, 217–218
and self-reported health, 218
treating, 232–239
and women, 232
Detroit, 158
Diabetes, 130–131, 171, 251–258
Diet, 251, 252, 254–258
Disabilities, 47
Discrimination, 26–27, 47, 53
Disease prevention, 248–250, 250–263
Disempowerment, 131
Distributive system, 42, 43
Subject Index 335

Diversity, 9
debates about, 99–100
within Latino groups, 92–117
overview, 95–96
Domestic violence. See Intimate
partner violence (IPV)
Dominican American National
Roundtable (DANR), 314
Dominican Americans, 151,
197–198
Dropouts, school, 184, 305
Drug use. See also Substance abuse
among Chicano youth, 185–186
and HIV/AIDS, 264, 265
prevention programs, 200–201
E
East Little Havana Parent Leadership
Program, 203, 205
Ecological-systems (E-S) perspective,
120–123
Ecological validity, 229
Economic development, 296–298
Ecosystemic perspective, 148–151,
152–153
Education, 54–59, 305–307
bilingual, 57–59
continuing, 127
and dropouts, 184
median years of schooling, 56
parental, 57
reform, 304–306
Elder abuse, 170–171
Elderly Latinos, 166–174
El Portal, 173–174
El Salvador, 33
Emergency Quota Act, 43–44
Employment, 54
Empowerment, 131–132, 309–312
En Acción: The National Hispanic
Leadership Initiative on Cancer
(NHLIC), 259
English, 184, 304
Enterprise Zone Act, 302
Entitlement programs, 168
Epidemiologic Catchment Areas
Study, 219–220
Espiritismo, 231–232
Essentialism, 95
Ethnic agencies, 229–230
Ethnic enclave, 54
Ethnic heritage, mixed, 112–115
Ethnic identity, 65–91
centrality, 83
conceptualizations of, 82–84
defined, 65–66
importance of, 66–67
linear/nonlinear nature of, 80–82
problems, 67–68
research on development of,
78–84
and sexual identity, 108–109
theoretical models of, 70–79
Ethnicity:
Chicano, 78–82
and class systems, 42
salience of, 83–84
and sexual orientation, 108
Ethnic loyalty, 71, 79–80
Ethnic matching, 239
Ethnic prestige, 45
Ethnic pride, 74
Ethnic stratification, 42–47
Exiles, Cuban, 29–30, 31–32
Expectations, client, 133–134
Exploitation, 17–18, 23–24
Extended family, 144
F
Familismo, 107, 109, 142, 166–167, 202,
223, 267
Family, 107, 141–179
cohesion, 186, 188–189
dysfunction and gangs, 191–192
and elderly Latinos, 169–170
extended, 144
problems resulting from breakdown
of, 186
structure, 142–145
Family-centered services, 134
336 SUBJECT INDEX

Family-focused interventions, 202–205
Family therapy, 152–153, 161–162,
203–205
Farmworkers, migrant, 18
Female burden-bearer, 173
Fertility rates, 148
Folk healers, 227–228
Fortune 1000 companies, 112
Full-service schools, 197–199
G
Gangs, 18, 190–193
and adolescents, 183
and family dysfunction, 191–192
girls, 190, 192–193
and group treatment, 206
intervention with, 201–202
and Latinas, 192–193
and violence, 192
Gay men, 107, 267–271
Gender, 51, 94, 101–104
Gender-role flexibility, 104
Gender roles, 149–151
Generalist practice, 127–128
Generation, 79–81
Genogram, 161
Gerrymandering, 293
Girl gangs, 190, 192–193
Gonzales, Elian, 314–315
Group therapy, 205–207
versus family therapy, 153
for HIV/AIDS prevention, 270–271
for mental health treatment, 231–239
Guatemala, 33
H
Hatch Act, 286
Health, 245–282
of Latino youth, 181, 183–185
obstacles to disease prevention and
health promotion, 248–250
overview, 245–248
and poverty, 167–168
and socioeconomic status, 308
Health care, 306, 308–309
Health circles, 277
Health insurance, 248–249, 308
Health policy, 308–309
Health promotion, 250–263
Healthy Families Act, 208
Healthy Families Initiative,
294–295
Heart disease, 246, 251–258
Hermanos de Luna y del Sol (HLS:
Brothers of the Moon and Sun),
269–270
Hierarchical class systems, 41–42
Hispanic American Alliance, 313
Hispanic Health and Nutrition
Examination Survey (HHANES),
217–219, 251
HIV/AIDS, 194, 246, 263–278
among MTFs, 110, 111
and homophobia, 107
and migrant workers, 271–278
prevention of, 266–267, 270–271,
273–274
and Puerto Ricans, 264–267
and women, 272–273
Homicide, 246
Homophobia, 47, 76, 107, 269
Honduras, 33
Household size, 148
Houston Communities in School,
195–196
Human capital theory, 51–54
Human services delivery systems,
145–147
Hypersegregation, 26–27
I
Identity, cultural, 85
Identity, ethnic, 65–91
conceptualizations of, 82–84
defined, 65–66
importance of, 66–67
Subject Index 337

Identity, ethnic (continued)
linear/nonlinear nature of, 80–82
problems, 67–68
research on development of, 78–84
and sexual identity, 108–109
theoretical models of, 70–79
Identity, majority, 85–89
Identity, racial:
conceptualizations of, 82–84
and majority identity, 85
theoretical models of, 70–79
Identity, role, 66
Identity, sexual, 108–109
Idioms of distress, 227
Illegal Immigration Reform and
Immigrant Responsibility Act, 303
Immersion, 74–76, 88–89
Immigration:
Cuban Americans, 29–30
and deportation, 105–107
illegal, 303–304
and mental health, 8
Mexicans, 17–18
and power, 43–44
Puerto Rican, 26–27
and welfare policy reform, 302–303
Immigration Reform and Control Act,
44
Income, 48–51, 57
Indigenous peoples, 5
Individual therapy, 207–208, 239
Inequality, 39–41
Inequality, structured, 65–91, 100
Infant health, 248
Insurance, health, 248–249, 308
Integrative awareness, 76–77
Intermarriage, 5
Interpersonal conflicts, 151
Interpersonal psychotherapy, 207
Intervention:
collaborative approaches, 272–273
community-based, 195–197
culturally and socially congruent,
228–239
family-focused, 202–205
for intimate partner violence,
158–162
school-based, 183, 195–197, 199–202
selection of, 133–135
skills, 125
Intervention field, 120–123
Intimate partner violence (IPV),
153–157
and alcohol, 156–157
family therapy for, 161–162
interventions, 158–162
model for understanding, 154–156
Intravenous drug use, 264, 265
Introspection, 76, 89
J
Jackson, Michael, 73–74
Jump into Action curriculum, 252
L
La Alianza Hispano Americano, 313
Labor, 17–18, 23–24
Labor market, 50, 52–53
Language, 304–306
Latinas:
and cancer prevention, 260–263
and gangs, 192–193
and HIV/AIDS, 263–264
and risky sexual behavior, 193–195
and sexual assault, 163, 164,
165–166
and substance abuse, 189–190
Latinegra, 114, 115
Latino National Political Survey
(LNPS), 59–61, 316
Latinos:
acculturation, 11
age, 148
Americanization of, 3–38
Black, 114–115
common problem themes, 132–133
concentration in labor market, 50
coping strategies, 144–145
culturally competent responses to
family problems, 151–153
deaths, 245–247
338 SUBJECT INDEX

diversity within groups, 92–117
ecosystemic perspective, 148–151
and education, 54–59, 304–306, 307
elderly issues, 166–174
ethnic identity, 65–91
family, 141–179
and Fortune 1000 companies, 112
gangs, 190–193
gay men, 267–271
GLBT, 107
health, 245–282
and HIV/AIDS, 263–278
income and occupation, 48–51
and intimate partner violence,
153–157
and mental health, 128–129,
215–244
and outreach efforts, 130
and policy benefit, 289–296
and political participation, 59–61,
285–286
and poverty, 147–148
power, 283–319
practice model for working with,
119–138
problem themes, 150–151
and school failure, 184
social stratification, 39–64
sociodemographic profile, 147
socioeconomic positions of, 48–54
substance abuse among youths, 187
underemployment, 54
undocumented, 105–107
and voting, 59–61, 290–292
vulnerability to labor market shifts,
52–53
youth, 181–214
La Vida, 158
League of United Latin American
Citizens (LULAC), 313
Lesbians, 108
Life chances, 112
Life Skills Training, 200–201
Linguistic matching, 239
Los Angeles, 190, 310–311
Low birth weight, 246
Loyalty, ethnic, 79–81
Lung cancer, 258
M
Machismo, 76, 154, 267, 268
Macro-level systems, 123
Majority identity, 85–89
Mammogram, 260
Marginality, 9, 304
Marginalization, 72
Marianismo, 155
Marielito Conflict, 31–32
Marin, Muñoz, 23, 24, 25
Mass media, 260, 261
Maternal-infant health, 246–248
Mediation, 201
Medicaid, 168, 249–250, 303
Melting pot philosophy, 8, 72–74
Mental disabilities, 47
Mental health, 215–244
and acculturation, 219, 220, 221
among minorities, 129
barriers to utilization of services, 129
child, 145
community-based services, 229–231
culturally and socially congruent
interventions, 228–239
cultural obstacles to services,
226–228
and group therapy, 231–239
and immigration, 8
increasing access to services,
224–228
and Latinos, 128–129, 216–224
Meritocracy, 45, 46–47
Meso-level systems, 122–123
Mexican American Legal Defense
Fund (MALDEF), 313
Mexican American Prevalence and
Services Survey, 221–223
Mexican Americans:
acculturation of, 11–21, 219–220
adaptation of, 6–7, 20
and alcohol, 219
and bilingual education, 57–58
and conflict, 12–20
and contact, 12
defined, 12
and depression, 217, 218
Subject Index 339

Mexican Americans (continued)
and education, 55
elderly, 169
full-service school, 198–199
and gangs, 190
and high school dropouts, 184
and HIV risk, 271–278
and intimate partner violence, 153–154
mental health, 185
problem themes, 150–151
relation between acculturation and
mental health, 221
and selective migration hypothesis,
220
and socioeconomic status, 3, 215
and teen pregnancy, 193
and voting, 59
women and health, 248
youth, 181, 185
Mexicans, 17–18
Mexico City, 158–160
Mexico-U.S. border, 303–304
Miami, 33, 203
Micro-level systems, 122
Midwestern Voter Registration Project
(MVRP), 314
Migrant farmworkers, 18
and condom use, 276–277
and HIV/AIDS, 263, 271–278
HIV prevention interventions, 273–278
undocumented, 291–292
Migration:
and gender, 103–104
Puerto Ricans, 26–27
and sexual orientation, 107
and stress, 224
Militancy, Puerto Rican, 24–26
Minorities:
in corporate America, 53
and mental health, 129
and self-esteem, 68–70
and service provider accountability,
135–136
Minority status, 51
Mixed racial heritage, 112–115
Modesto, California, 198–199
Molina, Gloria, 310
Morbidity and mortality, 245–248
Mothers of East Los Angeles (MELA),
310–311
MTF Transgender of Color Study, 110
Muzzle law, 23
N
National Alcohol and Family Violence
Survey, 154
National American Drug and Alcohol
Survey, 187
National Association of Latino
Elected and Appointed Officials
(NALEO), 314, 315
National Chicano Moratorium, 19
National Comorbidity Survey, 220–221
National Elder Abuse Incidence
Survey, 170
National Family Violence Resurvey, 153
National Hispanic Health and
Nutrition Examination Survey
(NHANES), 251
National Household Survey on Drug
Abuse, 187
National Latino Immigrant Survey,
291, 305
National Latino Political Survey, 305
National Longitudinal Study of
Adolescent Health, 115
National Survey of Hispanic Elderly
People, 167
Naturalization, 291
Needs, client, 133–134
Neglect, elder, 171
New Federalism, 297–298
New York City, 197
Nicaragua, 33
Nicaraguans, 186
O
Obesity, 251
Occupation, 48–51
Operation Bootstrap, 23–24
340 SUBJECT INDEX

Operation Gatekeeper, 303
“Operation Wetback,” 19
Oppression, 94–95, 95–96, 97–101,
109–110
Orden de Los Hijos de America, 313
Order of the Children of America,
313
Outreach imperative, 130
P
Panic disorder, 235
Pap smear screening, 260, 262
Paternalism, 89
Patriarchy, 104, 143, 149
Peers, 188–189
Penetration, community, 146
Personalismo, 143, 234, 270
Personal Responsibility and Work
Opportunity Act, 297, 302–303,
308–309
Pesticides, 258
Phenotype, 112
Physical disabilities, 47
Plática, 143
Policy benefit, 289–296
Political asylum, 34, 224
Political organizations, 312–316
Political participation, 283–319
Political power, 59–61, 288
Politics, grassroots, 309–312
Posttraumatic Stress Disorder (PTSD),
224
Potential practice field, 120–123
Poverty, 147–148, 215–216
and depression, 186
and elderly Latinos, 167–168
and gay men, 268
and health, 167–168, 249
and homophobia, 269
and intimate partner violence, 154
and Ronald Reagan, 297
understanding, 301–302
Power, 42, 43–44
Practice models, 127–136
Prayer, 235, 257
Pregnancy, teen, 193–194
Prestige, ethnic, 45
Pride, 68–70, 74
Privilege, 46–47, 52, 85–90, 100–101
Problem assessment, 147–151
Problem behaviors, 183
Professional commitment, 127
Proposition 54, 293, 294
Proposition 187, 106, 293
Proposition 209, 10, 293, 294
Proposition 227, 57, 293
Prostitution, 110, 272, 276
Protective factors, 183, 189–190
Proyecto Bienestar (Wellness Project),
230–231
Psychosocial adjustment, 113
Psychosocial problems, youth, 181,
183–185
Psychotherapy, interpersonal, 207
Public assistance, 249–250
Public policy, 287–289
Puerto Rican Legal Defense and
Education Fund (PRLDEF), 313
Puerto Ricans:
and acculturation, 21–27, 215
and adaptation, 26–27
and alcohol, 219
conflict, 22–26
contact, 21–22
and depression, 217–218
discrimination against, 26–27
and dropout rate, 184
and education, 55
elderly, 169
female gang members, 193
and gangs, 190
and group therapy, 231–232
and HIV/AIDS, 246, 263, 264–267
labor exploitation, 23–24
militancy and violence, 24–26
problem themes, 151
and socioeconomic status, 3, 215
substance abuse, 187
and voting, 59
women’s mental health groups,
232
youth, 181
Subject Index 341

R
Race, 83–84
mixed, 112–115
and skin color, 111–112
social stratification of, 43
Racial/cultural identity development
model (R/CID), 71–72, 77, 87–90
Racial identity:
conceptualizations of, 82–84
and majority identity, 85
theoretical models of, 70–79
Racialization, 26–27
Racial Privacy Initiative, 294
Racism, 87, 114
function of, 44–45
and gay men, 268
and homophobia, 269
institutionalized, 84
Racismo, 114
Rape. See Sexual assault
Reagan, Ronald, 297–298
Reflected appraisal, 68–69
Refugee Assistance and Education
Act, 31
Refugees, 33–35, 224
Relationship protocols, 125
Religion, 144–145, 235
Resegregation, 20–21
Resistance, 74–76, 88–89
RESPECT (Respect Encourages
Student Participation in
Empowering Communication
Techniques), 201–202
Respeto, 143
Resurrection Project, 312
Risk, 215–216
and Latino youth, 182
and substance abuse, 189–190
Role identity, 66
S
Salazar, Ruben, 19–20
Salt of the Earth (1953), 311
Salud en Acción (Health in Action),
261–262
Salud para Su Corazón, 253–254
San Francisco, 269
Santería, 227
Santero, 228
Scarface (1983), 32
School adjustment, 189, 190
School-based intervention, 183,
195–197, 199–202
School failure, 55, 183–185, 199–200,
305
Schools, full-service, 197–199
Secondary labor market, 52
Segregation, 20, 45, 58
Selective migration hypothesis, 220,
221
Self-acceptance, 74
Self-awareness, 99
Self-esteem, 68–70
Self-hate, 192
Self-help, 162
Self-rejection, 68–70, 73–74
Sensitivity, cultural, 4, 120
Service providers, 95–96, 283–319
and cultural sensitivity, 120
and the political arena, 285–286
Sex. See Gender
Sex between men, 272
Sexism, 47, 84
Sexual assault, 162–166
and cognitive-behavioral therapy
(CBT), 166
cultural differences, 163–164
model agency, 165–166
service utilization and needs, 165
Sexual behavior, risky, 183, 193–195
Sexual Experiences Survey, 163
Sexual identity, 108–109
Sexually transmitted diseases (STDs),
194, 246
Sexual orientation, 107–111
Simpatía, 143
Single-parent homes, 187
Skills, 125
Skin color, 53, 111–112
Smoking, 219, 258, 262–263
Social:
class, 40, 51
comparison, 68–69
342 SUBJECT INDEX

constructionism, 93–95
justice, 95–96, 312
oppression matrix, 97–99, 100
stratification, 39–64, 94
stress hypothesis, 216, 220
welfare, 10–11, 47, 296
work, 95–96, 121, 295–296
Social Security, 303
Sociodemographic profile, 147
Socioeconomic status (SES):
and Cuban Americans, 215
and health, 308
as indicator of social welfare, 3
and Mexican Americans, 215
and political power, 288
and Puerto Ricans, 215
and stability, 147–148
of U.S. Latinos, 48–54
vulnerability of, 296–309
Somatization, 226–227
South Americans, 223–224
Southwest Voter Registration Project
(SVRP), 314
Spanish Family Guidance Center,
203
Special education programs, 184
Specialized practice, 127–128
State Children’s Health Insurance
Program, 250
Status dimensions, 47
Stereotypes, 84–85
Stigma, 100–101
Stratification, 51–54, 54–59
Stratification, ethnic, 42–47
Stratification, social, 39–64, 94
defined, 39–41
Strengths perspective, 126, 134
Stress:
acculturative, 7–11, 149, 215–216
caregiver, 173
and Central Americans, 224
and elderly Latinos, 169
and suicide and depression, 186
Structured inequality, 65–91, 100
Substance abuse, 187–190. See also
Alcohol; Drug use
and adolescents, 183
among Latinas, 189–190
and family cohesion, 188–189
and peers, 188–189
preventing, 200–201
risk and protective factors among
Latino youth, 189–190
Suicide, 183, 185–187
Support groups, 172
Support systems, 144, 168–169
T
Task Force on Minority Mental
Health, 129
Taxes, 298–301
Teen pregnancy, 193–194
Teens. See Youth
Texas, 13–16
Theme Project, 199–200
Therapy, family, 152–153, 161–162,
203–205
Therapy, group, 153, 205–207
Therapy, individual, 207–208, 239
Thomas, Piri, 114
Tobacco use, 189
Transgender people, 109–111
Transphobia, 109–110
Transsexuals, 109
U
Underemployment, 54
Underutilization, 128–129
Undocumented Latinos, 18, 105–107,
291–292, 308–309
Unemployment, 154
U.S.-Mexico border, 303–304
V
Values, core, 142–143
Vieques, 22
Villaraigosa, Antonio, 295
Violence, 24–26, 170, 192. See also
Intimate partner violence (IPV)
Subject Index 343

Voting, 59–61, 287, 290–292
Voting Rights Act, 292–295
W
Washington, D.C., 196–197
Washington Heights, 197
Wealth, 41
Weight loss, 253
Welfare:
corporate, 298–301
reform, 53, 302–303
Western Hemisphere Act, 44
White conformity, 87
White dissonance, 88
White identity, 87–90
White immersion, 88–89
White integrative awareness, 89–90
White introspection, 89
White liberal syndrome, 88–89
White privilege, 46–47
White resistance, 88–89
Women:
and communication, 237
and group therapy, 232
and HIV/AIDs risk, 272
and politics, 310–311
and therapy, 235–238
Workers, undocumented, 18, 44
Y
Young Lords, 75
Youth, 181–214. See also Adolescents
addressing the problems affecting,
195–199
involvement in the political process,
291
and mixed racial heritage, 113
psychosocial and health problems
of, 183–195
risk antecedents, markers and
behaviors, 182
Youth Risk Behavior Surveillance
Study, 187
Z
Zoot Suit Riots, 18–19
344 SUBJECT INDEX

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