An integrative mixed-methods analysis examined traditional beliefs as associated with beliefs about self-care during pregnancy and with alcohol abstinence among young adult women from two rural U.S.-Mexico border communities. Quantitative (measured scale) variables and qualitative thematic variables generated from open-ended responses served as within-time predictors of these health-related outcomes. A weaker belief that life is better in big cities was associated with stronger self-care beliefs during pregnancy. Also, a weaker belief that small towns offer tranquil environments was associated with total abstinence from alcohol. Regarding the Hispanic Paradox, these results suggest that a critical appreciation of cultural traditions can be protective, as this avoids stereotypical or idyllic views of urban or rural lifeways, and promotes self-protective beliefs and behaviors.Keywords family traditions; rural lifestyle; mixed methods; Hispanic paradox; alcohol use
The "Hispanic Paradox"Among women from rural communities, traditional lifeways (traditionalism) may promote certain healthy outcomes (Coe, Attakai, Papenfuss, Giuliano, Martin, & Nuvayestewa, 2004); by contrast, a loss of cultural traditions during the process of acculturative change may promote disease or disorder. Recent Hispanic health research has identified an Hispanic paradox among low-acculturated Hispanics/Latinos,1 that is characterized by unexpectedly lower rates of adverse health outcomes observed among the least acculturated Mexican immigrants relative to their more acculturated Mexican American peers. This paradox has been observed within three health-related areas: the perinatal health of Hispanic/Latina women, mortality rates from cardiovascular disease, and rates of psychiatric disorder (Vega et al., 1998).Perinatal studies of low-birth-weight infants (Balcazar, Krull, & Peterson, 2001; FuentesAfflick, Hessol, & Pérez-Stable, 1999;Gould, Madan, Qin, & Chavez, 2003)
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript to more acculturated and affluent Mexican American women. Similarly, in communitybased studies of diagnosed psychiatric disorders, low-acculturated migrant Mexican farmworkers, when compared with native-born Mexican Americans and with non-Hispanic White Americans, exhibited the lowest rates of psychiatric disorder (Alderete, Vega, Kolody, & AguilarGaxiola, 2000). Some investigators have argued that methodological flaws produce these paradoxical effects (Palloni & Morenoff, 2001;Smith & Bradshaw, 2006), whereas others have argued that observed confounds do not obviate these paradoxical effects (Morales, Mara, Kington, Valdez, & Excarce, 2002). The recent assertion by Smith and Bradshaw (2006) that the Hispanic paradox does not exist is based on a study that uses a Spanish surname as a proxy measure for Hispanic ethnicity and also defines health advantage narrowly by using mortality as their major health outcome. Unfortunately, several of these studies have not examined deeper aspects of culture, ...