This NIDA conference has highlighted a willingness to look at doing things differently and merging some of what is happening in the scientific community with what is happening in communities around the country. This is a significant step for community-minded individuals.
Fred García, the former deputy at the White House's Office of National Drug Control Policy, and CSAP have done a good job in keeping prevention at the forefront. I would also like to acknowledge the Community Anti-Drug Coalitions of America, on whose board I serve, its diverse group of individuals, and Jim Copple, who has put together a remarkable program and staff.
I am going to take a step back in terms of everything that has been said over this past day and a half and move from what has been a cerebral discussion by bringing a little heart into the discussion. In 1977 Seymour Sarason made the simple statement that we need to take a look at prevention, because it is much more effective than our capacity to repair. Short-sightedness bordering on blindness to build up the clinical endeavor at the expense of prevention is not what we should be looking at. We should be looking at preventing drug use in our communities.
We need to frame this discussion of prevention in terms of what is happening in our country today and take into account the diversity that exists within our communities and within our country. Between 1980 and 1990, the fastest growing ethnic groups in this country were Hispanics, who grew by 53 percent, and Asian and Pacific Islanders, who grew by about 108 percent. The United States now is the fifth largest country in the world in which Spanish is spoken, and it is estimated that by the year 2000, more than half of California's population will be Spanish-speaking. We must take conscious action in terms of efforts to enact English-only alternatives that are being presented in certain States and communities.
We all approach our work from within a particular framework, with a particular world view; when we bring that into our work, we are influencing the culture in which we are working. When we look at culture, we explain it in a "folkloric" way or in a way that is "home" or "natural." In a culture, we do not have to explain anything to anyone about our language, our food, our dress, or our dance. All different types of culture exist. For example, we have Wall Street culture and street culture, and there is a huge difference between those two. We need to be aware that culture is what we acquire and what becomes natural to each of us. It is not transmitted biologically, but environmentally. Culture plays a profound role in who we are; we are programmed in our culture. Consequently, prejudices are learned, and "cultural dissonance" then becomes a clear part of what we need to work on in solving problems within our communities.
Different ethnic groups have contributed to the Hispano-Latino culture, including African Americans. The rituals of passage, spirit of survival, spirituality, and oral tradition of this particular culture have influenced what we have become and what we see today as the Hispano-Latino culture. The indigenous, Native American culture has also influenced the Hispano-Latino culture in terms of rituals and ceremonies and "working" collectively. For example, the concepts of community and collective ownership came from indigenous peoples. A family was extended. Love of Mother Earth and Mother Nature and the different arts are symbols of the indigenous culture. The resulting Spanish culture - the dance, the spirit of adventure, the language - is important to Hispano-Latino people. With the loss of language comes a loss of culture. Language is how we express ourselves and communicate with others; it is a key part of who and what we are as a people.
In developing assessments, we must be careful to develop instruments that are linguistically sensitive, particularly if individuals are monolingual. It is important to know whether they come from Central America or South America or whether they are Mexican, for example, because there are different dialects within different languages and different meanings for different words.
There are some key concepts in working with Hispanos-Latinos, especially when working with the family. Traditionally, we have had a large, extended, independent, agrarian-based system. Elderly individuals are venerated. In other cultures, elderly persons often are not accepted or respected for the wisdom they have to give to the community. Different models have been developed in terms of community, which is the extended family beyond bloodlines. Within communities there is also the extended family that is developed by confianze, which means trusting, mutual trust, and respect. We must be aware that all these things are important in terms of how assessment instruments are applied across cultural lines.
For Hispanos-Latinos, the term "machismo" represents the concept of being the leader, provider, and protector, not the common image of being drunk all the time - or "macho." We need to take a historical look back to see how these terms developed and where they came from.
Language and acculturation have influenced changing sex roles within the family. Within Hispano-Latino families today, the female has become the focal point, the "rooted" base that has kept the family culturally grounded. Women need to be acknowledged and appreciated for what they have done within our families and households.
Spirituality is another key concept in developing instruments. Catholicism is the spirituality piece of who and what some of us are as a people. How do you incorporate spirituality into the text? Celebration is an important part of who and what we are in terms of our community traditions, including religious traditions. It is important that we look at not only the mental, physical, and emotional piece but also the spiritual piece when we are developing our instruments.
Since 1963 there has been a lack of perception of meaning and significance, purpose, and belonging among individuals in U.S. society. There has been an increase in alcohol, tobacco, and other drug abuse. There has also been increased exposure to negative role models.
Television advertisers are taking a look at how to best get the attention of youth. Advertisers and researchers have found that if we target that part of our brain where emotional experiences are stored, the responses will be long-lasting and will drive our children to want to purchase and consume a product. An excellent book by David Walsh, called Selling Out America's Children, describes what is happening in the world of electronic media and how it influences us and breaks down some of the spirituality that exists within our communities.
Indigenous healing methods include the use of folk medicine and its remedios (remedies) and yerbas (herbs) and the different ways that we work within our communities in terms of health and health promotion. Some research has indicated that if promotores, the natural leaders in our communities, are taught and then conduct assessments and initiate different programs, they are much more effective than a skilled or trained individual from outside the community because they are already trusted and known within the community.
As I mentioned earlier, a key component of the cultura or culture of the different Latino peoples throughout the United States, as with the
African-American community and the Asian and Pacific Islander community, is spirituality. As we look at a medicine wheel and at what our indigenous brothers and sisters have taught us, we see that to maintain that balance and an effective human element within our communities and within ourselves, we need to use this particular orientation when we are conducting research.
I have a few recommendations in terms of research, policy, and laws within the Hispano-Latino population. The indigenous concept of law is important to consider because it seeks out the honesty to point ourselves in the direction that is the ideal. For example, in Germany they have thousands of traffic laws because they are very precise in what they do, and they also have thousands of accidents. In Italy they have four laws and almost no accidents. Their four laws are, "Keep moving, be creative, don't kill anyone, and stay on the road." If we keep things simple, we get the effect we are looking for.
To that end, we need epidemiological research regarding the health status of the various Hispano-Latino populations. We need to look at the natural support systems within the communities and have some of the research focus on those particular elements that are considered informal in the scientific sense. We need to take a look at the family program and the evaluation that is needed to determine which factors are associated with successful outcomes for culturally diverse populations.
I want to impress upon you again the need to include the whole concept of spirituality. The lack of spirituality is moving this whole country in a way that is destructive, a way in which we see things more materialistically and individualistically. In the indigenous ways of living successfully, materialism and individualism had no place. Instead, successful living was based on answering questions such as, "How can we create a healthy community for all and how can we work with one another and save the lives of our kids?"
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