Cultural Patterns and Death in the US - PDF

A Happy Funeral (LO: 5-1) The Happy Funeral is a book for young readers The book describes the funeral of Grandfather, who is Chinese American, through the perspectives of his two young granddaughters The traditional funeral rites are described, and the tone of...

A Happy Funeral (LO: 5-1) The Happy Funeral is a book for young readers The book describes the funeral of Grandfather, who is Chinese American, through the perspectives of his two young granddaughters The traditional funeral rites are described, and the tone of the funeral is somber but positive Laura’s realization at the end of the story is that, while she is sad, the funeral was a happy one because Grandfather was ready for his death, left a good legacy, and lived a full life The Significance of Studying Cultural Patterns (LO: 5-1) Unique beliefs and practices, grounded in specific social and historical contexts, coexist among the many subgroups within the larger society Awareness will increase the effectiveness in understanding and working with dying persons and bereaved families when one is committed to culturally conscientious practice To not do so fosters ethnocentrism The following slides offer a series of snapshots of attitudes and practices within four groups in the United States Hispanic Americans, Black Americans, Asian and Other Pacific Island Americans, and American Indians and Alaska Natives Hispanic Americans (LO: 5-2–5-6) Census estimates of the resident population of the 50 United States Largest minority group in the United States 18.2% of the total population in 2022 More than doubled since 1990 census Residents of U.S. territories are not included in census estimates The Hispanic portion of the American population has clearly been growing lately High immigration and high birth rates contribute toward increases Hispanic-American encounters with death, dying, and bereavement 9.1% of all deaths in the United States in 2021 Low age-adjusted death rates of 7.2 per 1,000 in 2021 13.2% of all deaths in the U.S. in 2021 Death rates of 10.8 per 1,000 in 2021  Hispanic Americans as a group have relatively high age- adjusted death rates for cancer, diseases of the heart, diabetes mellitus, and dementia-related causes Obesity, poor access to health services, and lack of health insurance have placed Hispanic Americans at a disadvantage Higher rates of homicide for young Hispanic- American males Hispanic-American attitudes toward death and death-related practices Attitudes toward death Importance of family The role of religion Relationship between life and death Fatalism and anticipatory grief Death-related practices Care of the dying (including hospice and end-of-life care) Presence at death Mourning practices After-death rituals Ongoing connections and presence of the deceased Religion and practices Day of the Dead Black-American Encounters with Death, Dying, and Bereavement (LO: 5-2–5-6) Second-largest minority group in the United States 13.2% of the total population in 2021 Death rates of 10.8 per 1,000, higher than those for the U.S. population as a whole Poverty, inadequate access to health care, and higher incidences of life-threatening behavior (homicide rates) have direct implications Cancer rates are 33% higher than for White Americans There is an urgent need to address the shared structural factors driving these widespread disparities Black-American attitudes toward death Importance of family  Strong emphasis on family support in providing end- of-life care within the home Suspicion of the medical community Believe they receive less health care than White Americans Believe they will not receive all of the appropriate health care they need if they write a living will Medical apartheid: Tuskegee syphilis study Death-related practices among Black Americans More resistance to advance directives and termination of life support More hospitalizations and intensive treatments in the 6 months immediately preceding death than for White Americans Less palliative/hospice services and organ donation Culturally conscientious care: more efforts are being made toward understanding culturally appropriate end-of-life care Coping with violent and non-violent deaths Mourning practices Funeral directors held in high regard The importance of storytelling Asian and Other Pacific Island Americans (AOPIA) (LO: 5-2–5-6) Individuals who trace their origins back to various countries in Asia or to the Pacific Islands Third-largest racial/ethnic minority group among residents of the United States at 6.4% of the total population of the U.S. in 2022 Largest of these communities are Chinese Americans, followed by Filipino Americans, Asian Indian Americans, Vietnamese Americans, and Korean Americans AOPIA encounters with death, dying, and bereavement 2.7% of all deaths in the United States in 2021 Leading causes of death: 1. cancer and 2. heart diseases (opposite of all other subgroups) Noticeably low homicide rates Asian-American men and women 65 years of age and older consistently have lower mortality rates than the comparable White-American population AOPIA attitudes toward death  More attention is needed on death-related attitudes as the population ages Communication issues: quite restrained in communicating what they are feeling Decision making: usually the oldest male or at least an older member of the family is expected to make any decisions Physician-assisted suicide Disapproved of by Hawaiian and Filipino-American groups Approved of by large numbers in Chinese- and Japanese-American groups Attitudes toward funerals AOPIA Death-Related Practices End-of-life care: there is more that is needed to be known Mourning practices: conservative Blending Western and non-Western elements in funeral rituals: adapting to legal boundaries Components in one description of a Chinese-American funeral Family visits mortuary together to present offerings to the deceased At the funeral proper, they pay last respects followed by a procession where spirit money is thrown from the hearse Flowers are placed on the coffin at the burial site, spirit money is burned, and a longevity banquet follows the ceremony Gravesite visits are frequent to maintain interaction with the deceased American Indians and Alaska Natives (AIAN) (LO: 5-2–5-6) There are hundreds of American-Indian groups in the United States and Canada Each American-Indian group has its own set of patterns of death- related encounters, attitudes, and practices 1.3% of the total population of the U.S. in 2022 Native American peoples’ health is impacted by structural legacies of settler colonialism AIAN encounters with death, dying, and bereavement  0.8% of all deaths in United States in 2021; estimated death rate of 7.9 per 1,000 Largest decline by the impact of COVID-19 on average life expectancy 4.6 years to 67.1 Higher homicide and suicide rates are subject to competing reports Leading causes of death are diseases of the heart, cancer, chronic liver disease (alcohol-related cirrhosis), and diabetes mellitus Longstanding inequalities in wealth High vehicular death rates Long distance travel Poverty and alcoholism AIAN Attitudes toward Death Role of nature and cycles of life Relationship between life and death A tendency to view life and death not in a linear but in a circular or interwoven fashion Communication patterns Navajo: talking about dying and death may cause it to happen Creek: value talking about, laughing, and sharing happy memories of the deceased Survivor actions and the post-death journey Navajo: what survivors do after the death of the person can affect the deceased individual’s journey into the next world AIAN death-related practices Challenges in providing end-of-life care: more needs to be known Caring for the dying: people from remote areas often are removed from their home communities Palliative care: cultural differences exist between medical caregivers and AIAN patients Mourning practices: grief or feelings of sorrow are expected but should be followed by positive adjustment and should not be prolonged  Post-death rituals: many AIAN groups have distinctive bereavement ritual