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Arab american culture and health care

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Arab-American Culture and Health Care. Najeh M Ahmad, MD. This chapter is intended to be a brief resource for health care professionals who are working with the Arab American community.

It Arab american culture and health care help practitioners in providing culturally appropriate health care by addressing some of the unique characteristics of the Arab-American culture and the implications of these characteristics on health care access and delivery; it is not in any way inclusive The term Arab is often associated with the region extending from the Atlantic coast of Northern Africa to the Arabian Gulf in which most people who live in that area call themselves Arabs.

This classification is based largely on a common language Arabic and a shared sense of geographic, historical, and cultural identity. The term Arab is not based on race; it includes peoples with widely varied physical features. The total population of the Arab world is approximately million in 22 Arab american culture and health care 2. Palestinians are presently either living under Israeli rule, autonomy of partial Palestinian Authority in the West Bank and Gazaor dispersed as refugees throughout the world.

Despite the national boundaries dividing the Arabs into nation states in the post-colonial period, Arabs generally view themselves as a unified entity Arab countries are diverse with respect to religious beliefs. They include Christians, Jews, and Muslims. The large majority of Arabs are Muslim 92 percenthowever, in total Arabs comprise only about 17 percent of the Islamic population worldwide.

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The religion of Islam is closely associated with Arab identity because of the origin of Islam in the Arab american culture and health care Peninsula and the fact that the language of Arabic is the sacred language of the Holy Qur'an Ethnic minority groups live in many Arab countries.

Differences within Arab culture also exist between people living in urban and those in rural areas, and among countries. These varied backgrounds must be kept in mind when one tries to apply the cultural norms described in the following paragraphs.

No practice is universal, and behaviors and attitudes, while they may follow certain trends or have a common influence, may vary greatly Map of the Arab countries. There are an estimated 2 to 3 million Arab Americans living in United States 1 6including individuals who are ethnically Arab or have emigrated from one of the approximately 22 countries that compose the contemporary Arab world 1.

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Arab ancestry, from census The exact number of Arab Americans is not known, because often they are reluctant to identify themselves as being of Arabic descent out of a general fear of authority or out of concern about possible negative social reactions 1.

There are also problems with the ways Arab immigrants to the United States have been classified. For example, before Arab immigrants were classified as Turks; later they were classified as Syrian, Asian, or African; and Palestinians who have emigrated since have been classified as nationals of the country from which they Arab american culture and health care, including Israel 5.

Approximately two thirds of Arab Americans were born in the United States 1.

Arab Americans tend to have more education than other U. Because of their tremendous diversity, one way of classifying Arab Americans has been with regard to the period of, and reason for, their emigration to the United States.

There have been three major waves of Arab immigration to the United Stateseach with distinct demographic characteristics and adjustment experiences.

These immigrants were mainly Christian or Muslim minorities, mostly merchants and farmers, and emigrated primarily for economic reasons 6.

These immigrants settled mainly in urban areas in the Northeast, including ManhattanBrooklyn, and Bostonand industrialized cities in the Midwest. These immigrants tended to blend in with the general population without many difficulties 1. The second wave of Arab immigrants began coming to the United States in following the creation of Israel and included many professionals and university students who remained in the United States after their education.

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This wave consisted of many more Muslims, including Palestinian refugees displaced from their land after the creation of Israel in 1. By the s, the Arab Arab american culture and health care was breaking free of European colonial rule and experiencing a surge of Arab consciousness, thus immigrants in the second wave were able to retain more of an Arab identity once they arrived in the United States 1 5.

These immigrants also settled in urban areas in the Northeast, as well as in Midwestern industrial cities, including Chicago and Cleveland in Ohio and Dearborn and Detroit in Michigan.

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This wave is still occurring and is expected to continue for some time. These immigrants often come to the United States to escape war or political instability or in search of economic opportunities 1and they have settled in a broader geographic pattern across the United Statesincluding the West Coast.

Today, the largest Arab American community in the United States is in Detroit, which has an Arab American population of more than 80, 1.

These new immigrants tend to be with a high education. Experiencing a more negative reception in the United States than earlier immigrants, members of the third wave have assimilated into mainstream society less and been active in creating Muslim schools and charities and providing Arab-language classes 1.

More than two-thirds of Arab Americans are employed. Of those, 73 percent hold managerial, professional, technical, or service positions. Seventy-two percent work in private sector, and 12 percent work in the public sector.

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Arab Americans have a higher median income than the average American family. About 11 percent of Arab Americans live in poverty, a number slightly higher Arab american culture and health care the overall population. Arab Americans are one of the most diverse ethnic groups in the United States in their cultural and linguistic backgrounds, political and religious beliefs, family structures and values, and acculturation to Western society 1.

Originating from many different countries with tremendous regional and national differences in language, politics, religion, and culture 1in many ways Arab Americans are only a loosely connected ethnic group. Because of this, there are a number of important national differences among Arab Americans that must be considered. Cultural communalities which have an impact on health care delivery may include 10 That also applies when interpreting services are needed.

Doctors may need to explain the nurse's role to the patient. They rely on their families, other relatives and close friends for support and help.

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For example you might have a diabetic Muslim patient refusing to take insulin Arab american culture and health care hospital pre prepared meals that contain Pork or pigs products.

This is changing rapidly with women getting their rights in many Arab countries. The ill are supposed to be exempt from fasting, but among people who are fasting, oral medication and IV solutions are prohibited. Muscular injections are permitted. Women are exempt from fasting during menstruation and 40 days post partum.

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Despite their illness the Muslim patient may try to fast during Ramadan. Muslims consider the left hand unclean since it is use to cleanse oneself after going to the toilet.

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A major stressor for Arab Americans is stereotyping of the Arab people, which has been exacerbated by recent world events. Honor sharaf is an important social aspect of the family. Under sharafthe actions of an individual can bring shame to the entire family.

Thus, an individual might choose to ignore a potential health concern such as drug addiction, mental illness, venereal disease, or a pregnancy out of fear that the family would consider the condition to be shameful. Health care professionals must have high sensitivity to these issues 10 This is especially true with recent immigrants: Many Arab countries provide free universal Arab american culture and health care care and private health care at costs much below those in the United States.

Therefore, new immigrants generally do not understand the complicated US healthcare system characterized by third-party insurance and managed care. Also, these new immigrants may not take advantage of the free or low-cost services offered by federally supported community health programs such as Medicare and Medicaid, because the programs may be unfamiliar with their language and culture.

They may stop taking the medicines once their symptoms improve, and may not return for a follow-up visit. It is clinically advisable to actively follow up with these patients to assure adherence to treatment regimens.

Understanding the culture and language of these patients will certainly increase adherence to medical advice.


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