FILIPINO AMERICANS

Alex Belk
NU 542: Transcultural Nursing and Healthcare
Dr. Laura Barrow
February 24, 2023
 Flag of the Philippines

(Brittanica, 2023)
 HISTORY

• Philippine Islands were named after King Philip II of Spain.

• Spain ceded the islands to U.S. after the Spanish-American War in 1898 for $20 million.
• Japanese occupation of the islands during WWII caused major destruction.
• Philippines were granted independence from U.S. following WWII.
• After years of attempted dictatorship and unstable government, there are currently a president
and vice president of the Philippines.

(Giger & Haddad, 2021).

 ECONOMY

• The Philippines’ economy revolves around agriculture (rice, corn, and coconuts).
• Fishing is the 2nd largest industry.
• The median family income is $75,000.
• Other major industries include chemicals, food processing, textiles, pharmaceuticals, and
electronics assembly.

(Giger & Haddad, 2021).

 WORKFORCE ISSUES

• Common workforce issues in the Philippines include inadequate use of

fertilizers, lack of incentive for farmers, poor farm management, and poor
quality seeds.
• Many nurses from the Philippines move to the U.S. and send money to their
relatives.
• Most Filipino nurses are lumped into the category of “Asian nurses” and can
face discrimination.

(Giger & Haddad, 2021).

 EDUCATION

• 43% of Filipino American males have a bachelors degree, and 50% of Filipino
American females hold this degree.
• Most third-wave Filipino immigrants have the same level of education as other
Americans.
• Filipino Americans typically are well educated regarding Western medicine
practices.
• In the Philippines, many parents work multiple jobs to send their children to
school.

(Giger & Haddad, 2021).

 PUBLIC SERVICES

• Agencies devoted to land reform have been working since the early 1900’s.
• Nongovernmental organizations (NGO) work with the poor population to help
establish housing and healthcare.
• Many other countries are involved in the Philippines to help the children.
• Military service is voluntary and its members are held in high regard.

(Countries and Their Cultures, n.d.).

 CORE CULTURAL PATTERNS

Some core cultural concepts seen in Filipinos are:

• Pride- a strong sense of pride is seen in a Filipino’s close circle and village, a
sense of national pride is not as strong due to independence struggles.
• Respect- showing respect to others, especially elders, is very important.
• Fatalism- Filipinos tend to accept what is thrown at them in life and handle it
with a sense of peace.
• Fellowship- bonding together and sharing stories are important in Filipino
culture.

(Scroope, 2017).
 LANGUAGE

• Tagalog is the national language of the Philippines.

• Most Filipino Americans speak Tagalog and English, often creating their own
hybrid language, Taglish.
• Filipinos are typically soft spoken and avoid disagreements.
• First generation Filipino immigrants often do not speak English and will
remain quiet to avoid embarrassment.

(Giger & Haddad, 2021).

 USE OF TOUCH & SILENCE

• Touching is common.
• Elders are often kissed on their forehead, cheeks, or hand.
• Handshakes are not frequently used.
• Filipinos often remain silent when they disagree with what is being
said.
• Concepts of shame and saving face are very sensitive in Filipino
culture.
• Taboo topics are often avoided, even with family; sex, tuberculosis, and
socioeconomic status.

(Giger & Haddad, 2021).

 VERBAL/NONVERBAL

• Avoiding disagreements is common and most Filipinos will agree with someone
to avoid hurting their feelings.
• The use of silence is common when in group settings.
• Using little eye contact with authority figures and superiors is common.
• Nurses are seen as authority figures so it can be difficult for the Filipino patient
to open up to the nurse without developing a relationship first.

(Giger & Haddad, 2021).

 SPACE

• Filipinos prefer a limited amount of personal space.

• This is thought to be a result of overpopulated living areas and a strong
connection to family.
• Filipino patients will typically have a large amount of family members present
when hospitalized.
Philippine Village

(Philippines Village Stock

Photos, Pictures & Royalty-
Free Images - IStock, n.d.)

(Giger & Haddad, 2021).

 TIME

• Filipino Americans are both present- and past-time oriented.

• The time orientation often depends on whether an event is work related or a
social gathering.
• “Filipino time” is a term used when a social event does not start on time and
many do not become annoyed or agitated.
• Filipino Americans take business very seriously and prompt arrivals and
deadlines are important.

(Giger & Haddad, 2021).

 FAMILY ROLES

• Historically, many Filipino American families were matriarchal due to

immigration laws after WWII.
• Now only 13.6% of Filipino American families are matriarchal.
• Younger Filipino generation’s values resemble the Americans their age compared
to traditional Filipino traditions and values.
• Children are taught to never question their elders.

(Giger & Haddad, 2021).

 MARRIAGE & PREGNANCY

• Married couples represent almost 60% of Filipino American families.

• Filipino women often share the news of pregnancy with two other family
members before their husband.
• Family and social support for pregnant females is very strong.
• Pregnant women are encouraged to get enough sleep and eat well.

(Giger & Haddad, 2021).

 CHILDBEARING & CHILDREARING
PRACTICES

• Midwives are used for the baby delivery if a physician is not available.
• Fathers are typically not with the wife while she delivers but instead with
friends for support.
• Circumcision is becoming more common for male babies before leaving the
hospital.
• Children may feel lost without their mother next to them.
• Parent-adolescent communication regarding sex and safe sex practices is not
common.

(Giger & Haddad, 2021).

 RELIGION & SPIRITUALITY

• The most practiced religion among Filipinos is Roman Catholic.

• This is thought to be because of the Spanish influence by missionaries (Giger
& Haddad, 2021).
• It is the only Christian nation in Asia.
• Religious freedom is granted in the constitution (Countries and Their Cultures,
n.d.).
• Islam is the 2nd most practiced religion in the Philippines.
 POLITICAL STRUCTURE

• The Philippines constructed it’s first constitution in 1935.

• In 1972 the president declared martial law. Then in 1987 a new constitution
was drafted and has been used ever since.
• The police force is a part of the army in the Philippines.
• 50% of the Philippine’s urban population live in poverty, 80% of the rural
population live below poverty.
• Homelessness is a major problem

(Giger & Haddad, 2021).

 BODY SIZE & STRUCTURE

• Filipinos are typically shorter than their White counterparts.

• Most Filipinos have a small frame and are petite.
• Filipino women are slimmer and leaner than White women.
• Filipino babies have lower birth weights than White babies.
• Filipino’s body size and structure is similar to Thais and Vietnamese persons.

(Giger & Haddad, 2021).

 SKIN COLOR & PHYSICAL
CHARACTERISTICS

• Skin color ranges from peach brown
to brown.
• At birth, Mongolian spots are
common.
• Body hair is sparse in both males
and females.
• Eyes are almond shaped.
• Male-pattern baldness is rare among
Filipinos.
Enzymatic & Genetic Variations
common among Filipinos:
1. Glucose-6-phosphate (G-6-PD)
2. Alpha-thalassemia, or
hemoglobin H disease.
3. Cleft lip and palate

(Giger & Haddad, 2021).

 SUSCEPTIBILITY TO DISEASE

• For Filipino Americans, heart disease is the leading cause of death, second is
stroke.
• Higher rates of diabetes are seen in Filipino Americans compared to their
White counterparts.
• Filipino Americans have the highest incidence rate of prostate and thyroid
cancers among other Asian Americans.

(Giger & Haddad, 2021).

 NUTRITIONAL PREFERENCES

• Filipino Americans tend to retain many traditional or customary food habits

from the Philippines.
• Typical Filipino dishes include pancit, lupia, and adobo.
• Many Filipino Americans cook with the theory of hot and cold foods.
• The dietary habits are often related to the level of acculturation.

(Giger & Haddad, 2021).

 PSYCHOLOGICAL CHARACTERISTICS

• Filipino Americans have low depression rates due to strong coping

mechanisms.
• Religious coping, distancing, and accepting responsibility are seen more
among Asian Americans than White Americans.
• Drinking alcohol is seen in about 50% of Filipino women.
• Filipino Americans are typically mild and gentle with passive temperments.

(Giger & Haddad, 2021).

 ENVIRONMENTAL HEALTH THREATS
• Overcrowding can be an issue in some
parts of the Philippines, it is the 13 th
most populous country.
• Dietary deficiencies are common due to
lack of agricultural diversity.
• Typhoons strike normally once a year.
• Deforestation is a major concern on the
island.
(Giger & Haddad, 2021).
Barriers to care:
• Many first-wave Filipino
immigrants do not speak
English and have little
education.
• Filipino Americans tend to
avoid disagreement and will
often agree to medical
procedures without a full
understanding.
“Typhoon havoc triggers calls for urgent
climate action in Philippines”
(Aben, 2022).
 RITUALS RELATED TO DEATH & DYING

• Filipino Americans view death as a spiritual event.

• If diagnosed with a terminal illness, many will choose to die at home.
• A first year anniversary of the death event is common in Filipino culture.
• When a Filipino is diagnosed with a terminal illness, the head of the household
should be consulted on how to tell the patient.
• Most Filipinos believe in an after life.

(Giger & Haddad, 2021).

 ILLNESS & WELLNESS BEHAVIORS

• Wellness behaviors of Filipino’s have three concepts; flushing, heating, and

protecting.
• Vinegar is used in almost all home remedies.
• Many Filipino Americans are fatalistic and view illnesses as the will of God.
• Some patient’s noncompliance with medical treatment may be due to a
fatalism-oriented point of view.
• Many Filipino Americans avoid illness by eating well, sleeping, exercising, and
using herbal supplements.

(Giger & Haddad, 2021).

 FOLK MEDICINE

• The Filipino folk medicine system is based on the Malaysian culture.

• Many Filipino Americans incorporate both folk medicine and Western
medicine into their illness behaviors.
• Shamans and curers are folk medicine healers in Filipino culture.
• The theory of the four humors is believed among many Filipinos.
• Folk beliefs have been passed on from many generations due to it having a
strong cultural identity.

(Giger & Haddad, 2021).

 HEALTH CARE PROVIDERS

• Doctors and nurses are seen as authority figures to many Filipinos.

• Health care providers should be aware of the patient’s culture and try not to
offend by using eye contact, touch, or offensive language.
• Nurses should research and educate the Filipino patients about which herbal
remedies to continue and which ones to avoid.
• Many third-wave immigrants use Western medicine practices instead of folk
medicine.

(Giger & Haddad, 2021).

 QUESTIONS?

1. When caring for an elderly first-wave Filipino immigrant, what might the
nurse do to make the patient more comfortable?
2. After a new diagnosis of hypertension, what might be a reason a Filipino
patient misses several appointments?
3. A middle age Filipino American is admitted for heart problems. After many
tests it is determined he needs a CABG. He doesn’t ask any questions and
answers “yes” to the doctor and nurse’s questions. Why might he be doing
this?
 REFERENCES

Aben, E. (2022, October 3). Typhoon havoc triggers calls for urgent climate action in
Philippines [photograph]. Arab News. Retrieved February 23, 2023, from
https://www.arabnews.com/node/2174436/world.
Brittanica (2023). Flag of the Philippines [photograph]. Retrieved February 22, 2023 from
https://www.britannica.com/place/Philippines/Sports-and-recreation
Countries and Their Cultures (n.d.). The Philippines. Retrieved February 22, 2023 from
https://www.everyculture.com/No-Sa/The-Philippines.html
Giger, J. N., & Haddad, L. G. (2021). Filipino Americans. In Transcultural nursing:
Assessment and intervention (8th ed.). Elsevier.
Philippines Village Stock Photos, Pictures & Royalty-Free Images - iStock. (n.d.).
Www.istockphoto.com [photograph] Retrieved February 23, 2023, from
https://www.istockphoto.com/photos/philippines-village
Scroope, C. (2017). Filipino Culture. Cultural Atlas. https://culturalatlas.sbs.com.au/filipino-
culture/filipino-culture-core-concepts#filipino-culture-core-concepts