Cultural Differences and Death
Culture is a unified set of values, ideas, beliefs, and standards of
behavior shared by a group of people; the way a person accepts,
and understands experiences over his/her life. The US is a
particularly rich society made up of many cultures over its entire
history. So learning about other cultural systems can enable us to
better appreciate or shift our own patterns as needed.
Why is it important to study and understand differences in culture
around death? WE stereotype around our own cultural practices
and assume that others treat death and dying like we do. Better we
understand the different cultural sensitivities so we can better reach
out and minister to those in need at such a difficult time.
Hispanic Americans- the largest minority group in the US- 41.3
million people- 14% of the total population. This is not a
homogeneous group, however, since these people come from
Cuba, Puerto Rico, Central America and other Spanish-speaking
countries. Those who have been here for generations have also
intermarried with other groups, leading to Tiger Woods calling
himself: Caublinasian- Caucasian, black, Asian and Indian. Most
in this country have come from Mexico.
Death rate in Hispanic people in US is lower than
Caucasians- but this may be due to self-selection- only the very
hardiest choose to come to the US. They are also a young
population, with a higher birth rate than other groups. The infant
mortality rate is also better than other groups. While their death
rates to heart disease and cancer are lower than other groups, their
deaths due to homicide are significantly higher, particularly for
young males.
Attitudes toward death:
Family is especially important to this group- tightly
knit with a value in taking care of elders at home.
Religion is also very influential in Latino homes and
most are Roman Catholic, so Catholic rituals play a big role in
death.
Traditional rituals and beliefs have to do with the
ongoing relationship between life and death- death is a
complement to life, so the idea of writing living wills or DNRs is
very confusing or negative in impact.
Fatalism/ anticipatory grief occur when a member of
the family faces a terminal illness. There is an acceptance of death
that allow for an ease of intensity in bereavement.
Death-related practices
Care of the dying- caregivers are usually female and they
tend not to ask for help with stress-relief or use nursing homes.
Presence at death- family try to be with the dying person to
work out any unresolved issues and if possible keep the person at
home.
Grieving practices- open expressions of grief for women,
stoic machismo for men
After-death rituals- open caskets, requiem mass in church,
procession to burial site
Religious roots- Catholic novena at home including a 9-day
period after the funeral in which the rosary is said in the deceased’s
name.
Day of the Dead- community celebration in which people
visit the cemetery, offer food to the spirits of the dead, family put
flowers on the graves.
Variations in mourning- some people experience dreams or
visitations from the recently passed family member. Depending on
how comfortable the person is with the visions, it can be
comforting to know the person is still present and interested in
communication with the living.
African-Americans share a common history in how their people
came to this country originally in slavery. Enslavement, treatment
as objects, and transport to the Americas left a psychic wound in
this group of people that they still struggle with in many ways.
They represent the second largest minority group in the US- 13%.
Death rates are higher for African-American people than for the
US population as a whole & for all subgroups. This is true even
when adjusted for SES. They are more likely to be in poverty,
which impacts mortality.
Life expectancy- A child born in 2004 is likely to live 5 years
longer if he is Caucasian than if he is African-American (73 years
vs. 78 years.) In 1990 it was found that African American men
living in Harlem were less likely to reach age 65 than men living in
Bangladesh, one of the poorest countries in the world.
Causes of death- even though African Americans make up 13% of
the population, the numbers of deaths to homicide overall were
almost equal between Caucasian and African American in the US
(8100 compared to 8600.) African American males compared to
Caucasian males death rate to homicide is 37.1 compared to 5.3
per 100,000. Homicide is the leading cause of death for African
American males from 15 – 24. While suicide rates are lower than
for Caucasians, that number is rising (9.0 compared to 12.3 per
100,000 deaths.)
Infant mortality- 2.4 times higher among African Americans in
2004- 13.8 compared to 5.7 per 100,000 live births. The disparity
is actually increasing. Maternal death rate is also significantly
higher: 34.7 compared to 9.3 per 100,000. And while breast cancer
deaths dropped for Caucasians from 1989 to 1992, it increased for
African American women. Correlative data reveals higher levels of
illegitimacy, blue collar families, inadequate prenatal care, low
birth rate which all together put these women and their pregnancies
at risk. This disparity of death rate continues regardless of
mother’s education- even increasing with higher levels of
education for the mother.
AIDS – among the 10 leading causes of death in African
Americans, whereas in the whole population, it is only 20th leading
cause of death. It is leading cause of death for A-A females 25 – 34
and second leading cause of death for A-A males 35- 44.
African American Attitudes toward DeathImportance of family- they try to care for their dying
relative at home if possible because there is a certain resistance to
putting a relative in a nursing home. The family is a powerful
support system for survivors.
Suspicion of the medical community- they believe they
receive poorer medical care than others do, and they fear if they
wrote a living will they would even receive poorer care. This is the
legacy of the Tuskegee syphilis experiment, where poor African
American men with syphilis were not treated during the study so
doctors could watch the progress of the disease. It was only halted
when the study got widespread publicity in 1972.
Advance directives and organ donation are much less
common in this group, due to suspicion of medical practices.
Mourning practices- the funeral is seen as a moment to
recognize the deceased person’s ability to stand up to others and
the man’s masculinity- this is measured by how many people come
to the funeral and what sort of casket is provided.
Storytelling- oral traditions from Africa hold that grief is
managed by telling the stories of the person and the survivor’s
bereavement experience.
Asian and Pacific Island Americans- the third largest minority in
US, 4.4%.
Death rates- lower than other groups, with cancer as the
leading cause of death for Asian Americans, as opposed to heart
disease in Caucasians.
Infant mortality rates- 3.8 per 100,000 are lower than all
other groups- lowest rates for Chinese Americans and highest for
Filipino Americans. Mortality rates for elders are significantly
lower than for Caucasians.
Attitudes toward Death
Communication issues- restrained to the point of not telling
the dying person of their prognosis. Death is taboo subject.
Decision making- patriarchal with the oldest male expected
to make critical decisions for the dying person
Physician assisted suicide- Filipinos who are mostly
Catholic see euthanasia or suicide as prohibited, but pain medicine
at the end to relieve suffering was fine. Filipinos and Hawaiians
are most resistant to physician assisted suicide. Chinese Americans
and Japanese Americans approved of physician assisted suicide by
large numbers. Hawaiians who most distrust medical professionals
also have the shortest life expectancy.
Attitudes toward funerals- disagreements arise within the
community regarding the type of funeral display, based on how
long the family member has been in this country and how
traditional some members of the family are. In general funerals are
significant life rituals, since ancestors are esteemed in this group.
Mourning customs- some groups are very conservative,
believing that remarriage after a spouse’s death is inappropriate.
Funeral rituals may intersect traditions with Western practices.
They may offer food and paper money (spirit money), paper house
or paper servants at the funeral to usher the deceased into the
afterlife, much like Egyptian practices from 5000 years ago. The
gravesite is cared for as representative of an ongoing relationship
between the living and the dead.
American Indians and Native Alaskans- 1% of the population
made up of hundreds of separate tribes.
Causes of death- much more likely to be communicable
diseases, diabetes mellitus, chronic liver disease and cirrhosis,
accidents, & suicide. AS they are living longer, heart disease and
cancer are increasing as a cause of death.
Infant mortality rate- significantly higher than all groups
except African Americans. Infants are at highest risk of dying with
SIDS. Alcohol abuse leads to alcohol-related cirrhosis of the liver
in Crow Indians of 8-9 times that of Caucasians. Deaths due to
homicide among the Crow are at 2 – 8 times that of the national
average. Deaths due to car accidents are twice that of the overall
rate in the US. Most accidents involve alcohol abuse. Partly as an
influence, they live in areas where they are far from others and the
roads in their areas are often poor. These death rates reveal a social
disorganization, cultural conflicts, and subculture of violence,
poverty and substance abuse. It almost seems these people have
internalized the abuse they suffered during the take over of their
lands and way of life and are acting accordingly in a selfdestructive manner. Jung would attribute this to the collective
shadow.
Attitudes toward death- death is regarded as part of life, so
there is a stoic acceptance without anxiety. Some taboos indicate
some fear of death- taboos that lead them to take dying people to
hospitals rather than see them die in their homes. There is a belief
that the home will be polluted by the negative spirit left by the
dying person.
Communication issues- some belief that talking about death
will cause it to happen, so advance directives are not wellaccepted. Self-reliance is highly valued in this group, so there is a
certain flattening of affect when grieving, and a resistance to
sharing their feelings at this time.
Post-death journey- some Navajos believe that what
survivors do after the death can affect the person’s journey into the
next world. There is a belief that we need death in order to have
life. Death is part of the circle of life, in order to become one with
Mother Earth.
Caring for the dying- in Canada there are native interpreters
to help First Nation people when they must come into the
hospitals. Some of these practices enable people to return to their
homes to spend their final days.
Rituals include going back to the native land so as to contact
the elders. There is the belief by the Cree people in Canada that
death is commonplace and also extremely significant. There should
be emotional release with support from others for the bereaved.
One should soon return to self-reliance. Navajos post-death rituals
include the family cleansing and preparing the body for burial,
mourning, disposing of the person’s belongings, blessing the body
with corn pollen, hair tied with an eagle feather to signify returning
home. On the 4th day the family wash themselves in a cleansing
ritual. Other groups celebrate the dead person’s life with feasting,
dancing, stories and gifts.