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“It's important to consider culture with health because different cultures view health differently,” said Rubenstein, an allied health major and Spanish minor from Long Island, NY. For example, she said Hispanic people living outside the U.S. have a higher rate of diabetes than those in the U.S., but they don't respond to diabetes treatment the way people do in the U.S.

“The umbrella topic we’re looking at is how do cultural constructs affect Hispanic health,” said Miller. “There are so many different avenues we can go with. We started with one project that led us to another, which has now led us to another. I’m sure this next one we’re working on this academic year will lead us to another. It’s just kind of ongoing.”

This academic year the team will focus on the Tampa Bay area specifically, and the perceptions of health care workers on topics such as having to use a translator to provide care in order to better understand health care worker attitudes towards the Hispanic population. They will also look at how Hispanics view healthcare providers and how they feel when they seek medical care, like going to a doctor’s office.

Dominican Republic

In 2019 Miller and Rubenstein traveled to the Dominican Republic to collect data through surveys both in-person and online with the goal of understanding how people are thinking about these issues and if it’s changing over time.

The surveys focused on traditional social constructs of gender roles that are specific to Hispanic populations and still permeate Hispanic culture today. Machismo, one of the constructs, is the stereotypical, macho man in society. The other is Marianismo: the more traditional subservient role of women.

Their findings showed that Hispanics living in Florida had much lower levels of these social constructs, compared to those in the Dominican Republic. When it came to their health, the team utilized Cohen’s Perceived Stress Scale in their survey questions, which gave them a general perceived stress score. They found that the Florida population had significantly higher levels of stress than those in the Dominican Republic. This led them to another question: Could acculturation account for the drastic difference in health?

Acculturation and Health

This past summer, Rubenstein received the Summer Undergraduate Research Fellowship (SURF) and has been working with Miller to determine how acculturation could have impacts on the health of Hispanic populations immigrating from Latin America to the U.S.

The duo collected data through surveys sent out using Qualtrics to Hispanic communities they’ve worked with previously. They created a survey based on previous research and validated scales, with about 40 questions relating to social constructs, acculturation, and health. For example, a statement like “the bills of the house should be in the man’s name,” is one that could appear on the survey. The respondent would then use a scale ranging from “strongly disagree” to “strongly agree” to answer.

They then analyze the responses from the Florida Hispanic population to evaluate how assimilation to a new culture may be attributed to health differences that they saw between the Florida and Dominican Republic populations.

So far, their findings may point to the fact that because Hispanic populations in Florida are adjusting to U.S. culture, which typically involves more non-Hispanic traditional roles, more of the women may be working or men may be taking on more responsibilities with child care. This could account for why the Florida populations’ stress is higher than those in the Dominican Republic, though they can’t say for certain just yet.

The two started the project in late May and spent the entirety of the summer collecting responses and working on the project remotely. Due mostly to the COVID-19 pandemic, they’ve experienced some difficulties gathering enough data with online surveys.

“The population that we work with here in Florida have lower education levels and a lot of them might be undocumented as well,” said Miller. The two say they’re working on some creative solutions to try and get more responses, and have been working with contacts in Florida to get the survey out to more people.

Once they have enough data to draw accurate statistics and conclusions from, they will send out their manuscript for publication. The team is aiming for the end of the fall semester.

“Once our research is published, I hope it will add to the large body of literature that questions socially constructed norms and seeks to understand the complex differences of people cross-culturally,” said Rubenstein. “On a simplistic level, I deeply hope our research encourages people to seek to understand one another before dismissing or belittling an idea that challenges what we may have previously thought to be true.”

Rubenstein, who is pursuing a career as a medical doctor, says that her time working on this research project has reaffirmed her lifelong desire to go into medicine.

“Having the research side of things and knowing how people think, coupled with the things that we were looking at like Spanish speaking people [and] the impact that culture has on health, I think I’ll better be able to treat patients of any background because I’ll know what to look for,” said Rubenstein.

Story by Mallory Culhane '21, journalism major

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