Today I will discuss another cultural belief: fatalismo. Fatalismo is the belief that one does not have control over his or her future but instead it is left to fate or God. It is the belief that fate cannot be changed and that life events are beyond one´s control. In recent years, there have been many studies conducted to examine the relationship between fatalismo and health behavior such as cancer screening, healthy diet and attitudes towards receiving information about their health status. Though much anecdotal evidence exists showing the negative impact of fatalismo on health behaviors, the studies have turned up inconclusive. This could be due to a variety of reasons (inadequate measures, unreliable scales, etc.), but it does give a warning against the over-application of this belief in the doctor-patient context. However, given its presence and possible impact on health, it is a topic that should be covered in Spanish for healthcare professionals courses. In this post, I will discuss what fatalismo is and, next week, how it can impact health and how we can encourage medical professionals to reflect on ways to connect with a patient who holds this belief.
Fatalismo has its roots in religious beliefs as well as possibly a lower socioeconomic status and negative past experiences. In terms of religious beliefs and fatalismo, it is often difficult to draw a clear line between the two, marking what characteristics belong to which belief. Though sickness and disease is not commonly viewed as a punishment from God, many do believe that it is something natural that occurs in nature and that only God can provide the cure. As Villagran, Collins and Garcia (:216) state regarding the Latino religious fatalistic outlook: “This approach means that control of cancer [or any other sickness] lies with a benevolent God who has the power to alleviate pain and suffering, and ultimately heal cancer patients.” The resulting behavior is an avoidance of information regarding their health status (when seriously ill) and, at times, a passivity towards preventative care or even medically-based treatments. At other times, fatalismo based on religious beliefs does not necessarily lead a patient to inaction but rather the opposite, acting in the hope that God will bless that action. This idea is reflected in certain sayings such as: ayúdate y Dios te ayudará and a quien madruga Dios le ayuda. However, not everyone takes this proactive stance and are, at times, more likely to fall back on the first reaction presented: que será será and si Dios lo quiera.
Nonetheless, it should not be assumed that fatalismo always goes along with religious beliefs. There may also be a connection between lower socioeconomic status and negative past experiences and a fatalistic outlook. Those of low socioeconomic status have less of an ability to effect change in their life. Additionally, many cannot afford the same number of screening tests or treatments as those from a higher socioeconomic status. Therefore, other sources consider the resorting to fatalismo as a coping mechanism for things that they feel like they cannot control. This plays out in a similar way with negative past experiences. In this case, the patient has seen senseless violence, poverty, inequality or even had a bad experience with a doctor which leads them to believe that we are all a product of our inevitable fate (again, possibly as a coping mechanism). Possibly for this reason, fatalismo can also be found, at times, among the African American and Asian populations in the United States.
In general, fatalismo has been found most often among immigrant Latinos from a lower socioeconomic status. However, it should be kept in mind that most studies show that, in comparison to popular belief (see news articles such as this one by Women´s Health), relatively few Latinos hold to fatalismo to the extent in which it affects their health status (for example, see Abraído-Lanza et al.). Many patients, despite holding to fatalismo in theory, are still willing to make healthy changes in their behaviors.
However, due to the impact fatalismo can have on health when it is present and when it does impede change, it is an important concept to present in Spanish for medical professionals courses. Next week, I will present some ways that fatalismo can effect the patient´s health and health behavior as well as some tips for introducing the topic in class.
Note: The image for the week is of the Greek gods of fate to express an idea not because Latinos believe in these gods. Most latino fatalismo comes from the Catholic faith.
Abraído-Lanza, Ana; Anahí Viladrich, Karen Flórez, Amarilis Céspedes, Alejandra Aquirre & Ana Alicia de La Cruz (2007). “Commentary: Fatalismo Reconsidered: A Cautionary Note for Health-Related Research and Practice with Latino Populations”. Ethn Dis 17(1): 153-158. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617551/ [9/13/2013]
Boyles, Salynn (2009). “Asocian el fatalismo adolescente con comportamientos de alto riesgo”. WebMD en español. URL: http://www.webmd.com/news/20090706/teen-fatalism-linked-to-risky-behavior [9/13/2013]
Braselton, Karen (2007). “Intercultural Encounters between United States Health Care Providers and Hispanic Immigrant Health Care Seekers: A Critical Ethnography.” Doctoral Dissertation. Southern Illinois University, Carbondale. URL: http://books.google.es/books?id=V8IrJNsGtTAC&printsec=frontcover#v=onepage&q&f=false [9/13/2013]
Carteret, Marcia (2011): “Cultural Values of Latino Patients and Families.” Dimensions of culture. URL: http://www.dimensionsofculture.com/2011/03/cultural-values-of-latino-patients-and-families/ [9/13/2013]
Edberg, Mark (2013). Health, culture and diversity. Jones and Bartlett Learning: Burlington, MA
Esparza Del Villar, Óscar Armando; Juan Quiñones Soto & Irene Concepción Carrillo Saucedo (2013). Propiedades psicométricas de la escala multidimensional de fatalismo y su relación con comportamientos de salud. Universidad de Ciudad de Juárez. URL: http://www.uacj.mx/difusion/publicaciones/Documents/Reportes/ICSA/Propiedades%20psicometricas%20RTI-SF-27.pdf
Hovey, Joseph & Lori Morales (2006). “Religious / Spiritual Beliefs: Fatalismo”. Yo Jackson (dir) Encyclopedia of Multicultural Psychology.
Loach, Barbara (2010). “Las Creencias”. Spanish for Professionals, Cedarville. URL: http://ctl.cedarville.edu/span/professionals/content/u3-Conocimientos.pdf [9/13/2013]
Villagran, M.; D. Collins & S. Garcia (2008). “Latina communication and cancer”. Emerging perspectives in health communication: Meaning, Culture and Power. Heather Zoller and Mohan Dutta (ed.). Routledge: New York.