Having gone through a period of both the Spanish and British Colonization, Jamaica has a deep history of cultural integration. The island itself, which lies south of Cuba, consists of fourteen Parishes. The population of the island is primarily black, along with a few East Indians, Whites and Chinese in the mix. The black demography primarily comprises of the descendants of the African slaves, which were brought onto the island by British Colonizers as a form of cheap labor. However, following its independence, Jamaica has grown into a developing country with a modern outlook on life while still being deeply rooted in its ethnic roots ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"s8oXHvqS","properties":{"formattedCitation":"(Deipolyi, 2018)","plainCitation":"(Deipolyi, 2018)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/TusjCSFv","uris":["http://zotero.org/users/local/0omESN17/items/B6UYWDYN"],"uri":["http://zotero.org/users/local/0omESN17/items/B6UYWDYN"],"itemData":{"id":895,"type":"article-journal","title":"Jamaican Food and Culture Fact Sheet","author":[{"family":"Deipolyi","given":"Lauren"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Deipolyi, 2018). The Purnell Model of Cultural Competence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rchk42AS","properties":{"formattedCitation":"(Purnell, 2005)","plainCitation":"(Purnell, 2005)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/DYAz2cdu","uris":["http://zotero.org/users/local/0omESN17/items/ALI27B9C"],"uri":["http://zotero.org/users/local/0omESN17/items/ALI27B9C"],"itemData":{"id":896,"type":"article-journal","title":"The Purnell model for cultural competence","container-title":"Journal of Multicultural Nursing & Health","page":"7","volume":"11","issue":"2","author":[{"family":"Purnell","given":"Larry"}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Purnell, 2005) analyzes the primary and secondary characteristics of a culture, which are vital to its survival. It includes the values, practices, cultures, beliefs, and norms of the system with regard to the cultural heritage of an individual. Thus, this paper seeks to address a number of constructs in the Jamaican culture with regard to the Purnell Model of Competence.
Discussion
The primary purpose of this model is to ensure that a healthcare provider has a baseline to provide care to an individual belonging to a certain culture, based on their individual beliefs and cultural norms. This ensures that while standards of healthcare are maintained, the cultural norms and moral values are also complied with, especially to put the patients at ease ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"NqlOnRSC","properties":{"formattedCitation":"(Purnell, 2005)","plainCitation":"(Purnell, 2005)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/DYAz2cdu","uris":["http://zotero.org/users/local/0omESN17/items/ALI27B9C"],"uri":["http://zotero.org/users/local/0omESN17/items/ALI27B9C"],"itemData":{"id":896,"type":"article-journal","title":"The Purnell model for cultural competence","container-title":"Journal of Multicultural Nursing & Health","page":"7","volume":"11","issue":"2","author":[{"family":"Purnell","given":"Larry"}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Purnell, 2005). Thus, here are the various constructs of Jamaican culture which need to be discussed in detail.
Nutrition Construct
Jamaica is a melting pot of culture, having been colonized by two very different world powers at one point. Add in the migrational activities, a hybrid of culinary traditions was created in Jamaica as a result. They have incorporated flavors and foods from all around the world, but also incorporate the national fruits and vegetables that are indigenous to the area ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Tpcua2WV","properties":{"formattedCitation":"(Nevius, 2002)","plainCitation":"(Nevius, 2002)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/BQmQEnBc","uris":["http://zotero.org/users/local/0omESN17/items/SDPE2VDB"],"uri":["http://zotero.org/users/local/0omESN17/items/SDPE2VDB"],"itemData":{"id":897,"type":"article-journal","title":"In The Spirit—A Review of Four Books on Religion in Jamaica During the Pre to Post Emancipation Era","container-title":"Caribbean quarterly","page":"71-81","volume":"48","issue":"4","author":[{"family":"Nevius","given":"Jim"}],"issued":{"date-parts":[["2002"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nevius, 2002).
Meaning of food
Jamaica, as mentioned, is a culture that is deeply integrated into its values and traditions. Jamaicans prefer organic, homegrown foods to this day and prefer that they source their food choices from places that best serves their needs with regard to flavor and nutrition ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sUyHbivh","properties":{"formattedCitation":"(Higman, 2008)","plainCitation":"(Higman, 2008)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/aSPC8GDp","uris":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"uri":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"itemData":{"id":898,"type":"book","title":"Jamaican Food: History, Biology, Culture","publisher":"University of the West Indies Press","URL":"https://books.google.com.pk/books?id=JorfAAAAMAAJ","ISBN":"978-976-640-205-1","author":[{"family":"Higman","given":"B. W."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Higman, 2008).
Common foods
The most commonly eaten foods in the Jamaican are Ackee and Codfish. Ackee was brought into the area by slaves and eventually became one of the most consumed foods in the area. The same can be said for codfish since it is native to the area, which shows that the Jamaican people prefer native foods that are considered staple foods in the area ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"P255n7DI","properties":{"formattedCitation":"(Higman, 2008)","plainCitation":"(Higman, 2008)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/aSPC8GDp","uris":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"uri":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"itemData":{"id":898,"type":"book","title":"Jamaican Food: History, Biology, Culture","publisher":"University of the West Indies Press","URL":"https://books.google.com.pk/books?id=JorfAAAAMAAJ","ISBN":"978-976-640-205-1","author":[{"family":"Higman","given":"B. W."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Higman, 2008).
Rituals
The Jamaican people prefer to consume foods in large dishes, considering that people prefer to live in a joint family system rather than nuclear families. Many dishes in large quantities are prepared for a single meal, with the quantity being fit enough to feed the entire family ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"mdhEQ3MS","properties":{"formattedCitation":"(Higman, 2008)","plainCitation":"(Higman, 2008)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/aSPC8GDp","uris":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"uri":["http://zotero.org/users/local/0omESN17/items/5Q4BUYST"],"itemData":{"id":898,"type":"book","title":"Jamaican Food: History, Biology, Culture","publisher":"University of the West Indies Press","URL":"https://books.google.com.pk/books?id=JorfAAAAMAAJ","ISBN":"978-976-640-205-1","author":[{"family":"Higman","given":"B. W."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Higman, 2008).
Deficiencies and Limitations
Anemia and Iron deficiency are the most prevalent micronutrient deficiencies among the Jamaican population, especially among children. The recorded prevalence can be anywhere between 48% for children aged 1 to 5 years and 24% at the age of 5 to 16 years. Following children, pregnant women in the country are most afflicted with anemia, with the prevalence being as high as 21% on average. This figure varies from parish to parish. While Anaemia and Iron deficiency was considered to be a problem, other problems that are common in most countries across the planet such as Vitamin A deficiency and iodine deficiency were not considered to be a public health problem in Jamaica ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"06X88IVe","properties":{"formattedCitation":"(FAO, 2010)","plainCitation":"(FAO, 2010)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/fncIQE8f","uris":["http://zotero.org/users/local/0omESN17/items/4JUS7GQM"],"uri":["http://zotero.org/users/local/0omESN17/items/4JUS7GQM"],"itemData":{"id":899,"type":"webpage","title":"Nutrition country profiles: Jamaica summary","container-title":"Food and Health Organization","URL":"http://www.fao.org/ag/agn/nutrition/jam_en.stm","author":[{"family":"FAO","given":""}],"issued":{"date-parts":[["2010"]]},"accessed":{"date-parts":[["2019",8,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (FAO, 2010).
On the other hand, while no formal survey has been carried out with regard to the Nutritional status of various age groups within the country. However, according to the Survey of Living Conditions in Jamaica, a 9% increase has been observed among the citizens in the past decade. This has contributed to the intake of high-fat foods and in turn is responsible for the increase in weight and prevalence of obesity among the adult population in Jamaica ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"H9HsWwnD","properties":{"formattedCitation":"(FAO, 2010)","plainCitation":"(FAO, 2010)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/fncIQE8f","uris":["http://zotero.org/users/local/0omESN17/items/4JUS7GQM"],"uri":["http://zotero.org/users/local/0omESN17/items/4JUS7GQM"],"itemData":{"id":899,"type":"webpage","title":"Nutrition country profiles: Jamaica summary","container-title":"Food and Health Organization","URL":"http://www.fao.org/ag/agn/nutrition/jam_en.stm","author":[{"family":"FAO","given":""}],"issued":{"date-parts":[["2010"]]},"accessed":{"date-parts":[["2019",8,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (FAO, 2010).
Health Promotion
Initially, considering the extreme living conditions the slave population of Jamaica was subjected to, they were reliant on traditional knowledge and herbal practices in the Country. Many of these approaches and beliefs directly correlated with African religious beliefs. Most folk medicine practitioners were condemned to operate in secret and treat people discreetly for the fear of being ostracized by society. This did more harm than good since people could not rely on medicine since there was no telling if the medicine was good or bad. Add in the harsh conditions made due to slavery that lead to the development of farming communities and the practice of herbal medicine. At present, while Jamaicans still believe in old practices, they have adopted western professional medicine to treat a number of illnesses
High-Risk Behaviors Construct
In 2013, a national survey of the population aged 15 to 74 years using cluster sampling was carried out for Jamaica Healthy Lifestyle Survey. It showed that most people in Jamaica are having regular blood pressure check, along with a reduction in multiple sexual partners. There has also been a reported increase in condom use among the sexually active female population in the country. Furthermore, while the use of cocaine and marijuana smoking are the biggest health risk behaviors in the country, a reduction in their prevalence has been observed. While a number of positive lifestyle trends were observed lately, most of them still remain common among the Jamaican adults. For this purpose, comprehensive health promotion programs need to be created to address such behaviors ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CX41o1Cd","properties":{"formattedCitation":"(Figueroa, Ward, Walters, Ashley, & Wilks, 2005)","plainCitation":"(Figueroa, Ward, Walters, Ashley, & Wilks, 2005)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/UbuLWDG4","uris":["http://zotero.org/users/local/0omESN17/items/R8UGZ95M"],"uri":["http://zotero.org/users/local/0omESN17/items/R8UGZ95M"],"itemData":{"id":"egBF9z5K/UbuLWDG4","type":"article-journal","title":"High risk health behaviours among adult Jamaicans","container-title":"West Indian Medical Journal","page":"70-76","volume":"54","issue":"1","author":[{"family":"Figueroa","given":"J. Peter"},{"family":"Ward","given":"E."},{"family":"Walters","given":"C."},{"family":"Ashley","given":"D. E."},{"family":"Wilks","given":"R. J."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Figueroa, Ward, Walters, Ashley, & Wilks, 2005).
Tobacco
According to comprehensive health promotion programs in the country, tobacco use is extremely harmful not only to the health of the citizens of Jamaica but also to its treasury and the general spirit of the country. According to a survey, more than 2000 children between the ages of 10 and 14, as well as 275000 adults above the age of 15 years use tobacco every day.
Alcohol
With around 40% of individuals consuming alcohol every day, alcohol is one of the most widely used drugs in the country, according to the National Council on Drug Abuse (NCDA). According to the most recent Household Drug Survey, about 75% of the population has reported having used alcohol at some point in their lifetime.
Recreational drugs
At present, the Jamaican law prohibits the use, cultivation, possession and even exchange of recreational drugs. While this particular law is randomly enforced, especially with regard to possession of a recreational drug for personal use, it is still an issue for the law enforcement agencies in the country. The general public realizes the consequences of possessing marijuana and the high costs associated with it, males with a previous criminal record are more at risk for receiving a longer sentence in comparison to first-time offenders or females ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9e1Tu1Lb","properties":{"formattedCitation":"(Russo & Grotenhermen, 2014)","plainCitation":"(Russo & Grotenhermen, 2014)","noteIndex":0},"citationItems":[{"id":662,"uris":["http://zotero.org/users/local/5VyEEXyp/items/WMBNC3XU"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/WMBNC3XU"],"itemData":{"id":662,"type":"chapter","title":"Crack Heads and Roots Daughters: The Therapeutic Use of Cannabis in Jamaica","container-title":"The Handbook of Cannabis Therapeutics","publisher":"Routledge","page":"365-380","author":[{"family":"Russo","given":"Ethan B."},{"family":"Grotenhermen","given":"Franjo"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Russo & Grotenhermen, 2014).
Physical activity and Safety
Jamaicans become sexually active at a relatively young age. Especially between the ages of 15-17 years according to a survey by the Reproductive Health Survey. Among the young adult population, 64% of males and 38% of females stated that they were sexually active. The Jamaican society shows most of the classical patterns of mating i.e. socialization, pregnancy, visiting unions, adolescent sexual activity, multiple relationships, common law marriage, casual sex, and legal marriage. The society also shows patterns of homosexuality, prostitution, safer sex practices, and intercourse. This shows that a culture of sex is prevalent among the members of society ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0VhppXa6","properties":{"formattedCitation":"(Chevnnes, 2012)","plainCitation":"(Chevnnes, 2012)","noteIndex":0},"citationItems":[{"id":"egBF9z5K/XdodS1vu","uris":["http://zotero.org/users/local/0omESN17/items/IQ6ZMS4W"],"uri":["http://zotero.org/users/local/0omESN17/items/IQ6ZMS4W"],"itemData":{"id":902,"type":"webpage","title":"Sexual practices and behavior in Jamaica: a review of the literature. | POPLINE.org","URL":"https://www.popline.org/node/322422","author":[{"family":"Chevnnes","given":"B"}],"issued":{"date-parts":[["2012"]]},"accessed":{"date-parts":[["2019",8,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chevnnes, 2012).
Death Rituals Construct
Death is regarded as a natural transformation, an intrinsic part of life in the Jamaican culture. In most parts of the word, a traditional wake takes place, followed by a period of mourning. However, in the Jamaican culture, the loved ones of the deceased celebrate the life lived by the deceased for Nine-Night. This ritual is also known as Set-up or Dead Yard. On the last of the nine nights, the people hold a grand celebration with food, music, dancing, white rum and sharing good old stories about the loved one that has just passed away ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nkBxuTfx","properties":{"formattedCitation":"(Huggins & Hinkson, 2017)","plainCitation":"(Huggins & Hinkson, 2017)","noteIndex":0},"citationItems":[{"id":663,"uris":["http://zotero.org/users/local/5VyEEXyp/items/G6LBE6S7"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/G6LBE6S7"],"itemData":{"id":663,"type":"article-journal","title":"Contemporary burial practices in three caribbean islands among christians of african descent","container-title":"OMEGA-Journal of Death and Dying","page":"0030222817732468","author":[{"family":"Huggins","given":"Camille L."},{"family":"Hinkson","given":"Glenda M."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Huggins & Hinkson, 2017).
Religious practices and use of prayer
The Jamaican people might be becoming more modern with the time, they are still deeply rooted in tradition. Ritual and ceremonies produced around the death of a loved one show just how dedicated these people are to their faith and religious practices. They pray for the dead and believe in the concept of eternal life, with the souls of the dead remaining among the living.
Meaning of life
As mentioned, 90% of the population of the country is black. Most of these individuals had slave ancestors. Thus, life holds great meaning for the Jamaican population. This makes the concept of death all the more real for this population. In Jamaica, death was and remains a vital presence.
Individual strength
In the Jamaican culture, individual strength is derived from family. This is the reason why the death of a child or a young adult is particularly devastating for the family members of the deceased. At a time like this, individual strength is derived from the strength of other family members in an effort to share in one another grief, given that this process can be rather isolating for loved ones.
Conclusion
Health professionals who provide support need to be cognizant of practice differences based on religion, culture, economics, family traditions, and individual preference and provide as much support and resource as possible. This is especially true for culturally rich and diverse cultures, like the Jamaican culture. This makes it the duty of all health professionals to adhere to Purnell’s model of cultural competence and provide care that is centered around the needs of a culture.
References
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Chevnnes, B. (2012). Sexual practices and behavior in Jamaica: A review of the literature. | POPLINE.org. Retrieved August 30, 2019, from https://www.popline.org/node/322422
Deipolyi, L. (2018). Jamaican Food and Culture Fact Sheet.
FAO. (2010). Nutrition country profiles: Jamaica summary. Retrieved August 30, 2019, from Food and Health Organization website: http://www.fao.org/ag/agn/nutrition/jam_en.stm
Figueroa, J. P., Ward, E., Walters, C., Ashley, D. E., & Wilks, R. J. (2005). High risk health behaviours among adult Jamaicans. West Indian Medical Journal, 54(1), 70–76.
Higman, B. W. (2008). Jamaican Food: History, Biology, Culture. Retrieved from https://books.google.com.pk/books?id=JorfAAAAMAAJ
Huggins, C. L., & Hinkson, G. M. (2017). Contemporary burial practices in three caribbean islands among christians of african descent. OMEGA-Journal of Death and Dying, 0030222817732468.
Nevius, J. (2002). In The Spirit—A Review of Four Books on Religion in Jamaica During the Pre to Post Emancipation Era. Caribbean Quarterly, 48(4), 71–81.
Purnell, L. (2005). The Purnell model for cultural competence. Journal of Multicultural Nursing & Health, 11(2), 7.
Russo, E. B., & Grotenhermen, F. (2014). Crack Heads and Roots Daughters: The Therapeutic Use of Cannabis in Jamaica. In The Handbook of Cannabis Therapeutics (pp. 365–380). Routledge.
