Discussion: Family’s values about education.

Mr. and Mrs. Evans are an African American couple who retired from the school
system last year. Both are 65 years of age a
nd reside on 20 acres of
land in a large rural
community approximately 5 miles from a Superfund site and 20 miles from two
chemical plants. Their household consists of
their two daughters, Anna, aged 40 years,
and Dorothy, aged 42 years; their grandc
hildren, aged 25, 20, 19, and 18; and their 2-
year-old great-grandson. Anna and Doro
thy and their children all attended the
university.
Mr. Evans’s mother and three of his
nieces and nephews live next door. Mr.
Evans’s mother has brothers, sisters, ot
her sons and daughters, grandchildren, and
great-grandchildren who live ac
ross the road on 10 acres of land. Other immediate and
extended family live on the 80 acres adjacent
to Mr. Evans’s mother. All members of
the Evans family own the land on which they live.
Mrs. Evans has siblings and extended fa
mily living on 70 acres of land adjacent
to Mr. Evans’s family, who live across the road. Mr. and Mrs. Evans also have family
living in Chicago, Detroit, New York, Sa
n Francisco, and Houston. Once a year, the
families come together for a reunion. Every other month, local family members come
together for a social hour. The family believes in
strict discipline with
lots of love. It is
common to see adult members of the family
discipline the younger children, regardless
of who the parents are.

Mr. Evans has hypertension and diabetes
. Mrs. Evans has hypertension. Both
are on medication. Their daughter Dorothy is
bipolar and is on me
dication. Within the
last 5 years, Mr. Evans has had several re
latives diagnosed with lung cancer and colon
cancer. One of his maternal uncles died last
year from lung cancer. Mrs. Evans has
indicated on her driver’s licen
se that she is an organ donor.
Sources of income for Mr. and Mrs. Ev
ans are their pensions from the school
system and Social Security. Dorothy receives SSI because she is unable to work any
longer. Mr. Evans and his br
others must assume responsibility for their mother’s Discussion: Family’s values about education.
medical bills and medication. Although she ha
s Medicare parts A and B, many of her
expenses are not covered.
Mr. and Mrs. Evans, all members of th
eir household, and al
l other extended
family in the community attend a large Bap
tist church in the city. Several family
members, including Mr. and Mrs. Evans, sing
in the choir, are members of the usher
board, teach Bible classes,
and do community ministry.
Study Questions
1.
Describe the organizational st
ructure of this family and identify strengths and
limitations of this
family structure
.
2.
Describe and give examples of what you be
lieve to be the family’s values about
education.
3. Discuss this family’s
views about child rearing.

4. Discuss the role that spirituality plays in this family.
5.
Identify two religious or spiritual practices in which members of the Evans
family may engage for treating hypert
ension, diabetes, and mental illness.
6.
Identify and discuss cultural
views that Dorothy and her parents may have about
mental illness and medication.
7.
To what extent are members of the Evans fa
mily at risk for illnesses associated
with environmental hazards?
8.
Susan has decided to become an organ donor. Describe how you think the Evans
family will respond to her decision.
9. Discuss views that African Ameri
cans have about advanced directives.
10. Name two dietary health risks for African Americans.
11.
Identify five characteristics to consider
when assessing the skin of African
Americans.
12. Describe two taboo views that Afri
can Americans may have about pregnancy.

AMISH CASE STUDY
Elmer and Mary Miller, both 35 years old, liv
e with their five children in the main
house on the family farmstead in one of th
e largest Amish settlements in Indiana.
Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’
cottage. Mary is the youngest of their ei
ght children, and when she married, she and
Elmer moved into the grandparents’ cottage
with the intention that Elmer would take
over the farm when Aaron wanted to retire.
Eight years ago, they traded living space.
Now, Aaron continues to help with
the farm work, despite increasing pain in hi
s hip, which the doctor advises should be
replaced. Most of Mary’s and Elmer’s sibli
ngs live in the area, though not in the same
church district or settlement. Two of Elmer’s brothers and their families recently
moved to Tennessee, where farms are less expensive and where they are helping to
start a new church district. Discussion: Family’s values about education.
Mary and Elmer’s fifth child, Melvin,
was born 6 weeks prematurely and is 1
month old. Sarah, aged 13, Martin, aged
12, and Wayne, aged 8, attend the Amish
elementary school located 1 mile from thei
r home. Lucille, aged 4, is staying with
Mary’s sister and her family for a w
eek because baby Melvin has been having
respiratory problems and their physician told
the family he will need to be hospitalized
if he does not get better within 2 days.
At the doctor’s office, Mary suggested
to one nurse, who often talks with Mary
about “Amish ways,” that Menno Martin, an
Amish man who “gives treatments,” may
be able to help. He uses “warm hands” to
treat people and is
especially good with

babies because he can feel what is wrong. Th
e nurse noticed that Mary carefully placed
the baby on a pillow as she prepared to leave.
Elmer and Mary do not carry any hea
lth insurance and are concerned about
paying the doctor and hospital bills associat
ed with this complicated pregnancy. In
addition, they have an appointment for Wayne
to be seen at Rile
y Children’s Hospital,
3 hours away at the University Medical Cent
er in Indianapolis, for a recurring cyst
located behind his left ear. Plans are being
made for a driver to take Mary, Elmer,
Wayne, Aaron, Annie, and two of Mary’s sist
ers to Indianapolis
for the appointment.
Because it is on the way, they plan to stop in
Fort Wayne to see an Amish healer who
gives nutritional advice and does “treatment
s.” Aaron, Annie, and Elmer have been
there before, and the other women are considering having treatments, too. Many
Amish and non-Amish go there and tell others
how much better they feel after the
treatments.
They know their medical expenses seem minor in comparison to the family
who last week lost their barn in a fire
and to the young couple whose 10-year-old child
had brain surgery after a fall from the hayl
oft. Elmer gave mone
y to help with the
expenses of the child and will go to the barn raising to help rebuild the barn. Mary’s
sisters will help to cook for the barn raisi
ng, but Mary will not help this time because
of the need to care for her newborn.
The state health department is concer
ned about the low immunization rates in
the Amish communities. One community-health nurse, who works in the area where
Elmer and Mary live, has volunteered to talk
with Elmer, who is on the Amish school
board. The nurse wants to learn how the health
department can work more closely with Discussion: Family’s values about education.