Cultural Competency in Health Care? ? Discussion Topic? Cultural Competency vs. Diversity After reading this week’s chapter, in your own words are cultural competency and diversity t

Chapter 2

Learning Objectives

· Define cultural competency and other key terms.

• Differentiate between cultural competency and diversity.

• Understand rapid demographic changes in the United States.

• Delineate key racial and ethnic groups in the United States including African Americans/Blacks, Asians/Pacific Islanders, Native Americans and Alaska Natives, Whites, and Hispanics.

• Recognize the significance of cultural competency and why it is imperative for healthcare organizations and public health.

I. Introduction

1. The difference between the concepts of cultural competence and diversity.

2. Emphasis on the fact that they are often used interchangeably

3. Chapter focuses on strategies to increase cultural competence and diversity as separate but interrelated entities.

4. The need to explore current and projected demographics pertaining to minority groups in the U.S.

5. A basis is established for that cultural competence is an imperative.

II. Demographic Changes.

1. Emphasizes the current demographic changes that are taking place in America.

III. Cultural Competence

1. A significant concept for healthcare and public health.

This section provides an opportunity to discuss the definition of cultural competence as provided by the key government entity entitled the U.S. Department of Health and Human Services, Office of Minority Health which is:

“ Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations”

IV. Linguistic Competence

1. This section focuses on the fact that many people in the U.S. do not speak

English or have limited English proficiency.

At this point, the definition of Linguistic competence, as indicated by the

National Center for Cultural competence should be provided which is a follows:

The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities..

2. An explanation of why certain individuals should not be used as interpreters. These individuals include:

a. Family members

b. Children

c. Non-clinical and bilingual staff

Rationale: confidentiality issues, misinterpretation of clinical terms, confusion in terms of dialects and inclusion of personal perspectives.

3. The importance of using a trained interpreter should be discussed.

4. Introduction of the term cultural filtration defined which is:

…when cultural beliefs or ideas are either included or removed from the interpretation process by the interpreter. This can also occur in the process of translation of written materials

V. Diversity, Race and Ethnicity

1. Diversity is defined at this point which is:

The makeup of the workforce of a given healthcare organization. This includes ethnic and racial backgrounds, age, physical and cognitive abilities, family status, sexual orientation, socioeconomic status, religious and spiritual values, and geographic location.

2. In this section majority and minority groups are delineated which are: (see

Table 2-6, pg. 22)

· The white population (majority group)

· Minority groups which are: African Americans/Blacks, Hispanics, Native Americans and Alaska Natives, Asians and Pacific Islanders and

· All of the groups are racial groups except Hispanics which are an ethnic group.

3. Definitions of race and ethnicity are provided which are as follows:

Race: biological variation including phenotypical differences in stature, skin color, hair color, facial shape and other inherited characteristics that may or may not be mutually exclusive in each individual

Ethnicity: a group or individual’s conception of cultural identity which includes a wide variety of learned behaviors that a human being uses in his or her natural and social environment to survive which may result in cultural demarcation between and within societies

VI. It is necessary at this point to review the various groups individually.

1. Hispanics/Latinos

a) an ethnicity

b) may be of any race

c) cam be further classified by nationality

Nationality defined: an identity that can be defined by a person’s place of legal birth or by a person’s associational citizenship status governed by where an individual resides and works, which may defy national boundaries and sovereignty

2. African Americans/Blacks

a) second largest minority group in the United States

b) represented throughout the country

c) greatest concentrations in the southeast and mid-atlantic regions (e.g. Louisiana, Mississippi, Alabama, Georgia, South Carolina and Maryland.

d) Have been referred to by many titles in the U.S. including Colored, Negro, Black, Afro-American, African American.

3. Native Americans and Alaska Natives

a) unequivocally American

b) indigenous to the U.S.

c) mislabeled as Indians by Christopher Columbus because he was lost during his

exploratory voyage thinking he was in India.

d) own their own lands by treaty rights.

4. Asian Americans and Pacific Islanders

a) grouped not by language but because they arrived from Asia (Vietnam, Indonesia,

Japan, Korea, China and other nations); come from approximately 50 countries

b) tend to assimilate into the mainstream

c) one of the fastest growing racial categories in the U.S.

e) extremely diverse based on nationality

VII. The Importance of Cultural Competency for Healthcare Organizations and Public Health

1. Blacks and Hispanics, combined with other minority groups are leading to emerging majorities.

Emerging majorities defined: a term used to describe inevitable change taking place in

American society based on the prediction that by the year 2050, in certain geographic

Areas in the year 2050, in certain geographic areas in the United States, the majority

Populations will be Hispanics and Blacks and other minorities (combined) and whites will be the minority group.

2. Culture

Culture defined: An integrated pattern of learned beliefs and behaviors that can be shared among groups. It includes thoughts, styles of communicating, ways of interacting, views on roles and relationships, values, practices and customs.

3. Institute of Medicine (IOM) Reports

a. Unequal Treatment: Confronting Racial and Ethnic Disparities in health care.

Recommendations:

· increasing awareness of racial and ethnic health disparities;

· integrating cross-cultural education into the training of

healthcare professions, use of evidence-based guidelines to promote consistency and equity of care

· continued research to assess disparities further and provide appropriate interventions.

b. In the Nation’s Compelling Interest: Ensuring Diversity in the

Health Care Workforce.

Focused on:

· Institutional policy level strategies aimed at increasing diversity within the healthcare workforce.

· Diversification of the fields of medicine, nursing and psychology.

VIII. Students

Steps: 1. Ensure that students from racially and ethnically minority groups are admitted to programs that will train them in these fields.

2. Health administration and public health curriculums must include information about racial and ethnic health disparities, cultural competence, diversity and the rapid changes in demographics in the U.S.

3. Assessment must take place to identify biases and stereotypes that students may hold.

4. Research must focus on health disparities, cultural competence and diversity.

IX. Fiscal Accountability and Cultural Competency

1. The fiscal bottom line of healthcare and public health organizations may have impacted if cultural groups are not serviced appropriately.

2. Benefits will include profitability based on maintaining and growing current and future market share and enhancing the reputation of healthcare and public health organizations with ethnic and racial minorities.

3. Developing a sustainable competitive advantage over organizations that are not proceeding with cultural competence and diversity efforts.

X. Accreditation and Culturally and Linguistically Appropriate Services in Health

Care Standards

Accrediting Organizations:

1. Council on Education for Public Health (CEPH)

2. The Joint Commission

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© 2010 Jones and Bartlett Publishers, LLC

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