A Whole New World

1. A Whole New World Developing Cultural Competence

2. Why Global Awareness? • Global society • Immigration/ refugees • Changing U.S. Demographics • A worldview provides an ideological basis for food practices

3. Examples: • Photographs of 30 families in 24 countries • The photographers watched typical families the world over as they farmed, shopped, cooked, and ate. • At the end of each visit, they created a portrait of the family surrounded by a week’s worth of their groceries.

4. Australia-$376.45 USD-

5. Bhutan-$5.03 USD + Homegrown Foods ($29.06 worth)-

6. Chad-$1.23 USD + Food Rations ($24.37)-

7. Ecuador-$31.55 USD-

8. Germany-$500.07 USD-

9. United States-$159.18 USD-

10. Mexico-$189.09 USD-

11. The burden is on US to become culturally competent

12. What is culture? Shared History • Thoughts • Actions • Customs • Beliefs • Values • Institutions

13. Cultural Values • Principles or standards that members of a cultural group share in common

14. Terms to be aware of: • Diversity – differences among groups of people (physical, socioeconomic, language, gender, age, etc.) • Cross-cultural – interaction between or among individuals who represent different cultures • Ethnocentric – one’s own cultural view is considered best

15. Demographics and Population Trends

19. Ethnic Groups in the U.S. - 2006 • 68% White Americans • 14.8% Hispanic • 12.4% - Black • 4.4% Asian Americans • 2.0% Multiracial • 0.8% Native Americans • 0.14% Native Hawaiians or other Pacific Islanders • 6.4% “Some other race” By 2042 non-Hispanic whites will no longer make up the majority

20. Health Disparities • Socioeconomic status • Lack of insurance • Cultural Beliefs • Traditional Therapies • Access • Discrimination • Bridging the language gap

21. Developing Cultural Awareness • Knowledge • Awareness of own beliefs and attitudes • Remember - Characteristics of groups are simply generalities • Avoid stereotyping

22. Developing Cultural Awareness • Encounters • Communication Styles • Cultural food practices • Common health practices • Health care values, beliefs, and practices • Attitudes toward seeking help from health care providers • Religious behaviors and beliefs

23. Developing Cultural Awareness • Interventions • Caring • Appreciation • Respect for clients • Practical considerations

24. US Cultures - USDHHS • Hispanic Americans • Asian and Pacific Islanders • American Indians and Alaskan Natives • Black Americans • Religious Cultures

25. Hispanic Americans • Largest and Fastest Growing Minority Group in the US • Communication Styles • Expressing negative emotions is generally considered to be impolite • Touching between persons is common • Avoiding eye contact signals respect and attentiveness

26. Hispanic Americans • Food Patterns • Beans/Legumes • Rice • Breads/Tortillas • Corn and Corn Products • Chile Peppers • Tomatoes • Meat/Poultry/Fish • Minimal Use of Dairy Products

27. Hispanic Americans • Unique Cultural Issues • High school graduation rates are lower than average • Increased levels of poverty • “Role of God” for spiritual and health rewards and protection • Nutrition Education and Counseling • Strong familial ties • All family members may be involved in decision making and counseling

28. Asian and Pacific Islanders • Communication Styles • Respect for authority figures • Eye contact may be seen as disrespectful • Usually will not shake hands with people of the opposite sex • Focus is upon the family rather than the individual

29. Asian and Pacific Islanders • Food Patterns • Rice • Vegetables • Fruit • Fish/Pork/Poultry • Nuts • Tofu • Diet Generally Low in Dairy Products

30. Asian and Pacific Islanders • Unique Cultural Issues • Strive to reach balance or equilibrium • Holistic religious beliefs • Disease results from an “imbalance” and can be affected by food consumption • Nutrition Education and Counseling • Increase calcium intake • Reduce sodium intake

31. American Indians and Alaska Natives • Communication Styles • Speak using a low tone of voice • Expect people to listen attentively • Direct eye contact is often disrespectful • When greeting a person, soft hand touches are better than firm handshakes • “Yes” and “No” responses are considered to be complete answers • An “Elder” may speak for the whole tribe

32. American Indians and Alaska Natives • Food Patterns • Wild Game • Sheep/Goat • Fish • Beans/Squash/Corn • Celery/Onion/Spinach/Potatoes • Cantaloupe/Watermelon • Wild Berries • Added Grey Clay (provides minerals)

33. American Indians and Alaska Natives • Unique Cultural Issues • Strive for balance and harmony with nature • Desire to bring honor to their family and tribe • High rates of alcohol abuse • Lower socioeconomic status • Nutrition Education and Counseling • “Thrifty Genotype” can lead to Type Two Diabetes and Obesity

34. Black Americans • Communication Styles • Personal questions should not be asked upon meeting someone for the first time • Direct eye contact is seen as impolite • Touching another person’s hair is offensive • Participate in engaging and expressive conversations

35. Black Americans • Food Patterns • “Soul Food” made with wild animals such as squirrels, rabbits, deer, etc. • Black-Eye-Peas/Okra/Collard Greens • Flour based Gravies/Pork Fat • Apple or Peach Cobblers/Candid Yams • Red Pepper/Cayenne • Sweetened Iced Tea/Kool-Aid • Decreased Dairy Consumption (Lactose Intolerance)

36. Black Americans • Unique Cultural Issues • Family and region are key elements to society • Poverty and low income • Nutrition Education and Counseling • Respond well to action oriented goals and activities • Counseling is more successful when the client or patient can take an active role • Reduce fried and high salt foods

37. Religious Cultures • Jewish Communication Styles • Most Jewish people in the US speak English as their primary language • Appreciate direct conversation and enjoy analyzing issues • Prefer sitting and standing close (within 2 feet) to another person when in conversation • Emphasize respect and hospitality

38. Religious Cultures • Jewish Food Patterns • Pastrami/Matzoh • Restriction on pork and pork products • Restriction on fish without scales and fins • Dairy is not eaten with meat at a meal • Kosher slaughtering and foods standards • Blood removed from all foods • Non-cloven hoofed animals are acceptable • Unleavened bread during the Passover

39. Religious Cultures • Unique Cultural Issues • Clearly defined gender roles • Tend to marry early and have large families • Unleavened bread may be low in zinc • Nutrition Education and Counseling • Identifying unique foods, such as Kosher foods, at the grocery store

40. A few points to remember: • Increasing ethnic food shops may present a problem with increased food poisoning issues (traditional food preparation methods) • Enculturation (rules passed from generation to generation) encompass many food habits • Many foods have symbolism (Ex. Bread) • Learn: • Core foods • Edible/Inedible foods • Meal Cycles

41. Remember: • Be unbiased – not everyone needs to eat like we eat! • A diverse culture adds a richness to the tapestry of our lives