1 / 39

Cultural Competence

Cultural Competence. “It is not what we don’t know that hurts us; it is what we know that isn’t so”. Hispanics: can no longer be ignored. 40 million and growing, 14% of the U.S population, 40% of the U.S. population growth in 2002

Download Presentation

Cultural Competence

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.


Presentation Transcript

  1. Cultural Competence “It is not what we don’t know that hurts us; it is what we know that isn’t so”

  2. Hispanics: can no longer be ignored • 40 million and growing, 14% of the U.S population, 40% of the U.S. population growth in 2002 • American Hispanics buying power: larger than that of any Spanish speaking country in Latin America. • $600 billion in buying power. • 1 out of 7, 18-49 year olds is Hispanic

  3. Age Distribution by Sex and Hispanic Origin: 2002 Non-Hispanic White Hispanic Male Female Male Female Note: Each bar represents the percent of the Hispanic (non-Hispanic White) population who were within the specified age group and of the specified sex. Source: Current Population Survey, March 2002, PGP-5

  4. Percent Distribution of Hispanicsby Type: 2002 Source: Current Population Survey, March 2002, PGP-5

  5. Regional Population Distribution by Hispanic Origin: 2002 Hispanic Northeast Midwest South West Source: Current Population Survey, March 2002, PGP-5

  6. What is culture? • It is an established way of understanding the interpreting the world • Every group has a different way of expressing life, religion, and art; it has a set of values, traditions, beliefs, social ways, language, and history that differ from other groups.

  7. What is cultural competence? • It is the integration and transformation of knowledge about a people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services; thereby producing better outcomes • It is more than awareness or sensitivity!

  8. It is a journey not a destination. It is when persons are able to honor the integrity of another’s unique differences while demonstrating abilities to work effectively even synergistically with them • Awareness—knowledge—skills—encounters—celebration--incorportate

  9. Smoking Cessation Counseling Percent of current smokers counseled by a physician to quit Hispanic English Speaker Hispanic Spanish Speaker Total Asian American African American White Hispanic Source: Commonwealth Fund 2001 Health Care Quality Survey

  10. How do disparities arise? • Differences in the quality of care/service received • Differences in access to care/service • Differences in social, political, economic, or environmental exposures which result in differences in quality of life/health

  11. Racial and Ethnic Distribution of Selected Health Professions: Source: HRSA, U.S. Census 2000

  12. Levels of cultural incompetence • Institutional • Personally mediated • internalized

  13. Institutional cultural incompetence • Differential access to the goods, services, and opportunities of society by ethnicity or race. • Examples • Housing, education, employment, income • Medical facilities • Information, resources, voice

  14. Personally mediated • Differential assumptions about the abilities, motive, and intents of others by race or ethnicity • Prejudice and discrimination • Examples • Police brutality, physician disrespect, shopkeeper vigilance, waiter indifference, teacher devaluation

  15. Internalized cultural incompetence • Acceptance by the stigmatized race/ethnicity of negative messages about our own abilities and intrinsic worth • Examples • Self devaluation • White man’s ice is colder • Resignation, helplessness, hopelessness • Accepting limitations to our full humanity

  16. Cultural incompetence and racism • What is racism? • A system of structuring opportunity and assigning value based on phenotype (race, ethnicity) that • Unfairly disadvantages some individuals and communities • Unfairly advantages other individuals and communities • Undermines the potential of the whole society

  17. Cultural incompetence like racism is a conveyer belt Don’t get carried away!

  18. Advancing cultural competence • Set the agenda • Collect data • Coordinate action

  19. Reactions to race • Behavioral risk factor surveillance system • How do people classify you? • How often do you think about your race/ethnicity? • Do you feel you were treated worse than, the same as, or better than people of other races? • When seeking services do you feel your experiences were worse than, the same as or better than for people of other races? • Have you felt upset, sad, frustrated because of how you were treated based on our race?

  20. Measure institutional incompetence/racism • Scan for evidence of racial/ethnic disparities • Routinely monitor outcomes by race/ethnicity • “Could racism or cultural incompetence be operating here?” • Identify mechanisms • Examine written policies • Query unwritten norms and practices • “how is racism or cultural incompetence operating here?”

  21. Advancing cultural competence • Coordinating action • Promulgate cultural competence protocols • Implement reminder systems • Monitor provider practice • Train a diverse workforce • Provide cultural competence training • Train and deploy translators • Community oversight?

  22. Advancing cultural competence • Conversations on cultural incompetence and racism • Define it • Acknowledge impacts on corporate well being in a global economy, on health • Acknowledge waste to the nation

  23. Advancing cultural competence • Confronting institutional racism and cultural incompetence • Put it on the organizations agenda • Ask “how is racism and cultural incompetence operating here?” • Organize and strategize to act • Dismantle, remodel, create a structure, a policy, a practice, a norm

  24. “best practices” in cultural competency • Define culture broadly • Value client’s cultural beliefs • Recognize complexity in language interpretation • Facilitate learning between providers and communities and customers • Involve the ethnic group in defining and addressing service needs • Institutionalize cultural competence

  25. Value client’s cultural beliefs • The extent to which you learn about and value the target community’s knowledge, attitudes, and beliefs • How is that information applied to improve service • How to talk about sensitive issues • Be willing to explore the individual life experiences to find the underlying causes of their behaviors

  26. Recognize complexity in language interpretation • Being able to speak the language is not enough • Recognize the linguistic variation within a cultural group • Recognize the cultural variation within a language group • Recognize the variation in literacy levels in all language groups

  27. Hispanics Who Speak Spanish as Primary Language Have More Problems Communicating with Their Physicians Percent of adults Base: Hispanics with health care visit in past two years. Source: The Commonwealth Fund 2001 Health Care Quality Survey.

  28. Facilitate learning between providers and communities • Create environments where learning can occur • Learn about the cultural context, knowledge, beliefs, and attitudes of the communities you serve • Communities need to learn about the providers • Both need to learn how collaboration benefits both

  29. Involve the community in defining and addressing service needs • More than satisfaction with services, involve your client and community in identifying community needs, assets, barriers and in creating the appropriate responses • Clients and community play an active role in needs assessment, program development, implementation, and evaluation • Community voting members of boards, focus groups, advisory boards

  30. Institutionalize cultural competence • Integral part of the strategic plan • Sustainable funding for cultural competence • Design replicable activities

  31. Twenty guidelines for successThe Rimm Report • Set high educational expectations, expect them to complete college and beyond, whether you did or not. Discuss careers, expect them to have careers, educational attainment is the highest priority. • Pressure teaches resilience; expect much and they will expect much of themselves; coach for success

  32. Twenty guidelines for success • Motivation is as critical as ability; IQ is not a limitation; motivation, interest, perseverance • View your child as intelligent, good thinkers and problem solvers. Value their work, be positive about your own work, have family projects. Promulgate a work ethic, love of accomplishment, build a sense of personal competence

  33. Twenty guidelines for success • Assertiveness can be learned; if necessary get professional help that will help your child view themselves as hardworking, smart, and independent • Middle and high school years are more important; search for schools with dedicated and inspiring teachers

  34. Twenty guidelines for success • Encourage development of math and science skills; begin in preschool; play with toys that involve spatial relationships – puzzles/blocks. Reading is a high priority. Begin reading during infancy, let them see you enjoy reading. • Encourage taking advanced courses even it means a B rather than a A

  35. Twenty guidelines for success • Skip a grade if they are not academically challenged • Extracurricular activities are important- music, art, dance, orchestra, drama and sports. Learning to handle busy schedules teaches them how to handle complexity and ambiguity as adults

  36. Twenty guidelines for success • Competition – encourage entering contests, debates, creative problem solving meets. Winning builds confidence, losing builds character. To be successful in a competitive society they will have to experience winning and losing • Travel with your child

  37. Twenty guidelines for success • Teach them that popularity is not important; to value independence from peers; that they can be different • Don’t glorify your experimentation with substances; today’s drugs are more dangerous • Be a coach not a judge; set firm limits; avoid overpunishment

  38. Twenty guidelines for success • Make sure your child gets leadership opportunities and responsibilities; don’t label your child • Parents were the most frequent role model; your children are watching you… • Believe in your child’s survival skills; let them know they too can persevere

  39. Guidelines for success • Teach them to value challenge, contribution, and creativity. Teach them how to be daring and courageous; role play skills

More Related