Diversity in health care Dynamics of Care in Society Diversity in health care 1

Objectives Differentiate between culture, ethnicity, and race Identify some of the major ethnic groups in the US Provide an example of acculturation in the US Create an example of how bias, prejudice, or stereotype can cause barriers to effective relationships Describe ways to avoid bias Differentiate between a nuclear and extended family Identify ways in which language, personal, space, touching, eye contact, and gestures are affected by cultural diversity Compare and contrast the diverse health beliefs of different ethnic/cultural groups Give examples of how health care providers can show respect for an individual’s beliefs & for cultural diversity

Culture The values, beliefs, attitudes, languages, symbols, rituals behaviors, and customs unique to a particular group of people that is passed from on generation to another Includes: Family relations Child rearing Education Occupational choice Social interaction Spirituality Religious beliefs Food preferences Health beliefs Health care

Culture Culture is learned. Culture is shared. Culture is social in nature. Culture is dynamic and constantly changing.

Ethnicity A classification of people based on national origin and/or culture. Members share a common heritage, geographic location, social customs, language, and beliefs. Common Ethnic Groups African American Asian American European American Hispanic American Middle Eastern / Arabic American Native American

Race Classification of people based on physical or biological characteristics including: Color of skin, hair, and eyes Facial features Blood type Bone structure Cuts across multiple ethnic/cultural groups

Gender Gender: refers to the cultural and social differences that distinguish men from women Sex: refers to the biological differences that distinguish males from females Gender equality: the conditions under which girls and boys, women and men, can reach their full potential without discrimination (through equal access to nutrition, health care, education, and opportunities to make decisions in their households and communities, it also includes legal equality)

Cultural Diversity Includes: Family organization Language Personal space Touching Eye contact Gestures Health care beliefs Spirituality Religion Differences based on culture, ethnicity, and race that influence one’s behavior, self-perception, judgment of others, and interpersonal relationships

Cultural Assimilation Absorption of a culturally distinct group into a dominant or prevailing culture Requires that a cultural group alter their unique beliefs and behaviors and adopt the ways of the dominant culture However, in the US, we are striving for a society where cultural differences are appreciated and respected.

Acculturation The process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics. Occurs slowly over a long period of time. Example: Recent immigrants are more likely to use the language and follow the behavior patterns of their origin country than their children or grandchildren ex: become more “Americanized”

Sensitivity The ability to recognize and appreciate the personal characteristics of others. It is essential for health care professionals to understand and respect these differences to provide care that meet the needs of all individuals.

Bias A preference that inhibits impartial judgment of others Common biases: Age Education Physical size Occupation Sexual preference Gender

Prejudice A strong feeling or belief about a person or subject that is formed without reviewing facts or information Causes fear and distrust of others Interferes with interpersonal relationships Health care workers must be aware of our prejudices and to make every effort to obtain as much information about a situation as possible

Do Now online: At Face Value: Issues with Stereotypes Stereotyping Process of assuming that everyone in a particular group is the same It ignores individual characteristics and “labels” the individual May occur with regard to: Race Gender Body size Occupation Ethnicity

Stereotyping vs. Generalization A stereotype is an ending point. No attempt is made to learn whether the individual in question fits the statement. Stereotyping can have negative results. We often stereotype people simple on the basis of appearance.

Stereotyping vs. Generalization A generalization is a beginning point. It indicates common trends, but further information is needed to ascertain whether the statement is appropriate to a particular individual. It is important to remember that there are always differences between individuals.

Overcoming Bias, Prejudice, and Stereotyping Be conscious of your own personal and professional values and beliefs Learn as much as you can about different ethnic/cultural groups Be sensitive to behaviors and practices that are different from your won Remember that you do not have to adopt others’ beliefs, but you must respect them

Overcoming Bias, Prejudice, and Stereotyping Develop friendships with a wide variety of people Ask and encourage questions from others to share ideas and beliefs Evaluate all information before forming an opinion Be open to all differences Avoid offensive language and jokes Understand that mistakes happen. Apologize and forgive.

Language Health care provides must determine a patient’s ability to communicate and intervene to help those who do not understand English by use of: Translators Family members Gestures or pictures Cue cards (read handout)

Personal Space The distance people require to feel comfortable when interacting with others Varies greatly among ethnic/cultural groups Health care providers must be alert to a patient’s verbal and nonverbal cues to determine personal space

Eye Contact Eye contact is affected by cultural beliefs Lack of eye contact is usually interpreted as “not listening” but in some cultures is a sign of respect Health care workers must be alert to an individuals comfort level when using direct eye contact and adjust accordingly

Gestures Are used to communicate (remember non verbal communication) Can vary among ethnic/cultural groups Health care providers must be aware of how a patient responds to gestures and avoid any that seem to be offensive

Health Care Beliefs Vary widely throughout all groups Can affect an individuals response to health care Most cultures have common conceptions regarding: The cause of illness Ways to maintain health Appropriate response to pain Effective methods of treatment

Health Care Beliefs Reactions to Pain & Other Health Issues Response to pain is culturally influenced Patient in pain may not show it Listen to patients who freely express their discomfort Recognize influence of cultural & individual beliefs about health Respect patient’s right to react to health care issues any way he wants to Don’t stereotype a patient’s perceptions or responses based on culture

Religion An organized system of belief in a superhuman power or higher power Are associated with a particular form or place of worship May include beliefs about birth, life, illness, death, and dietary practices Atheist – one who does not believe in any deity Agnostic – one who believes that the existence of God cannot be proved or disproved

Respecting Cultural Diversity Each individual must be regarded as a unique individual Ways to achieve this goal is to: Listen as patients express their beliefs Appreciate individual different differences Learn more about cultural and ethnic groups in your area Recognize signs of prejudice, bias, or stereotyping

Culture & HC Activity Mark’s Story Disabled (8 min) may have to use google chrome A Day in the Sleep Clinic (use handouts)

CDC Statistics Health, United States is an annual CDC report on trends in health statistics CDC data on Risk Factors & Health Indicators by Race/Ethnicity & Gender

FOR TEACHING TOLERANCE ACTIVITY com·pas·sion a feeling of deep sympathy and sorrow for another who is stricken by misfortune, **accompanied by a strong desire to alleviate the suffering. dig·ni·ty 1. bearing, conduct, or speech indicative of self-respect or appreciation of the formality or gravity of an occasion or situation. 2. nobility or elevation of character; worthiness: dignity of sentiments.

Diversity in Health Care Practices… To Be Discussed in more depth in a later unit…. Folk Medicine Cutaneous stimulation Therapeutic touch Acupuncture Acupressure Natural Remedies Herbs Be aware of possible interactions with prescriptions Keep personal opinions & biases to yourself