1. Pharmacy in Public Health: Cultural Competence Course, date, etc. info

2. Learning Outcomes Define cultural competence Differentiate cultural competence and linguistic competence List the 3 components of knowledge required for cultural competence Provide 2 examples of cultural knowledge Identify 3 characteristics of a practice site that denotes cultural competence

3. Culture is: A pattern of learned behaviors and beliefs shared among members of a group Parents and grandparents teach culture to children by example and instruction – Visiting a member of the family who is ill – Going to work or school even when you are sick and may be contagious – Foods and how foods are cooked

4. Identify examples of cultural influences in the cartoon (Source: www.CartoonStock.com)

5. Cultural competence means: Having the attitude, knowledge, and skill that enable you to act in a manner that is respectful and responsive to the needs of others Being able to provide services that are respectful and responsive to the needs of the community

6. Key Points of Cultural Competence No universal culture as culture is influenced by local conditions Differs from professional competence; a person can be professionally competent but not culturally competent and vice versa Recognize that culture is related to ethnic background or race but that other factors also contribute to culture

7. Cultural Competence vs. Linguistic Proficiency Linguistic proficiency is the ability to speak, read, and write in a specific language Cultural competency is one’s ability to address the learned behaviors and beliefs of persons from different cultural groups Linguistic proficiency does not guarantee cultural competence but it can facilitate cultural competence

8. Culture, Race, Ethnicity Race refers to the genetic characteristics of a group of people however differences tend to be small Ethnicity (census definition) “…person’s ethnic origin or descent, roots, heritage, place of birth, or parents’ place of birth…” Culture is based on learned behaviors and beliefs and is associated with race and ethnicity or nationality

9. Changes in Diversity in the United States

10. Health Disparities Difference in life expectancy and health status related to racial and ethnic populations; examples: – Infant mortality is twice that of whites among African-American and American Indian populations – American Indians and Alaskan Natives are 2.3 times as likely to have diabetes Impact on overall health of Americans

11. Interpreters vs. Translators Interpreters work with the spoken language; they verbally convey what one person says in one language to a second person in a different language Translators work with written language; they render a document written in one language into a document written in a second language

12. Title VI of the Civil Rights Act of 1964 Prohibits discrimination based on race, color, or national origin of programs receiving federal funds Addresses both verbal and written communication Interpreter and translation services are required to meet the requirements of the Act

13. Problematic Interpreter Models

14. Preferred Interpreter Models

15. CLAS Standards Developed by the Office of Minority Health in the Department of Health and Human Services; addresses 3 areas – Culturally competent care – Language access services – Organizational supports

16. The Pyramid of Cultural Competence

17. Attitudes Beliefs related to cultural issues and their relationship to health – Enabling attitudes—desire for best outcome possible – Barriers—belief that health issues are universal Attitudes form the base of the pyramid; enabling attitudes allow the development of knowledge and skill

18. Knowledge Represents specific facts related to culture – Belief that injections are more powerful than tablets or capsules – Preference for receiving services in the home rather than the clinic Knowledge that culture is often community specific – Communities with similar ethnic heritage and shared language may have very different cultural values

19. Skill Have the ability to modify services so that they are culturally appropriate for the local population Represents the apex of the pyramid as practitioners can have appropriate attitudes and knowledge but fail to change services Example—addressing the effects of oral contraceptives on fertility

20. Developing Enabling Attitudes Sensitivity training – Reflect on culture, racism, sexism, etc. – Case studies Awareness training – Population level statistics can alert you to presence of minority groups and their needs

21. Identifying Cultural Characteristics Related to Health

24. Culture of Western Medicine and Public Health Belief that the individual is responsible for their health Illness belongs to medically derived categories Only one approach to medicine—that of western medicine Patients need to conform to the system; the system is not expected to adapt to patient needs

25. Knowledge of Your Own Culture Ask a person outside your culture to tell you about American culture Identify your subculture within the larger American culture (e.g. western, urban, professional) Ask your grandparents what is important for other cultures to know about you and your culture

26. Learn Cultural Competence Skills Obtain experience at a practice site that demonstrates cultural competency – Use CLAS standards to identify a site Use guided reflection – Have someone with some experience guide the discussion and ask questions Establish a structure for learning – e.g. a journal club – e.g. keep a diary or journal

27. Summary Cultural competency means having the attitude, knowledge, and skill to provide services that are respectful and meet the needs of population Practice sites that provide culturally competent care will meet the CLAS standards Cultural competency requires the practitioner to develop a strategy for learning about culturally appropriate care