1. Essentials of Cultural Competence in Pharmacy Practice: Chapter 10 Notes Chapter Author: Dr. Norma Kiser-Larson Biracial and Bicultural Patients

2. Learning Objectives 1. Identify common biracial cultures. 2. Articulate unique challenges facing individuals who are biracial and bicultural. 3. Understand unique family dynamics when working with patients who have more than one ethnic or racial background.

3. Some Key Terms Most texts focus on culture and ethnicity. Race is rarely included or only briefly mentioned. Race: There are many definitions! Spector: “The concept of race reflects self-identification by people according to the race or races with which they closely identify.” Giger and Davidhizar: “People of the same race share varying degrees of similar physical features such as stature, skin color, hair texture, or blood group.”

4. More Key Terms… Bicultural: mixing of cultures, race, and combination of races and ethnicity. Biracial: (1)A person of one race and cultural heritage functioning in another culture, such as mainstream American society; (2) “when an individual crosses two racial and cultural groups, the individual is considered ‘biracial’”(Giger and Davidhizar) Racial identity: what an individual thinks about his or her race. Racial identification: what a person says about his or her race.

5. Racial Identity Explore strength of identity Bicultural identity integration (BII) Cultural conflict Cultural distance Chapter examples: the Lumbee tribe in North Carolina Aboriginal-Chinese people UK-Greek

6. Biracial Identity Issues Identity develops in a context of relationship to others. A major issue for biracial people is not feeling accepted by others. To resolve this: The process of feeling accepted is smoother when the person feels accepted by parents and other family members Engage in an activity that will make a difference in one’s own life as well as the lives of others

7. Cultural Beliefs and Practices with Pharmaceutical Implications U.S. Mainstream Medical System Based on Allopathic (conventional medicine) Philosophy (scientific method) Folk Medicine/Homeopathic Natural folk medicine Magico-religious folk medicine Herbal treatments: Corn silk Dandelion root Eucalyptus Ginseng Lady slipper plant Licorice root Peach leaves or mullein roots Pine needles Red oat tree sap Sarsaparilla Tobacco Wild yellow plum tree bark, mullein leaves, alum root

8. Traditional Healing or Ethnocultural Health Care Therapies (See Table 10-3) Acupuncture Ayurvedic Braucher or Baruch-doctor Curanderismo Qi gong Reiki Santeria

9. Reflection Questions 1. What do you consider to be your heritage? How does this influence how you interact with others? 2. As a working pharmacist, what biracial and bicultural individuals are you likely to serve? 3. How will you be prepared to work with individuals with ethnic and racial backgrounds with which you are unfamiliar?