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

2. 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

3. 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

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

5. 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

6. 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

7. 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)

8. 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

9. 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.

10. 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”

11. 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.

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

13. 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

14. 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

15. 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.

16. 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.

17. 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

18. 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.

19. 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)

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

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

28. 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

29. 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.

30. 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