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Enhancing Culturally and Linguistically Appropriate Services in Public Health Preparedness Ira SenGupta Cross Cultural Health Care Program Seattle, WA.

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Presentation on theme: "Enhancing Culturally and Linguistically Appropriate Services in Public Health Preparedness Ira SenGupta Cross Cultural Health Care Program Seattle, WA."— Presentation transcript:

1 Enhancing Culturally and Linguistically Appropriate Services in Public Health Preparedness Ira SenGupta Cross Cultural Health Care Program Seattle, WA A CLAS Act

2 © Cross Cultural Health Care Program Inspiration “ If you want to move people, it has to be toward a vision that ’ s positive for them, that taps important values, that gets them something they desire, and it has to be presented in a compelling way that they feel inspired to follow. ” — Martin Luther King Jr.

3 © Cross Cultural Health Care Program Session Goals Identify the key concepts of the 14 Culturally and Linguistically Appropriate Services (CLAS) standards Define the concepts of diversity, culture, and cultural competency and their relevance in public health preparedness Describe practical applications of culturally competent communication strategies in public health preparedness

4 © Cross Cultural Health Care Program Culturally and Linguistically Appropriate Services (CLAS) Standards 14 National Recommended Standards: To inform, guide, and facilitate implementation of CLAS Three themes: 1.Culturally competent care (Standards 1-3) 2.Language access services (Standards 4-7) 3.Organizational supports for cultural competence (Standards 8-14)

5 © Cross Cultural Health Care Program CLAS Goals To contribute to the elimination of racial and ethnic health disparities To improve the health of all Americans

6 © Cross Cultural Health Care Program Cultural Competency “To be culturally competent doesn’t mean you are an authority in the values and beliefs of every culture. What it means is that you hold a deep respect for cultural differences and are eager to learn, and willing to accept, that there are many ways of viewing the world.” — Okokon O. Udo, PhD Integrative Health and Wellness Northwestern Health Sciences University

7 © Cross Cultural Health Care Program The Compelling Reasons for Cultural Competence 1.Responding to demographic changes 2.Eliminating disparities in the health status of people of diverse racial, ethnic, & cultural backgrounds 3.Understanding the impact of individual and organizational culture 4.Improving the quality of services & outcomes 5.Enhancing the workplace environment 6.Meeting legislative, regulatory, & accreditation mandates Adapted from: National Center for Cultural Competence, Georgetown University

8 © Cross Cultural Health Care Program US’s Changing Demographics Demographics beyond black and white—now a complex mosaic of races & ethnicities million Hispanics million Blacks million Asian Americans - 4 million Native Americans Most significant trend is the record growth of Hispanic Americans. Persons with physical and mental impairments are the largest single “minority” (approx. 49 million).

9 © Cross Cultural Health Care Program US Demographics: Language & Adult Literacy Skills According to Census 2000: Among the million people aged 5 and over, 47.0 million (18%) speak a language other than English at home. 21% to 23% or some 40 to 44 million of the 191 million adults in the U.S. have extremely limited reading and quantitative skills (Level 1). Source: US Census Bureau Census 2000 National Center for Educational Statistics

10 © Cross Cultural Health Care Program Question What proportion of the 40–44 million people who speak a language other than English at home were born outside of the US? A. 1% B. 10% C. 20% D. 30%

11 © Cross Cultural Health Care Program Many Factors Contribute to Health Disparities Behavioral choices Genetic predisposition Nutrition Access to medical care Environmental and occupational conditions Poverty Source: Final Report of the Health Disparities May 9, 2001 Washington State Board of Health

12 © Cross Cultural Health Care Program Inequality “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.” — Dr. Martin Luther King Jr.

13 © Cross Cultural Health Care Program From Cultural Bump to Cultural Congruence Defining culture, diversity, and understanding the impact on human interactions

14 © Cross Cultural Health Care Program Diversity Encompasses Issues Related to…. race color class age experience ability gender ethnicity language religion politics sexual orientation gender identity socio-economic status resident status...within each community

15 © Cross Cultural Health Care Program “Actually, the most important part of culture... is that which is hidden and internal but which governs the behavior encounter.”* *Source: Edward T. Hall, 1976 Understanding Culture

16 © Cross Cultural Health Care Program Cultural Competence Actualized The state of being capable of functioning effectively in the context of cultural differences* *Adapted from Terry Cross, PhD Northwest Indian Child Welfare Association

17 © Cross Cultural Health Care Program Elements of Cultural Competence Awareness of one’s own culture Awareness and acceptance of difference Understanding the dynamics of difference Development of cultural knowledge Celebration of diversity

18 © Cross Cultural Health Care Program The Impact of Personal Culture on Communication Incorrect assumptions about the other Language and communication style issues Biases against the unfamiliar Personal values in conflict Expectations that others will conform to established norms Adapted from Selma Myers Conflict and Culture

19 © Cross Cultural Health Care Program Experience “We are either equipped by our past experiences or handicapped by them.” — Ehab Hanna, M.D. Department of Head and Neck Surgery M.D. Anderson Cancer Center

20 © Cross Cultural Health Care Program Working in Communities To offer culturally appropriate care requires being open to the expec- tations, perceptions, and realities of the various communities.

21 © Cross Cultural Health Care Program Survey Findings: Barriers to Services Cultural issues Perceived limitations of western approach to healthcare Money Bias Language Interpreters Transportation Child care

22 © Cross Cultural Health Care Program Categories of Flu Treatments— Ingested Herbal Treatments Hundreds are used in this country. Modern forms are often processed and lack traditional treatment information and context. Many teas are popular and most are mildly effective at treating symptoms. Source: Margie Akin PhD

23 © Cross Cultural Health Care Program Foods to Fight the Flu African groundnut (peanut) chicken soup Other traditional soups have other nutrients that may be lacking in everyday diet—such as extra protein in this traditional African chicken soup. Source: Margie Akin PhD

24 © Cross Cultural Health Care Program Cultural Bump... As a result of a personal interaction you are: confused frustrated angry misunderstood helpless hopeless

25 © Cross Cultural Health Care Program Ethnocentrism Misinterpretation and misjudgment based on looking at another person’s behavior from your own cultural reference point. Ethnocentric misjudgments result in culturally biased interactions.

26 © Cross Cultural Health Care Program Power Involves the capacity to influence, for one’s own benefit, the forces that affect one’s life. Powerlessness thus is the inability to exert such influence. Basch (1975, p. 513) has stated that “the feeling of controlling one’s destiny to some reasonable extent is the essential psychological component of all aspects of life.” This means that a sense of power is critical to one’s mental health. Everyone needs it. Elaine Pinderhughes Understanding Race, Ethnicity, and Power.

27 © Cross Cultural Health Care Program The Negative Cycle of Communication Person A Emotions Angry Hopeless Helpless Frustrated Confused Misunderstood Depressed Person B Actions Violence Withdrawal Passive-aggressive Blame Substance Abuse Homicide Suicide ©Ira SenGupta, 2002

28 © Cross Cultural Health Care Program Question What does it take to bring you out of this negative communication cycle? (We are opening the phone lines for group discussion. Please tell us your answer either verbally or via text chat.)

29 © Cross Cultural Health Care Program Five Steps to Cultural Competency Awareness of self and the other Acknowledgement Honest validation Negotiation Action: choices and options ©Ira SenGupta, May, 2002, Health and Healing

30 © Cross Cultural Health Care Program Communication Across Cultures: Skills That Make a Difference Realize your viewpoint may not be the only one. Strive to be non-judgmental. Question your assumptions constantly. Understand what others feel. Be more flexible... less resistant. Celebrate & honor differences.

31 © Cross Cultural Health Care Program Key Learning The more accurate information we have about others, the more likely we will be able to respond with respect and understanding. The more familiar we are, the more comfortable we become. And with comfort and time, comes trust resulting in effective communications. Familiarity Comfort Trust Effective Communications

32 © Cross Cultural Health Care Program A Summary Dare to bridge across barriers Allow for fragility due to circumstance Honor the mystery of building connections

33 © Cross Cultural Health Care Program Cultural Competency—A Practical View “To be culturally competent doesn’t mean that you will never encounter cultural bumps. What it means is that you will be more aware of how and why cultural bumps happen while skillfully navigating them for best outcomes.” —Ira SenGupta, CCHCP, December 05

34 © Cross Cultural Health Care Program Final Thoughts... You and I We meet as strangers, each carrying a mystery within us. I cannot say who you are. I may never know you completely. But I trust that you are a person in your own right, possessed of a beauty and value that are the Earth's richest treasures. So I make this promise to you; I will impose no identities upon you, but will invite you to become yourself without shame or fear. I will hold open a space for you in the world and allow your right to fill it with an authentic vocation and purpose. For as long as your search takes, you have my loyalty. Author Unknown

35 © Cross Cultural Health Care Program Human Rights “Where after all do universal Human Rights begin? In small places and close to home, so small and so close that they cannot be seen on any map of the world.” — Eleanor Roosevelt NY Times, Dec. 1965

36 © Cross Cultural Health Care Program The Cross Cultural Health Care Program Vision: Healthcare in every community every community in healthcare Contact information: Ira SenGupta, Executive Director 270 South Hanford St. Ste. 208 Seattle, WA Ph: Website:

37 © Cross Cultural Health Care Program Further Readings 1. Quality Health Services for Hispanics: The Cultural Competency Component 2. World's Apart, the video series: 3. An excellent video: Communicating Effectively through an Interpreter D=27&list=27%2C25%2C23 D=27&list=27%2C25%2C23 4. Quiz for healthcare providers on quality & culture

38 © Cross Cultural Health Care Program References Quality Health Services for Hispanics: The Cultural Competency Component, 2001, p.10 U.S. Bureau of the Census, Resident Population Projections of the United States: Middle, Low, and High Series, 1996 to 2050 Boston Public Health Commission, Disparities Project Data Report, June


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