Algernon Black:
Why not let people differ about their answers to the great mysteries of the Universe? Let each seek one's own way to the highest, to one's own sense of supreme loyalty in life, one's ideal of life. Let each philosophy, each world-view bring forth its truth and beauty to a larger perspective, that people may grow in vision, stature and dedication.
This entry continued ...
Anais Nin:
We do not grow absolutely, chronologically. We grow sometimes in one dimension, and not in another; unevenly. We grow partially. We are relative. We are mature in one realm, childish in another. The past, present, and future mingle and pull us backward, forward, or fix us in the present. We are made up of layers, cells, constellations.
Anne Frank:
We all live with the objective of being happy; our lives are all different and yet the same.
Daniel Patrick Moynihan:
Everyone is entitled to their own opinion, but not their own facts.
Donald Williams:
For those who have seen the Earth from space, and for the hundreds and perhaps thousands more who will, the experience most certainly changes your perspective. The things that we share in our world are far more valuable than those which divide us.
Ecclesiastes:
For everything there is a season,
And a time for every matter under heaven:
A time to be born, and a time to die;
A time to plant, and a time to pluck up what is planted;
A time to kill, and a time to heal;
A time to break down, and a time to build up;
A time to weep, and a time to laugh;
A time to mourn, and a time to dance;
A time to throw away stones, and a time to gather stones together;
A time to embrace, And a time to refrain from embracing;
A time to seek, and a time to lose;
A time to keep, and a time to throw away;
A time to tear, and a time to sew;
A time to keep silence, and a time to speak;
A time to love, and a time to hate,
A time for war, and a time for peace.
Ecclesiastes 3:1-8
Elbert Hubbard:
Religions are many and diverse, but reason and goodness are one.
The Roycroft Dictionary and Book of Epigrams, 1923
Eugene McCarthy:
As long as the differences and diversities of mankind exist, democracy must allow for compromise, for accommodation, and for the recognition of differences.
Franklin Thomas:
One day our descendants will think it incredible that we paid so much attention to things like the amount of melanin in our skin or the shape of our eyes or our gender instead of the unique identities of each of us as complex human beings.
in Gloria Steinem, Outrageous Acts and Everyday Rebellions, 1983
Harry Emerson Fosdick:
The fact that astronomies change while the stars abide is a true analogy of every realm of human life and thought, religion not least of all. No existent theology can be a final formulation of spiritual truth. The Living of These Days, 1956
James Baldwin:
It is a great shock at the age of five or six to find that in a world of Gary Coopers you are the Indian.
Jerome Nathanson:
The price of the democratic way of life is a growing appreciation of people's differences, not merely as tolerable, but as the essence of a rich and rewarding human experience.
Jimmy Carter:
We have become not a melting pot but a beautiful mosaic. Different people, different beliefs, different yearnings, different hopes, different dreams.
John F. Kennedy:
If we cannot end now our differences, at least we can help make the world safe for diversity.
John F. Kennedy:
The wave of the future is not the conquest of the world by a single dogmatic creed but the liberation of the diverse energies of free nations and free men.
Margaret Mead:
If we are to achieve a richer culture, rich in contrasting values, we must recognize the whole gamut of human potentialities, and so weave a less arbitrary social fabric, one in which each diverse human gift will find a fitting place.
Marian Wright Edelman:
When Jesus Christ asked little children to come to him, he didn't say only rich children, or White children, or children with two-parent families, or children who didn't have a mental or physical handicap. He said, "Let all children come unto me."
Mark Twain:
It were not best that we should all think alike; it is difference of opinion that makes horse races.
Martin Luther King Jr.:
Human salvation lies in the hands of the creatively maladjusted.
Mary Catherine Bateson:
Insight, I believe, refers to the depth of understanding that comes by setting experiences, yours and mine, familiar and exotic, new and old, side by side, learning by letting them speak to one another.
Mohandas K. Gandhi:
Non-cooperation is a measure of discipline and sacrifice, and it demands respect for the opposite views.
Mohandas K. Gandhi:
I do not want my house to be walled in on all sides and my windows to be stiffled. I want all the cultures of all lands to be blown about my house as freely as possible. But I refuse to be blown off my feet by any.
Mohandas K. Gandhi:
It is the duty of every cultured man or woman to read sympathetically the scriptures of the world. If we are to respect others' religions as we would have them respect our own, a friendly study of the world's religions is a sacred duty.
Pearl S. Buck:
We send missionaries to China so the Chinese can get to heaven, but we won't let them into our country.
Ralph Waldo Emerson:
In the matter of religion, people eagerly fasten their eyes on the difference between their own creed and yours; whilst the charm of the study is in finding the agreements and identities in all the religions of humanity.
Rene Dubos:
Human diversity makes tolerance more than a virtue; it makes it a requirement for survival.
Celebrations of Life, 1981
Robert A. Heinlein:
One man's religion is another man's belly laugh.
Robert F. Kennedy:
Ultimately, America's answer to the intolerant man is diversity, the very diversity which our heritage of religious freedom has inspired.
Thomas Jefferson:
Difference of opinion is helpful in religion.
Thursday, March 29, 2007
Saturday, March 24, 2007
Lack of Cultural Competency Increases Disparities in Cancer Care for Racial/Ethnic Patients and the Poor
Lack of Cultural Competency Increases Disparities in Cancer Care for Racial/Ethnic Patients and the Poor
New "Pocket Guide" Shows Healthcare Professionals How to Deliver Culturally-Centered Cancer Care
March 1, 2007 (Nashville, Tenn.) -- At a time when changing demographics requires clinicians to speak in a new language when interacting with patients and family members, the Intercultural Cancer Council (ICC) is joining forces with Meharry Medical College to improve the cultural competency of those health professionals who provide cancer care to the nation’s racial/ethnic minorities and the rural poor.
At a "teach-in" for medical students which will be held Thursday, March 1, 2007 at 10:00am on the campus of Meharry Medical College, the organizations will unveil a new "Pocket Guide"-- Cultural Competence in Cancer Care: A Health Care Professional’s Passport -- giving health care professionals a systematic approach for interacting with multicultural and economically disadvantaged cancer patients and their families. This 121-page guide is an enhancement of the first edition released in 2004 and highlights the influences of culture, geography, socioeconomic status and geography on the health behaviors of the rural poor and the five largest racial/ethnic groups in the U.S.: African Americans, Latinos/Hispanics, American Indians and Alaskan Natives, Asians and Asian Americans, and Native Hawaiian and other Pacific Island Populations. Of special significance, this latest edition adds information on the Appalachia populations, providing recommendations on how to interact with patients from rural America.
Intended to improve the ability of physicians, nurses and other health professionals to communicate with medically underserved patients about all aspects of cancer care, the new guide also documents the consequences of not delivering culturally competent cancer care at the community level. Specifically, the guide reveals major disparities in access to quality cancer care at all points in the process -- from screenings and diagnosis to access to state-of-the-art cancer therapies and end-of-life palliative care. Some of the findings cited in the guide include:
•
African Americans have the highest death rate from colon and rectal cancer of any racial and ethnic group in the U.S. and when it is detected at a localized stage, the survival rate is 84 percent. However, only 33 percent of these cancers are detected at a localized stage.
•
Latinos/Hispanics have higher incidence and death rates of stomach cancer compared to non-Hispanic Whites.
-More-
•
Cancer is becoming the leading cause of death for Alaska Native women and is the second leading cause of death among all other Native men and women.
•
Chinese Americans experience the highest mortality rate for liver cancer.
•
The incidence and mortality from thyroid cancer are higher among Filipinos than any other ethnic group.
•
Cervical cancer incidence rates among Vietnamese women are more than 2 ½ times higher than rates for any other ethnic group.
•
Native Hawaiians have the highest mortality rates in the nation for cancers of the corpus uteri and stomach.
•
The Appalachian region has a higher mortality rate for all cancers than the U.S. as a whole.
"The lack of cultural competency is a serious problem that results in greater suffering and higher death rates from cancer for multicultural patients compared to the White population as a whole," said Dr. Patricia Matthews-Juarez, associate vice-president of Faculty and Development at Meharry Medical College and one of the guide’s authors. "All patients deserve the same access to quality cancer care and this starts with a recognition that culture counts."
To improve the cultural competency of physicians and other health professionals, the guide provides a primer on the culturally appropriate behaviors and attitudes toward cancer prevention and control that differ by multicultural and socio-economic status of patients. This includes common verbal and nonverbal communications, such as shaking hands, looking the patient in the eye, how far to sit or stand from the patient and the use of touch. Some of the insights described in thepr
imer are: Health care professionals should begin clinical visits by addressing the adult patient by titles such as Mr. Mrs. or Ms. Calling an adult patient by his or her first name
d
emonstrates lack of respect and is demeaning. "Faith in God" is a strong predictor of how African American patients handle the understanding and diagnosis of cancer.
When communicating with Latino/Hispanic families, "respecto" (respect) must be conveyed at first to the father, then to the mother, then to the other older adults and finally to the older and younger children. Informal use of language will also increase the
l
evel of suspicion and sharpen defenses. Because doctors, nurses and other health professionals represent sources of authority for Latinos/Hispanics, the clinician should allow the patient to avoid eye contact as a way of showing respect. Pacific Islanders, who consider direct eye contact with authority figures as rude, share this form of nonverbal communication.
Out of a sense of "respecto," many Latino/Hispanic patients will avoid disagreeing or even asking the simplest questions.
Most indigenous languages do not include a word for "cancer." Thus, when discussing prevention and early detection, specialists advise replacing the word "cancer" with "health," such as "breast health screening."
Some Asian American patients and their families embrace the holistic approach to health. The use of tonics and herbs to strengthen resistance to disease and to improve overall health may be a barrier to cancer prevention and screening activities.
Among the disadvantaged, such as the rural poor living in Appalachia, educational attainment, literacy and functional literacy are often barriers to cancer care. Not understanding what the health care professional is talking about during a clinic visit may
-More-
2
contribute to some patients feeling ashamed about their literacy level and therefore, not admitting that they do not understand what is being said or what is in print. Accordingly, specialists recommend using plain language, defining the terms used in cancer care, and employing educational tools such as videos and DVDs to facilitate patient understanding among this population group.
"By improving the cultural competency of health professionals, we can improve how communities deliver cancer care to the most vulnerable citizens," said Armin D. Weinberg, PhD, another of the guide’s authors, who is also the Director of Chronic Disease Prevention and Control Research Center at Baylor College of Medicine and the co-founder of the ICC. "This information, combined with an ongoing dialogue between clinicians, patients and their family members will enable more Americans to the receive quality cancer care to which they are entitled."
To develop the new "Pocket Guide," the Intercultural Cancer Council organized the information around critical concepts found in the literature on culture and cultural competence and then enlisted a panel of experts to review this information. The expert panel was comprised of M. Alfred Haynes, MD, Past Director of the Drew-Meharry-Morehouse Cancer Center and Chair of the Institute of Medicine/Unequal Burden of Cancer study on minorities and cancer; Neil A. Palafox, MD, Professor and Chair, Department of Family Medicine and Community Health at the University of Hawaii; and Harold P. Freeman, MD, former Director of the Center to Reduce Health Disparities at the National Cancer Institute. In addition, an advisory committee of more than 30 specialists focusing on the medically underserved reviewed and vetted the information.
The guide can be purchased for $6.00 per copy plus shipping charges by contacting 1.877.243.6642 or www.iccnetwork.org/news/Pocket_Guide_Order_Form.pdf. All proceeds from sales of the guide will be used to further the activities of the Intercultural Cancer Council.
The Intercultural Cancer Council operates under the auspices of Baylor College of Medicine, Houston, Texas, and is an advocacy organization whose mission is to advance policies, programs, partnerships and research to eliminate the unequal burden of cancer among racial and ethnic minorities and medically underserved populations. For more information, visit www.iccnetwork.org.
Meharry Medical College, located in Nashville, Tennessee, is the largest private, comprehensive historically black institution for educating health professionals including dentists and scientists in the United States. It exists to improve the health and health care of minority and underserved communities by offering excellent education and training programs in the health sciences; placing special emphasis on providing opportunities to people of color and individuals from disadvantaged backgrounds, regardless of race or ethnicity; delivering high quality health services; and conducting research that foster the elimination of health disparities.
New "Pocket Guide" Shows Healthcare Professionals How to Deliver Culturally-Centered Cancer Care
March 1, 2007 (Nashville, Tenn.) -- At a time when changing demographics requires clinicians to speak in a new language when interacting with patients and family members, the Intercultural Cancer Council (ICC) is joining forces with Meharry Medical College to improve the cultural competency of those health professionals who provide cancer care to the nation’s racial/ethnic minorities and the rural poor.
At a "teach-in" for medical students which will be held Thursday, March 1, 2007 at 10:00am on the campus of Meharry Medical College, the organizations will unveil a new "Pocket Guide"-- Cultural Competence in Cancer Care: A Health Care Professional’s Passport -- giving health care professionals a systematic approach for interacting with multicultural and economically disadvantaged cancer patients and their families. This 121-page guide is an enhancement of the first edition released in 2004 and highlights the influences of culture, geography, socioeconomic status and geography on the health behaviors of the rural poor and the five largest racial/ethnic groups in the U.S.: African Americans, Latinos/Hispanics, American Indians and Alaskan Natives, Asians and Asian Americans, and Native Hawaiian and other Pacific Island Populations. Of special significance, this latest edition adds information on the Appalachia populations, providing recommendations on how to interact with patients from rural America.
Intended to improve the ability of physicians, nurses and other health professionals to communicate with medically underserved patients about all aspects of cancer care, the new guide also documents the consequences of not delivering culturally competent cancer care at the community level. Specifically, the guide reveals major disparities in access to quality cancer care at all points in the process -- from screenings and diagnosis to access to state-of-the-art cancer therapies and end-of-life palliative care. Some of the findings cited in the guide include:
•
African Americans have the highest death rate from colon and rectal cancer of any racial and ethnic group in the U.S. and when it is detected at a localized stage, the survival rate is 84 percent. However, only 33 percent of these cancers are detected at a localized stage.
•
Latinos/Hispanics have higher incidence and death rates of stomach cancer compared to non-Hispanic Whites.
-More-
•
Cancer is becoming the leading cause of death for Alaska Native women and is the second leading cause of death among all other Native men and women.
•
Chinese Americans experience the highest mortality rate for liver cancer.
•
The incidence and mortality from thyroid cancer are higher among Filipinos than any other ethnic group.
•
Cervical cancer incidence rates among Vietnamese women are more than 2 ½ times higher than rates for any other ethnic group.
•
Native Hawaiians have the highest mortality rates in the nation for cancers of the corpus uteri and stomach.
•
The Appalachian region has a higher mortality rate for all cancers than the U.S. as a whole.
"The lack of cultural competency is a serious problem that results in greater suffering and higher death rates from cancer for multicultural patients compared to the White population as a whole," said Dr. Patricia Matthews-Juarez, associate vice-president of Faculty and Development at Meharry Medical College and one of the guide’s authors. "All patients deserve the same access to quality cancer care and this starts with a recognition that culture counts."
To improve the cultural competency of physicians and other health professionals, the guide provides a primer on the culturally appropriate behaviors and attitudes toward cancer prevention and control that differ by multicultural and socio-economic status of patients. This includes common verbal and nonverbal communications, such as shaking hands, looking the patient in the eye, how far to sit or stand from the patient and the use of touch. Some of the insights described in thepr
imer are: Health care professionals should begin clinical visits by addressing the adult patient by titles such as Mr. Mrs. or Ms. Calling an adult patient by his or her first name
d
emonstrates lack of respect and is demeaning. "Faith in God" is a strong predictor of how African American patients handle the understanding and diagnosis of cancer.
When communicating with Latino/Hispanic families, "respecto" (respect) must be conveyed at first to the father, then to the mother, then to the other older adults and finally to the older and younger children. Informal use of language will also increase the
l
evel of suspicion and sharpen defenses. Because doctors, nurses and other health professionals represent sources of authority for Latinos/Hispanics, the clinician should allow the patient to avoid eye contact as a way of showing respect. Pacific Islanders, who consider direct eye contact with authority figures as rude, share this form of nonverbal communication.
Out of a sense of "respecto," many Latino/Hispanic patients will avoid disagreeing or even asking the simplest questions.
Most indigenous languages do not include a word for "cancer." Thus, when discussing prevention and early detection, specialists advise replacing the word "cancer" with "health," such as "breast health screening."
Some Asian American patients and their families embrace the holistic approach to health. The use of tonics and herbs to strengthen resistance to disease and to improve overall health may be a barrier to cancer prevention and screening activities.
Among the disadvantaged, such as the rural poor living in Appalachia, educational attainment, literacy and functional literacy are often barriers to cancer care. Not understanding what the health care professional is talking about during a clinic visit may
-More-
2
contribute to some patients feeling ashamed about their literacy level and therefore, not admitting that they do not understand what is being said or what is in print. Accordingly, specialists recommend using plain language, defining the terms used in cancer care, and employing educational tools such as videos and DVDs to facilitate patient understanding among this population group.
"By improving the cultural competency of health professionals, we can improve how communities deliver cancer care to the most vulnerable citizens," said Armin D. Weinberg, PhD, another of the guide’s authors, who is also the Director of Chronic Disease Prevention and Control Research Center at Baylor College of Medicine and the co-founder of the ICC. "This information, combined with an ongoing dialogue between clinicians, patients and their family members will enable more Americans to the receive quality cancer care to which they are entitled."
To develop the new "Pocket Guide," the Intercultural Cancer Council organized the information around critical concepts found in the literature on culture and cultural competence and then enlisted a panel of experts to review this information. The expert panel was comprised of M. Alfred Haynes, MD, Past Director of the Drew-Meharry-Morehouse Cancer Center and Chair of the Institute of Medicine/Unequal Burden of Cancer study on minorities and cancer; Neil A. Palafox, MD, Professor and Chair, Department of Family Medicine and Community Health at the University of Hawaii; and Harold P. Freeman, MD, former Director of the Center to Reduce Health Disparities at the National Cancer Institute. In addition, an advisory committee of more than 30 specialists focusing on the medically underserved reviewed and vetted the information.
The guide can be purchased for $6.00 per copy plus shipping charges by contacting 1.877.243.6642 or www.iccnetwork.org/news/Pocket_Guide_Order_Form.pdf. All proceeds from sales of the guide will be used to further the activities of the Intercultural Cancer Council.
The Intercultural Cancer Council operates under the auspices of Baylor College of Medicine, Houston, Texas, and is an advocacy organization whose mission is to advance policies, programs, partnerships and research to eliminate the unequal burden of cancer among racial and ethnic minorities and medically underserved populations. For more information, visit www.iccnetwork.org.
Meharry Medical College, located in Nashville, Tennessee, is the largest private, comprehensive historically black institution for educating health professionals including dentists and scientists in the United States. It exists to improve the health and health care of minority and underserved communities by offering excellent education and training programs in the health sciences; placing special emphasis on providing opportunities to people of color and individuals from disadvantaged backgrounds, regardless of race or ethnicity; delivering high quality health services; and conducting research that foster the elimination of health disparities.
Spanish Calla Lilly Cards
Are you serving Latino families with hospice services?
Click to Order the Spanish Calla Lillies card.
CLUES
www.clues.org
CLUES (Comunidades Latinas Unidas En Servicio) offers five core services including mental health, chemical health, education, employment and elder wellness.
National Alliance for Hispanic Healthwww.hispanichealth.orgA national resource on Hispanic health issues.
Salud Integralwww.healtheast.org
HealthEast’s Salud Integral is a bilingual and bicultural clinic providing health care services to the Latino community.
NHPCO Spanish sectionwww.nhpco.org
The National Hospice and Palliative Care Organization (NHPCO) has hospice materials in Spanish for patients and their families. Located in Alexandria, VA, they can be reached at (703) 837-1500 or nhpco_info@nhpco.org.
Resource Center of the Americaswww.americas.orgSelection of Spanish and English language books.
Are you serving Latino families with hospice services?
Click to Order the Spanish Calla Lillies card.
CLUES
www.clues.org
CLUES (Comunidades Latinas Unidas En Servicio) offers five core services including mental health, chemical health, education, employment and elder wellness.
National Alliance for Hispanic Healthwww.hispanichealth.orgA national resource on Hispanic health issues.
Salud Integralwww.healtheast.org
HealthEast’s Salud Integral is a bilingual and bicultural clinic providing health care services to the Latino community.
NHPCO Spanish sectionwww.nhpco.org
The National Hospice and Palliative Care Organization (NHPCO) has hospice materials in Spanish for patients and their families. Located in Alexandria, VA, they can be reached at (703) 837-1500 or nhpco_info@nhpco.org.
Resource Center of the Americaswww.americas.orgSelection of Spanish and English language books.
The Jewish Hospice Manual: A Guide to Compassionate End-of-Life Care for Jewish Patients and their Familiesby Rabbi Lamm, D.D., and Barry M. Kinzbruner, M.D.This manual was prepared for professional and volunteer hospice caregivers who may be unfamiliar with Judaism and the needs of terminally ill Jewish patients. It is almost conversational in tone and will enable the caregiver to handle difficult situations confidently, effectively, and quickly.Paperback: 137 pp
Twin Cities Jewish Healing Program
www.jfcsmpls.org
The Twin Cities Jewish Healing Program offers comfort, hope and strength to people experiencing loss, life challenges, illness, dying and grief. TCJHP partners with TwinCities hospitals, nursing homes and hospices in an ongoing effort to provide culturally sensitive care and spiritual support to Jewish patients.
Twin Cities Jewish Healing Program
www.jfcsmpls.org
The Twin Cities Jewish Healing Program offers comfort, hope and strength to people experiencing loss, life challenges, illness, dying and grief. TCJHP partners with TwinCities hospitals, nursing homes and hospices in an ongoing effort to provide culturally sensitive care and spiritual support to Jewish patients.
Cultural Competency
Staff Development Cultural Competency ToolboxClick here for lending library resources available at no cost to hospice organizations.Trading Beliefs: Four Hmong Families Consider Relinquishing Their Traditional Health BeliefsA 20-minute video program produced by the Minnesota Center for Health Care Ethics; 1997. This video traces the experiences of four Hmong families who have sought help from western medicine, and explains what can be done to insure successful cross cultural medical care relationships. Contact Hospice Minnesota for more information.Worlds Apart: Four-Part Series on Cross-Cultural Healthcare4 videos with guide, produced by Fanlight Productions, Boston, MA; 2003; 49 minutes
This four-cassette series shows how cross-cultural conflicts arise and how they can affect health decisions and outcomes. It discusses language barriers, cultural and religious beliefs, racial and ethnic disparities in health care, and reasons for non-adherence to medications. Contact Hospice Minnesota for more information.
Mayo Clinic College of Medicine: Patient Diversity, Religious Diversity, Specific Diversity Groups, Transcultural Web Resources, Workplace Diversity
www.mayo.edu/education/nursing-research/diversity.html#religiousdiversity
Minnesota Department of Health, ImmigrantHealth http://www.health.state.mn.us/divs/idepc/refugee/immigrant/index.html
CLAS Standards and Final Report, Office of Minority Healthwww.omhrc.gov/CLAS
National Standards of Practice for Interpreters in Health CareNational Council on Interpreting for Health Care (NCIHC)www.ncihc.org/sop.php
MN Taskforce on Serving Immigrant & RefugeePopulations www.health.state.mn.us/divs/idepc/refugee/ihtf/ihtfabout.html
National Hospice and Palliative Care Organization End-of-Life Cultural CompetencyResources www.nhpco.org
The Center for Cross Cultural Healthwww.crosshealth.com
Profiles provide health care professionals with background information on different cultural groups. Profiles available include Albanian, Bosnian, Hmong, Nuer, Jewish American, Ukrainian, and Vietnamese. Price: $2.00 (+postage) for each profile.
New and updated profiles are also available including European American, Russian Jewish, Somali, and South Asian. Price is $5.00 plus postage for each profile.
Closing the Gap-Newsletter of Office of Minority Health
www.omhrc.gov/OMH/sidebar/omh-publications.htm
Institute of Medicine Report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care”, 2002; www.iom.edu/view.asp?id=4475
Language Linewww.languageline.com877-886-3885 or info@languageline.com
This four-cassette series shows how cross-cultural conflicts arise and how they can affect health decisions and outcomes. It discusses language barriers, cultural and religious beliefs, racial and ethnic disparities in health care, and reasons for non-adherence to medications. Contact Hospice Minnesota for more information.
Mayo Clinic College of Medicine: Patient Diversity, Religious Diversity, Specific Diversity Groups, Transcultural Web Resources, Workplace Diversity
www.mayo.edu/education/nursing-research/diversity.html#religiousdiversity
Minnesota Department of Health, ImmigrantHealth http://www.health.state.mn.us/divs/idepc/refugee/immigrant/index.html
CLAS Standards and Final Report, Office of Minority Healthwww.omhrc.gov/CLAS
National Standards of Practice for Interpreters in Health CareNational Council on Interpreting for Health Care (NCIHC)www.ncihc.org/sop.php
MN Taskforce on Serving Immigrant & RefugeePopulations www.health.state.mn.us/divs/idepc/refugee/ihtf/ihtfabout.html
National Hospice and Palliative Care Organization End-of-Life Cultural CompetencyResources www.nhpco.org
The Center for Cross Cultural Healthwww.crosshealth.com
Profiles provide health care professionals with background information on different cultural groups. Profiles available include Albanian, Bosnian, Hmong, Nuer, Jewish American, Ukrainian, and Vietnamese. Price: $2.00 (+postage) for each profile.
New and updated profiles are also available including European American, Russian Jewish, Somali, and South Asian. Price is $5.00 plus postage for each profile.
Closing the Gap-Newsletter of Office of Minority Health
www.omhrc.gov/OMH/sidebar/omh-publications.htm
Institute of Medicine Report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care”, 2002; www.iom.edu/view.asp?id=4475
Language Linewww.languageline.com877-886-3885 or info@languageline.com
Saturday, March 17, 2007
Cultural Competence in Healthcare
Cultural Competence in Healthcare is not so much about learning facts about particular cultures you might encounter. It has more to do with hospitality: cultivating an openness that communicates that you want to hear about others’ beliefs and practices. If your manner invites people to trust you, they can teach you what you need to know to be sensitive to their family’s particular needs.
Attitudes of Culturally CompetenceUnderstanding:
Acknowledging that there can be differences between our Western and other cultures' healthcare values and practices.
Empathy: Being sensitive to the feeling of being different.
Patience: Understanding the potential differences between our Western and other cultures' concept of time and immediacy.
Respect: The importance of culture as a determinant of health.The existence of other world views regarding health/illness.The adaptability and survival skills of our patients.The influence of religious beliefs on health.The role of bilingual/bicultural staff.
Ability: To laugh with oneself and others.Trust: Investment in building a relationship with patients which conveys a commitment to safeguard their well-being.
Guidelines for Communicating Across Cultural Differences
The United States is a “tossed salad” of groups from all over the world. Therefore, do not assume that an exotic-looking person is not an American. The forms of address differ among cultures; don’t assume that it is appropriate to address someone by his/her first name. In addition, the wife’s last name is not always the same as the husband’s.
Ask first.Don’t always expect direct answers to direct questions; many cultures address questions and issues in a more indirect way.Caregivers must explore the health-related beliefs and practices of each patient individually. The degree to which the information in this section may be true for each patient will be heavily influenced by social and economic factors, educational background of the patient and the patient's family, urban vs. rural origin, level of acculturation to the life and ways of the United States, length of time in the United States, and many other cultural, social, and individual factors.
The following questions may be useful in assessing culturally diverse patients and families:So that I might be aware of and respect your cultural beliefs...
Can you tell me what languages are spoken in your home and the languages that you understand and speak?
Please describe your usual diet. Also, are there times during the year when you change your diet in celebration of religious and other ethnic holidays?
Can you tell me about beliefs and practices including special events such as birth, marriage and death that you feel I should know?
Can you tell me about your experiences with health care providers in your native country?
How often each year did you see a health care provider before you arrived in the U.S.?
Have you noticed any differences between the type of care you received in your native country and the type you receive here?
If yes, could you tell me about those differences?Is there anything else you would like me to know?
Do you have any questions for me? (Encourage two-way communication)
Do you use any traditional health remedies to improve your health?
Is there someone, in addition to yourself, with whom you want us to discuss your medical condition?
Are there certain health care procedures and tests which your culture does not allow?
Are there any other cultural considerations I should know about to serve your health needs?
Websites with cultural information related to different cultural groups:
http://www.diversityresources.com/rc21d/menu_diversity_awareness.html
http://ggalanti.com/cultural_profiles.html
Web-based Self-Assessment for Health Care Practitioners
http://www11.georgetown.edu/research/gucchd/nccc/features/CCHPA.html
HRRV Library Resources
Hospice Care and Cultural Diversity, Infeld et al, 1995, Hayworth Press.
How Different Religions View Death and Afterlife, 2nd Edition, Johnson & McGee, eds., 1998, Charles Press.
Ethnic Variations in Dying, Death, and Grief: Diversity in Universality, Irish et al, eds., 1993,
Taylor & Francis.
How to Be a Perfect Stranger: The Essential Religious Etiquette Handbook, Third Edition, Matilins & Magida, eds., 2003, Skylight Paths Publishing.
Culture & Nursing Care: A Pocket Guide, Lipson et al, eds., 1996, UCSF Nursing Press.
The Education of Little Tree: A True Story, Forrest Carter, 1976, University of New Mexico Press.
For more information on accessing medical interpreter services through AT&T, available 24/7, speak to a social worker or Karen Smithson.
Attitudes of Culturally CompetenceUnderstanding:
Acknowledging that there can be differences between our Western and other cultures' healthcare values and practices.
Empathy: Being sensitive to the feeling of being different.
Patience: Understanding the potential differences between our Western and other cultures' concept of time and immediacy.
Respect: The importance of culture as a determinant of health.The existence of other world views regarding health/illness.The adaptability and survival skills of our patients.The influence of religious beliefs on health.The role of bilingual/bicultural staff.
Ability: To laugh with oneself and others.Trust: Investment in building a relationship with patients which conveys a commitment to safeguard their well-being.
Guidelines for Communicating Across Cultural Differences
The United States is a “tossed salad” of groups from all over the world. Therefore, do not assume that an exotic-looking person is not an American. The forms of address differ among cultures; don’t assume that it is appropriate to address someone by his/her first name. In addition, the wife’s last name is not always the same as the husband’s.
Ask first.Don’t always expect direct answers to direct questions; many cultures address questions and issues in a more indirect way.Caregivers must explore the health-related beliefs and practices of each patient individually. The degree to which the information in this section may be true for each patient will be heavily influenced by social and economic factors, educational background of the patient and the patient's family, urban vs. rural origin, level of acculturation to the life and ways of the United States, length of time in the United States, and many other cultural, social, and individual factors.
The following questions may be useful in assessing culturally diverse patients and families:So that I might be aware of and respect your cultural beliefs...
Can you tell me what languages are spoken in your home and the languages that you understand and speak?
Please describe your usual diet. Also, are there times during the year when you change your diet in celebration of religious and other ethnic holidays?
Can you tell me about beliefs and practices including special events such as birth, marriage and death that you feel I should know?
Can you tell me about your experiences with health care providers in your native country?
How often each year did you see a health care provider before you arrived in the U.S.?
Have you noticed any differences between the type of care you received in your native country and the type you receive here?
If yes, could you tell me about those differences?Is there anything else you would like me to know?
Do you have any questions for me? (Encourage two-way communication)
Do you use any traditional health remedies to improve your health?
Is there someone, in addition to yourself, with whom you want us to discuss your medical condition?
Are there certain health care procedures and tests which your culture does not allow?
Are there any other cultural considerations I should know about to serve your health needs?
Websites with cultural information related to different cultural groups:
http://www.diversityresources.com/rc21d/menu_diversity_awareness.html
http://ggalanti.com/cultural_profiles.html
Web-based Self-Assessment for Health Care Practitioners
http://www11.georgetown.edu/research/gucchd/nccc/features/CCHPA.html
HRRV Library Resources
Hospice Care and Cultural Diversity, Infeld et al, 1995, Hayworth Press.
How Different Religions View Death and Afterlife, 2nd Edition, Johnson & McGee, eds., 1998, Charles Press.
Ethnic Variations in Dying, Death, and Grief: Diversity in Universality, Irish et al, eds., 1993,
Taylor & Francis.
How to Be a Perfect Stranger: The Essential Religious Etiquette Handbook, Third Edition, Matilins & Magida, eds., 2003, Skylight Paths Publishing.
Culture & Nursing Care: A Pocket Guide, Lipson et al, eds., 1996, UCSF Nursing Press.
The Education of Little Tree: A True Story, Forrest Carter, 1976, University of New Mexico Press.
For more information on accessing medical interpreter services through AT&T, available 24/7, speak to a social worker or Karen Smithson.
Refugees boost North Dakota's population
By Bob Reha
Minnesota Public Radio
August 20, 2002
People in North Dakota are celebrating the new census numbers. The 2000 Census showed that for the first time in years, the state did not lose people. In fact, the state's population grew by slightly less than one percent. The gain is attributed to an influx of refugees escaping persecution and civil war. The majority of these new Americans have settled in Fargo, N.D.
Obwono Ajang is orginally from the Sudan. He has worked at Cardinal IG for more than three years. Ayunk says the only way out for refugees is to work hard and improve their standard of living. Ayunk is now an American citizen.
BY THE NUMBERS: Native countries of foreign-born residents in North Dakota
•Total: 12,114
•Canada: 3,017
•Germany: 912
•Bosnia and Herzegovina: 741
•Mexico: 582
•United Kingdom: 497
(MPR Photo/Bob Reha)
Foreign-born residents make up two percent of North Dakota's population. In Fargo, the numbers tell an interesting story. The majority of foreign-born residents come from Bosnia and Herzegovina, then Canada, followed closely by Africa.
Foreign-born residents make up four percent of Fargo's population, but 11 percent of those foreign-born residents are living below the poverty line. Census officials define that as an income of just over $17,000 for a family of four. For an individual, the figure is $8,500.
Refugees first starting arriving in Fargo-Moorhead 10 years ago. Amhar Lalic came from Bosnia seven years ago. Lalic is a team leader on the production line at Cardinal IG, a manufacturer of insulated glass windows. Lalic says he came here a poor refugee but he's not poor any more.
"Maybe a few years ago after I came here. But you know, everything changes, and over the years you build things up," says Lalic. "Right now I buy anything that I want. I don't have that kind of problem."
Lalic is in the majority at Cardinal IG. Of the company's 250 employees, 55 percent of them ae new Americans. Lalic says everyone gets along. He doesn't see many people complaining about their work. Lalic is an American citizen now, and enjoys living in the area.
"Nothing feels like home, but I feel like I'm welcomed here. I don't know how to explain it. They welcome me and ... they give me a job, and I'm happy with it," says Lalic.
Mike Arntson is a production manager at Cardinal IG in Fargo. Arntson says 55 percent of the plant's workforce are new Americans. Arntson says the large number of refugees who work at the plant was not by design. "They're good employees who work hard," he says.
Obwono Ajang operates a machine the workers call a bender. It shapes aluminum into frames for the windows. Ajang arrived in Fargo more than three years ago from the Sudan. He says working is important to him. It's a way to establish his independence.
"The only way out for us is to work hard so that we can improve our living standard, because here we don't have relatives - we don't have nobody," Ajang says.
Starting pay at Cardinal IG is $7.15 per hour, $2 above minimum wage. The company also offers profit-sharing for its employees.
Production manager Mike Arntson says the company didn't recruit refugees for employment. He says Cardinal IG hires the best qualified applicants for the jobs. All they have to do is demonstrate a willingness to work hard, and give their best effort.
Arntson says he's surprised the large number of refugees working at the plant has gotten a lot of attention.
"People forget that this is the United States of America and that this is a very new country," Arntson says. "It wasn't 100 years ago - I know in my case, my grandparents and great-grandparents were new Americans."
Arntson says history is repeating itself. He says this is just the latest influx of people into the United States who will become a valuable part of the workforce.
"Maybe sometimes they feel more fortunate to be living here than some of us do," Arntson says.
According to census data, 11 percent of refugees living in Fargo-Moorhead aren't as fortunate as Cardinal IG employees. David Martin, director of public affairs for the Fargo-Moorhead Chamber of Commerce, says historically refugees have been able to improve their lives through education and hard work. He believes history will repeat itself.
"There are always going to be disparities, but I think that over time those things do level out," Martin says. "As people become more a part of the broader community, and as they are more in the community over a longer period of time, they have more economic opportunity as well."
Martin says there are signs that's beginning. This week, a number of Sudanese refugees are starting classes at area schools.
Minnesota Public Radio
August 20, 2002
People in North Dakota are celebrating the new census numbers. The 2000 Census showed that for the first time in years, the state did not lose people. In fact, the state's population grew by slightly less than one percent. The gain is attributed to an influx of refugees escaping persecution and civil war. The majority of these new Americans have settled in Fargo, N.D.
Obwono Ajang is orginally from the Sudan. He has worked at Cardinal IG for more than three years. Ayunk says the only way out for refugees is to work hard and improve their standard of living. Ayunk is now an American citizen.
BY THE NUMBERS: Native countries of foreign-born residents in North Dakota
•Total: 12,114
•Canada: 3,017
•Germany: 912
•Bosnia and Herzegovina: 741
•Mexico: 582
•United Kingdom: 497
(MPR Photo/Bob Reha)
Foreign-born residents make up two percent of North Dakota's population. In Fargo, the numbers tell an interesting story. The majority of foreign-born residents come from Bosnia and Herzegovina, then Canada, followed closely by Africa.
Foreign-born residents make up four percent of Fargo's population, but 11 percent of those foreign-born residents are living below the poverty line. Census officials define that as an income of just over $17,000 for a family of four. For an individual, the figure is $8,500.
Refugees first starting arriving in Fargo-Moorhead 10 years ago. Amhar Lalic came from Bosnia seven years ago. Lalic is a team leader on the production line at Cardinal IG, a manufacturer of insulated glass windows. Lalic says he came here a poor refugee but he's not poor any more.
"Maybe a few years ago after I came here. But you know, everything changes, and over the years you build things up," says Lalic. "Right now I buy anything that I want. I don't have that kind of problem."
Lalic is in the majority at Cardinal IG. Of the company's 250 employees, 55 percent of them ae new Americans. Lalic says everyone gets along. He doesn't see many people complaining about their work. Lalic is an American citizen now, and enjoys living in the area.
"Nothing feels like home, but I feel like I'm welcomed here. I don't know how to explain it. They welcome me and ... they give me a job, and I'm happy with it," says Lalic.
Mike Arntson is a production manager at Cardinal IG in Fargo. Arntson says 55 percent of the plant's workforce are new Americans. Arntson says the large number of refugees who work at the plant was not by design. "They're good employees who work hard," he says.
Obwono Ajang operates a machine the workers call a bender. It shapes aluminum into frames for the windows. Ajang arrived in Fargo more than three years ago from the Sudan. He says working is important to him. It's a way to establish his independence.
"The only way out for us is to work hard so that we can improve our living standard, because here we don't have relatives - we don't have nobody," Ajang says.
Starting pay at Cardinal IG is $7.15 per hour, $2 above minimum wage. The company also offers profit-sharing for its employees.
Production manager Mike Arntson says the company didn't recruit refugees for employment. He says Cardinal IG hires the best qualified applicants for the jobs. All they have to do is demonstrate a willingness to work hard, and give their best effort.
Arntson says he's surprised the large number of refugees working at the plant has gotten a lot of attention.
"People forget that this is the United States of America and that this is a very new country," Arntson says. "It wasn't 100 years ago - I know in my case, my grandparents and great-grandparents were new Americans."
Arntson says history is repeating itself. He says this is just the latest influx of people into the United States who will become a valuable part of the workforce.
"Maybe sometimes they feel more fortunate to be living here than some of us do," Arntson says.
According to census data, 11 percent of refugees living in Fargo-Moorhead aren't as fortunate as Cardinal IG employees. David Martin, director of public affairs for the Fargo-Moorhead Chamber of Commerce, says historically refugees have been able to improve their lives through education and hard work. He believes history will repeat itself.
"There are always going to be disparities, but I think that over time those things do level out," Martin says. "As people become more a part of the broader community, and as they are more in the community over a longer period of time, they have more economic opportunity as well."
Martin says there are signs that's beginning. This week, a number of Sudanese refugees are starting classes at area schools.
CARDINAL IG EMPLOYEES
EXHIBIT AT HJELMKOLMST
Meg Luther Lindholm – Photographer
Wayne Gudmundson – MSUM Advisor
Sara Dalen – Hjelmkolmst
Dean Sather – Hjelmkolmst
Dave Pinder – Plant Manager since plants inception in 1998
Some of the countries that their employees come from are: Bosnia, Sudan, Somalia, Iraq, Mexico, Haiti, Vietnam, Romania, Central African Republic, Nigeria, El Salvador, Costa Rica, South Africa, Iran
Ana Grossman – Romania
Cuong Pham – South Vietnam
Jehen Ali – Northern Iraq (Muslim)
Jok Mach Ayvel – Southeran Sudan
Abdulrahman Noor – Somalia
Irfan Jupic - Bosnia
Obwonyou Ajang – Southern Sudan
Myamer Hajric – Bosnia
Estab and Ana Acevedo – Mexico, El Salvador
Eunice Olson – Central African Republic
Hasoon Khoshnow –Northeran Iraq
Mustafa Luguf – Somalia (Muslim)
Ali Mhoammed – Somalia
Louima Port – Haiti
Abdi Abdi – Somalia
Sarbart Kasim – Northern Iraq (Kurdish)
Payman Habib and Shelan Kamim – Northern Iraq
Jinan Kasim – Northern Iraq
Johan Yolo – Sudan
Son Vu – South Vietnam
Gervais Langaudo – Central African Republic
Kout Yolo and Haditha (Matiop) Sliman – Southern Sudan (Christian)
Dahabo Hassan – Somalia
Jasmin Hiseni – Bosnia
Clement Harambe – Southern Sudan
Bosnia
Nurija Beganovic - Bosnia
Rizgar Bawa – northern Iraq
Nezar Music – Bosnia
Jehan Ahi – Northern Iraq
Elijah Addai – Ghana
Dahabo Hassan – Somalia
Meg Luther Lindholm – Photographer
Wayne Gudmundson – MSUM Advisor
Sara Dalen – Hjelmkolmst
Dean Sather – Hjelmkolmst
Dave Pinder – Plant Manager since plants inception in 1998
Some of the countries that their employees come from are: Bosnia, Sudan, Somalia, Iraq, Mexico, Haiti, Vietnam, Romania, Central African Republic, Nigeria, El Salvador, Costa Rica, South Africa, Iran
Ana Grossman – Romania
Cuong Pham – South Vietnam
Jehen Ali – Northern Iraq (Muslim)
Jok Mach Ayvel – Southeran Sudan
Abdulrahman Noor – Somalia
Irfan Jupic - Bosnia
Obwonyou Ajang – Southern Sudan
Myamer Hajric – Bosnia
Estab and Ana Acevedo – Mexico, El Salvador
Eunice Olson – Central African Republic
Hasoon Khoshnow –Northeran Iraq
Mustafa Luguf – Somalia (Muslim)
Ali Mhoammed – Somalia
Louima Port – Haiti
Abdi Abdi – Somalia
Sarbart Kasim – Northern Iraq (Kurdish)
Payman Habib and Shelan Kamim – Northern Iraq
Jinan Kasim – Northern Iraq
Johan Yolo – Sudan
Son Vu – South Vietnam
Gervais Langaudo – Central African Republic
Kout Yolo and Haditha (Matiop) Sliman – Southern Sudan (Christian)
Dahabo Hassan – Somalia
Jasmin Hiseni – Bosnia
Clement Harambe – Southern Sudan
Bosnia
Nurija Beganovic - Bosnia
Rizgar Bawa – northern Iraq
Nezar Music – Bosnia
Jehan Ahi – Northern Iraq
Elijah Addai – Ghana
Dahabo Hassan – Somalia
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