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Cultural Competency: A Critical Element of Health Care and Health Research

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Ronny A. Bell, PhD, MS Professor of Epidemiology and Prevention Director, Maya Angelou Center for Health Equity Wake Forest University School of Medicine – PowerPoint PPT presentation

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Title: Cultural Competency: A Critical Element of Health Care and Health Research


1
Cultural Competency A Critical Element of
Health Care and Health Research
  • Ronny A. Bell, PhD, MS
  • Professor of Epidemiology and Prevention
  • Director, Maya Angelou Center for Health Equity
  • Wake Forest University School of Medicine

2
WHO ARE YOU?
3
What are the factors that make you you?
  • Family/friends
  • Where you grew up
  • Where you live
  • Religious beliefs
  • Education
  • Entertainment
  • Employment
  • Travel experiences
  • Tastes in Foods and Beverages
  • Race/Ethnicity

4
What is Culture?
  • An integrated pattern of human knowledge,
    belief, and behavior that depends upon the
    capacity for symbolic thought and social
    learning
  • The set of shared attitudes, values, goals, and
    practices that characterizes an institution,
    organization or group
  • Source Wikipedia

5
What is Cultural Competence?
  • Having a defined set of values and principles,
    and demonstrated behaviors, attitudes, policies,
    and structures that allow for effective work
    cross-culturally.

National Center for Cultural Competence, 1998
6
What is Cultural Competence?
  • Having the capacity to
  • (1) value diversity,
  • (2) conduct self-assessment,
  • (3) manage the dynamics of difference,
  • (4) acquire and institutionalize cultural
    knowledge, and
  • (5) adapt to diversity and the cultural contexts
    of communities they serve.

National Center for Cultural Competence, 1998
7
What is Cultural Competence?
  • Incorporate the above components in all aspects
    of policy-making, administration, practice and
    service delivery, systematically involve
    consumers, families and communities.

National Center for Cultural Competence, 1998
8
Cultural Competence in Health Care
  • The ability of systems to provide care to
    patients with diverse values, beliefs and
    behaviors, including tailoring delivery to meet
    patients social, cultural, and linguistic
    needs. (Betancourt, 2002)

9
Cultural Competence in Health Care
  • Having the capacity to function effectively as
    an individual and an organization within the
    context of the cultural beliefs, behaviors and
    needs presented by consumers and their
    communities. (Office of Minority Health, 2001)

10
Cultural Competence in Health Care
  • At a systems, organizational or program level,
    cultural competence requires a comprehensive and
    coordinated plan that includes interventions on
    levels of
  • policy making
  • infra-structure building
  • program administration and evaluation
  • the delivery of services and enabling supports
    and
  • the individual.
  • Denboba, MCHB, 1993

11
Cultural Competence in Health Care
  • At the individual level, cultural competence
    means an examination of ones own attitude and
    values, and the acquisition of the values,
    knowledge, skills and attributes that will allow
    an individual to work appropriately in cross
    cultural situations.

Denboba, MCHB, 1993
12
Cultural Competence in Health Care
  • Cultural competence mandates that organizations,
    programs and individuals must have the ability
    to
  • value diversity and similarities among all
    peoples
  • understand and effectively respond to cultural
    differences
  • engage in cultural self-assessment at the
    individual and organizational levels
  • make adaptations to the delivery of services and
    enabling supports and
  • institutionalize cultural knowledge.

13
Cultural Competence in Health Research
  • Asking the right questions
  • Asking the right questions the right way
  • Answering the right questions the right way

14
Institute of MedicineUnequal Treatment Report
15
(No Transcript)
16
Why is Cultural Competence Important in Health
Care?
  • Excess rates of diabetes, hypertension and stroke
    among African Americans and Latinos relative to
    whites will cost the health care system 23.9
    billion dollars in 2009.
  • Medicare alone will spend an extra 15.6 billion,
    and private insurers will spend an extra 5.1
    billion.
  • Over the next decade, the total cost is
    approximately 337 billion.
  • Left unchecked, these annual costs will more than
    double by 2050 as the representation of Latinos
    and African Americans among the elderly increases.

Waidman, The Urban Institute, http//www.urban.org
/publications/411962.html
17
Racial and Ethnic Health Disparities in North
Carolina REPORT CARD 2006
Office of Minority Health and Health
Disparities And State Center for Health
Statistics North Carolina Department of Health
and Human Services
18
Current Smoking Rates in North Carolina, by
Race/Ethnicity, 2004
State Center for Health Statistics
19
Smoking During Pregnancy, by Race/Ethnicity, 1996
- 2000
State Center for Health Statistics
20
Percentage of Middle Schoolers who Ever Smoked,
by Race/Ethnicity 1999 - 2000
State Center for Health Statistics
21
(No Transcript)
22
Cultural Competence and Tobacco Prevention
  • Understanding the unique patterns of initiation
    and use of tobacco
  • Understanding the cultural and economic value
    attached to tobacco
  • Recognizing the symbols/images that convey
    messages important for tobacco prevention
  • Utilizing the forms of communication that are
    important to communities

23
www.aaip.org, www.diabetes.org
24
www.lumbeetribe.com
25
The Peoples Clinic
  • African American
  • 7 African American owned newspapers in NC
  • American Indian
  • 6 Tribes
  • Latino
  • 1 Latino Media Enterprise

26
Summary
  • Cultural competency is a critical but often
    elusive component of delivering health care and
    conducting health related research
  • Effort should be made enhance the cultural
    competency of individuals and systems that
    provide health care and conduct health research
  • Providing cultural competency makes business
    sense, but, more importantly, its THE RIGHT
    THING TO DO!
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