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Module 1b Objectives. Learners will:. List three compelling reasons why cultural and linguistic competency is important to behavioral health and primary care service delivery; Describe the intersection of culture, health and social determinants ; and
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Module 1b Objectives Learners will: • List three compelling reasons why cultural and linguistic competency is important to behavioral health and primary care service delivery; • Describe the intersection of culture, health and social determinants; and • Describe Cross’ Cultural Competence Continuum Model.
Our Children: 0 - 17 years of age PERCENTAGE OF CHILDREN AGES 0–17 IN THE UNITED STATES BY RACE AND HISPANIC ORIGIN, 1980–2014 AND PROJECTED 2015–2050 NOTE: The abbreviation NH refers to non-Hispanic origin. The abbreviation NHPI refers to the Native Hawaiian and Other Pacific Islander population. Each group represents the non-Hispanic population, with the exception of the Hispanic category itself. Race data from 2000 onward are not directly comparable with data from earlier years. Data on race and Hispanic origin are collected separately. Persons of Hispanic origin may be of any race. SOURCE: U.S. Census Bureau, Population Division.
American Community Survey 5-Year Estimates 2010 – 2014, Duval County
Immigrants Immigrants • The term “immigrant” encompasses a wide range of people who enter the United States through different channels, both regular and irregular, and who have different immigration statuses. Congress determines which groups are eligible for benefits and services provided through the Refugee Services program.
Refugees The U.S. Refugee Act of 1980 defines a refugee as: A person who is outside his or her country; is unwilling or unable to return to his or her home country, and is able to demonstrate persecution or a well-founded fear of persecution based on race, religion, nationality, political opinion, or membership in a particular social group.
Federal Mandates • Title VI of the Civil Rights Act of 1964 • Title I of the Americans with Disabilities Act of 1990
Federal Mandates & Regulatory Standards Cultural & Linguistic Appropriate Standards (CLAS) Council of Accreditation (COA) Joint Commission on the Accreditation of Health Care Facilities (JACHO) Commission on Accreditation of Residential Facilities (CARF) Title VI of the Civil Rights Act of 1964
Health Equity The 2003 Institute of Medicine (IOM) publication “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” determined that the development and implementation of training programs for health care providers around topics of cultural competence offers promise in reducing health disparities.
Health Equity • Suicide is the 3rd leading cause of death for African American males • 15 – 19 years of age. • Suicide is the 4th leading cause of death for African American females 15 – 19 years of age. • Native American/Alaskan Native youth have the highest rates of suicide-related fatalities. • A nationwide survey of youth in grades 9–12 in public and private schools in the U.S. found Hispanic youth were more likely to report attempting suicide than their black and white, non-Hispanic peers. • (Department of Health and Human Services, National Center for Health Statistics, Centers for Disease Control, 2014)
Health Equity • Across community-based settings, children and youth with mental health problems and their families are less likely to receive needed mental health services if they come from a diverse background, are part of an underrepresented minority group, or come from a family with limited English proficiency. • Racially and ethnically diverse children and youth with mental health problems are also more likely to access mental health services through the juvenile justice system. • In emergency department settings, children and youth of color and those from families with limited English proficiency are: • • disproportionately under-identified • • more likely to experience long waiting times and longer lengths of stays • • more likely to have a mental health-related visit that involves law enforcement
Education Disparities • Racial minorities are more likely than White students: • Suspended from school • Black students are suspended and expelled at 3xs the rate of White students. • Less access to rigorous math and science classes • Twenty-five percent (25%) of high schools with the highest percentage of black and Latino students do not offer higher level courses • Taught by lower-paid teachers with less experience • Black students are more than 4xs as likely, 2Xs as likely for Latino students to attend schools where 1 out of 5 teachers does not meet all state teaching requirements. • (New York Times, School Data Finds Pattern of Inequality along Racial Line, March 2014)
Health Equity: Root Causes Health advocates often share health disparities and disproportionalities without focusing on the root causes and social determinants of poor health outcomes.
The shoe that fits one person pinches another; there is no recipe for living that suits all cases. Each of us carries his own life-form... • Eric Jung
Selena Webster-Bass, MPH The Voices Institute Cultural and Linguistic Competency Educator selena@voicesinst.org 904.504.9772
