Facing the Future: Diversity in the US and the Need for Cultural Competency

1. Facing the Future: Diversity in the US and the Need for Cultural Competency Adelita G. Cantu, PhD(c), RN Education Coordinator Juntos Podemos

2. Diversity in the US • Between 1990 & 2000, the US population increased from 248.7 million to 281.4 million. • 75,1% are white • 12.5% are Hispanic • 12.3% are African-American • 3.6% are Southeast Asian • 0.9% are Native American or Alaskan Native • 0.1% are Native Hawaiian or other Pacific Islander • 5.5% are some other race • 2.4% are of two or more races

3. Race Categories as Used in Census 2000 • White refers to people having origins in any of the original peoples of Europe, the Near East, and the Middle East, or North Africa. This category includes Irish, German, Italian, Lebanese, Turkish, Arab, and Polish • Black or African American refers to people having origins in any of the black racial groups of Africa, and includes Nigerians and Haitians or any person who self-designated this category regardless of origin

4. Race Categories as Used in Census 2000 • American Indian or Alaskan Native refers to people having origins in any of the original peoples having origins in ay of the original peoples of North, South, or Central American, and who maintain tribal affiliation or community attachment. • Asian refers to people having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent. This category includes the terms Asian Indian, Chinese, Filipino, Korean, Japanese, Vietnamese, Burmese, Hmong, Pakistani, and Thai.

5. Race Categories as Used in Census 2000 • Native Hawaiian and other Pacific Islander refers to people having origins in any of the original peoples of Hawaii, Guan, Samoa, Tahiti, the Mariana Islands, and Chuuk. • “Some other race” was included for people who are unable to identify with the other categories. Additionally, the respondent could identify, as a write-in, with two races.

6. The Growth of the Hispanic Population • Over past decade, Hispanics: • rose from 22.4 million to 35.3 million, a 57.9% increase • largest group are Mexicans, followed by Puerto Ricans, Cubans, Central Americans, South Americans, and Dominicans • ¾ of Hispanics live in the West and South, 50% living in Texas & California • median age for Hispanics is 25.9% while for US is 35.3%

7. Nationwide • Total estimated # of RNs: 2,696,540 • Total estimated # of Hispanic RNs: 54, 861 • Hispanics comprise more than 12% of the US population, but only 2% of RNs Source: http://bhpr.hrsa.gov/healthworkforce/reports/msurvey/mss1.htm

8. Currently Licensed Texas RN’s Residing in Texas by Ethnicity 09/01/2004 Source: Board of Nurse Examiners

9. The young age of Hispanics in the US makes them ideal candidates for recruitment into the health professions, an area with crisis-level shortages of personnel, especially of minority representation.

10. Culture • Culture is defined as the totality of socially transmitted behavioral patterns, arts, beliefs, values, customs, lifeways, and all other products of human work and thought characteristics of a population of people that guide their worldview and decision making.

11. Attitude • Attitude is a state of mind or feeling about some matter of a culture. Attitudes are learned; for example, some people think that one culture is better than another culture.

12. Belief • A belief is something that is accepted as true, especially as a tenet or a body of tenets accepted by people in an ethnocultural group. A belief among cultures is that is a pregnant woman craves a particular food substance and does not satisfy the craving, the baby will be born with a birthmark in the shape of the craving.

13. Cultural patterns may be explicit or implicit, are • primarily learned and transmitted within family, are • shared by most members of the culture, and are • emergent phenomena that change in response to • global phenomena. Culture is largely unconscious • and has powerful influences on health and illness. • health-care providers must recognize, respect, • and integrate clients’ cultural beliefs and practices • into health prescriptions.

14. Cultural Competence • Increasing one’s consciousness of cultural diversity improves the possibilities for health-care providers to provide culturally competent care. • Developing an awareness of one’s own existence, sensations, thoughts, and environment without letting it have an undue influence on those from other backgrounds. • Demonstrating knowledge and understanding of the client’s culture, health-related needs, and meanings of health and illness.

15. Cultural Competence • Accepting and respecting cultural differences. • Not assuming that the health-care provider’s beliefs and values are the same as the client’s. • Resisting judgmental attitudes such as “different is not as good.” • Being open to cultural encounters. • Adapting care to be congruent with the client’s culture. Cultural competence is a conscious process and not necessarily linear. Purnell, L. D. & Paulanda, B. J. (2003). Transcultural Health Care: A Culturally Competent Approach, F. A. Davis: Philadelphia