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Cultural Diversity

Cultural Diversity. Olga Usynska. Definition of terms. Cultural diversity is the differences among people that result from ethic, racial and cultural variables. Definition of terms. What is Culture?

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Cultural Diversity

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  1. Cultural Diversity Olga Usynska

  2. Definition of terms • Cultural diversity is the differences among people that result from ethic, racial and cultural variables

  3. Definition of terms • What is Culture? • - shared lifestyle, values, beliefs, ideals and behavior of a particular group. Picture it as a luggage that each of us carries around for our lifetime. It is sum of beliefs, practices, habits, likes, dislikes, norms, customs, rituals and so forth that we learned from our families during the years of socialization. In turn, we transmit cultural luggage to our children.

  4. Dominant culture and minorities • Dominant culture is the group, whose values prevail within a society • Minority group is composed of an ethnic, racial, or religious group that constitutes less than a numerical majority of the population

  5. “The United States, already one of the most diverse societies in the world, is becoming increasingly multicultural and multilingual” Lester, 1998 The strength and greatness of America lies in the diversity of its people…

  6. Growing Diversity in America During the Past 20 years • White population increased 10% • African American populationincreased 30% • Native American population increased58 % • Hispanic population increased 125%

  7. Projected Demographics • In 2020 the population of African-Americans is predicted to double and that of Asian-Americans and Hispanic/Latinos to triple • By the year 2050, white Americans’ share of the total population will decline from 75% to under 50%

  8. Multiculturalism in United States The dominant culture is composed of white middle-class Protestants of European ancestry The minorities are Native Americans, African Americans, Asian Americans and Hispanic Americans

  9. But… • “In many localities so-called minorities are now, in fact, the majority” • (ANA, 1998) In California Population of 38 Million • 1/3 of the population is of Hispanicorigin • Over 10% Asian • Over 4% more than one race • Nearly 17% identify as “Other race”

  10. In California • 1 in 4 are foreign born, 37% of theseentered the US after 1990 • Nearly 40% of the population over theage of 5 speaks a language other thanEnglish at home.

  11. Food preferences and related effects on health African Americans

  12. Food preferences and related effects on health AsianAmericans

  13. Food preferences and related effects on health HispanicAmericans

  14. Food preferences and related effects on health NativeAmericans

  15. Effects of biologic variations on selected drugs African Americans • Isoniazid (drug used to treat tuberculosis) is rapidly metabolized, thus becoming inactive quickly; occurs in approximately 60% of population. • An enzyme deficiency interferes with metabolism of primaquine (used to treat malaria); occurs in approximately 35% of population. • Antihypertensive drugs (e.g., propranolol) need to be administered in higher doses to produce same effects as in European Americans

  16. Effects of biologic variations on selected drugs Asian Americans • Isoniazid (drug used to treat tuberculosis) is rapidly metabolized, thus becoming inactive quickly; occurs in approximately 85%-90% of population. • Rapid metabolism of alcohol results in excessive facial flushing and other vasomotor symptoms.

  17. Effects of biologic variations on selected drugs Asian Americans • Chinese men need only about half as much propranolol (antihypertensive drug) as European American men. • Asian people need smaller doses of alprazolam (antianxiety drug) to achieve same blood levels as their European American counterparts; the drug is also metabolized more slowly (remains in the bloodstream longer) in Asian men.

  18. Effects of biologic variations on selected drugs • Due to liver enzyme differences, caffeine is metabolized and excreted faster than by people of other cultural groups. European Americans

  19. Effects of biologic variations on selected drugs Native Americans • Isoniazid (drug used to treat tuberculosis) is rapidly metabolized, thus becoming inactive quickly; occurs in approximately 60%-90% of population. • Rapid metabolism of alcohol results in excessive facial flushing and other vasomotor symptoms.

  20. Ethnic Health Disparities African Americans • Highest death rate from colon and rectalcancer of any ethnic group in the U.S. • African Am women, diagnosed with breastcancer, have a 71% survival rate vs. an86% rate for white women.

  21. Ethnic Health Disparities Native Americans • 2-3 times more likely to have diabetesmellitus that the general population • Higher than average mortality ratesassociated with heart disease, TB, suicide, pneumonia, influenza, homicide, andalcoholism

  22. Differing Health Belief System • Magicoreligious HBS: people believe that supernatural forces influence health and illness • Holistic Belief System: the forces of nature must be kept in natural balance and harmony • Scientific or Biomedical HBS: health and illness are controlled by a series of physical and biomedical process that can be analyzed and manipulated by humans. Disease and illness are caused by microorganism or malfunction of body

  23. Factors that influence Health Beliefs and Behaviors of Culturally Diverse Ind/Grp Traditional health and illness practices: • Natural folk medicine • Magico-religious medicine • Use of food • Religious practicies • Use of Healers • Social organizations – refers to family unit; environment in which people grow up and live. • Description of family in this cultural group • Gender and age roles that affect choice of whom to communicate

  24. Elderly women healers "Community Mother" or "Granny" "Root doctor" Voodoo healer ("Mambo" or "oungan") Spiritualist Herbs, roots Poultices Oils Religious healing through rituals, (e.g., laying on of hands) Talismans are worn around the wrist or neck, or carried in a pouch to ward off disease Folk medicine: healers and practices African Americans

  25. • Herbalist • Physician Use of hot and cold foods Herbs (e.g., ginseng root, which is used as a restorative potion) Soups Cupping, pinching, and rubbing Meditation Acupuncture Acupressure Application of tiger balm (a salve) to relieve muscular pain Folk medicine: healers and practices Asian Americans

  26. Exercise Medication (prescribed and over-the-counter) Modified diets Amulets Religious healing rituals Nurse Physician Folk medicine: healers and practices European Americans

  27. Curandero – combinaiton of prayers, herbs, and other rituals to treat traditional illnesses, especially in children Espiritualista (spiritualist) - foretelling of future and interpretation of dreams, combination of prayers, herbs, potions, amulets for curing illnesses, including witchcraft) Yerbero (herbalist) – consultation for herbal treatment of traditional ilnesses Sobadora (bonesetters) – massage and manipulation of bones and joints used to treat a variety of ailments, including musculoskeletal condition Parteras (lay midwifes) – assisting for women in childbirth and newborn care Folk medicine: healers and practices Hispanic Americans

  28. Cultural Diversity and Health Care • We All Have It! • Obvious Manifestations: • Religion • Ethnicity • National Origin (language) • Gender

  29. Cultural Diversity and Health Care • Less Obvious Manifestations: • Age • Education • Educational Status • Mobility (including handicaps)

  30. Ethnicity • Sense of identification of a collective cultural group • Characteristic of an ethnic group: • Common language • Same food preferences • Shared traditions • Religion • Shared values, symbols, literature, folklore, music

  31. AFRICAN-AMERICANS Communication • Languages include English and Black English • Head nodding does not necessarily meanagreement • Direct eye contact is often viewed as being rude • Nonverbal communication is very important • It is considered to be intrusive to ask personalquestions of someone on initial contact ormeeting

  32. AFRICAN-AMERICANS Time orientation and space • Oriented more to the present than the future • Close personal space is important • Touching another's hair is sometimes viewed as offensive

  33. AFRICAN-AMERICANS Social roles • Large extended-family networks are important • Many single-parent, female-headed households • Religion is usually Protestant (Baptist) • Strong church affiliation with community isimportant • Social organizations are strong within com­munities

  34. AFRICAN-AMERICANS Health and illness • Harmony with nature • No separation of body, mind, and spirit • Illness is a disharmonious state that may be caused by demons or spirits • Illness can be prevented by nutritious meals, rest and cleanliness

  35. AFRICAN-AMERICANS Health risks • Sickle cell anemia • Hypertension • Coronary heart disease • Cancer (especially stomach and esophageal) • Lactose intolerance • Coccidioidomycosis

  36. AFRICAN-AMERICANS Implementation • Avoid stereotyping • Do not label Black English as an unacceptableform of language • Clarify meaning of client's verbal and nonverbalbehavior • Be flexible and avoid rigidity in scheduling care • Encourage involvement with family • A folk healer or herbalist may be consulted beforean individual seeks medical treatment

  37. ASIAN-AMERICANS Communication • Languages include Chinese, Japanese, Korean, Vietnamese, English • Silence is valued • Eye contact is considered rude • Criticism or disagreement is not expressedverbally • Head nodding does not necessarily meanagreement • The word "no" is interpreted as disrespect for others

  38. ASIAN-AMERICANS Time orientation and space • Oriented more to present • Social distance is important • Usually do not touch others during conversation • Touching is unacceptable with members of oppo­site sex • The head is considered to be sacred; thereforetouching someone on the head is disrespectful

  39. ASIAN-AMERICANS Social roles • Devoted to tradition • Large extended-family networks, loyalty to immediate and extended family and honor are valued • Family unit is very structured and hierarchical • Men have the power and authority, and womenare expected to be obedient • Religions include Taoism (Buddhism), Islam,Christianity • Social organizations are strong within the community

  40. ASIAN-AMERICANS Health and illness • Health is a state of physical and spiritual harmony with nature and a balance between positive and negative energy forces (yin and yang) • A healthy body is viewed as a gift from ancestors • Illness is viewed as an imbalance between yin and yang • Yin foods are cold, and yang foods are hot; cold foods are eaten when one has a hot illness, and hot foods are eaten when one has a cold illness • Illness is contributed to prolonged sitting or lying, or to overexertion

  41. ASIAN-AMERICANS Health risks • Hypertension • Cancer (stomach and liver) • Lactose intolerance • Thalassemia • Coccidioidomycosis

  42. ASIAN-AMERICANS Implementation • Avoid physical closeness and excessive touching;only touch a client's head when necessary, informing the client before doing so • Limit eye contact • Avoid gesturing with hands • Clarify responses to questions • Be flexible and avoid rigidity in scheduling care • Encourage involvement with family • A healer may be consulted before an individual seeks out traditional treatment

  43. EUROPEAN (WHITE)-ORIGIN AMERICANS Communication • Languages include national languages, English • Silence can be used to show respect or disrespect for another, depending on situation • Eye contact is viewed as indicating trustworthiness

  44. EUROPEAN (WHITE)-ORIGIN AMERICANS Time orientation and space • Future oriented • Aloof and tend to avoid close physical contact • Handshakes are used for formal greetings

  45. EUROPEAN (WHITE)-ORIGIN AMERICANS Social roles • The nuclear family is the basic unit; the extended family is also important • The man is the dominant figure • Religion includes Judeo-Christian • Community social organizations are important

  46. EUROPEAN (WHITE)-ORIGIN AMERICANS Health and illness • Health is usually viewed as an absence of disease or illness • Have a tendency to be stoical when expressing physical concerns • Primarily rely on modern Western health care delivery system

  47. EUROPEAN (WHITE)-ORIGIN AMERICANS Health risks • Breast cancer • Heart disease • Diabetes mellitus • Thalassemia

  48. EUROPEAN (WHITE)-ORIGIN AMERICANS Implementation • Monitor and assess client's body language • Respect client's personal space

  49. HISPANIC-AMERICANS Communication • Languages include Spanish and Portuguese, with various dialects • Tend to be verbally expressive, yet confidentiality is important • Eye behavior is significant; for example, the "evil eye" can be given to a child if a person looks at and admires a child without touching the child • Avoiding eye contact indicates respect and attentiveness • Direct confrontation is disrespectful, and the expression of negative feelings is impolite • Dramatic body language, such as gestures or facial expressions, is used to express emotion or pain

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