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HEALTH DISPARITIES AND CULTURALLY COMPETENT CARE SASHA A. RARANG, MSN, CCM, RN

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Page 1: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

HEALTH DISPARITIES AND CULTURALLY COMPETENT CARE

SASHA A. RARANG, MSN, CCM, RN

Page 2: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Determinants of Health

Page 3: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Health Disparities

• They refer to differences in measures of health status between different groups of people living in a community, a state, or entire nation.

• They occur when one group of people has a – higher incidence or mortality rate than another– when survival rates are less for one group than

another.

Page 4: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Health Disparities

Factors and Conditions Leading to Health Disparities– Race, ethnicity, and culture– Geographic location– Income, education, and occupation– Gender– Age – Health care provider attitude

Page 5: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Health Disparities

Impact of Health Disparities on HealthCancer-African Americans have higher rates than whites.Diabetes mellitus- more in minority groups with higher risk of complications.Obesity- affects African American , Mexican American and white women.

Page 6: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Nursing Interventions to eliminate Health Disparities

• Treat all pts equally.• Monitor for their response to therapy.• Be a pt advocate regardless of cultural

differences.• Be aware of one’s own biases.• Give the same standards of care to all pts.• Participate in research.

Page 7: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Culture

• Culture encompasses the knowledge, values, beliefs, art, morals, law, customs, and habits of the members of the society.

• Culture includes the systems of technology, education, social structures and political practices.

• Cultural patterns of behavior develop over time, shared by members of the same cultural group and transmitted to the next generation.

Page 8: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Culture

Page 9: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Culture

• Values are the set of rules by which individuals, families, groups and communities live.

• Acculturation- an individual or group learns how to take on many, but not all values, beliefs of another culture.

• Assimilation-and individual or group from one culture adopts certain features of other culture; it may be voluntary or forced on a group.

• Subcultures-smaller and may not hold all of the values of the dominant culture:

Religious subcultures- Catholics, Jews, MuslimsEthnic subcultures- African Americans, Hispanics and

Native Americans.

Page 10: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Culture

• Ethnicity-groups whose members share a common social and cultural heritage.

• Race- share a common ancestry and physical characteristics such as skin color, bone structure, or blood group.

• Stereotyping- viewing members of a specific culture, race or ethnic group as being alike and sharing the same values and beliefs.

• Ethnocentrism-belief of once own ways are superior to those of others from different culture, ethnic, or

racial background.• Trans-cultural nursing-study and analysis of cultures and

subcultures.

Page 11: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Cultural Competence• Cultural awareness-Identify one’s own cultural

background, values, biases.• Cultural Knowledge- learn, assess, read, view

documentations and do not make assumptions.• Cultural skills- become aware of cultural differences,

be alert for unexpected responses.• Cultural encounter-interact with different cultural

groups, attend cultural events, visit markets and restaurants , learn about their beliefs and practices.

Page 12: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Cultural Diversity in the Health Care Workplace

Page 13: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Cultural Diversity in the Health Care Workplace

Page 14: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Cultural Factors Affecting Health and Health Care

Personal SpaceIntimate distance 0-18 inches.Personal distance 18 inches to 4 feet.Social distance 4-12 feet or more.

Touch Nurse must ask permission before touching anyone.

NutritionFood and rituals associated with food. Immigrants may face with many unfamiliar foods.

Page 15: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Cultural Factors Affecting Health and Health Care

MedicationsNational Medical Association (NMA) and National Pharmaceutical Council (NPC) titled “Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment.”

Ex: Isosorbide dinitrate and Hydralazine-for African American pts.

Psychologic FactorsCulture-bound syndrome that is within a cultural group

Ex: Susto- Latin America-soul loss, fright sickness which can cause loss of appetite, anxiety, social

withdrawal.

Page 16: Determinants of Health Health Disparities They refer to differences in measures of health status between different groups of people living in a community,

Nursing Management:Reducing Health Disparities and Increasing

Cultural Competency

Nursing Implementation-Communication- Voice tone, gestures, spoken words, small talk, silence.-Choosing an interpreter-should be trained, able to translate, act as pts advocate, be culturally sensitive.