Transcript Slide 1

Pharmacy in Public Health:
Cultural Competence
Course, date, etc. info
Learning Outcomes
• Define cultural competence
• Differentiate cultural competence and
linguistic competence
• List the 3 components of knowledge required
for cultural competence
• Provide 2 examples of cultural knowledge
• Identify 3 characteristics of a practice site that
denotes cultural competence
Culture is:
• A pattern of learned behaviors and beliefs
shared among members of a group
• Parents and grandparents teach culture to
children by example and instruction
– Visiting a member of the family who is ill
– Going to work or school even when you are sick
and may be contagious
– Foods and how foods are cooked
Identify examples of cultural
influences in the cartoon
(Source: www.CartoonStock.com)
Cultural competence means:
• Having the attitude, knowledge, and skill that
enable you to act in a manner that is
respectful and responsive to the needs of
others
• Being able to provide services that are
respectful and responsive to the needs of the
community
Key Points of Cultural Competence
• No universal culture as culture is influenced by
local conditions
• Differs from professional competence; a
person can be professionally competent but
not culturally competent and vice versa
• Recognize that culture is related to ethnic
background or race but that other factors also
contribute to culture
Cultural Competence vs. Linguistic
Proficiency
• Linguistic proficiency is the ability to speak,
read, and write in a specific language
• Cultural competency is one’s ability to address
the learned behaviors and beliefs of persons
from different cultural groups
• Linguistic proficiency does not guarantee
cultural competence but it can facilitate
cultural competence
Culture, Race, Ethnicity
• Race refers to the genetic characteristics of a
group of people however differences tend to
be small
• Ethnicity (census definition) “…person’s ethnic
origin or descent, roots, heritage, place of
birth, or parents’ place of birth…”
• Culture is based on learned behaviors and
beliefs and is associated with race and
ethnicity or nationality
Changes in Diversity in the United
States
Health Disparities
• Difference in life expectancy and health status
related to racial and ethnic populations;
examples:
– Infant mortality is twice that of whites among
African-American and American Indian
populations
– American Indians and Alaskan Natives are 2.3
times as likely to have diabetes
• Impact on overall health of Americans
Interpreters vs. Translators
• Interpreters work with the spoken language;
they verbally convey what one person says in
one language to a second person in a different
language
• Translators work with written language; they
render a document written in one language
into a document written in a second language
Title VI of the Civil Rights Act of
1964
• Prohibits discrimination based on race, color,
or national origin of programs receiving
federal funds
• Addresses both verbal and written
communication
• Interpreter and translation services are
required to meet the requirements of the Act
Problematic Interpreter Models
Preferred Interpreter Models
CLAS Standards
• Developed by the Office of Minority Health in
the Department of Health and Human
Services; addresses 3 areas
– Culturally competent care
– Language access services
– Organizational supports
The Pyramid of Cultural
Competence
Attitudes
• Beliefs related to cultural issues and their
relationship to health
– Enabling attitudes—desire for best outcome
possible
– Barriers—belief that health issues are universal
• Attitudes form the base of the pyramid;
enabling attitudes allow the development of
knowledge and skill
Knowledge
• Represents specific facts related to culture
– Belief that injections are more powerful than
tablets or capsules
– Preference for receiving services in the home
rather than the clinic
• Knowledge that culture is often community
specific
– Communities with similar ethnic heritage and
shared language may have very different cultural
values
Skill
• Have the ability to modify services so that
they are culturally appropriate for the local
population
• Represents the apex of the pyramid as
practitioners can have appropriate attitudes
and knowledge but fail to change services
• Example—addressing the effects of oral
contraceptives on fertility
Developing Enabling Attitudes
• Sensitivity training
– Reflect on culture, racism, sexism, etc.
– Case studies
• Awareness training
– Population level statistics can alert you to
presence of minority groups and their needs
Identifying Cultural Characteristics
Related to Health
Identifying Cultural Characteristics
Related to Health
Identifying Cultural Characteristics
Related to Health
Culture of Western Medicine and
Public Health
• Belief that the individual is responsible for
their health
• Illness belongs to medically derived categories
• Only one approach to medicine—that of
western medicine
• Patients need to conform to the system; the
system is not expected to adapt to patient
needs
Knowledge of Your Own Culture
• Ask a person outside your culture to tell you
about American culture
• Identify your subculture within the larger
American culture (e.g. western, urban,
professional)
• Ask your grandparents what is important for
other cultures to know about you and your
culture
Learn Cultural Competence Skills
• Obtain experience at a practice site that
demonstrates cultural competency
– Use CLAS standards to identify a site
• Use guided reflection
– Have someone with some experience guide the
discussion and ask questions
• Establish a structure for learning
– e.g. a journal club
– e.g. keep a diary or journal
Summary
• Cultural competency means having the
attitude, knowledge, and skill to provide
services that are respectful and meet the
needs of population
• Practice sites that provide culturally
competent care will meet the CLAS standards
• Cultural competency requires the practitioner
to develop a strategy for learning about
culturally appropriate care