Health Disparities and Cultural Competence

Frontier School of Midwifery and Family Nursing

1st Annual Diversity Weekend

Frances Horton, SNMSonja Pownall, SNM

Tasha Parker, SNM

Pre-assessmentWhat are some of the some of the health issues facing African Americans due to the disparities in health care?

African AmericansThe largest minority group in the United StatesThere are glaring disparities in all areas of health care from:Health disparities among the African-American population

include: Life expectancy Heart disease Diabetes Hypertension Infant mortality (including low birth weight and pre-term

births) Maternal Morbidity and Mortality Cancer HIV/AIDS Asthma

Campinha-Bacote, (2009).

Healthy People, (2010).

The disparities in healthcare are experienced by all minority groups

Where language barriers, racial and ethnic differences exist-there is a need for culturally competent care. The care begins with sensitivity and recognition of the needs of diverse groups. Reducing healthcare disparities among minorities will lead to improved outcomes in maternal and neonatal health.

As in the goals of Healthy People 2010 and the next initiative in 2020, this presentation seeks to examine the facts as reported by various studies as well as practical solutions to meet these goals.

Talking Drum, (2011).

Clinical Trials It is well known that African - Americans do not participate

in clinical trials at the rate of other ethnic groups. One example of this disparity is the Tuskegee Experiment. In this experiment poor African Americans with syphillis were deliberately not treated but studied without their knowledge and consent.

This study was not that long ago. In fact it went on for forty

years from 1932 to 1972 and was supposedly to study the progression of untreated syphillis. The study involved poor African American men who thought they were receiving free health care . The experiment was done without the knowledge and consent of the participants and was sanctioned by the US government with full participation and knowledge of the attorney general and physicians .

Brooks. Pascal, Sly & Hsiao (

In the article African American Women and Clinical Trials: Perceived barriers to participation and potential solutions, five major causes were identified:

• Fear• Mistrust• Lack of

Knowledge• Misinformation• Past history of

clinical trials

Brooks, Pascal, sly & Hsiao ,(2009).

Strategies to Enhance Participation

•Education•Diversity race among health care professionals•Utilizing credible professionals•Inviting African Americans to participate in clinical trials

Culturally Competent Care

Steps to providing culturally competent care:

A sincere desire with humility to understand your patients cultural constructs and views.A genuine belief in the care and dignity of

others.A willingness to learn and adapt care that

integrates three things: Sensitivity,Respect and effective treatment.

Campinha-Bacote, J. (2009).

Culturally Competent Care Concordance – matching

the demographic of employees with the community they serve.

Cultivate – policy and procedures that reinforce a diverse workforce.

Reinforcement – recruitment and retention of a diverse staff, set diversity goals & reassess them.

Dreachslin, J.., 2008

Commit to Truly Compassionate Care

As healthcare providers we need to commit to giving the most respectful and compassionate care possible.

We are here to commit to making a change.

Post-test True or False:

In order to provide culturally competent care, providers should expect those of different cultures to adhere to our ideals?

True or False:

Culturally competent providers do not need to have an understanding of the cultures of others to provide excellent care?

References

Brooks, M. M., Pascal, A. M., Sly, J. R. & Hsiao, T. (2009). African-American women and clinical trials: Percieved barriers and potential solutons. US Journalof Health Studies, (24) 2, 298-305.

Campinha-Bacote, J., (2009). A culturally competent care model for African Americans. Urologic Nursing, (29) 1, 49-56.

Deachslin, J., (2008). Ratial and Ethnic Disparities: Why Diversity Leadership Matters. Journal of Healthcare Management 50, 1. P. 8-13.

Healthy People 2010, (2011). Retrieved from www,healthypeople.gov

Talking Drum, (2011). Retrieved from http://www.thetalkingdrum.com/tus.html