Leadership Consortium for DD handout 1 in... · 2012. 6. 29. · 6/29/2012 4 Population Self-Identified by Race & Ethnicity in 2010 Total Population = 9,009,073 Two or More Races

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A program of theUniversity of Delaware’s

Department of Human Development and Family Studies

National Center for Cultural Competence

LEADERSHIP FOR CULTURAL AND LINGUISTIC COMPETENCE:

CLAIMING THE CHALLENGE

Tawara D. GoodeAssistant Professor & Director

National Center for Cultural Competence

June 28, 2012Newark, Delaware

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Slide Source:© 2012 ‐ National Center for Cultural Competence

Reasons to AddressCultural and Linguistic Competence

Demographic changes in the U.S., its territories, and tribal communities

Diversity in world views and beliefs about… disability, self‐determination, education, advocacy, independence

Improve quality, effectiveness, and satisfaction with services and supports

‐ Federal and state legislation ‐ Regulatory and accreditation mandates

Address racial, ethnic, linguistic, socio‐economic, and geographic disparities

Top 10 Countries of Birth of Legal Permanent Residents in the United States in 2010

Total 1,042,625

1. Mexico 139,1202. China 70,8633. India 69,1624. Philippines 58,1735. Dominican Republic 53,8706. Cuba 33,5737. Vietnam 30,6328. Haiti 22,5829. Colombia 22,40610. South Korea 22,227

Data Source: U.S. Department of Homeland Security, Office of Immigration Statistics

Slide Source:© 2012 - National Center for Cultural Competence

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Top 10 States of Residence for Persons Obtaining Permanent Legal Residence Status in FY 2010

California 208,446New York 147,999Florida 107,276Texas 87,750New Jersey 56,920Illinois 37,909Massachusetts 31,069Virginia 28,607Maryland 26,450Georgia 24,833

Data Source: U.S. Department of Homeland Security, Office of Immigration Statistics, Persons Obtaining Legal Permanent Resident Status During FY 2010 by Region of Birth and Selected Characteristics Slide Source:© 2012 - National Center for Cultural Competence

State Total Number

Race and Ethnicity in the U.S. in 2010

Total 308,745,538

White 223,553,265 72.4%Black or African American 38,929,319 12.6%American Indian & Alaska Native 2,932,319 0.9%Asian 14,674,252 4.8%Native Hawaiian & Other Pacific Islander 540,013 0.2%Hispanic or Latino 50,447,594 16.3%Some Other Race 19,107,368 6.2%Two or More Races 9,009,073 2.9%

Data Source: U.S. Census Bureau, 2010 Census Brief: Overview of Race, and Hispanic Origin 2010, March 2011.


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Population Self-Identified by Race & Ethnicity in 2010

Total Population = 9,009,073 Two or More Races

Data Source: U.S. Census Bureau, 2010 Census, Summary File 1, Tables P8 & P9 Slide Source:© 2012 - National Center for Cultural Competence

Not Hispanic or Latino

White; Black or African American 1,834,212 1,588,362

White; American Indian and Alaska Native 1,432,309 1,205,924

White; Asian 1,623,234 1,487,712

White; Native Hawaiian and Other Pacific Islander 169,991 147,804

White; Some Other Race 1,740,924 139,799

Black or African American; American Indian and Alaska Native 269,421 237,850

Black or African American; Asian 185,595 170,144

Black or African American; Native Hawaiian and Other Pacific Islander 50,308 45,395

Black or African American; Some Other Race 314,571 86,923

American Indian and Alaska Native; Asian 58,829 46,572

American Indian and Alaska Native; Native Hawaiian and Other Pacific Islander 11,039 7,544

American Indian and Alaska Native; Some Other Race 115,752 9,148

Asian; Native Hawaiian and Other Pacific Islander 165,690 149,561

Asian; Some Other Race 234,462 130,871

Native Hawaiian and Other Pacific Islander; Some Other Race 58,981 12,072

Three or more races743,755 500,800


One in five Americans will be foreign‐born in 2050.Passel, J.D. & Cohen, C. (2008). U.S. population projections: 2005‐2050. Washington, DC: Pew Research Center.

SEVEN LEVERS OF CHANGE DRIVING CULTURAL AND LINGUISTIC COMPETENCE

Demographic Diversity and Immigration “…the 2010 Census reveals that the U.S. is at a demographic pivot point between its racial past and multi‐ethnic future ... the nation is transitioning from a largely white/black nation …”Frey, W.H. (2011). A pivotal decade for America’s white and minority populations. State of Metropolitan America, No. 28. Washington, DC: The Brookings Institute.

Of the 289 million persons five years and older in the U.S., 70.6 million (24%) speak a language other than English at home. U.S. Census Bureau (2012). Place of birth by language spoken at home and ability to speak English in the United States. Washington, DC: U.S. Census Bureau.

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Getting on the Same Page:Definitions and Conceptual Frameworks

Culture, Cultural Diversity, Cultural Competence, Linguistic Competence

Are we on the same page?

culturally aware

cultural sensitivity

culturally appropriate

culturally effective

culturally relevantculturally

competent

cultural humility

culturally & linguistically competent

linguistically competent

cultural proficiency

multicultural competence

T.D. GoodeSlide Source:© 2012 ‐ National Center for Cultural Competence

culturally relevant cultural responsiveness

linguistically appropriate

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Culture is the learned and shared knowledge that specific groups use to generate their behavior and interpret their experience of the world. It includes but is not limited to:

thought

languages

values

beliefs

customs

practices

courtesies

ritualscommunication

roles

relationships

expectedbehaviors

Culture applies to racial, ethnic, religious, political, professional, and other social groups. It is transmitted through social and institutional traditions and norms to succeeding generations. Culture is a paradox, while many aspects remain the same It is also dynamic, constantly changing.

manners ofinteracting

Slide Source:© 2012 ‐ National Center for Cultural CompetenceData Source: Gilbert, J. Goode, T., & Dunne, C., 2007.

Cultural Diversity

Goode & Jackson, 2009

The term cultural diversity is used to describe differences in ethnic or racial classification & self‐identification, tribal or clan affiliation, nationality, language, age, gender, sexual orientation, gender identity or expression, socioeconomic status, education, religion, spirituality, physical and intellectual abilities, personal appearance, and other factors that distinguish one group or individual from another.

Slide Source: © 2012 ‐ National Center for Cultural Competence

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Debates about Identity: Perspectives on Disability & Race

Slide Source: 2012 ‐ National Center for Cultural Competence

VIEWS ON DISABILITY IDENTITY

The population of people who experience disability is extraordinarilydiverse and, therefore, the idea of a common disability identity isolates disability artificially from intersecting identities related to race, gender,sexuality, class, age, and other axes of social significance. (p.43).


SOURCE: Gill, C. & Cross, W. (2010). Disability Identity and Racial‐Cultural Identity Development: Points of Convergence, Divergence and Interplay. In F. Balcazar, Y. Suarez‐Balcazar, T. Taylor‐Ritzler, & C. Keys (Eds.), Race, Culture, and Disability: Rehabilitation Science and Practice. Sudbury, MA: Jones and Bartlett Publishers

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RACIAL IDENTITY vs. DISABILITY IDENTITY



There is no simple relationship between race and disability.

Some people of color with disabilities have prioritized their identification and affiliation with persons who share their cultural/racial heritage and have had little contact with disability groups.

They tend to see disability in terms oflimitation rather than identity.(p.46)

RACIAL IDENTITY vs. DISABILITY IDENTITY

Some people of color have substantial contact with disability groups.

They are more likely to identify as being “disabled” and to reference parallels between race and disability.

Some say that their experiences of race‐based oppression have prepared them to understand disability as a socialminority experience. This suggests intersectional expressions of identify. (p.46)



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What is cultural competence? What does it mean to you as a leader?

policies

practices

behaviorsstructures

attitudes

…requires that organizations have a clearly defined, congruent set of values and principles, and demonstrate behaviors, attitudes, policies, structures, and practices that enable them to work effectively cross‐culturally.

(adapted from Cross, Bazron, Dennis & Isaacs, 1989.

CULTURAL COMPETENCE


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Five Elements of Cultural CompetenceINDIVIDUAL LEVEL

acknowledge cultural differences

understand your own culture

engage in self‐assessment

acquire cultural knowledge & skills

view behavior within a cultural context

1

2

3

4

5

(Cross, Bazron, Dennis and Isaacs, 1989)Slide Source:© 2012 ‐ National Center for Cultural Competence

1• value diversity

2• conduct self‐assessment

3• manage the dynamics of difference

4• institutionalize cultural knowledge

5• adapt to diversity (values, polices, structures & services)

Five Elements of Cultural CompetenceORGANIZATIONAL LEVEL

(Cross, Bazron, Dennis and Isaacs, 1989)Slide Source:© 2012 ‐ National Center for Cultural Competence

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ESSENTIAL ELEMENTS IN ACULTURALLY COMPETENT SYSTEM


policy making

administration

practice & service delivery

patient, family, consumer

community

These five elements must be manifested at every level of an organization or system including:

and reflected in its attitudes, structures, policies, practices, and services.

Adapted from Cross, Bazron, Dennis, & Isaacs, 1989


What are the demographic trends in languages spoken in the …


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1. SPANISH/SPANISH CREOLE 34,547,0772. CHINESE 2,464,5723. TAGALOG 1,480,4294. FRENCH/FRENCH CREOLE 1,355,8055. VIETNAMESE 1,207,004 6. GERMAN 1,104,3547. RUSSIAN 851,1748. ITALIAN 798,8019. ARABIC 767,31910. AFRICAN LANGUAGES 699,518

LANGUAGES SPOKEN AT HOME FOR POPULATIONS 5 YEARS AND OLDER IN THE U.S.

Data Source: U.S. Census Bureau, American Community Survey Results, Languages Use in the U.S. 2007, Slide Source: National Center for Cultural Competence, 2012

Languages Spoken at Home in the U.S. in 2010

English only 229,637,302 (79.4%)

Total other languages 59,578,443 (20.6%)

Speak Spanish or Spanish Creole 37,019,615 (12.8%)

Speak Indo European languages 10,700,982 (3.7%)[French (Patois, Cajun), French Creole, Italian, Portuguese, Portuguese Creole, German, Yiddish, Other West Germanic languages, Scandinavian languages, Greek, Russian, Polish, Serbo-Croatian, Other Slavic languages, Armenian, Persian, Gujarathi, Hindi, Urdu, Other Indic languages]

Speak Asian and Pacific Island languages 9,254,903 (3.2%)[Chinese, Japanese, Korean, Mon-Kymer, Cambodian, Miao, Hmong, Thai, Laotian, Vietnamese, Tagalog, other Pacific Island language]

Other Languages 2,602,941 (0.9%)[Navajo, Other Native American languages, Hungarian, Arabic, Hebrew, African languages, other unspecified languages]

Total Population 5 years and over 289,215,746

Slide Source:© 2012 - National Center for Cultural CompetenceData Source: U.S. Census Bureau, 2010 American Fact Finder, Table DP02 – Selected Social Characteristics in the U.S.

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What is Linguistic Isolation ?

Linguistic Isolation refers to households in which no person over the age of 14 speaks English at least very well.

Linguistically Isolated Households in the U.S. in 2010

All Households 4.6%

Households speaking --

Spanish 24.7% Other Indo-European languages 16.2% Asian and Pacific Island languages 26.9% Other Languages 16.8%


Data Source: U.S. Census Bureau, 2010 American Fact Finder, Table S1602


What is linguistic competence?

What should you know about language access in your role as leader?

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LINGUISTIC COMPETENCE

Policy

Practices

Structures

Procedures

Dedicated Personnel Resources

Dedicated Fiscal

Resources

LINGUISTIC COMPETENCE FRAMEWORK

Data Source: Goode & Jones, Revised 2009, National Center for Cultural Competence

is the capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse groups including persons of limited English proficiency, those who are not literate or have low literacy skills, individuals with disabilities, or those who are deaf or hard of hearing

requires organizational and provider capacity to respond effectively to the health literacy needs of populations served

ensures policy, structures, practices, procedures and dedicated resources to support this capacity

Linguistic Competence

Goode & Jones, Revised 2009, National Center for Cultural Competence


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What are the legal mandates, guidance, or standards related to linguistic competence and

language access


Title VI of the Civil Rights Act of 1964‐ Sec. 601 ensures –nondiscrimination in Federally Assisted programs and states that “No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance”.

– http://www.hhs.gov/ocr/civilrights/resources/laws/index.html

Title VI ‐ Civil Rights Act of 1964SEC. 601 TITLE VI‐‐NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS

Data Source: Civil Rights Act of 1964, P.L. 88‐62Slide Source: © 2012 ‐ National Center for Cultural Competence

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Who Does Title VI Protect?


EVERYONE!

Title VI protects persons of all colors, races, and national origins.

Title VI protects against national origin discrimination and are not limited to U.S. citizens.

Title VI states that:“no person shall be discriminated against on the basis of race, color, or national origin. Section 601 and 42 USC 2000d et. Seq.

Provisions related to language access:

Service providers must take reasonable steps to provide meaningful access to their programs by persons with limited English proficiency (LEP). [68 Fed. Reg. 153 at 47322]

Providers that must provide language assistance services in order to comply with Title VI should implement policies and procedures to provide information in appropriate languages and ensure that LEP persons are effectively informed of and have meaningful access to covered programs. [68 Fed. Reg. 153 at 47320]

http://usinfo.state.gov/usa/infousa/laws/majorlaw/civilr19.htm

Title VI – National Origin Discrimination


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Who is Covered Under Title VI?

Recipients of HHS assistance may include, for example:

• Hospitals, nursing homes, home health agencies, and managed care organizations.

• Universities and other entities with health or social service research programs.

• State, county, and local health agencies.

• State Medicaid agencies.

• State, county and local welfare agencies.

• Programs for families, youth, and children.

• Head Start programs.

• Public and private contractors, subcontractors and vendors.

• Physicians and other providers who receive Federal financial assistance from HHS

Slide Source: © 2012 National Center for Cultural Competence

Cultural and Linguistic Competence: LEP Guidance and CLAS Standards


HHS Guidance to Federal Financial AssistanceRecipients Regarding Title VI Prohibition AgainstNational Origin Discrimination Affecting Limited

English Proficient Persons

National Standards on Culturally and Linguistically Appropriate Services

(CLAS)

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Four Factors of the Title VI Guidance

1. the number of LEP persons that are

eligible to be served or likely to be

affected in the recipient's service area

2. the frequency with which the recipient encounters LEP persons

3. the importance of the program activity or service

4. resources available to the recipients

DATA SOURCE: U.S. Department of Health & Human Services, Office of Civil Rights Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons


Slide Source:© 2012 National Center for Cultural Competence

Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency

U.S. Department of Justice

U.S. Department of Education

U.S. Department of Health & Human Services

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Leading cultural and linguistic competence:Key ConceptsChallenges

Lessons Learned

Targeted Institute: Claiming the Challenge: Leadership for Cultural and Linguistic Competence July 2010GUCCHDNCCC

Leaders lead people

Leaders are needed in times

of change

Managers manage things

Managers are needed to improve and keep the status

quo

Leadership vs. ManagementUnderstanding the difference is the first step to understanding

one’s role as a leader.


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Advocacy is the act of pleading or arguing in favor of something such as a cause.

It is the pursuit of influencing outcomes by putting hard issues on the table.

Leadership is the mobilization of resources to bring about the change.

Both leadership and advocacy keep people focused on the issue.

Leadership galvanizes the people to change their ways.

Leadership vs. Advocacy


Leadership is a set of personal attributes,

qualities, and skills either

intuitive and/or acquired that rouses and motivates

others. (Northouse, 2001).

Slide Source: National Center for Cultural Competence, 2012

Leadershipby

Position

Leadershipby

Influence

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The Challenges

Differing definitions and frameworks

Insufficient knowledge, commitment, and leadership to implement cultural and linguistic competence at the organization or system level

The myth that there is little to no evidence (about cultural and linguistic competence)

Need for additional validated measures to assess cultural and linguistic competence

Changing social, political, economic climates

Excerpt from: Goode, T.D. & Like, R.C. (2012). Advancing and sustaining cultural and linguistic competence in the American health system: Challenges, strategies, and lessons learned. In D. Ingle, A. Chiarenza, I. Kotsioni, and W. Devillé (Eds.), Inequalities in Health Care for Migrants and Ethnic Minorities, COST Series on Health and Diversity Volume II, Antwerp: Garant .

Cultural and Linguistic Competence

within the Context of Organizational Change


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Considering Cultural & Linguistic Competency within the Context of Organizational Change

Does making progress require

changes in people’s values, attitudes

and or habits of behaviors?

Adaptive Challenge vs.

Technical Challenge

Reference: Heifetz, R.A. (1994). Leadership Without Easy Answers. Cambridge, MA: The Belknap Press of Harvard University Press


Data Source: Prochaska, J.O., Redding, C.A. & Evers, K.E. (1997). A Transtheoretical Model and Stages of Change. In K. Glanz, F.M. Lewis, B.K. Rimer (Eds.) Health Behavior and Health Education: Theory Research and Practice a (2nd edition) (pp. 60‐84). San Francisco, CA,: Jossey‐Bass Publishers.

Pre‐contemplation

Contemplation

Preparation

Action

Maintenance

no intention to take action in the foreseeable future; unaware or under-aware of the need for change

aware that problem exists and seriously thinking about overcoming it; but not has not yet made a commitment

combines intention and behavioral criteria; initiation of ‘baby steps’

modification of behavior, experiences, and environment; short-term changes in place and planning for long-term change

consolidates the gains attained during the action phase and works to prevent relapse


Prochaska’s Stages of Change

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Organizational Change Theories Applied to Cultural & Linguistic Competency

Resistance is a characteristic of any major organizational change effort and a major reason why organizational change efforts fail. (Prochaska, Prochaska and Levesque, 2001).

Resistance should be expected in different stages of multicultural organizational change because the topics of prejudice, discrimination and oppression are controversial and emotionally charged. (Brantley, Frost and Razak, 1996).

The Transtheoretical Model of Change suggests that it is counterproductive to forge ahead with action without addressing issues such as resistance, that stand in the way of individual and organizational readiness for change.

Data Source:Mayeno, L. Multicultural Organizational Development: A Resource for Health Equity, in Cultural Competence in Health Care Series, The California Endowment and Compasspoint Nonprofit Services, April 2007.


BiasStereotyping

DiscriminationMarginalization

“ISMs”

Disparities Inequities

DisproportionalityPower Differentials

Slide Source: © 2012 ‐ National Center for Cultural Competence

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LESSONS OF THE JOURNEY

T.D. Goode

Leadership

Shared Ownership

The ISMs: Confronting the Undercurrents

Keeping it Real

Weave into the Fabric of the Organization


Effective leadership for diversity requires having the integrity to take principled stands.

A trusted leader admits and corrects mistakes.

It will be impossible to take leadership on the most difficult issues of oppression without a team of support, for without support, isolation and discouragement take over

Principles from Leading Diverse Communities

Data Source: National Coalition Building Institute, 2005


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THOUGHTS ABOUT LEADERSHIP


We are continually faced with a series of great opportunities brilliantly disguised as insoluble problems. John W. Gardner

In the middle of difficulty lies opportunity.

Albert Einstein

Taking the next steps

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CONTACT US

National Center for Cultural Competencehttp://[email protected]

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Leadership Consortium for DD handout 1 in... · 2012. 6. 29. · 6/29/2012 4 Population Self-Identified by Race & Ethnicity in 2010 Total Population = 9,009,073 Two or More Races