Case Study: Tufts Winter Enrichment Program: Sharewood Clinic

The increasing population of immigrants in the United States has contributed to health disparities in the health care system. Cultural competence can remove health disparities by eliminating personal biases, and treating every person with respect. Simply recognizing and accepting different cultures is not enough, one must be able to consistently recognize and understand the differences in order to be culturally competent. Knowledge and culturally competent practices are a must for nurses to deliver quality care in our rapidly changing multicultural world (Edelman, 2014 p. 25).

Cultural competency aids in closing the “disparities gap” in health care. ("OMH," 2012, para. 2) In doing so, health professionals and their clients are better able to discuss concerns without cultural differences getting in the way of effective communication and problem solving. Being respectful of and sensitive to the client’s health beliefs, culture, values, and diverse needs can bring positive outcomes within treatment and patient care. After all, is it not the main job of the health care provider to ensure patient trust? Open forms of communication when dealing with client issues can only be provided if the patient is comfortable with his provider and believes his

The most recent survey of homeless individuals conducted January 29, 2014 revealed 958 homeless adults with no dependants, 70 of which were completely unsheltered, and an additional 130 homeless adults who also had dependent children with them. 208 of these homeless adults are chronically homeless (HUD’s 2014 Continuum of Care Homeless Assistance Programs, Populations, and Subpopulations, 2014).Wayside Christian Mission reaches approximately 7,000 homeless individuals annually (Wayside Christian Mission, 2007). In the Journal of General Internal Medicine, a majority of homeless individuals surveyed stated that they felt discriminated against or that they received lesser care because of their poverty or homelessness (Wen, Hudak, & Hwang, 2007). Homeless and impoverished individuals suffer from high rates of depression, psychiatric illness, alcohol and or substance abuse, HIV/AIDS, TB, Trauma, preterm birth, COPD, low birth weight, musculoskeletal problems, decreased access to care, foot problems, malnutrition, and high Emergency Room utilization (Stanhope & Lancaster, 2014). Not only do homeless persons have a high rate of illness, but they are also less able to appropriately treat health problems. Many homeless individuals have limited access to care, cannot afford medications or nutritious food, and may have difficulty with managing a strict

As a child, growing up in a low income household has made me humble and attentive to other’s situations. Similarly, my South Asian family has instilled a strong nature to serve others, which is the reason I have been involved in service learning activities throughout my undergraduate career, such as LIFT – Chicago and Refugee One. Even post-graduation, my work at Wekaw caters to urban underserved populations. In graduate school, I wish to continue this involvement in campus organizations which enforce diversity inclusion, whether it is joining a volunteering club aiding community populations or conducting research with immigrants. This is one aspect of diversity I can contribute to Rosalind Franklin University, and is also why my professional goal is to work in a community hospital serving diverse populations.

I have learned that it is important that educators  and health providers be trained on cultural competency to understand the population they are serving. Marks, Sims, and Osher (King, Sims, & Osher, n.d.) define cultural competency  as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross–cultural situations" ( as cited in Cross et al., 1989; Isaacs & Benjamin, 1991). Health providers and educators should investigate demographic patterns or trends in the place where they live and work. This brings awareness of the types of cultures that they might come across when they are working with people. Organizations should integrate and implement policies that promote the value of  diversity, self-assessment, manage the dynamics of difference, acquire and institutionalize cultural knowledge, and adapt to diversity and the cultural contexts of communities they serve (Georgetown  University, 2004). Georgetown University (2004) also stresses that culture competency grows gradually and is always open for improvement.

I am a Brazilian black male with military experience and diplomatic knowledge who grew up in a low-income household in a developing country. In addition, I have traveled to about 35 countries and am acquainted with people from different socioeconomic backgrounds, religions, ethnic groups and nationalities. These characteristics and experiences allow me to see the world from perspectives that are unusual for most people. Besides being open-minded and non- judgemental toward all my future patients, I personally understand the difficulties faced by people of color, immigrants and individuals from low-income families. In sum, my background and my cultural literacy will allow me to be a sensitive and culturally aware patient-centered care.

This essay reviews key concepts of culture and diversity in the context of their role in causing and/or making worse disparities in health programs.

In a perfect world, race, ethnicity and culture would have no negative effect on the medical care we receive, yet problems do arise and it affects the quality of care the patient receives. Language barrier, poor socioeconomic status, and poor health literacy also contribute to health care disparity. For Lia, it was more than her skin color, it was all of the above, her parents did not speak English and they were illiterate. They had trouble understanding the American healthcare system, had trouble or little interest in adjusting to or understanding the American culture. They didn’t work, which in addition to cross cultural misunderstanding, helped contribute to animosity between the Hmong and the host community, because some in the Merced area did not like or appreciate the fact that some Hmong did not work and relied on welfare to make ends meet. All these factors, contributed to the poor quality of

In the preparation of writing this paper, I reviewed several educational videos from the U.S. Department of Health and Human Services (n.d.) that show healthcare providers interacting with patients from different cultures. I chose the video that shows a Hispanic man interacting with his surgeon. I chose this video because all counties in Ohio except one are seeing increases in the Hispanic population. There has been a nine

Cultural competence in health care describes the ability to provide care to patients with diverse values, beliefs and behaviors, including tailoring health care delivery to meet patients’ social, cultural and linguistic needs. The need for healthcare systems to increase cultural competence and personalize care for ethnic patient minorities should not be ignored. Healthcare systems should promote better understanding and communication between diverse ethnic patients and caregivers. Hospitals should design a system that caters to the needs of all the populations they serve and not just apply a one-size-fits-all approach. Becoming a culturally competent health care organization is a critical component in reducing health care disparities.

A reformation of the achievement levels of African-Americans starts through the investment of high achieving mentors, families, and friends. It begins with African-Americans straying away from statistical choices, such as placing improper value on education, community involvement, and health. The overcoming of such adversities involved with being an African-American woman has propelled my career goals. By striving to become a pharmacist and non-profit leader I am showing that the accomplishments of African-American women in health and leadership are not abnormal. One of the major causes of minority health disparities is the lack of minority health providers. As a healthcare provider, I will be better able to promote wellness in minority populations.

As a nurse aide working in a hospital, there are multiple instances where privilege and differences in power affect the way I, and those around me, engage with patients. For the privilege memo, I wish to discuss how my own personal benefits of being a white person affect the patients I work with as well as other minorities. For the community profile, I plan to take a deeper look into the black community, if possible specifically Somalian Americans. There are numerous new Somalian Americans in the Fargo community that I have encountered before both in and out of the health care systems. Delving into their experiences with health care in the America will aide my attempt to educate myself about minorities in health care environments both nationally and

The first step to achieving complete cultural competency is valuing diversity. It is a process that requires cultural humility. Unlike competency, cultural humility goes beyond simply being knowledgeable of differences, but having a humble desire to ensure a lifelong commitment to intercultural exchange (Tervalon & Murray-Garcia, 1998). I have witnessed some Americans oppose the idea of immigration and strongly believe that American services should not cater to immigrants. They believe that all foreigners should learn English and the United States should not accommodate their linguistic needs. These same people are aware of the cultural differences that exist in America, but lack cultural humility and appreciation for diversity, making it difficult for them to attain complete cultural competency. A public health professional cannot go into a community, assuming that everyone thinks and behaves like them. They must be open-minded, flexible, empathetic, and aware of the differences and similarities that exist. Therefore, cultural humility is a prerequisite in achieving cultural competence.

Anderson, P. A., Gill, P. S., Greenfield, S. M., & Loudon, R. F. (1999). Educating medical students for work in culturally diverse societies. Journal of American Medical Association, 282. 875-880.

Recognizing that ethnic identity is only one facet of diversity. My clinical practices involve serving many individuals who have diverse personal and cultural identities. During case conceptualization I routinely ask clients to describe their own values and perspectives to add to my understanding while increasing their comfort. As I serve an increasingly diverse population, keen observation and feedback from clients will continue to illuminate pathways to expanding my awareness and understanding. I see no end to my professional journey to provide culturally responsive