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Unformatted text preview: Unit 2
Diversity in Healthcare It is because we are different that
each of us is special.
each The overwhelming question facing the
United States during the 21st century is
how this country will accommodate
increasing cultural diversity.
increasing Diversity in Health Care
• By the year 2050, it is expected that:
– The non-Hispanic white population will
decrease from 70 percent to 50 percent of the
– The Hispanic population will increase from
12.5 percent to 25 percent.
– The Asian population will increase from 3
percent to 8 percent.
– The African American population will increase
from 12 percent to 14 percent
from What is Diversity?
Diversity is defined as “the full range of
human similarities and differences in
group affiliation including gender,
race/ethnicity, social class, role within an
organization, age, religion, sexual
orientation, physical ability, and other
(Dreachslin, Four Layers of Diversity
Four Resident Population Estimates
July 1, 1997* July 1, 2000* July 1, 2050** All Races 267,784 (100%) 275,306 (100%) 403,686 (100%) White 194,746 (72.7%) 196,669 (71.4%) 212,990 (52.8%) Hispanic 29,182 (10.9%) 32,478 (11.8%) 98,228 (24.3%) Black 32,339 (12.1%) 33,490 (12.2%) 53,466 (13.2%) 9,537 (3.6%) 10,619 (3.9%) 35,759 (8.9%) 1,979 (0.7%) 2,047 (0.7%) 3,241 (0.8%) Asian Americans /
American Indian (Numbers in millions)
* Source: U.S. Census Bureau. Profiles of General Demographic Characteristics 2000. Populations Estimates Program. May, 2001
** Source: U.S. Census Bureau. Projections of the Resident Population by Race, Hispanic Origin, and Nativity: Middle Series, 2050 to 2070. Populations Projections Program. January 13, 2000 Changing U.S. Demographics
• Ethnic and racial composition of America
• Gender and education levels by age
• Aging of the population Aging of the Population
• Older adults represent the fastest growing
segment of the U.S. population.
• In 2003, nearly 36 million Americans were age 65
and older. By 2050, that number will grow to
almost 87 million.
• The oldest segment of the population (85+) grew
from just 100,000 in 1900 to 4.2 million in 2000.
• The 85+ segment of the population is projected to
grow from 4.2 million in 2000 to nearly 21 million
in What is Culture?
• ‘Culture’ refers to integrated patterns of
human behavior that include the language,
thoughts, communications, actions,
customs, beliefs, values, and institutions of
racial, ethnic, religious or social groups.
racial, Aspects of Culture that Affect
Occupation Ability/Disability Religion/Spirituality Socio-Economic
Status Health Status Gender
Sexual Orientation Culture of Western Medicine
• Dominance over nature
• Therapeutic aggressiveness
• Future orientation
• Standardization What is Cultural
A set of congruent behaviors, practices, attitudes and
policies that come together in a system, agency or
among professionals that enables effective work in
‘Competence’ implies having the capacity to function
effectively as an individual and an organization within the
context of the cultural beliefs, behaviors and needs
presented by consumers and their communities.
(HHS Office of Minority Health, 1999)
(HHS Definition of Cultural
• Is the ability of individuals and systems to
respond respectfully and effectively to
members of all cultures, races, classes,
ethnic religious backgrounds and social
groups in a manner that recognizes,
affirms and values the cultural similarities
and differences and their worth.
(Jezewski, 2001) Implications for the
• Need to be “cultural competent” to serve
diverse patient populations
• Increase need of health services as the
population continues to age
• Lack of younger and diverse workers
entering healthcare professions
• Lack of women and other minorities in
healthcare leadership roles
healthcare Why is Cultural Competence
• Existing Differences
• Existing Disparities
• Link Between Disparities and Cultural
Competency Need for Cultural Competence
• Respond to current and projected demographic
changes in the United States
• Reduce long-standing disparities in the physical and
mental health - status of people from differing racial,
ethnic and cultural backgrounds
• Improve the quality of services and primary care
• Comply with legislative, regulatory and accreditation
National the Cultural Competence. 2003.
• Creation of a competitive edge in Center formarket place Health Disparities & Culture
How does culture make a difference?
• Because minorities are underrepresented
among health professionals
• Patients and providers often have different
• In these instances, language,
socioeconomic status, and ethnicity may
influence the provision of health services.
Culturally Effective Pediatric Care, American Academy of Pediatrics, Committee on
Pediatric Workforce, 1997–1998 Cultural Competency Workforce
Cultural Diversity Management
Diversity management is defined as “a
strategically driven process whose
emphasis is on building skills and creating
policies that will address the changing
demographics of the workforce and patient
(Svehla, 1994; Weech-Maldonado, et al. 2002). What can you do?
• Understand that different perspectives,
values and beliefs exist.
• Work to overcome language and cultural
• Become familiar with the issues and
challenges being faced by patients of other
• Think about the individual - work to build
Develop a greater sense of curiosity and Understand different Beliefs and Bias
Those in poverty
Persons with disabilities
Patients with HIV/AIDS
Cultural minorities (e.g., Amish, Appalachian)
Migrant workers/homeless/displaced persons
Persons with mental illness What is an Attitude?
An attitude is a mind set or tendency to act
in a particular way due to both an
individual’s experience and temperament.
individual’s Tri-Component Model of Attitudes
Tri-Component Actions Feelings Beliefs Our goals...
• Watch: http://www.cbsnews.com/video/watch/?
• To open our minds and our hearts and
teach others the context and skills for
providing culturally effective health care
• To treat every encounter as a cross-cultural
• Because… In the end, it’s not what we don’t
know that will destroy us but rather the
failure to respond appropriately to what we ...
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- Spring '11