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Cultural Awareness and Diversity

As patient populations become more culturally diverse, being able to effectively communicate with your patients and provide culturally appropriate chiropractic care will become an even greater challenge. To help you with evaluating and improving your office’s cultural awareness, we have put together a brief article on the importance of diversity training, along with links to self-assessment tools.

Cultural competence is having the capacity to function effectively within the context of the cultural beliefs, behaviors and needs of diverse consumers and their communities.

The Minnesota population, most likely your patient base, is becoming more culturally diverse. Minnesota has large populations of Somalis and Hmong, as well as immigrants from other African countries, Asia, Hispanic/Latino countries and the Middle East. One in ten Minnesotans do not speak English. The ever-changing demographics in Minnesota and across the country require health care providers to take a proactive approach to providing effective care.

Fulcrum strongly encourages all providers to assess their ability to meet the specific health care needs of the communities they serve. Everyone in your office interacting with patients and their families can impact a patient’s experience and their perception of quality care.

To get a sense of your cultural competency, a short Quiz is available on Stratis Health’s Culture Care Connection website.

Language and Effective Clinical Care

Effective communication is key in establishing relationships and providing effective clinical care to patients from diverse populations. Providing linguistically appropriate care is not only a good idea, it is mandated by the federal government. All health care providers receiving federal funds are required by Title VI of the Civil Rights Act to provide Language Access Services to limited English-proficient speakers (LEP). This includes providers receiving payments for patients in government-based programs (i.e., Medicare and Medicaid).

Know the 14 Standards

The Office of Minority Health (a division of the U.S. Department of Health and Human Services) has developed a set of 14 standards for health care providers related to culturally competent care, language access and organizational support. These are referred to as the Culturally and Linguistically Appropriate Services (CLAS) Standards and include four mandated standards related to Language Access Services. For example, CLAS Standard 4 states:

“Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.”

Language Access Services

Language Access Services (LAS) is the collective name for any service, including interpreting (oral communication) and translation (written communication), that helps diverse and non-English speaking patients obtain the same access to and understanding of health care services an English speaker would have.

Where can you go for information on interpretation services? The Minnesota Department of Health maintains a roster of interpreters. This list will contain contact and network participation status, along with specialty experience.

Health Issues and Treatment Customs VARY By ethnicity

Information on the Stratis Health website will illustrate the health differences between the 17 major ethnic groups. For example:

  • African Americans are affected disproportionately by the leading causes of death in the US, including cancer, obesity, diabetes, heart disease, hypertension, and HIV/AIDS.
  • Depression is common among Somali refugees, who may have lost family members or endured horrible events during the war. An estimated 30 percent of refugees have been tortured and may be suffering from post-traumatic stress disorder.
  • Adoptions of a Western diet and sedentary lifestyle have led to a dramatic increase in obesity, diabetes, hypertension, heart disease, and stroke in the American Hmong population. In addition, many Hmong who consume large quantities of fish taken from Minnesota lakes and rivers are at risk of exposure to mercury and PCBs.
  • Middle Easterners tend to prefer a gradual, prolonged disclosure of information, rather than a brief explanation of diagnosis and prognosis. Health care providers are advised to compare the treatment they recommend with the way they would treat a member of their own family.

Resources To Help You With Cultural Awareness Issues

One of the richest resources for you on the topic of providing health care to diverse populations is Stratis Health’s Culture Care Connection website.

At this site you will be able to:

  • Assess your cultural competency (Culture Care Connect Quick Quiz)
  • Identify the cultural mix in each of the counties your clinic serves
  • Learn information about each cultural group you serve, including common medical issues related to their ethnicity, cultural concerns, social structure, diet, religions, end-of-life attitudes and customs
  • Access tools and training opportunities to help improve your cultural awareness

At the federal level, the Office of Minority Health’s website offers an abundance of information on cultural competence, including:

  • Guides and Resources
  • CLAS Standards
  • Training Tools for Providers