PBH.715 Week 9 Lecture

PBH.715 Week 9 Lecture

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  | http://online.mcphs.edu Week 9Lecture Instructor: Gina Crosley-Corcoran, MPH PBH 715 – Introduction to Social & Behavioral Sciences
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  | http://online.mcphs.edu HEALTH DISPARITIES,DIVERSITY, & CULTURAL COMPETENCE
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  | http://online.mcphs.edu Introduction  Thisweek we will be looking more closely at the concepts of race, ethnicity, health disparities, diversity, and cultural competence.  There is still some debate about the concepts of race and ethnicity and how these are defined and determined.  There is also much debate about the cause(s) of health disparities – and thus how best to address it.
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  | http://online.mcphs.edu The Conceptof Race  Traditionally, race has been based upon supposed biological differences across racial groups  There is little evidence to support this approach  Genetic variation within groups is actually greater than it is between groups  Concept has been discarded by many disciplines, but public health has, thus far, retained it  Though this concept is used by public health and the Census Bureau, it is poorly defined at best
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  | http://online.mcphs.edu The Conceptof Race  In social sciences, race is viewed as a social construct with very limited biological significance.  Increasingly used to denote sociocultural groupings  Changes the view of health disparities from biological (genetic differences across races) to being part of larger social inequalities  Ethnicity is now used more frequently  Refers to broader construct of social groups with shared history, sense of identity, and cultural roots
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  | http://online.mcphs.edu Health Disparities Steady improvements in health indicators in the US have not been reflected in the morbidity and mortality gap between African Americans and European Americans  Five models have been proposed to explain health disparities
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  | http://online.mcphs.edu Health Disparities:Models • Disparities explained in terms of genetic variation across populations Racial-genetic model • Disparities can be attributed to differences in prevalence of specific risk or protective health behaviors Health behavior model • Differences in health status across racial and ethnic groups are attributed to disproportionate percentage of minority groups are found within lower socioeconomic class Socioeconomic status model
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  | http://online.mcphs.edu Health Disparities:Models • Explains disparities in terms of structural, interpersonal, and psychological stress experienced disproportionately by members of socially disadvantaged groups • Includes the impact of institutional and interpersonal racism Psychosocial stress model • Integrates a dual perspective • Focuses on health implications of racially stratified societies and on social construction of goals and aspirations within minority groups Structural-constructivist model
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  | http://online.mcphs.edu Cultural Competence Refers to the ability of healthcare providers to deliver culturally appropriate services to members of different ethnic and linguistic group  Expanded to include organizational level competence  Includes attitudes, skills, behaviors, and policies that help to ensure successful work across cultures  Organizational cultural competence has been divided into six stages that range from cultural destructiveness to cultural proficiency  Individual cultural competence ranges from denial to integration
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  | http://online.mcphs.edu Cultural Competence The assumption has been made that increased cultural competence leads to decreased health disparities  Not accepted by everyone  No evidence to support this assumption  Cultural sensitivity  Demonstrating basic empathy and sensitivity to patients in general and treating them as individuals in a respectful and caring manner  The overriding belief is that all patients should be treated as individuals, receiving respectful, caring treatment regardless of culture/race/ethnicity
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  | http://online.mcphs.edu Social Constructionof Cultural Diversity in Public Health Location in the public domain • Requires that issues be framed as the “common good” • Must make successful claims that something is a serious “public health issue” requiring resources and attention • Work is inherently political and so influenced by politics in ways that private healthcare is not Epidemiology as the core discipline • Based upon the assumption that health and disease states are not evenly distributed across populations • By design, separates people into groups based upon certain characteristics (like race, gender, age) • Program planning is population-based and tends to focus on marginalized, “hard to reach” populations
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  | http://online.mcphs.edu Social Constructionof Cultural Diversity in Public Health Core values Feed into construction of diversity Humanitarianism, universalism, altruism Basic assumptions Greater attention to cultural diversity is a good thing and will lead to positive benefits for the defined group Can actually lead to reinforcement of negative stereotypes and may draw unwanted attention Conflation of diversity with census categories Set by directives of the Office of Management and Budget Sociopolitical categories which may have little or no real meaning for health-related purposes
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  | http://online.mcphs.edu Summary  Ourfocus this week has been on definitions of race and ethnicity as well as cultural competence and health disparities  We have examined a variety of social constructs and the potential impacts (positive and negative) of these “definitions”  These are concepts which are continuing to evolve and will be a significant part of the future of public health and your work as a public health practitioner
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  | http://online.mcphs.edu Week 9Assignment Live Book Discussions