Cultural Proficiency in Addressing Health Disparities

by Kosoko-Lasaki, Sade; Cook, Cynthia Theresa; O'Brien, Richard L.

• ISBN13: 9780763751746
• ISBN10: 076375174X
• Edition: 1st
• Format: Paperback
• Copyright: 2008-09-12
• Publisher: Jones & Bartlett Learning

Summary

This book will help us to address Healthy People 2010, which challenges individuals, communities, and professionals to take specific steps to ensure that good health, as well as long life, are enjoyed

Table of Contents

Foreword	p. ix
Acknowledgments	p. xi
Introduction	p. xiii
List of Contributors	p. xv
Addressing Health Disparities in the 21st Century	p. 1
Overview of Health Disparities	p. 1
Definition of Health Disparities	p. 1
Models of Health Disparities	p. 3
Factors Contributing to Health Disparities	p. 5
Need for Relevant, Effective Interventions	p. 7
Historical Perspectives of Health Disparities	p. 8
Contemporary Disparities	p. 9
Progress on Eliminating Disparities	p. 14
Health Workforce Education	p. 14
Cultural Competence and Trust	p. 16
Communication and Disparities	p. 16
Environmental Disparities	p. 18
Solutions for the Reduction/Elimination of Health Disparities	p. 18
Race/Ethnicity, Trust, and Health Disparities: Trustworthiness, Ethics, and Action	p. 37
Trust and Trustworthiness: Meanings, Distinctions, and Relevance	p. 38
Addressing Trustworthiness: From Theory to Principles to Action Guides	p. 43
What Health Professionals and Institutions Should Do	p. 50
Justness, Health Care, and Health Disparities	p. 57
The Idea of Health Disparities	p. 59
How Justness and Health Disparities Might Be Considered an Ethics Afterthought	p. 60
The Turn Toward "Professionalism"	p. 62
Justness from a New View	p. 65
The Role of Academic Medical Centers in the Elimination of Racial and Ethnic Health Disparities	p. 73
Recruiting for Diversity	p. 75
Cultural Competency Training	p. 77
Health Disparities Research	p. 80
Advocacy	p. 82
Nursing Perspectives in Addressing Health Disparities	p. 87
"We just want to be treated like everybody else."	p. 87
"Water, water everywhere, but who's stopping to drink?"	p. 88
"Never trust anybody over 30? Why, they're talking about me!"	p. 88
"Oh, come on, Valda. You're being much too sensitive!"	p. 89
The Role of Nurses in Promoting Cultural Competency	p. 90
Demographic Challenges to Contemporary Nurses	p. 91
Nurses Bridging the Gaps	p. 92
Adding Insult to Injury	p. 96
The Many Faces of Patient Vulnerability	p. 97
The Ground Meat Parable, or "If I really listen I will understand."	p. 98
Full Circle: The Qualified Medical Interpreter in the Culturally Competent Healthcare System	p. 103
The Why and How of Language Access in Health Care	p. 104
The Professional Interpreter: Beyond Bilingualism	p. 106
Examples as Food for Thought	p. 109
Cultural Proficiency: Challenges for Health Professionals	p. 117
Communication	p. 118
Cultural Understanding	p. 120
Trust	p. 122
Actions by Others to Ensure Culturally and Linguistically Appropriate Care	p. 123
Experiences of Minority Professionals	p. 124
Cultural Competency Research: Description of a Methodology. Part I	p. 129
Background Information	p. 130
Research Design	p. 131
Community Assessment Instrument (Pre-Test)	p. 137
Community Assessment Instrument (Post-Test)	p. 146
Cultural Competency Instrument: A Description of a Methodology. Part II	p. 149
Background	p. 150
Research Design	p. 151
Cultural Competency Instrument (CCI)	p. 156
Statistical Models in Health Disparities Research	p. 159
Study Design	p. 160
Health Disparities Measures	p. 162
Statistical Models	p. 170
Addressing Health Disparities: The Hispanic Perspective	p. 183
Access to Care	p. 188
Immigration and Acculturation	p. 189
Health across the Life Course	p. 191
Chronic and Communicable Disease	p. 194
Mental Health	p. 199
Occupational and Environmental Health	p. 200
Social and Behavioral Health	p. 204
How to Address Health Disparities among Hispanics	p. 206
Health Disparities among Native American People of the United States	p. 225
Historical Origins of Health Disparities in Native Americans	p. 226
Federal Trust Relationship with Native American Tribes	p. 227
Population and Socioeconomic Characteristics	p. 228
Geographic Isolation and Cultural Barriers to Health Care	p. 229
Mortality	p. 230
Cardiovascular Diseases	p. 233
Malignant Neoplasms	p. 233
Unintentional Injuries	p. 234
Diabetes Mellitus	p. 235
Natality, Infant Mortality, and Maternal Health	p. 236
Suicide	p. 237
Substance Abuse	p. 238
Sexually Transmitted Disease/HIV	p. 238
Behavioral Health Risk Characteristics	p. 239
Oral Health	p. 239
Other Areas and Health Disparities	p. 239
Population to Health Professionals Ratio	p. 240
Indian Healthcare System	p. 240
Addressing Health Disparities in American Indians	p. 241
Addressing Health Disparities in Immigrant Populations in the United States	p. 247
Definitions of Immigrants, Foreign-Born Persons, Refugees, and Naturalized Citizens	p. 248
The Numbers of Immigrants and Foreign-Born Persons in the United States	p. 249
Health Disparities in Immigrant and Foreign-Born Populations	p. 256
Access to Health Care among Immigrants	p. 265
Policies and Practices Intended to Eliminate Health Disparities among Immigrants	p. 266
Cultural Proficiency among Healthcare Providers and Researchers	p. 267
Ethical, Legal, and Social Implications of Research with Immigrants as Subjects	p. 271
Minority Attitudes and Perception of Health Care: A Comparison of Comments from a Cultural Competency Questionnaire and Focus Group Discussion	p. 281
Research Design	p. 282
Results	p. 284
Health Disparities: The Nebraska Perspective	p. 311
Who Are the "Cornhuskers"?	p. 311
Health Disparities in Nebraska	p. 313
What Is Nebraska's Commitment Today? What Are We Doing?	p. 316
Nebraska's Office of Minority Health and Health Disparities	p. 317
State Financing for Nebraska's Public Health	p. 318
Health Education of Racial/Ethnic Minorities	p. 319
The Need for Public Health Leadership	p. 320
Cultural Proficiency and Health Disparity: The St. Louis, Missouri, Perspective	p. 331
The Emergence and Growth of the City of St. Louis	p. 332
Financial Development and Socioeconomic Disparities	p. 333
Health Disparity in St. Louis: How Did It Happen?	p. 333
The Genesis of Disparities	p. 335
The Question of Racism	p. 336
Education and Its Role in Healthcare Disparity in St. Louis	p. 337
Cultural Proficiency in Clinical Medicine	p. 337
The St. Louis Perspective: How Can We Make It Better?	p. 339
Health Disparities in the Pediatric Age Group	p. 343
Background	p. 345
Literature Review	p. 346
Pediatric Diversity	p. 351
Education	p. 352
Perceived Health Disparities	p. 353
Healthcare Insurance	p. 353
Addressing Health Care in Communities	p. 357
The Community Approach	p. 359
The Need for Community Empowerment	p. 360
History	p. 362
Community Solutions to Health Disparities	p. 365
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research	p. 373
Economic Dimension of Health Disparities	p. 375
Economic Status and Its Measurement	p. 376
Income Distribution	p. 377
Some Evidence on Economic Studies of Health Disparities	p. 380
Some Policy Reflections	p. 380
Conclusion: Global and Domestic Health Disparities-Possible Solutions	p. 385
About the Authors	p. 391
About the Contributors	p. 395
Index	p. 413
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