Berta Alicia Bejarano, M.B.A., C.I.
Diversity Director
Kaiser Permanente
What Is Diversity?

- Race
- Ethnicity
- Age
- Income
- Education
- Language
- Employment
- Gender
- Sexual Orientation
- Social Status
Cultural Competence

Is the delivery of health care services that
acknowledges and understands cultural
diversity in the clinical setting, respect
member’s health beliefs and practices, and
values cross-cultural communication.
How Many Languages Do
Our Kaiser Members
Represent?

 120 Different Spoken Languages
 110 Written Languages
 80% of KP hospitals & clinics encounter LEP patients
 63% daily/weekly
 17% monthly
Latinos in the U.S.

 50 million today
 20 years
 150 million
 Demographic revolution
 Health Care Reform
Latinos & Diabetes

 2000 2 million of the 30 million Hispanics in America
had diabetes
 1/3 unaware
 5% of Latinos between the ages of 20 and 44 have
diabetes
 20% of Latinos between the ages of 45 and 74 have
diabetes
 Half of all Latinos with diabetes have not been
diagnosed.
Why Resistance?

 Do not feel sick
 Interruption of their lifestyles
 Interruption of their work
 Side effects of medication
 Home/natural remedies instead of medication
Challenge

 Latinos with diabetes often are labeled as "resistant
to treatment" when the real problem may simply be
that the majority of health information provided to
the Latino community often lacks language and
cultural sensitivity, making it hard to understand.
Develop Your Cultural
Knowledge
Understand Beyond

Language
 Not all Latinos in California are Mexicanos
 Learn about the community you will serve
 Alameda County
 San Jose County
 Marin County
 San Francisco County/Daly City
Develop Your Cultural
Knowledge
Understand Beyond

Language
 Family Issues
 Religious Beliefs & Customs
 Folk Medicine Practices
 Dietary Practices
 Pain
 Fatalism
 End of Life Decision Making
Cultural Views

 Can strongly influence how individuals understand
and practice health care, including:
 What is considered a health problem
 How systems and concerns are addressed
 The type of treatment to be provided
 Who should provide treatment
 Who is involved in the decision-making process
Tips for Working With
Interpreters

 Choosing an interpreter is critical to obtaining the
best health outcome
 Avoid using children, friends, and family
 Avoid using jargon. Use short statements with
adequate pausing. Ask one question at a time.
 SB 775: Prohibits any child under 17 to interpret
Interpreter Vs.
Translator

 What is the difference?
 Is there a difference?
 Interpreter
 Translator
Translation Errors

 Kaiser Permanente Consent Form
 Sign Here:___________
 Cantonese Translation:
 Spit Here: ___________
 Gerber Baby Food: French Vomiting
 Ford Pinto-Brazil: Slang for Male Genitals
CLAS Standard 4
Office of Minority Health, US Dept. of Health and
Human Services

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.
Cultural Attitudes

 Sometimes communication can be difficult.
 At times patient’s knowledge about their bodies or
medical history is less than optimal, needing further
explanation.
 Patient’s expectations, based on cultural attitudes
regarding their health, may affect the outcome of the
medical treatment.
Diversity

Understanding Beyond
Language

“Having a better understanding of culture will enhance
your ability to provide patient care. Language alone
does not serve much if you do not understand the
culture”
Questions?

Berta.a.bejarano@kp.org Email
415.491.3132 Office