Dynamics of
Care in Society
DIVERSITY
IN
HEALTH CARE
1
OBJECTIVES
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Differentiate between culture, ethnicity, and race
Identify some of the major ethnic groups in the US
Provide an example of acculturation in the US
Create an example of how bias, prejudice, or stereotype can
cause barriers to effective relationships
Describe ways to avoid bias
Differentiate between a nuclear and extended family
Identify ways in which language, personal, space, touching,
eye contact, and gestures are affected by cultural diversity
Compare and contrast the diverse health beliefs of
different ethnic/cultural groups
Give examples of how health care providers can show
respect for an individual’s beliefs & for cultural diversity
DO NOW:
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Surgeon’s Dilemma
Stereotypical thinking is one of the major barriers
to awareness. Generalizations can help to make
sense of the world but they can also seriously
mislead us...
A young man who had been badly injured in a car
accident has been brought into a hospital's accident
and emergency department. The doctor determines
that emergency brain surgery is required.
Accordingly, the brain surgeon is paged. Upon seeing
the patient, the surgeon exclaims, ‘My God, I can't
operate on that boy! He's my son!’
That is so, but the surgeon is not the boy's father.
How can the apparent contradiction be explained?
CULTURE
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The values, beliefs,
attitudes, languages,
symbols, rituals
behaviors, and
customs unique to a
particular group of
people that is passed
from on generation to
another
Includes:
 Family relations
 Child rearing
 Education
 Occupational choice
 Social interaction
 Spirituality
 Religious beliefs
 Food preferences
 Health beliefs
 Health care
CULTURE
Culture is
 Culture is
 Culture is
 Culture is
changing.
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learned.
shared.
social in nature.
dynamic and constantly
ETHNICITY
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A classification of
people based on
national origin
and/or culture.
Members share a
common heritage,
geographic location,
social customs,
language, and
beliefs.
Common Ethnic Groups
 African American
 Asian American
 European American
 Hispanic American
 Middle Eastern / Arabic
American
 Native American
RACE
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Classification of people based on physical
or biological characteristics including:
Color of skin, hair, and eyes
 Facial features
 Blood type
 Bone structure
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Cuts across
multiple ethnic/cultural
groups
GENDER
Gender: refers to the cultural and social
differences that distinguish men from women
 Sex: refers to the biological differences
that distinguish males from females
 Gender equality: the conditions under which
girls and boys, women and men, can reach
their full potential without discrimination
(through equal access to nutrition, health care,
education, and opportunities to make decisions
in their households and communities, it also
includes legal equality)
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CULTURAL DIVERSITY
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Differences based
on culture,
ethnicity, and race
that influence one’s
behavior, selfperception,
judgment of
others, and
interpersonal
relationships
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Includes:
Family organization
Language
Personal space
Touching
Eye contact
Gestures
Health care beliefs
Spirituality
Religion
CULTURAL ASSIMILATION
Absorption of a culturally distinct group
into a dominant or prevailing culture
 Requires that a cultural group alter
their unique beliefs and behaviors and
adopt the ways of the dominant culture
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However, in the US, we are striving for a society
where cultural differences are appreciated and
respected.
ACCULTURATION
The process of learning the beliefs and
behaviors of a dominant culture and
assuming some of the characteristics.
 Occurs slowly over a long period of
time.
 Example:
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 Recent
immigrants are more likely to use
the language and follow the behavior
patterns of their origin country than their
children or grandchildren
 ex: become more “Americanized”
DO NOW:
EVERYONE HAS CULTURE…ANSWER THE
FOLLOWING & THEN RANK THEM IN ORDER
OF IMPORTANCE
What music do you like to listen to?
What kind of traditions do you have?
What foods do you like?
What holidays are important to you?
What is most important in life to you?
Is you extended family important to you?
Why or Why not?
SENSITIVITY
The ability to recognize and
appreciate the personal
characteristics of others.
 It is essential for health care
professionals to understand and
respect these differences to provide
care that meet the needs of all
individuals.
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BIAS
A preference that inhibits impartial
judgment of others
 Common biases:
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 Age
 Education
 Physical
size
 Occupation
 Sexual preference
 Gender
PREJUDICE
A strong feeling or belief about a
person or subject that is formed
without reviewing facts or information
 Causes fear and distrust of others
 Interferes with interpersonal
relationships
 Health care workers must be aware of
our prejudices and to make every
effort to obtain as much information
about a situation as possible
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Do Now online:
At Face Value: Issues with Stereotypes
STEREOTYPING
Process of assuming that everyone in a
particular group is the same
 It ignores individual characteristics and
“labels” the individual
 May occur with regard to:
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Race
 Gender
 Body size
 Occupation
 Ethnicity
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Stereotyping vs.
Generalization
• A stereotype is an ending point.
• No attempt is made to learn whether
the individual in question fits the
statement.
• Stereotyping can have negative
results.
• We often stereotype people simple on
the basis of appearance.
Stereotyping vs.
Generalization
• A generalization is a beginning point.
• It indicates common trends, but
further information is needed to
ascertain whether the statement is
appropriate to a particular individual.
• It is important to remember that
there are always differences between
individuals.
OVERCOMING
BIAS, PREJUDICE, AND STEREOTYPING
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Be conscious of your own personal and
professional values and beliefs
Learn as much as you can about different
ethnic/cultural groups
Be sensitive to behaviors and practices that
are different from your won
Remember that you do not have to adopt
others’ beliefs, but you must respect them
OVERCOMING
BIAS, PREJUDICE, AND STEREOTYPING
Develop friendships with a wide variety
of people
 Ask and encourage questions from others
to share ideas and beliefs
 Evaluate all information before forming
an opinion
 Be open to all differences
 Avoid offensive language and jokes
 Understand that mistakes happen.
Apologize and forgive.
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LANGUAGE
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Health care provides must determine a
patient’s ability to communicate and
intervene to help those who do not
understand English by use of:
 Translators
 Family
members
 Gestures or pictures
 Cue cards
(read handout)
PERSONAL SPACE
The distance people require to feel
comfortable when interacting with
others
 Varies greatly among ethnic/cultural
groups
 Health care providers must be alert to
a patient’s verbal and nonverbal cues
to determine personal space
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EYE CONTACT
Eye contact is affected by cultural
beliefs
 Lack of eye contact is usually
interpreted as “not listening” but in
some cultures is a sign of respect
 Health care workers must be alert to
an individuals comfort level when using
direct eye contact and adjust
accordingly
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GESTURES
Are used to communicate
(remember non verbal
communication)
 Can vary among
ethnic/cultural groups
 Health care providers
must be aware of how a
patient responds to
gestures and avoid any
that seem to be offensive
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Think!
If you have ever needed Health care– how did you feel?
ANXIOUS
CONFUSED
ISOLATED
SCARED
Do Now:
•What would you most like the staff caring for
you to know about you?
•What would you most like them to understand?
•In Groups make a list of the things you would
like considered if you had to go into hospital
Main areas that people of various cultures will be
concerned about:
•Food
•Modesty
•Clothing/ jewelry
•Hygiene
•Family planning
•Childbirth
•Blood transfusions
•Care of the dying/death
•Post mortems
•Organ transplantation
We need to feel listened to and valued so caring
Staff will need to have a good knowledge of many
different religions and cultures
Ask the individual or the family what it is that they need
and what they want the staff to be aware of. Irrespective
of whether or not a person belongs to a religious or
cultural group they will have preferences and needs which
are individual and personal.
HEALTH CARE BELIEFS
Vary widely throughout all groups
 Can affect an individuals response to
health care
 Most cultures have common conceptions
regarding:
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 The
cause of illness
 Ways to maintain health
 Appropriate response to pain
 Effective methods of treatment
HEALTH CARE BELIEFS
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Reactions to Pain & Other Health Issues
 Response to pain is culturally influenced
 Patient in pain may not show it
 Listen to patients who freely express
their discomfort
 Recognize influence of cultural &
individual beliefs about health
 Respect patient’s right to react to health
care issues any way he wants to
 Don’t stereotype a patient’s perceptions
or responses based on culture
RELIGION
An organized system of belief in a
superhuman power or higher power
 Are associated with a particular form or
place of worship
 May include beliefs about birth, life,
illness, death, and dietary practices
 Atheist – one who does not believe in any
deity
 Agnostic – one who believes that the
existence of God cannot be proved or
disproved
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Jehovah's Witnesses
Religious Beliefs regarding blood transfusions
Jehovah's Witnesses have sincerely held views, based on the
Bible, that taking blood into one's body is morally wrong.
This includes whole blood or its components, such as packed
red cells, plasma, white cells and platelets.
Jehovah's Witnesses are allowed to choose about whether to
accept products such as albumin, immunoglobulin or clotting
factors.
Blood samples may be taken for pathological testing as long as
any unused blood is disposed of and not reused.
Dialysis will usually be accepted provided that no other source
of blood is used.
Jehovah's Witnesses will accept medical treatment in all other
respects apart from those involving the use of blood or blood
components.
RESPECTING CULTURAL DIVERSITY
Each individual must be regarded as a
unique individual
 Ways to achieve this goal is to:
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 Listen
as patients express their beliefs
 Appreciate individual different differences
 Learn more about cultural and ethnic groups in
your area
 Recognize signs of prejudice, bias, or
stereotyping
CULTURE & HC ACTIVITY
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Mark’s Story Disabled (8 min) may have
to use google chrome
A Day in the Sleep Clinic (use handouts)
CDC STATISTICS
• Health, United States is an annual CDC
report on trends in health statistics
• CDC data on Risk Factors & Health
Indicators by Race/Ethnicity & Gender
• Use detail view
FOR TEACHING TOLERANCE ACTIVITY
com·pas·sion
a feeling of deep sympathy and sorrow for another
who is stricken by misfortune, **accompanied by a
strong desire to alleviate the suffering.
dig·ni·ty
1. bearing, conduct, or speech indicative of selfrespect or appreciation of the formality or
gravity of an occasion or situation.
2. nobility or elevation of character;
worthiness: dignity of sentiments.
DIVERSITY IN HEALTH CARE
PRACTICES…
To Be Discussed in more depth in a later
unit….
 Folk Medicine
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Cutaneous stimulation
Therapeutic touch
Acupuncture
Acupressure
Natural Remedies
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Herbs
Be aware of possible interactions with prescriptions
Keep personal opinions & biases to yourself