Calendar Personal tools You are here: Resources for Cancer Information and Support Introduction Racial and ethnic minorities and medically underserved groups are more likely to develop cancer and die from it than the general U.
Inverting this problem by viewing the barriers as arising from the culture of biomedicine provides greater direction for practice. Integral to the delivery of culturally appropriate diabetes care are practitioner competencies in specific areas of cultural knowledge, as well as specific skills in intercultural communication, tripartite cultural assessment, selecting among levels of intensity of cultural interventions neutral, sensitive, innovative, or transformativeadapting patient education, and developing community partnerships.
The disparity in health status and access to care that exists between Anglo and minority populations in the United States has been a recognized problem since at least the early s.
Research has consistently documented that on almost any measure, minorities have poorer health than do Anglos. A decade later, in Healthy People Midcourse Review and Revisions, Shalala 2 stated that minority groups continue to experience disproportionately worse health outcomes than do Anglo-Americans.
In fact, there is considerable evidence of increasing health disparities between white and minority groups. Instead, actual diabetes-related deaths are rising among African-American and Native-American populations.
Further, fewer minority people with diabetes are aware of their diagnosis: Mortality rates in these same minority groups are two to five times higher than among Anglos. The incidence of complications such as end-stage renal disease, retinopathy, and amputations among minorities is also disproportionately high.
Diabetic nephropathy, as well as kidney and liver failure, is three to seven times higher in African Americans, Mexican Americans, and Native Americans, and rates of amputations are two to four times higher than among Anglos. Diabetes is one of six specifically targeted areas of this initiative.
Issues to be addressed under this ambitious initiative include lack of access to quality health services, environmental hazards in homes and neighborhoods, poverty, and need for effective prevention programs tailored to specific community needs.
Thus, there is a professional mandate to address the growing disparity, particularly in the face of the demographic imperative resulting from the increasing proportions of minority populations in the United States.
For most ethnic minority groups, discussion of cultural dynamics in health care cannot take place without consideration of the ways in which culture intersects with issues of poverty and equity, including access to and utilization of health care, individual and institutional racism, and a lack of cultural competence on the part of health providers and programs.
Although some system-wide barriers to care are considered elsewhere in this issue, they also need special consideration with most ethnic minority populations because the issues are heightened by the cultural dynamic. For example, the income of Mexican Americans lags considerably below that of Anglos.
Low income is both a direct and indirect financial barrier to access. Further, many Hispanics live in states with the most stringent Medicaid eligibility criteria and are therefore excluded from public financing programs.
This financial-political situation precludes having a regular source of health care and use of preventive health services.
Interviews with nearly 40 patients who had been admitted with this condition revealed that the primary cause was cessation of insulin therapy. Half of the patients interviewed stopped therapy because of lack of money to purchase insulin from an outside pharmacy or to obtain transportation to the hospital.
Further, several patients were unaware of diabetes management strategies for sick days and dosage adjustments. The authors concluded that up to two-thirds of episodes of DKA may be preventable by improving patient education and access to care.
Tribal peoples were stripped of their lands and forcibly resettled on reservations, which today have some of the highest rates of unemployment in the United States. For many years, rates of diabetes were very low among Native Americans.
In the s, the Cornell University Medical Team provided care and conducted physical examinations for the majority of the members of the Many Farms Navajo community and found few cases of type 2 diabetes. They found that members of the community are now 10 times more likely to have diabetes than they were 30 years ago.
Key changes in the community included a reliance on the federally subsidized commodities food program that distributes excess farm produce, consisting primarily of refined flour, cheese, lard, and refined sugar. The recent conceptualization of fry bread as a traditional Native American food is largely a result of the commodities food distribution program.
A Study of Trends in Beliefs and Attitudes Toward Cancer Eva Schernhammer & Gerald Haidinger & models of health beliefs aim to explain people's health behaviors by relating them to their beliefs. Table 1 Summary statistics comparing with individual beliefs regarding potential for cancer cure and causes for developing cancer. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer. Cultural Barriers to Treatment and Compliance by Marcia Carteret, M. Ed. | Mar 1, Because many health beliefs and behaviors are culturally-based, it follows that when two different cultures come together in a health care setting, a .
These factors, coupled with a dramatic reduction in physical activity resulting from altered traditional work patterns and greater access to fast foods, has resulted in an epidemic of diabetes in this and other Native American communities.
The need to consider cultural factors in the care of people with diabetes has been identified for several decades. Yet we are not close to effectively addressing this issue in practice. Further, by thinking that culture is what other people have, we objectify culture and distance ourselves from it and from ethnic patients.
We have failed to adequately address our responsibilities as practitioners for having competent knowledge and skill sets and using them effectively when working with ethnic clients. It is exceptionally difficult to describe or comprehend the extent to which ethnocentrism and racism have been woven into the fabric of our health care system.
These provider beliefs, coupled with an undeveloped skill set, result in inadequate care. We need knowledge-based strategies delivered by culturally skilled practitioners to truly address diabetes health issues with minority clients.
Ethnocentric or culturally encapsulated programs result in under-use and premature termination; arguably, this constitutes professional malpractice. These skills include the informed abilities to:Belief and Traditions that impact the Latino Healthcare. Claudia Medina, MD, MHA, MPH. Program Director.
How culture influences health beliefs • Cultural issues play a major role in patient compliance. – The use of healing/treatment practices in health provision and seeking behaviors.
Cultural and Socioeconomic Factors Affecting Cancer Screening, Early Detection and Care in the Latino Population. Perceptions of cancer causes, positive personal experiences with cancer cures, and knowledge of cancer cures and causes generally improved across all groups.
Those with less education were less likely to believe that cancer could be cured in , a difference that resolved in Cultural Barriers to Treatment and Compliance by Marcia Carteret, M. Ed.
| Mar 1, Because many health beliefs and behaviors are culturally-based, it follows that when two different cultures come together in a health care setting, a .
cure/treatment of fracture, unexplainable ailments, malaria, poison and even infertility to mention but a few. Although development, civilization and education among other factors have helped to introduce change tremendously towards these beliefs and behavior to . Abstract: Health attributions influence health beliefs and subsequent health behaviors.
Health attributions are partly shaped by culture. In turn, cultural health attributions affect beliefs about disease, treatment, and health practices. Like-wise, culture influences health and healing practices.