Transcript Document

Relating Ethnicity and Culture to
Healthcare Marketing
August 8, 2003
August 8, 2003
Page 1
Pamela L. Schneider
Senior VP, Client Services Director
Rick Johnson & Company, Inc.
August 8, 2003
Page 2
Our Agency Has a Plethora of Healthcare Experience
• Integrated Health Systems
• Hospitals
• Managed Care
• Physician Specialty Groups
• Clinics and Solo Practitioners
• Recruitment and Retention
• Community Healthcare Leadership
The list goes on…
August 8, 2003
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August 8, 2003
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Let’s Begin Today by
Discussing Some Statistics
August 8, 2003
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Percent of Persons Who Are American Indian and
Alaskan Native by County in New Mexico
36.9% to 74.7% Includes:
San Juan, McKinley and
Cibola Counties
10.9 – 16.3% Includes: Rio
Arriba, Sandoval and
Socorro Counties
Source: United States Census
Bureau Data: www.census.gov
August 8, 2003
NOTE: Bernalillo County – 13.5% of NM NA pop. or 23,623Page 6
Percent of Persons who are Hispanic or Latino by
County in New Mexico
72.9 – 81.6% Includes:
Rio Arriba, Mora, San
Miguel and Gaudalupe
Counties
44.9 – 63.4% Includes: Taos,
Colfax, Harding, Santa Fe,
Valencia and Socorro as well as
Grant, Hidalgo, Luna and Dona
Ana Counties
Source: United States
Census Bureau Data:
www.census.gov
August 8, 2003
Note: Bernalillo County is 30.4% of NM Pop. or 236,285
Page 7
Percent of Persons who are Anglo in New Mexico
by County
Source: United States Census
Bureau Data: www.census.gov
August 8, 2003
Page 8
U.S. Census Data on Nativity and Language Proficiency in New Mexico
NATIVITY AND
PLACE OF BIRTH
NUMBER
PERCENT
Total population
1,819,046
100.0
Native
1,669,440
91.8
Born in United States
1,650,808
90.8
State of residence
937,212
51.5
Different state
713,596
39.2
18,632
1.0
149,606
8.2
Entered 1990 to March
2000
58,482
3.2
Naturalized citizen
52,103
2.9
Born outside United
States
Foreign born
August 8, 2003
Source: United States Census Bureau Data: www.census.gov
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U.S. Census Data on Nativity and Language Proficiency in New Mexico
Language Spoken
at Home
Number
Percent
Population 5 years
and over
1,689,911
100.0
English only
1,072,947
63.5
Language other than
English
616,964
36.5
Speak English less
than "very well"
201,055
11.9
Spanish
485,681
28.7
Speak English less
than "very well"
158,629
9.4
August 8, 2003
Source: United States Census Bureau Data: www.census.gov
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Other Population Statistics – Census Bureau
Subject
Total Population
Percent
National Percent
100%
100%
Male
49.20%
49.10%
Female
50.80%
50.90%
Hispanic/Latino Population
42.10%
12.50%
Native American Population
9.50%
0.90%
White (alone) Population
44.70%
69.10%
People who speak a language other than
English at home 5+ years
36.50%
17.90%
Persons below National Poverty Line
18.40%
12.40%
August 8, 2003
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10 LEADING CAUSES OF DEATH IN THE AMERICAN INDIAN
CAUSE OF DEATH
% OF ALL DEATHS IN AGE GROUP
Unintentional Injury
17.00%
Malignant Neoplasms
12.60%
Liver Disease
8.20%
Diabetes Mellitus
7.20%
Cerebrovascular
5.00%
Suicide
3.50%
Influenza & Pneumonia
3.10%
Homicide
1.70%
Nephritis
1.40%
All Others
25.60%
Source: The Center for Disease Control Website: www.webapp.cdc.gov
August 8, 2003
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10 LEADING CAUSES OF DEATH IN THE HISPANIC POPULATION
CAUSE OF DEATH
% OF ALL DEATHS IN AGE GROUP
Heart Disease
20.80%
Malignant Neoplasms
20.00%
Unintentional Injury
9.70%
Cerebrovascular
5.70%
Diabetes Mellitus
5.10%
Liver Disease
4.00%
Chronic Lower Respiratory
Disease
3.40%
Homicide
2.60%
Suicide
2.40%
Influenza & Pneumonia
1.80%
Source: The Center for Disease Control Website: www.webapp.cdc.gov
August 8, 2003
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Our DMA is One of the Top 15 Hispanic Markets in the Country
Market
%/TV Households
Los Angeles
30% (1,585,390)
1
New York
15% (1,100,030)
2
Miami-Ft. Lauderdale
37% (550,190)
3
Houston
22% (399,220)
4
Chicago
12% (384,140)
5
Dallas-Ft. Worth
15% (324,120)
6
San Antonio
44% (317,810)
7
San Francisco – Oak- SJ
13% (317,200)
8
Phoenix
16% (246,160)
9
Harl-Wslco-Brns-Mca
81% (232,270)
10
Albuquerque-Santa Fe 33% (206,710)
August 8, 2003
Hispanic Rank
Source: 2003
Nielsen Universe
Estimates
11
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Approximately 38% of the DMA Population is Hispanic
Total DMA Population
1,597,000
Hispanic Percentage
38%
Hispanic Population
602,000
Non-Hispanic Percentage
62%
Non-Hispanic Population
995,000
Source: 2003 Nielsen Universe Estimates
August 8, 2003
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Hispanics Growing Twice as Fast as Non-Hispanics
A Rapidly Growing Population
Hispanic
1990
2000
579,224
785,386
Non-Hispanic 935,845
1,053,660
% Change
32%
13%
Source: 1990 and 2000 Census (New Mexico state population
August 8, 2003
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More Than Four Out of Five Hispanic
Households Speak Spanish
Speak Spanish
82%
Speak English Only
18%
Source: 2003 Nielsen Universe Estimates
August 8, 2003
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More Than Four Out of Five Hispanic
Households Speak Spanish
• Conveying your message to your target audience is
accomplished most effectively in their
language of comfort.
• The language of comfort is the language spoken at
home.
• Spanish-language dominant Hispanics think and feel
in Spanish.
Source: 2003 Nielsen Universe Estimates
August 8, 2003
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But It’s More than Just Spanish…
August 8, 2003
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It’s About Reaching Them with Relevance
• It’s necessary to connect with target consumers
–
–
–
–
Emotionally
Rationally
Intellectually
Culturally
• To connect in these ways, you must know about their level
of acculturation
August 8, 2003
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Acculturation, Not Assimilation
• Assimilation:
– A group leaves culture and customs behind and adopts
culture and customs of another group
• Acculturation:
– A group adopts or borrows customs and traits from
another culture
August 8, 2003
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Acculturation is Defined as…
• “Change resulting from contact between cultures”
• “The process by which people adopt or borrow customs and traits from
another culture”
• “A merging of cultures as a result of prolonged contact”
• “Mutual influence of different cultures in close contact”
August 8, 2003
Source: “Acculturation” Microsoft Encarta Online Encyclopedia 2000
StrategyPage
Research
22 Corp.
Webster New World Dictionary, Third College Edition
Key Indicators of Acculturation
• Language
• Values
August 8, 2003
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Latino Acculturation Values (L.A.V.s.)™
UNACCULTURATED
ACCULTURATED
Success;
Success:
Family/group
satisfaction
Class
distinction/
authority
Personal
Achievement
Obedience/
attached to
traditions
Individualism
Collectivism
Avoidance
of direct
confrontation
Cooperation/
respect
Fatalism
August 8, 2003
Freedom/
open to change
Equality
Assertiveness/
aggressiveness
Competition
Control
over destiny
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Latino Acculturation Stratification
UNACCULTURATED
CULTURAL
LOYALIST
CULTURAL
EMBRACER
ACCULTURATED
(TM)
CROSS
CULTURER
CULTURAL
INTEGRATORS
• Foreign Born
• Foreign Born
• U.S. Born
• U.S. Born
• Recent arrival
• Resident
• First generation
• 2nd, 3rd Generation
• Spanish
dependent
• Spanish
Preferred
• Bilingual &
Bicultural
• English
Preferred
• Traditional values
• Professional
• Professional
• Latino Proud
• Aspirational
• Fashion-forward
• Retro-acculturation
• In touch with roots
• Influential
August 8, 2003
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Acculturation Nationally Among Hispanic Adults 18+
9%
Partially
25%
Unacculturated
66%
Acculturated
Source: Strategy Research Corp.
August 8, 2003
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Albuquerque is Highly Acculturated Market
• Top 3 Most Acculturated Markets in U.S.:
– San Antonio
– Albuquerque
– San Francisco
August 8, 2003
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Acculturation Among HA 18+ - Albuquerque
15%
Partially
21%
Unacculturated
64%
Acculturated
August 8, 2003
Source: Strategic Research Corp. 2002
PageCorp.
28
Source: Strategy Research
Factors Influencing Acculturation
•
•
•
•
•
•
•
•
Employment
Length of Residency in U.S.
Language Use/Preference (home and work)
Birthplace of Parents
Education
Generation U.S. Born (1st, 2nd, 3rd, etc)
Media Preferences (Spanish or English)
Values and Attitudes
August 8, 2003
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Research Shows…
• Advertising to Hispanics in English is not as effective
as speaking to them in Spanish
• Spanish language commercials have better ad recall.
(61%)
• Hispanics have better comprehension of
Spanish-language commercials (57%).
• Spanish commercials are 4.5% times more influential
in making purchases decisions.
Source: Roslow Research Group Inc., Spanish vs English Advertising Effectiveness Among Hispanics 2000
August 8, 2003
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Ethnicity is defined as:
rel: of, relating to, or originating from the
traits shared by members of a group as a
product of their common heredity and
cultural tradition(s)
August 8, 2003
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Culture is defined as syn:
breeding, cultivation, polish, refinement
rel: development, education, learning;
enlightenment; refinement, breeding,
erudition, manners, class
August 8, 2003
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Culture-Sensitive Healthcare:
Hispanic
August 8, 2003
Page 33
“Hispanic”
• The term “Hispanic” was created by the U.S.
Census Bureau in 1970 as an ethnic category
for persons who identify themselves as being
of Spanish origin.
• “Hispanic” denotes neither race nor color, and a
Hispanic may be White, Black or American
Indian
• Many members of the younger Hispanic population
demographic now prefer the term “Latino”.
August 8, 2003
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“Hispanic”
• The classification “Hispanic” includes people of
many different origins and cultures.
• Although there is a unifying thread of language and
some cultural similarities inherited from the
Spanish settlers – There is also a tremendous
variety within the Hispanic community
August 8, 2003
Page 35
Keys to a Good Professional
Relationship with Your Hispanic
Patients
August 8, 2003
Page 36
Show respeto –
• People from many Hispanic cultures offer (and
expect to receive) deference on the basis of age,
sex and status.
• Patients will naturally offer respeto to the health
provider, an authority figure with high social,
educational, and economic status.
• In return, patients rightfully expect to be treated
with respect.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 37
The Healthcare Provider Shows respeto by:
• Addressing Adults by title and family name (Mr./Señor,
Mrs./Señora Y, or Madam/Doña)
• Shaking hands at the beginning of each meeting.
• Using usted rather than the informal tu for “you”, when
speaking Spanish.
• Making eye contact, without necessarily expecting
reciprocation, since some (especially rural) patients
may consider it disrespectful to look the health
provider, an authority figure, in the eye.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 38
The Healthcare Provider Shows respeto by:
• Speaking directly to the patient, even when
speaking through an interpreter.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 39
Show personalismo.
• Patients from many Hispanic cultures expect to
establish a personal, one-on-one relationship –
not to be confused with an informal
relationship – with the health provider.
• Although establishing a relationship based on
personalismo may seem time-consuming, it can
actually save time and prevent negative
outcomes.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 40
The Healthcare Provider Shows personalismo by:
• Treating patients in a warm and friendly – but not
unduly informal – manner.
• Showing genuine interest in and concern for
patients by asking them about themselves and
their family.
• Sitting close, leaning forward and using gestures
when speaking with the patient.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 41
Involve the Family in Decision Making and Care.
• Families are a source of emotional and physical
support and are expected to participate in
important medical decisions.
• The definition of “la familia” is much broader in most
Hispanic cultures than in Anglo cultures
• La familia may show loyalty and support by gathering
at the hospital.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 42
Accept a different sense of time.
• Many people from Hispanic cultures have what might
be called a “global” or “indefinite” sense of time –
rather than an exact sense of day and hour – in
making and keeping appointments.
• Similarly in presenting a complaint, they may not be
able to attach a specific calendar date to the onset
or conclusion of a medical complaint or an event.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 43
Accept a different sense of time.
• They may instead be able to link the event to a season,
a phase of the moon, or a particular occurrence,
such as a holiday or celebration.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 44
Take pains to establish understanding and
agreement.
• Many patients’ sense of respect for authority may
cause them to avoid conflict or confrontation with
the health provider by saying too readily that they
understand how to take a medication or will follow
a treatment plan.
• The health provider must ensure that understanding
is achieved and must try to gain real acceptance of
the treatment plan and a commitment to follow it.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 45
Respect the spiritual side of physical complaints.
• Many Hispanic patients complain that health
practitioners, by discounting supernatural and
psychological causes of complaints, offer only a
fragmentary approach to care.
• To these patients, this amounts to treating the
symptoms, not the disease itself.
• Practitioners are advised to ask their patients what
they believe to be the cause of a complaint and to
refrain from ridiculing or discounting the patient’s
belief in supernatural or psychological causes.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 46
Potential Culture-Related Health
Concerns Among Hispanic Populations
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 47
Persons from some Hispanic cultures may have
tendency toward certain health concerns because
of cultural factors.
Specific concerns include:
• High incidence of teenage pregnancy
• Low incidence of breast feeding
• Where breast feeding is practiced, a tendency to do so
for a short period and to introduce solid foods
earlier than recommended
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 48
Specific concerns include:
• Very low intake of vitamin A.
• Alcohol abuse, especially by young Mexican males
(abetted by cultural taboos against female
disclosure of alcohol use).
• Drug use at levels higher than among non-Hispanic
Whites.
• A high prevalence of undetected non-insulindependent diabetes
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 49
Specific concerns include:
• A high incidence of tuberculosis (recommend
aggressive screening
• A high risk for mental health problems such as
depression, anxiety, and substance abuse.
•Dietary concerns due to:
• High consumption of fats (often lard, especially for lower
income people) and fried foods
• A traditional diet high in carbohydrates from beans and rice
or corn tortillas
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 50
Specific concerns include:
•Dietary concerns due to:
• Low intake of green or leafy vegetables and/or milk and
eggs, especially in conjunction with increased
consumption of meat and fast foods as acculturation
occurs.
• Little tradition for “recreational” physical exercise outside
the context of field or other physical labor.
• Excessive reliance on Azarcon which is about 90 percent
lead, as a home remedy for gastrointestinal/intestinal
complaints.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 51
Specific concerns include:
• Sharing with family and friends, of hypodermic
needles and syringes, which in Mexico are often
used to administer vitamins, medications, and
contraceptives.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 52
Folk Beliefs of Some Hispanics About Health and
Illness That Can Affect Care and Treatment
• Good health is a matter of luck that can easily change.
Sick persons may be the innocent victims of “fate,”
with little responsibility for taking action to regain
health.
• Illness may be the result of negative forces in the
environment or a punishment for transgressions.
• Balance and harmony are important to health and
well-being. Illness may be the result of an
imbalance.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 53
Folk Beliefs of Some Hispanics About Health and
Illness That Can Affect Care and Treatment
• The natural and supernatural worlds are not clearly
distinguishable, and body and soul are inseparable.
Telling a patient that an illness is all in the mind is
meaningless because there is little or no distinction
between somatic and psychosomatic illness.
• Cure requires family participation and support. The
family’s role is to indulge the patient, provide
unconditional love and support, and participate in
health care decision making.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 54
Folk Beliefs of Some Hispanics About Health and
Illness That Can Affect Care and Treatment
• While education and training may be somewhat
important, what truly matters is the caregiver’s
“gift” or “calling” for curing illness.
• Moaning, far from being a sign of low tolerance to
pain, is a way to reduce pain and to share it with
interested others.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 55
Folk Beliefs of Some Hispanics About Health and
Illness That Can Affect Care and Treatment
• Diseases may be divided into Anglo and traditional
diseases and may be either natural or unnatural.
• Many people mix and match “modern” medicine and
traditional care, consulting modern health
providers for Anglo and natural diseases, and folk
healers for traditional and unnatural diseases.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page
August 8, 2003
Page 56
American Indian
Native American
August 8, 2003
Page 57
Culture-Sensitive Healthcare: American Indian
• The term “American Indian” refers to members of
Indian Tribal nations who live in the United States.
• “Native American,” a term that has become
unpopular among American Indian groups, refers
to American Indians, Eskimos, and Aleuts as one
racial ethnic group.
• Fact: The Native American group as a whole is
expected to reach 4.3 million by 2050.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 58
Culture-Sensitive Healthcare: American Indian
• The majority live in Oklahoma, California, Arizona
and New Mexico.
• Poverty is higher than in the rest of the population
and continues to increase.
• In 1979, 27% of the American Indian population
lived below the poverty line; by 1989 this figure
had grown to 31%, by 1999 this figure had grown
again to 33%.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 59
Keys to a Good Professional Relationship with
American Indian Patients
Make the Patient Welcome. First meetings are
important.
• Extend a warm greeting and smile.
• Shake hands, introduce yourself, and allow the
patient to do the same (thereby showing respect
to his or her ancestors)
• Thank the patient for having chosen your health
facility.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 60
Keys to a Good Professional Relationship with
American Indian Patients
• A western style handshake is appropriate and
appreciated, don’t be surprised if it is returned by
an unusually weak or strong one.
• The traditional Navajo greeting is not to shake hands,
but to extend the hand and gently touch the other
person’s hand.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 61
Keys to a Good Professional Relationship with
American Indian Patients
Use Eye Contact Judiciously.
• Prolonged eye contact is considered a sign of
disrespect and should be avoided.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 62
Keys to a Good Professional Relationship with
American Indian Patients
Take Your Time.
• It is important to spend time with the patient and to
avoid appearing hurried or nervous.
• Patients often travel great distances at great financial
hardship to see a physician; if the physician spends
only five or ten minutes with them, the message is
clear and negative.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 63
Keys to a Good Professional Relationship with
American Indian Patients
Speak Plainly.
• Avoid medical or other terms that may not be
understood, but at the same time, don’t talk down to
the patient or appear to treat him or her as a child.
• A soft concerned voice will do much to make the
patient feel at ease.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 64
Keys to a Good Professional Relationship with
American Indian Patients
Respect Silence.
• Be concise and give the patient time to reflect on what
you are saying.
• Don’t try to fill up the time.
• American Indians are taught the value of silence and
may also need time to mentally translate what they
hear into their own language.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 65
Keys to a Good Professional Relationship with
American Indian Patients
Understand Tribal Diagnosis.
• The patient may have come to you following diagnosis
by a tribal diagnostician.
• Due to this, the patient may be unfamiliar with the
technique of identifying the specific location of pain.
• Instead of asking the patient, “Where is the pain?”,
ask the patient to point to the most intense area of
pain.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 66
Keys to a Good Professional Relationship with
American Indian Patients
Accommodate Tribal Healing.
• Patients may wish to perform certain tribal healing
ceremonies, even in the hospital.
•Try to accommodate these healings as a way to
improve both the patient’s and the family’s
confidence in the care.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 67
Keys to a Good Professional Relationship with
American Indian Patients
Show Special Respect to the Elderly.
• Great respect is given to the elderly, in spite of taboos
connected with death.
• Caregivers gain approval by treating the elderly with
kindness and respect and not appearing to criticize
or scold them.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 68
Keys to a Good Professional Relationship with
American Indian Patients
Think Carefully About Family Care.
• Poverty, distance from the medical facility, and
taboos against dying in the home may make it
impractical to release to the family a patient needing
long-term or terminal care.
• Discuss options with the family and try to ascertain
attitudes about home care before releasing a person
into the family care.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 69
Keys to a Good Professional Relationship with
American Indian Patients
Involve the Extended Family.
• Extended family plays an important role in healthcare
decision making.
• Often many family members will appear with a patient
who is to be admitted for a hospital stay.
• Include family members when decisions regarding
treatment options are needed.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 70
Keys to a Good Professional Relationship with
American Indian Patients
Involve the Extended Family.
• Very often, a patient will postpone surgery because
the consent of the family leader, often the eldest
female must be obtained first.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 71
Keys to a Good Professional Relationship with
American Indian Patients
Accept a Different Sense of Time.
• Most American Indians are present-oriented and take a
casual approach to clocks and time, which is viewed as
a continuum with no beginning and no end.
• Poses difficulties with regulation of medication.
• Watch telling the patient to take medications with
meals, as the patient may have three meals today, two
meals tomorrow and four the meals the day after that.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 72
Keys to a Good Professional Relationship with
American Indian Patients
Accept a Different Sense of Time.
• Many Indians are task-conscious rather than timeconscious, paying more attention to finishing task than
to a clock or to an appointment schedule.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 73
Keys to a Good Professional Relationship with
American Indian Patients
Give and Expect Generosity.
• Indian culture discourages competitive behavior and
encourages giving, sharing, and cooperation.
• Generosity and doing things for others are regarded
highly.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 74
Potential Culture-Related Health Concerns Among
American Indians
• Average life expectancy of 71.1 years –lower than all
other races in the United States.
• Many health problems and the high incidence of
accidents and suicides.
• The Infant death rate is high, a fact attributed to a
high incidence of diarrhea and a harsh physical
environment.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 75
Potential Culture-Related Health Concerns Among
American Indians
• Women may choose not to seek prenatal care, because
pregnancy and birth are considered normal processes
and health facilities are associated with illness and
disease.
• Pregnant Navajo women are forbidden to attend
traditional healing ceremonies to avoid contact with
illness or disease.
• Hold your maternal and child care clinics in a location
separate from other clinical services.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 76
Potential Culture-Related Health Concerns Among
American Indians
•A high incidence of non-insulin-dependent (Type II)
diabetes – increased dramatically in New Mexico.
•American Indians are genetically predisposed to the
disease – triggered by a radical change in eating habits
and increase in obesity among this population.
•Myocardial infarction incidence is higher among Navajo
men and a gradual increase among Navajo women.
•Alcoholism among this population is very high.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 77
Potential Culture-Related Health Concerns Among
American Indians
• Fetal Alcohol Syndrome is also fairly high among this
population.
• Navajo children have low length-for-age and high
weight-for-length measures because of suboptimal
nutrition.
• Of the 10 leading causes of death among American
Indians, 5 are related to diet.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 78
Religious and Spiritual Beliefs That Can Affect
Care and Treatment
Tribes share a number of fundamental health, illness,
and illness prevention beliefs.
•
Life comes from the Great Spirit (or Supreme
Creator) and all healing begins with him.
•
Man is a threefold being made up of body, mind and
spirit.
•
Health or wellness is due to a preservation of
harmony among the body, heart, mind and soul.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 79
Religious and Spiritual Beliefs That Can Affect
Care and Treatment
Tribes share a number of fundamental health, illness,
and illness prevention beliefs.
•
Plants and animals, as well as humans, are part of
the spirit world that exists alongside, and is
intermingled with, the physical world.
•
Death is not an enemy but a natural phenomenon of
life
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 80
Navajo Application of These Beliefs
•
Navajo society is matriarchal - Women hold a
higher position than men
•
Focus of Navajo traditional religion is on
maintaining a harmonious relationship with all
living things.
•
Illness is thought to result from improper thought
and behavior affecting oneself as well as the
external, natural world of plants, animals, and the
environment.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 81
Navajo Application of These Beliefs
•
Illness also is attributed to an improper use of
ceremonies.
•
As a rule, Navajo may not seek medical care for a
number of discomforts and acute illnesses for which
a non-Navajo would seek relief.
•
Illness, like death, is simply viewed and accepted as
a natural part of life.
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 82
Marketing and Advertising to Hispanic and Native
American Populations
Be culturally sensitive and aware
Spanish language spots (radio or television should be
produced specifically for the market and not a lift of
the English spot)
Native Americans can be spoken to in their own
language on radio (much tougher – there are many
different dialects within the state)
Source: Virginia Tech’s Office of Multicultural Affairs Home Page – Updated 2002
August 8, 2003
Page 83