Transcript Slide 1

A Whole New World
Developing Cultural Competence
Why Global Awareness?
•
•
•
•
Global society
Immigration/ refugees
Changing U.S. Demographics
A worldview provides an
ideological basis for food practices
Examples:
• Photographs of 30 families in 24
countries
• The photographers watched typical
families the world over as they
farmed, shopped, cooked, and ate.
• At the end of each visit, they
created a portrait of the family
surrounded by a week’s worth of
their groceries.
Australia
-$376.45 USD-
Bhutan
-$5.03 USD + Homegrown Foods
($29.06 worth)-
Chad
-$1.23 USD + Food Rations ($24.37)-
Ecuador
-$31.55 USD-
Germany
-$500.07 USD-
United States
-$159.18 USD-
Mexico
-$189.09 USD-
THE BURDEN IS ON US TO BECOME
CULTURALLY COMPETENT
What is culture?
Shared History
• Thoughts
• Actions
• Customs
• Beliefs
• Values
• Institutions
Cultural Values
• Principles or standards that
members of a cultural group share
in common
Terms to be aware of:
• Diversity – differences among groups of
people (physical, socioeconomic,
language, gender, age, etc.)
• Cross-cultural – interaction between or
among individuals who represent different
cultures
• Ethnocentric – one’s own cultural view is
considered best
Demographics and
Population Trends
Ethnic Groups in the U.S. - 2006
•
•
•
•
•
•
•
•
68% White Americans
14.8% Hispanic
12.4% - Black
4.4% Asian Americans
2.0% Multiracial
0.8% Native Americans
0.14% Native Hawaiians or other Pacific Islanders
6.4% “Some other race”
By 2042 non-Hispanic whites will no longer
make up the majority
Health Disparities
•
•
•
•
•
•
•
Socioeconomic status
Lack of insurance
Cultural Beliefs
Traditional Therapies
Access
Discrimination
Bridging the language gap
Developing Cultural Awareness
• Knowledge
– Awareness of own beliefs and attitudes
– Remember - Characteristics of groups are
simply generalities
– Avoid stereotyping
Developing Cultural Awareness
• Encounters
–
–
–
–
Communication Styles
Cultural food practices
Common health practices
Health care values, beliefs, and
practices
– Attitudes toward seeking help
from health care providers
– Religious behaviors and beliefs
Developing Cultural Awareness
• Interventions
–
–
–
–
Caring
Appreciation
Respect for clients
Practical
considerations
US Cultures - USDHHS
• Hispanic Americans
• Asian and Pacific Islanders
• American Indians and Alaskan
Natives
• Black Americans
• Religious Cultures
Hispanic Americans
• Largest and Fastest Growing
Minority Group in the US
• Communication Styles
– Expressing negative emotions is generally
considered to be impolite
– Touching between persons is common
– Avoiding eye contact signals respect and
attentiveness
Hispanic Americans
• Food Patterns
– Beans/Legumes
– Rice
– Breads/Tortillas
– Corn and Corn Products
– Chile Peppers
– Tomatoes
– Meat/Poultry/Fish
– Minimal Use of Dairy Products
Hispanic Americans
• Unique Cultural Issues
– High school graduation rates are lower than
average
– Increased levels of poverty
– “Role of God” for spiritual and health
rewards and protection
• Nutrition Education and Counseling
– Strong familial ties
– All family members may be involved in
decision making and counseling
Asian and Pacific Islanders
• Communication Styles
– Respect for authority figures
– Eye contact may be seen as disrespectful
– Usually will not shake hands with people of the
opposite sex
– Focus is upon the family rather than the
individual
Asian and Pacific Islanders
• Food Patterns
– Rice
– Vegetables
– Fruit
– Fish/Pork/Poultry
– Nuts
– Tofu
– Diet Generally Low in Dairy Products
Asian and Pacific Islanders
• Unique Cultural Issues
– Strive to reach balance or equilibrium
– Holistic religious beliefs
– Disease results from an “imbalance” and can
be affected by food consumption
• Nutrition Education and Counseling
– Increase calcium intake
– Reduce sodium intake
American Indians and
Alaska Natives
• Communication Styles
– Speak using a low tone of voice
– Expect people to listen attentively
– Direct eye contact is often disrespectful
– When greeting a person, soft hand touches are
better than firm handshakes
– “Yes” and “No” responses are considered to be
complete answers
– An “Elder” may speak for the whole tribe
American Indians and
Alaska Natives
• Food Patterns
– Wild Game
– Sheep/Goat
– Fish
– Beans/Squash/Corn
– Celery/Onion/Spinach/Potatoes
– Cantaloupe/Watermelon
– Wild Berries
– Added Grey Clay (provides minerals)
American Indians and
Alaska Natives
• Unique Cultural Issues
– Strive for balance and harmony with nature
– Desire to bring honor to their family and tribe
– High rates of alcohol abuse
– Lower socioeconomic status
• Nutrition Education and Counseling
– “Thrifty Genotype” can lead to Type Two
Diabetes and Obesity
Black Americans
• Communication Styles
– Personal questions should not be asked upon
meeting someone for the first time
– Direct eye contact is seen as impolite
– Touching another person’s hair is offensive
– Participate in engaging and expressive
conversations
Black Americans
• Food Patterns
– “Soul Food” made with wild animals such as
squirrels, rabbits, deer, etc.
– Black-Eye-Peas/Okra/Collard Greens
– Flour based Gravies/Pork Fat
– Apple or Peach Cobblers/Candid Yams
– Red Pepper/Cayenne
– Sweetened Iced Tea/Kool-Aid
– Decreased Dairy Consumption (Lactose
Intolerance)
Black Americans
• Unique Cultural Issues
– Family and region are key elements to society
– Poverty and low income
• Nutrition Education and Counseling
– Respond well to action oriented goals and
activities
– Counseling is more successful when the client
or patient can take an active role
– Reduce fried and high salt foods
Religious Cultures
• Jewish Communication Styles
– Most Jewish people in the US speak English as
their primary language
– Appreciate direct conversation and enjoy
analyzing issues
– Prefer sitting and standing close (within 2 feet)
to another person when in conversation
– Emphasize respect and hospitality
Religious Cultures
• Jewish Food Patterns
– Pastrami/Matzoh
– Restriction on pork and pork products
– Restriction on fish without scales and fins
– Dairy is not eaten with meat at a meal
– Kosher slaughtering and foods standards
– Blood removed from all foods
– Non-cloven hoofed animals are acceptable
– Unleavened bread during the Passover
Religious Cultures
• Unique Cultural Issues
– Clearly defined gender roles
– Tend to marry early and have large families
– Unleavened bread may be low in zinc
• Nutrition Education and Counseling
– Identifying unique foods,
such as Kosher foods,
at the grocery store
A few points to remember:
• Increasing ethnic food shops may present a
problem with increased food poisoning issues
(traditional food preparation methods)
• Enculturation (rules passed from generation to
generation) encompass many food habits
• Many foods have symbolism (Ex. Bread)
• Learn:
– Core foods
– Edible/Inedible foods
– Meal Cycles
Remember:
• Be unbiased – not everyone needs to eat
like we eat!
• A diverse culture adds a richness to the
tapestry of our lives