This artwork is by SNMA Member and Mayo Medical School student, Kayla Nixon. Reaching, an acrylic painting on canvas inspired by the coloring style and elongated figures of artist Ernie Barnes, addresses the pertinent issues in African American society of education, parenting, and the lack of one or both. Stereotypes and media representation are confronted by the uncommon image of a black girl feverishly climbing through shelves of books.
Electronic versions of JSNMA back issues through Summer 2008.
Scholarly articles on the topic of cultural competence commonly cite three realities (Betancourt, Green, Carrillo & Park, 2005). First, the population of the United States is rapidly becoming more diverse in its racial and ethnic demography (U.S. Census Bureau, 2009). Second, significant disparities exist between racial and ethnic groups in the U.S. population (Smedley, 2002). Finally, in order to prevent these disparities from worsening and to eventually eliminate health disparities, it is necessary to develop a more diverse and culturally competent health care workforce and delivery system (Smedley, 2004). While the rationale behind efforts to promote cultural competence is relatively straightforward, the number of studies that report quantifiable outcomes for such interventions is limited. The growing body of evidence suggests, however, that culturally competent interventions implemented at multiple levels of the health care system can be effective in improving health outcomes in minority populations.
What was done cannot be undone, but we can end the silence … We cannot be one America when a whole segment of our nation has no trust in America. We can stop turning our heads away. We can look at you in the eye, and finally say, on behalf of the American people, what the United States government did was shameful and I am sorry. (Clinton, 1997)
Andrew Hillman is an ambitious and passionate MAPS members from Region IX. He currently serves as president of the MAPS Chapter at Queen’s College. This summer he was afforded the opportunity to journey to Thailand and amassed a new perspective on the world and his position within it. As an aspiring physician of color, Andrew recognizes the need for cultural competency and his trip to Thailand allowed him to work towards addressing that need.
No two patients are the same. As a result, health care professionals attempt to place patients in discrete categories as a way of reducing variability during the provision of care. These categories can be based on one or more variables, including age, sex and race. While the tendency to categorize patients is useful in customizing the most appropriate care, it can also be discriminatory, especially if patients are grouped inaccurately or if certain groups acquire preferential outcomes.
Since 1900, the percentage of Americans aged 65 years and older has tripled, largely due to advancements in technology and lifestyle changes. These statistics are important when considering the future of health and health care in the United States. As such, every effort should be made to continue identifying disparities in health and health care and effective methods to eliminate them. It has become ever more important to not only research and effectively address health disparities prevalent in the elderly population, but also to train the next generation of health care providers to care specifically for this particular demographic.
Providing care for patients more often than not requires treating more than the medical problem. Many medical schools now teach using a bio-psycho-social model, recognizing how one aspect can influence the other. The spiritual component can be seen as a subset of the model or perhaps a separate dimension on its own. Spirituality does not equate to religion. The former is more individualized and can even be at odds with one’s religion or lack thereof.
The history of race and medicine is a deep and complex trail of deception, misperception, social struggles and exploitation. In particular, the history of Blacks and the institution of medicine provide several examples of how scientists and health professionals used medicine and science to promote theories concerning the inferiority of blacks. From pluralist theories of different origins for different races, to the development of diseases specific to one race, racial biology has formed a deep seated question of whether there are true anatomical and physiological differences among mankind. From the early 18th to mid-19th century, several theories were employed to support the belief that blacks were an inferior race. Decades later, the works of two black, male scholars added to the growing thoughts concerning racial health and hierarchy. The association between the theories proposed under black, male scholarship can be linked to efforts to eliminate the use of racial and physiological differences to promote discriminatory practices.