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cultural competency > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what is health promotion?

A

-enables people to increase control over their own health with wide range of interventions used such as education, policy, outreach, etc
-addresses and prevents the root causes of ill health (sometimes related to individual but sometimes related to SDOH)

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2
Q

3 factors of health promotion

A
  1. good governance for health
  2. health literacy
  3. healthy cities
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3
Q

good governance for health

A

policy development

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4
Q

health literacy

A

making sure individuals have the knowledge, skills, and resources they need in order to engage in healthy behaviors

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5
Q

healthy cities

A

strong leadership at municipal level within cities to make sure funds and resources are being allocated to initiatives to promote healthy behavior

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6
Q

possible settings of health promotion

A

-settings where individuals are at a majority of the time
-schools, workplace, community/faith based, hospitals, private sector

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7
Q

the ottawa charter

A

-1986
-UN to make commitment to public health/communities using health promotion interventions

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8
Q

cultural competency

A

Involves understanding and appropriately responding to the unique
combination of cultural variables and the full range of dimensions
of diversity that the professional and client/patient/family bring to
interactions

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9
Q

different groups to target for cultural compentency

A

racial/ethnic differences, disabilities, aging population, gender identity, country of origin, veteran status

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10
Q

components of cultural competence continuum

A

-cultural destructiveness
-cultural incapacity
-cultural blindness
-cultural pre contemplation
-cultural competence
-cultural proficiency

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11
Q

cultural destructiveness

A

characterized by intentional attitudes, policies and practices that are destructive to cultures and consequently to individuals within the culture, often extreme and believe there is one race

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12
Q

cultural incapacity

A

characterized by lack of capacity to help minority clients or communities due to extremely biased beliefs and paternal attitude toward those not of a mainstream culture

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13
Q

cultural blindness

A

characterized by the belief that service or helping approaches traditionally used by the dominant culture are universally applicable regardless of race or culture, these services ignore cultural strengths and encourage assimilation

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14
Q

cultural pre competence

A

characterized by the desire to deliver quality services and a commitment to diversity indicated by hiring minority staff, initiating training and recruiting minority members for agency leadership but lacking information on how to maximise these capacities, this level of competence can lead to tokenism

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15
Q

cultural competence (on continuum)

A

characterized by acceptance and respect for difference, continuing self assessment, careful attention to the dynamics of difference, continuous expansion of knowledge and resources and adaption of services to better meet the needs of diverse populations

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16
Q

cultural proficiency

A

characterized by holding culture in high esteem- seeking to add to the knowledge base of culturally competent practice by conducting research, influencing approaches to care, and improving relations between cultures, promotes self determination

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17
Q

What would NOT be considered a factor in culture and cultural diversity?

A

annual salary

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18
Q

Which of the following is TRUE regarding developing cultural competency?

A

Understanding one’s own culture is the first step in developing cultural competence.

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19
Q

What is the most important thing a person can do to consider the influence of one’s own biases and beliefs and the impact it may have on service delivery?

A

Complete a self-assessment

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20
Q

In the cultural competence continuum, what level of competence is on the most negative end (or the far left side of the continuum) ?

A

cultural destructiveness

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21
Q

What point along the cultural competence continuum is characterized by the belief that helping approaches traditionally used by the dominant culture are universally applicable?

A

cultural blindness

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22
Q

What would NOT be an ideal step in improving cultural competency?

A

Treating all patients the same, regardless of cultural beliefs

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23
Q

A lack of cultural competency may result in which of the following?

A

Lack of adherence to treatment plan
Liability/Malpractice claim
Miscommunication between provider and patient

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24
Q

Clinicians have a responsibility to advocate on behalf of families and communities at risk for health disparities. What is an example of advocacy specific to cultural competency?

A

Provide appropriate and culturally relevant consumer information and marketing materials

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25
Q

What is NOT one of the three key elements in health promotion?

A

Health equity

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26
Q

What would be the ideal health promotion setting for the 26-64 age group?

A

workplace

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27
Q

healthy people 2030 overarching goals

A

-attain healthy, thriving lives and well being, free of preventable disease, disability, injury and premature death
-eliminate healthy disparities, achieve health equity and attain health literacy to improve the health and well being of all
-crate social, physical and economic environments that promote attaining full potential for health and well being for all
-promote healthy development, healthy behaviors, and well being across all stages of life
-engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well being of all

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28
Q

demographic shift

A

changes in population or consumer statistics based on socioeconomic factors such as age, income, gender, occupation, education, family size, and similar descriptive variables

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29
Q

race

A

the biological variation including phenotypical differences in stature, hair color, facial shape, and other inherited characteristics that may or may not be mutually exclusive in each individual
-a social concept that changes over time
-the categorization of parts of a population based on physical appearance due to a particular historical, social and political forces

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30
Q

ethnicity

A

-group or individuals concept of cultural identity which includes learned behaviors which may result in cultural distinctions between/within society

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31
Q

ethnicity includes

A

-a common proper name to identify and express the “essence” of the community
-shared historical memories, or better, shared memories of a common past including heroes, events and their commemoration
-one or more elements of common culture which need not be specified but normally include religion, customs and language

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32
Q

US Census Bureau projects that in the next 2 decades, the nation:

A

-will be more diverse
-majority of the population will be concentrated in urban areas
-immigration will continue to drive demographic shifts
-increasing number of US residents will speak a language other than english
-number of people 60 and older will continue to increase

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33
Q

5 categories of immigrants

A
  1. legal permanent residents
  2. temporary migrants (students, seasonal workers)
  3. humanitarian migrants (refugees)
  4. naturalized US citizens (have gone through natural formalization process)
  5. persons illegally present
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34
Q

largest groups of immigrants in us

A

Hispanic/Latinos and Asians

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35
Q

of foreign born people living in the US is

A

increasing

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36
Q

language in US

A

-350 languages spoken
-80% of US 5 years and older speaks only English
-California has largest percent of residents who speak language other than english at home

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37
Q

aging population in the year 2030

A

-all baby boomers will be older than 65
-will be 73% of population

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38
Q

by year 2030, immigration is projected to overtake

A

natural increase as the primary driver of population growth

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39
Q

% of US population identifying as gay, lesbian or bisexual

A

3.5%

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40
Q

% of US population identifying as transgender

A

0.3%

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41
Q

% of US adults with one basic action or activity limitation (disability)

A

26%

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42
Q

gender more likely to report a disability

A

women

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43
Q

African Americans

A

-persons whose lineage includes ancestors who origination from any of the Black racial groups in africa
-58% of Black population resides in southern region of US
-when compared to white population, have higher proportion of younger people, members are less likely to be married and large proportion of house holds maintained by women
-less likely to have health insurance

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44
Q

Hispanic/Latinos

A

-18% of US population, estimated to increase to 24 by 2065
-those of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race
-younger on average than whites with 1 in 3 being under age of 18
-health influenced by factors such as language barrier, lack of access to preventative care and lack of insurance

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45
Q

what group represents the highest number of Hispanics in US

A

Mexicans

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46
Q

median age of hispanics/latinos

A

28

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47
Q

median age of non-hispanic whotes

A

43.5 years

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48
Q

Asians

A

-people who have origins in Far East, Southeast Asia or Indian subcontinent (from Cambodia, China, Philippines, India, Japan, Korea, Malaysia, Pakistan and Vietnam)
-despite being considered the “model minority” Asians experience many differences between ethnic groups
-more likely to be married and live in family house holds
-higher SES
-more educated

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49
Q

median age of Asians

A

36.1 years

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50
Q

population with highest life expectance

A

asian women

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51
Q

Native Hawaiin and Pacific Islanders

A

-people who are natives of Hawaii and other Pacific Islands (Polynesian, Micronesian, Melanesian)
-higher rates of smoking, alcohol consumption and obesity than other groups
-13% live under poverty line

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52
Q

median age of NHOPI

A

28.7 years

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53
Q

American Indians and Alaska Natives

A

-original peoples of North, Central and South American who maintain tribal affiliation or community attachment
-565 federally recognized Indian and Alaska tribes, more than 100 state recognized tribes
-disproportionately affected by heart disease, cancer, accident/unintentional injury, diabetes, stroke, mental health issues, suicide, obesity, substance abuse, SIDS, teen pregnancy, liver disease, hepatitis
-15% have no health insurance

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54
Q

Whites

A

-have origins in Europe, Middle East or North Africa
-largest racial group in US (61%)
-tend to have higher income and education
-more likely to have private health insurance

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55
Q

diversity

A

Thedynamicphilosophyofinclusionbasedonrespectforcultures, beliefs,values,andindividualdifferencesofallkinds.Itrespects
andaffirmsthevalueindifferencesinethnicityandrace,gender,
age,sexualorientation,socioeconomicstatus,linguistics,religion,
politics,andspecialneeds

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56
Q

macro culture

A

values/beliefs shared by individuals living in same country

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57
Q

microculture

A

values/beliefs shared by specific group members (ex: religion)

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58
Q

culture

A

-is learned, shared, transmitted from one generation to next
-helps organize and interpret life
-includes thoughts, styles or communication, ways of interacting, views on roles and relationships, values, practices and customs
-includes SES
-physical and mental ability
-sexual orientation and occupation

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59
Q

cultural universals

A

behavioral traits and patterns shared by all cultures around the world

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60
Q

dominant cultures

A

-larger or more dominant group in a given society
-values: individualism and privacy; informality in interaction with others; high regard for achievement; punctual

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61
Q

Western medicine sees health from

A

Biomedical model
-state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity

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62
Q

Greek views on health

A

not only absence of negative states but also the presence of positive ones

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63
Q

Latin American views on health

A

a balance between hot and cold- not temperature and also the power of difference substances in the body

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64
Q

Chinese views on health

A

based on religion and philosophy, special emphasis on Ying and Yang (positive and negative energies), balance is health

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65
Q

how culture affects health behavior

A

eye contact, proximity, touching, F to M conversation vs same gender, speaking loudly vs. softly

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66
Q

cultural competence

A

set of congruent behaviors, patterns, attitudes and policies that come together in a system or agency or among professionals, enabling effective work to be done in cross-cultural situations

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67
Q

journey of cultural competence

A

-assessing culture by being aware of your own culture
-value diversity by developing a community of learning with students
-manage the dynamics of difference by appreciating the power of conflicts
-resolve the conflicts
-adapting to diversity by committing to continuous learning
-institutionalizing cultural knowledge

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68
Q

cultural competence within organizations

A

-have defined set of values/principles and demonstrative behaviors, attitudes, polucies adn strictures that enable them to work effectively cross-culturally
-have capacity to 1. value diversity, 2. conduct self assessment 3. manage the dynamics of difference 4. acquire and institutionalize cultural knowledge and 5. adapt to diversity adn cultural contexts of the communities they serve

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69
Q

health disparities

A

differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups in US

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70
Q

1 health disparity in US

A

poverty

71
Q

health equity

A

includes a person’s ability to attain their full health potential without interference from their social position or ethnic/racial background

72
Q

health inequalities

A

summary measures of population health associated with individual or group attributes such as income, education or race/ethnicity

73
Q

in picture of those watching game (difference between equality and equity)

A

-equality: giving everyone same size box so they all get taller
-equity: giving those who need it more/shorter a taller box so that they are all same height and can see game

74
Q

social determinants of health definition

A

-conditions in which people are born, grow, live, work and age and the wider set of forces adn systems shaping the conditions of daily life
-include economic policies/systems, development agendas, social norms, social policies and political systems

75
Q

morbidity indications

A

-environmental quality
-mental health
-nutrition, physical activity, obesity
-oral health, tobacco

76
Q

environmental quality

A

30-40% of health burden related to environment (more common in poorer countries)

77
Q

mental health

A

1 in 4 have mental health disorder, reduce stigma, offer resources to kids

78
Q

oral health

A

most chronic condition for kids is tooth decay, kids in low income have more cavities, often from food access to sweets and may not have access to dental care

79
Q

health disparities associated with race/ethnicity

A

-infant morality
-cancer screening and management
-CVD
-diabetes
-HIV infection/AIDS
-immunizations

80
Q

infant mortality rate

A

black mothers have higher rates, US is ranked 34th in the world in terms of infant mortality

81
Q

cancer screening and management for race/ethnicity

A

-cancer higher in african american men and pacific islander women
-vietnamese women have higher rates of cervical cancer
-afican american women have higher breast cancer mortality rates (often because of the drive to take care of their family first and less screening)

82
Q

CVD related to race/ethnicity

A

-CVD is the lead cause of death in minorities and low income people

83
Q

diabetes related to race/ethnicity

A

-african americans and hispanics twice as likely to have diabetes

84
Q

immunizations related to race/ethnicity

A

-non whites less likely to be vaccinated

85
Q

gender health disparities

A

-there is a difference between life expectancy in men and women
-women live 4-5 years longer
-men are more likely to have insurance and go to doctor

86
Q

health disparities in age

A

-older adults have challenged to pay for health care due to fixed income
-80% of older adults have chronic conditions
-transportation is an issue (live in rural areas or cannot drive)

87
Q

health disparities in those with disabilities

A

-13% report disability
-most common disability involves walking or independent living
-likelihood of having a disability increases with age

88
Q

5 SDOH

A

-education access and quality
-health care and quality
-neighborhood and built environment
-social and community context
-economic stability

89
Q

many forms of racism

A

-unmet expectations may be misinterpreted as racism and subtle forms have replaced more overt forms of discrimination

90
Q

economic stability SDOH

A

employment, income, expenses, debt, medical bills, support

91
Q

neighborhood and physical environment

A

housing, transportation, parks, playgrounds, walkability, zip code/geography

92
Q

education SDOH

A

literacy, language, early childhood education, vocational training, higher education

93
Q

food SDOH

A

food security, access to healthy options

94
Q

community, safety, and social context SDOH

A

social integration, support systems, community engagement, stress, exposure to violence/trauma, policing/justice policy

95
Q

health care system SDOH

A

health coverage, provider and pharmacy availability, access to linguistically and culturally appropriate and respectful care, quality of care

96
Q

people of color vs. white on many measures of health status

A

people of color fare worse than their white counterparts across many measures of health status

97
Q

higher percentage of private health insurance of non elderly by race/ethnicity

A

white and asian

98
Q

race/ethnic group with the highest rates of being uninsured

A

hispanic and american indian alaskan natives

99
Q

COVID-19 health disparities

A

-american indian and alaska native, black and hispanic people experiences disproportionate rates of illness and death due to covid
-higher premature excess deaths
-increased risk of exposure due to living, working, and transportation situations
-increased barriers to testing
-disproportionate toll on financial security and mental health and well being of people of color

100
Q

Office of Minority Health: CLAS Standards

A

the national CLAS standards are intended to help advance health equity, improve quality, and help eliminate health care disparities by establishing a blue print for health and health care organizations

101
Q

legal requirements for cultural competency

A

-the Liaison Committee on Medical Education Requirements
-EMTALA
-Hill Burton Act
-Title VI of Civil rights act of 1964

102
Q

building a culturally-competent practice

A

-conduce an initial assessment to see what groups you may come into contact with and their needs
-evaluate capacity and define goals by looking at financials and human resources available
-implement changes to accommodate difference racial/ethnic minorities

103
Q

complementary health approaches (CHAs)

A

a group of diverse health care and medical systems used together with conventional medicine

104
Q

conventional medicine

A

practiced by a MD, DO and allied health professionals such as PTs, psychologists and RNs

105
Q

integrative medicine or healing

A

practice that places strong emphasis on holistic health approach. this type of practice generally includes selected CHAs. focuses on treating the whole person

106
Q

mind and body practices

A

complementary health approaches that include a large diverse group of techniques or procedures taught or administered by a teacher or a trained practitioner.
-ex: yoga, pilates or massage therapy

107
Q

herbal medicines

A

medicines that include herbal materials, herbs, her preparations and finished herbal products, containing parts of plants or other plant materials

108
Q

folk/traditional medicine

A

method of healing that has persisted thoughtout human culture, long before conventional medicne was developed

109
Q

folk healers

A

work under variety of names and are found in all cultures, often lack formal education

110
Q

use of CHAs in US ranges from

A

32-36%

111
Q

there has been a increase in these CHAs

A

yoga, meditation and chiropractors

112
Q

most popular CHA

A

nonvitamin, non mineral dietary supplements

113
Q

second most popular CHA

A

deep breathing exercises

114
Q

CHA use increases with

A

educational level

115
Q

CHA use along with private insurance

A

higher use of CHA with those who had private insurance compared to those uninsured

116
Q

ethnic/racial group most likely to use CHAs

A

non hispanic whites

117
Q

most common CHAs among adults

A
  1. natural products
  2. deep breathing
  3. yoga, tai chi, qi gong
  4. chiropractor or osteopathic manupulation
  5. meditation
  6. massage
118
Q

disesases/conditions CHAs were most freq. used

A

-back pain
-neck pain
-joint pain/stiffness
-cvd
-arthritis, gout, lupus, fibromyalgia
-anxiety, depression

119
Q

most common CHAs used for childrebn

A

-natural products
-chiropractor
-yoga
-deep breathing
-homeopathy

120
Q

disases children used CHAs for

A

-back/neck pain
-other musculoskelatal
-head/ chest cold
-anxiety/ stress
-ADHD
-insomnia

121
Q

role of health educator for CHAs

A

educate the public regarding CHAs at schools, businesses, communities, health care facilities

122
Q

most popular herbal supplements

A

ginseng
echinacea
ginko biloba
garlic
feversew
saw palmetto
kava

123
Q

qi gong

A

chinese discipline combining the use of gentle physical movements, mental focus and deep breathing directed toward specific parts of the body. performed in repetitions and normallu performed 2 or more times a week for 30 mins at a time

124
Q

tai chi

A

mind-body practice originating in china as a martial art
-move body slowly and gently while breathing deeply and medicating
-believe that helps the flow throughout the body of a propose vital energy called qi

125
Q

NCCIH guidelines for choosing a CHA practitioner

A
  1. check with health care provider first to find recommendations of CHA providers
  2. find out as much as you can about potential provider (education, training, certifications, etc)
  3. find out if practitioner is willing to work with your conventional health provider
  4. explain all of your health conditions to CHA provider and find out if they have right training and experience working with people of your specific needs
  5. don’t assume health insurance will cover practitioners services, contact your insurance
  6. tell all of your providers about the CHA approaches you use, keep everyone informed
126
Q

religion

A

practice of participation in a culturally based activities, including prayer and meditation, attendance of services, reading texts, and performing rituals

127
Q

spirituality

A

the emotional or experiential expression of “feelings of experiences of aw, wonder, harmony, peace or connectedness with the universe or a higher power” may not be rooted in an organized church

128
Q

2/3 of seniors identify as

A

white and christian

129
Q

26% of christian seniors identify as

A

white evangelical protestant

130
Q

19% of christian seniors identify as

A

white mainline protestant

131
Q

16% if christian seniors identify as

A

white catholic

132
Q

young adults are three times more likely to

A

identify as religiously unaffiliated compared to seniors

133
Q

sex that makes up most of religious groups

A

women

134
Q

sex more likely to classify as religiously unaffilicated or atheist or agonistic

A

men

135
Q

there is a ___ trend in church attendance

A

downward, 25% each year

136
Q

% protestant/other christian

A

46%

137
Q

% catholic

A

20%

138
Q

% unaffiliated from religion

A

24%

139
Q

% morman

A

2%

140
Q

% jewish

A

2%

141
Q

% muslim

A

1%

142
Q

% other religion

A

1%

143
Q

worldview

A

focused on individual inner subjectivity in relation to an external world, strives to identify the meaning and value of the universe and human life

144
Q

contimuum of religous ideaologies

A

-monotheism: 1 god
-polytheism: 1+ gods
-pantheism: god is everywhere but not an individual being
-deism: there is a higher power but not a personal god
-agonistic: not sure
-atheism: there is no god

145
Q

very religious americans made

A

healthier choices when related to smoking, healthy eating and exercise

146
Q

female genital mutilation

A

-female circumcision to control her sexiality
-done when a women is coming of age
-done in Asia, Africa, Middle East
-violation of human rights and dangerous

147
Q

nutritional taboos

A

in rural areas girls may marry and have kids right when they hit puberty but their food intake is far below what is recommended to support preganancy and breast feeding so she becomes malnourished, iron and protein deficiency

148
Q

Latino/Hispanic religous beliefs

A

-curanderismo (healing rituals)
-strong belief in prayer
-use of holy objects

149
Q

african american religious beliefs

A

-role of prayer strong
-herbs
-relaxation
-folk magic

150
Q

aisian american religous beliefs

A

-strong support of religous community
-harmony and imbalance
-acupuncture
-herbal medicine
-physical movements (tai chi or quong di)

151
Q

spiritual competence characterized by 3 interrelated dimensions

A
  1. an awareness of one’s personal worldview
  2. an understanding of the client’s spiritual worldview
  3. the ability to design and implement intervention strategies that are appropriate, relevant adn sensitive to the clients spiritual worldview
152
Q

strategies for developing spiritual competence

A

-self assessment
-consultation (with informed experts)
-religious norms (expand knowledge)
-epistemological humility (many ways of knowing exists, cultural humility)

153
Q

the main goal of the Healthy People initiative is to

A

develop processes for all people to obtain optimal health

154
Q

which of the following demographic changed will occur in next decade

A

-US population more diverse
-increase in immigrants
-older adults will increase

155
Q

the most commonly spoken languare in US is

A

english

156
Q

an international college student would be considered a

A

tempoary migrant

157
Q

what state has the largest percentage of residents who speak abother language at home other than english

A

california

158
Q

what is expected to be the primary driver of population growth by the year 2030

A

immigration

159
Q

T/F men are more likely than women to report a disability

A

false

160
Q

in the racial groups, what race has the largest proportion of its households maintained by women

A

african americans

161
Q

In the racial groups, what race is disproportionately affected by heart disease, cancer, unintentional injuries, suicide, and substance abuse?

A

american indians and alaska natives

162
Q

when working with a diverse population the most important thing for health educators to do is

A

not stereotype

163
Q

what environmental factor contributes to teh most increased asthma morbidity

A

traffic exhaust

164
Q

approximately ____ adults in US report having a mental disorder

A

1 in 4

165
Q

according to figure 3.2 what is most prevalent mental health issues for 12-17 age group

A

anxiety

166
Q

T/F there is a link between oral health and heart disease

A

true

167
Q

what is the single most preventable cause of disease, disability, and death in US

A

tobacco use

168
Q

in US, infant mortality rate is highest in what ethnic/racial group

A

non-hispanic black

169
Q

in terms of breast cancer, what race/ethnicity has the highest mortality rates compared to other racial/ethnic groups?

A

african american women

170
Q

According to the Pew Research Center, what is the most common disability in the U.S. population?

A

walking or independent living

171
Q

which of the following would not be considered a natural supplement: saw palmetto, garlic, ayurveda, flax

A

ayurveda

172
Q

what of the following statements is true regarding the use of CHAs in US for adults

A

CAIH use increases with educational level

173
Q

what complementary health approach is a technique used to relieve tension and stress by systematically tensing and relaxing successive muscle groups

A

progressive relaxation

174
Q

What is an ancient Chinese discipline combining the use of gentle physical movements, mental focus, and deep breathing directed toward specific parts of the body?

A

qi gong

cultural competency (2 decks)

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