Cultural Awareness Cultural Awareness Issues in Chiropractic Issues in Chiropractic Faculty Faculty Development Day Development Day July 15, 2002 July 15, 2002 Cheryl Hawk, DC, PhD Cheryl Hawk, DC, PhD Director of Chiropractic Sciences Director of Chiropractic Sciences Dept. of Graduate Studies Dept. of Graduate Studies
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Cultural Awareness Issues in Chiropractic Faculty Development Day July 15, 2002 Cheryl Hawk, DC, PhD Director of Chiropractic Sciences Dept. of Graduate.
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Cultural AwarenessCultural AwarenessIssues in ChiropracticIssues in Chiropractic
What is “cultural competency”?What is “cultural competency”?
Set of skills, knowledge & attitudes Set of skills, knowledge & attitudes related to a clinician’srelated to a clinician’s understanding and respect for patients’ understanding and respect for patients’
values, beliefs, expectationsvalues, beliefs, expectations awareness of his/her own assumptions and awareness of his/her own assumptions and
value systemvalue system ability to adapt care to be congruent with ability to adapt care to be congruent with
patients’ expectations and preferences.patients’ expectations and preferences.
WHY should DCs be WHY should DCs be “culturally competent”?“culturally competent”?
• US population is increasingly US population is increasingly culturally diverseculturally diverse
• Different cultures have different Different cultures have different health behavior and health riskshealth behavior and health risks
• Doctor-patient communication and Doctor-patient communication and rapport are affected by cultural rapport are affected by cultural differencesdifferencesThis affects outcomes!This affects outcomes!
US population is US population is increasingly culturally increasingly culturally
diversediverse
Racial Racial Distribution of Distribution of US Population US Population
20002000
White White (72%)(72%)
HispaniHispanicc
Afr-AmAfr-Am
AsianAsian
Am. Am. IndianIndian
Are we keeping pace with Are we keeping pace with these changes?these changes?
US population vs chiropractic US population vs chiropractic patientspatients
% non-white/Hispanic% non-white/Hispanic
General population (1998)General population (1998) 28%28%
DC patients (1974-82)DC patients (1974-82) 4% 4%
DC patients (1997-98)DC patients (1997-98) 5%5%
Ethnic diversity in the US Ethnic diversity in the US MD and DC workforceMD and DC workforce
% Non-white/Hispanic% Non-white/Hispanic• General populationGeneral population 28% 28%• MDsMDs 7% 7%• MD students (2000)MD students (2000) 34% 34%• DCsDCs 7% 7%• DC students (PCC 2002)DC students (PCC 2002) 9% 9%
US DCsUS DCs
19911991 1998 1998
FemaleFemale 13.3% 19.2% 13.3% 19.2% 51%51%
AsiaAsia nn 0.8 0.8 1.81.8 4 4
HispanicHispanic 1.6 1.6 1.71.7 1313
African AmericanAfrican American 0.5 0.5 0.60.6 1212
American IndianAmerican Indian 0.2 0.2 0.80.8 1 1
GenGen. . poppop..
and… and… why should we care?why should we care?
• Only Only 11%11% of all Americans see a of all Americans see a chiropractor annuallychiropractor annually
• Minority populations are not Minority populations are not benefiting from chiropractic carebenefiting from chiropractic care
• Chiropractic is not helping eliminate Chiropractic is not helping eliminate health disparitieshealth disparities
• Bottom line: Bottom line: it’s the right thing to it’s the right thing to do!do!
Different cultures have Different cultures have different health behavior and different health behavior and
health riskshealth risks
Examples of US Health Behavior Examples of US Health Behavior Differences: Differences: Reduced Physical Reduced Physical
ActivityActivity
• WomenWomen• Lower income/educationLower income/education• African-Americans and HispanicsAfrican-Americans and Hispanics• Older adultsOlder adults
by age 75, 33% men, 50% women by age 75, 33% men, 50% women have no physical activity at allhave no physical activity at all
Source: Healthy People 2010
Examples of US Health Examples of US Health Behavior Differences: Behavior Differences: overweight/obesity*overweight/obesity*
• ALL: 50%!!ALL: 50%!!• Lower income women and Lower income women and
• Personal vs. impersonal stylePersonal vs. impersonal style• Non-verbal cuesNon-verbal cues• LanguageLanguage• Respect (it’s a two-way street!)Respect (it’s a two-way street!)
Communication issuesCommunication issues
• Language (spoken and written)Language (spoken and written) Non-English speakersNon-English speakers Educational levelEducational level Acceptable topicsAcceptable topics