PART 1
Health Locus of Control
PART 2
CONCLUSIONS
METHODS
DISCUSSION
APPENDIXES
Cultural Competence
It strikes an infectious cord in my body how this society preaches individuality yet demands assimilation. This discordant reality extends through our prejudices, and manifests in our distaste for other languages, accents, ways of dress, and virtually any other custom one can think of. We are not alone in our hatred of otherness (although other cultures are less underhanded in this practice): "ethnic cleansing" is currently plaguing Kosovo, and Cuban airport officials (with some reason) have been known to harass Americans at immigrations. This hatred of otherness might mitigate in the existence of illness in those who are not assimilated in this society, as well as in those who assimilate but withdraw from their country of origin. It may not be acculturation at all which effects health, but the society's treatment of individuals in various modes. "You make me sick" could acquire a new meaning here.
From this necessitates addressing the health concerns of ‘others'. "Despite the many differences among the cultures that make up our nation, we all have the same basic needs concerning our health: to be able to tell the story of our illness, to receive competent care, and to be acknowledged and valued" (Levy & Hawks, 1996). The implications of this statement make obvious the need for health professionals to foster efforts to appreciate frames of reference outside of their own, while recognizing the similarities we as humans all share: the need for a social support system. The following, however, divulges a fact that health professionals prefer not to expose:
The large number of ethnic and cultural groups in the U.S. precludes the possibility that health care providers can achieve universal cultural competence. Among African-Americans, there are major cultural differences between urban and rural dwellers, native-born individuals and immigrants from the Caribbean and elsewhere, and Christians and Muslims. Among the major Hispanic immigrant populations (Mexican, Puerto Rican, and Cuban) socioeconomic status influences attitudes about health, disease, and medicine. Similarly, among Native American groups, there are vast differences in belief systems, education, and socioeconomic status. Immigrants from China, Japan, Vietnam, Korea, India, and other Asian nations also have their own distinctive cultures.
-Levy & Hawks, 1996.
Indeed, not only are there an unfathomable number of cultural niches out there, but each individual on this planet houses idiosyncracies which prevent universal communication. But differences between individuals have not precluded people from engaging in meaningful conversations, and differences in culture should not alienate groups from each other. One suggestion encourages community based programs: "The changing demographics and the stresses associated with acculturation make it imperative that helping professionals focus on the need for community based health and human services" (Tran et al., 1996, p. 164). I believe such a system would encourage rather than inhibit communication amongst cultures.
Ideally, an eclectic approach to health would be maintained: the different forms of healing from these cultures would be fostered in addition to each other, rather than in exclusion of each other. Each system may have its advantages. Furthermore, a richness is afforded pluralistic societies: "racially mixed populations of the Caribbean . . . offer unique possibilities for cross-cultural creativity and philosophy unavailable to monocultural societies, or to those which aspire monoculturalism" (Prescott, 1996, p. 150). We have creative access in this country to so many different ways of thinking, yet we limit our theories the Western model (in health and beyond).
