TopicThis site is focused on analyzing the current medical system in the United States and how culture plays a role in the care that different people receive. These topics will focus on Native American cultural communities in North Carolina and how their culture influences their health choices, different ways of understanding their health, and receiving treatment from a healthcare setting.
This topic is important to analyze and discuss because understanding racial disparities within our health system helps us see how racism and racial inequities have moved throughout our society and continues to exist today within our institutions. |
GoalThe goal of this website is to inform readers of the connection between different cultures in North Carolina and how their culture influences their health. By understanding from a humanities perspective, how things such as culture, can directly influence our health choices and care. Medical systems have implicit biases and inequities integrated into its system, and this affects care that is given to cultural community members. By bringing an awareness to inequities that certain communities face, it helps increase our consciousness in order to prevent these things from going any further and creating spaces where equity and implicit biases don’t exist within health care.
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Cultural Awareness
Cultural differences among patients have the largest impact in healthcare settings. Socioeconomic class, education, age, gender and other health disparities also play a role. There are endless stereotypes associated with cultural groups and it is crucial for healthcare providers to not generalize their patient due to cultural stereotypes. People’s connection to their culture is extremely personal and individualized. Acting on assumptions in regard to stereotypes can potentially harm the patient and their trust and respect of their provider (Galanti, 2000).
Having cultural awareness helps all providers administer better care to all of their patients. Recognizing and understanding cultural competencies are what ensures high-quality, equitable treatment. Something as simple as eye contact is perceived in many ways across different cultures. Having knowledge and a cultural competency allows provider to have some background knowledge going into a patient’s medical case, before developing a personal relationship with the patient and discovering more personalized cultural beliefs. Providing the most relevant care possible is not independent of being aware of a patient’s cultural beliefs (Galanti, 2000). |
Knowledge of cultural customs can help avoid misunderstanding and enable practitioners to provide better care.
(Galanti, 2000, p. 335)
Institutionalized Discriminaton
The United States has seen a consistent pattern throughout its history with marginalized racial groups receiving substandard care in comparison to the dominate ethnic group. Overall care in the United States has improved for all of its residents over the past half century, but African Americans, Native Americans, and other minority groups have higher rates of death and disease. This comes from an overarching societal problem, not just from a few individual providers and practices (Williams et. al, 2000). We can see that things such as “geographic maldistribution of medical resources, racial differences in patient preferences, pathophysiology, economic status, insurance coverage, as well as in trust, knowledge, and familiarity with medical procedures” affect the level of care that certain populations receive and the quality of it (Williams et al., 2000, p.75).
Actions that could be analyzed to have a prejudiced background to them may not be intentional, they still need to be recognized. Although providers are not inherently trying to discriminate against their patients, a great deal of present-day discrimination is not intentional or not conscious thinking. Certain discriminatory behaviors and practices have been engrained into the norms of society without a second thought. This unconscious bias harms the patients’ health and enforces negative stereotypes. Certain policies that are aimed at decreasing discriminatory practices in healthcare are directed toward intentional behaviors; the underlying institutionalized racism is harder to address with a simple policy (Williams et al., 2000).
Actions that could be analyzed to have a prejudiced background to them may not be intentional, they still need to be recognized. Although providers are not inherently trying to discriminate against their patients, a great deal of present-day discrimination is not intentional or not conscious thinking. Certain discriminatory behaviors and practices have been engrained into the norms of society without a second thought. This unconscious bias harms the patients’ health and enforces negative stereotypes. Certain policies that are aimed at decreasing discriminatory practices in healthcare are directed toward intentional behaviors; the underlying institutionalized racism is harder to address with a simple policy (Williams et al., 2000).
White Standard
In the United States, the White population has the best health outcomes when compared to other races. In the categories of live births, health status, smoking, obesity, hypertension, health insurance coverage, mortality, and infant deaths, Whites perform the best. American Indians have worse rates in almost every category when compared to Whites (Center for Disease Control, 2021).
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Not acknowledging someone’s race is also a detriment to their health. Having colorblindness does not recognize the inequities that they face due to the color of their skin. Educational textbooks' images use a White body as the standard, so the basis of identifying illnesses and diseases comes from a White standard. This lack of diversity in textbooks is one of the many ways we can see the huge lack of diversity in our medical systems.
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North Carolina
We know racism and discrimination lead to health disparities and impact the health and safety of our employees, our members and our communities. Health inequity impacts all North Carolinians. In published studies, North Carolina is consistently in the lower percentile of state health rankings. Data shows our state’s health system ranked #36 out of 50 states overall and #46 out of 50 for disparities. Think about that ... we're #46 out of 50 states.
- Dr. Tunde Sotunde MD, MBA, FAAP, President and CEO Blue Cross NC
Sotunde, T. (2021)
Progress
The NC Healthcare Association is starting their own initiative in regard to supplying the state with more equitable care for everyone. This announcement is focused on three different areas with education, innovation, and data. These focus on Anti-bias education in hospitals to all staff, identifying and targeting ways to reduce disparities that are conducive to each specific healthcare setting, and using data to analyze trends where these inequity gaps are and how to improve quality of care outcomes. Although the NC healthcare Association represents all of the medical systems in North Carolina, the level of acceptance and motivation towards tackling racial inequities has varied from county to county. For the first time ever, the UNC Health System created and selected an Executive Director for Health Equity. Most counties are on board with acknowledging this health inequity based on race, but it has not been without its pushback. Bladen county is refusing to accept and declare that this is a public health crisis and Governor Roy Cooper is facing pushback for wanting to expand access to Medicaid (Stradling, R. 2020)
References:
Center for Disease Control. (2021, March 2). FastStats - Health of White Population. https://www.cdc.gov/nchs/fastats/white-health.htm.
Galanti G. A. (2000). An introduction to cultural differences. The Western journal of medicine, 172(5), 335–336. https://doi.org/10.1136/ewjm.172.5.335
Sotunde, T. (2021, March 24). Diversity, Equity & Inclusion. Blue Cross NC. https://www.bluecrossnc.com/diversity-equity-inclusion.
Stradling, R. (2020, November 18). North Carolina hospitals join others in declaring racism a public health crisis. The News & Observer. https://www.newsobserver.com/news/local/article247235884.html.
Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review, 21(4), 75–90.
Center for Disease Control. (2021, March 2). FastStats - Health of White Population. https://www.cdc.gov/nchs/fastats/white-health.htm.
Galanti G. A. (2000). An introduction to cultural differences. The Western journal of medicine, 172(5), 335–336. https://doi.org/10.1136/ewjm.172.5.335
Sotunde, T. (2021, March 24). Diversity, Equity & Inclusion. Blue Cross NC. https://www.bluecrossnc.com/diversity-equity-inclusion.
Stradling, R. (2020, November 18). North Carolina hospitals join others in declaring racism a public health crisis. The News & Observer. https://www.newsobserver.com/news/local/article247235884.html.
Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review, 21(4), 75–90.