Cultural Humility in Behavioral Health _ ________________________________________________________
affect patients. Other facets of diversity include socioeconomic status, disability, sexual orientation, religion, and gender iden- tification. These facets of diversity can serve as dimensions that marginalize and/or oppress patients as well. POVERTY Poverty is often a consequence of immigrants having fled war zones, disaster areas, and regions of extreme high unemploy- ment. More recently, the COVID-19 global pandemic shifted the trend in poverty rates which had been declining for a decade. Following the 2008 world financial crisis, U.S. poverty rates peaked in 2010 at 15.1% before steadily declining to a rate of an historic low of 10.5% in 2019 (Statista Research Department, 2022). Beginning in 2020, the official poverty rate was 11.4%, up 1% from 2019 which marked the first annual increase since 2009. In 2020, there were 37.2 million people in poverty, about 3.3 million more than in 2019 (U.S. Census Bureau, 2020). However, poverty is not equally distributed throughout the American population. According to new research, 74.7 million people have lost work since the start of the pandemic, with the majority of jobs lost in industries that were already paying below-average wages. Many who lost work and income are running out of money and savings. In January 2022, some 24 million adults reported experiencing hunger, and more than six million said they feared being evicted or foreclosed on in the next two months due to their inability to make rent or mortgage payments. Living in a stressful state of poverty can lead to an increase or onset of psychological distress. The instability that often accompanies mental illness can also lead to poverty. The cycle continues and grows as more people find themselves reeling from the pandemic’s physical, financial, and emotional impacts. By contrast, higher-income people have been relatively unscathed economically (Human Rights Watch, 2022), and certain groups are disproportionately impacted by poverty. Women, children, and racial and ethnic minorities experience poverty more often than men, working adults, and White people, and individuals with disabilities experience poverty more often than those without current disabilities (Institute on Disability, 2020; U.S. Census Bureau, 2020). The unequal distribution of poverty across the population reflects the disparities in opportunities these subpopulations experience throughout their lives. Some examples of the disparity of opportunities include a disproportionate number of racial and ethnic minorities living in low-income neighborhoods and experiencing insufficient educational opportunity as well as women continuing to earn less than men (the most current data show that women earn 83 cents for each dollar men earn; U.S. Bureau of Labor Statistics, 2022).
POPULATION BY RACE SELF-IDENTIFICATION FOREIGN BORN RACE NUMBER OF PEOPLE PERCENTAGE White 20,375,810 45.5% Asian 12,097,155 27% Some Other Race 6,617,226 14.8% Black or African American 4,270,404 9.5%
Native American Indian and Alaska Native Native Hawaiian and Other Pacific Islander Two or More Races
198,677
0.4%
146,444
0.3%
460,543
0.2%
Based on data from the Pew Research Center (2020a) Table 4
Self-Assessment Quiz Question 2. In 2018, from which country/region did the highest number of foreign-born people residing in the US come from by place of birth? A) South America. B) East and Southeast Asia. C) Mexico. D) Sub-Saharan Africa. Mental and behavioral healthcare professionals must be careful not to make sweeping generalizations regarding the characteris- tics or needs of any population. Further, patients are influenced by a variety of factors, including level of acculturation (to be discussed later), immigration experience, experiences with discrimination, and ability to speak English. Therefore, it is imperative that healthcare professionals ask patients about their personal experiences and important events in their lives. Some cultural generalizations may help clinicians increase their knowledge of specific cultures and enhance their understand- ing of a portion of patients’ differing experiences. However, this is not intended to shift the healthcare professional’s focus away from developing a better understanding of the dynam- ics of race, immigration, and other facets of diversity within the current social, economic, and political environment of the U.S. Mental and behavioral healthcare professionals are better prepared to both understand and help their patients if they are able to understand the cultural climate in which their diverse patients live and that climate’s role in accommodating or marginalizing them. Moreover, healthcare professionals will provide better care for their patients if they develop a better understanding of how they personally are accommodated and marginalized by American culture. Race, ethnicity, and immigration status are only a few of the facets of diversity that
Research shows that the poverty rate in the U.S. is increasing. Healthcare professionals must be aware of data relating to poverty and work to decrease the growing problem of poverty.
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