_____________________________________________________________ Cultural Competence: An Overview
Historical adversity and institutional racism contribute to health disparities in this group. For the Black population, patient assessment and treatment planning should be framed in a context that recognizes the totality of life experiences faced by patients. In many cases, particularly in the provision of mental health care, equality is sought in the provider- patient relationship, with less distance and more disclosing. Practitioners should assess whether their practices connect with core values of Black culture, such as family, kinship, com- munity, and spirituality. Generalized or Eurocentric treatment approaches may not easily align with these components of the Black community [42]. Providers should also consider the impact of racial discrimination on health and mental health among Black patients. Reports indicate that expressions of emotion by Black patients tend to be negatively misunderstood or dismissed; this reflects implicit or explicit biases. Asian Patients As of 2019, 22.9 million Americans identified as Asian [43]. Between 2000 and 2019, Asians experienced the greatest growth compared with any other racial group at 81% [44; 45]. The Chinese group represents the largest Asian subgroup in the United States, and it is projected that this population will grow to 35.7 million between 2015 and 2040 [46; 47]. In 2019, Chinese Americans (excluding Taiwanese Americans) numbered at 5.2 million [43]. They also have the highest edu- cational attainment; 54.6% of Asians 25 years of age or older had a bachelor’s degree or higher in 2019 [43]. “Asian” is a single term widely used to describe individuals who have kinship and identity ties to Asia, including the Far East, Southeast Asia, and the Indian subcontinent [48]. This encompasses countries such as China, Japan, Korea, Vietnam, Cambodia, Thailand, India, Pakistan, and the Philippines. Pacific Islander is often combined with Asian American in census data. The Pacific Islands include Hawaii, Guam, Samoa, Fiji, and many others [48]. There are more than 25 Asian/ Pacific Islander groups, each with a different migration his- tory and widely varying sociopolitical environments in their homelands [49]. Asian American groups have differing levels of acculturation, lengths of residency in the United States, languages, English- speaking proficiency, education attainment, socioeconomic statuses, and religions. For example, there are approximately 32 different languages spoken among Asian Americans, and within each Asian subgroup (e.g., Chinese), multiple dialects may be present [49; 50]. In 2019, California had the largest Asian American population, totaling 5.9 million [44]. Recommended best practices when caring for Asian American patients include: • Create an advisory committee using representatives from the community. • Incorporate cultural knowledge and maintain flexible attitudes. • Provide services in the patients’ primary language.
• Develop culturally specific questionnaires for intake to capture information that may be missed by standard questionnaires. • Emphasize traditional values and incorporate tradi- tional practices (e.g., acupuncture) into treatment plans, when appropriate and desired. • Explore patient coping mechanisms that draw upon cultural strengths. Latino/a/x or Hispanic Patients In 2020, the Hispanic population in the United States numbered 60.6 million [51]. The majority of the Hispanic population in the United States (63.3%) identify themselves as being of Mexican descent [53]. Approximately 27% of the U.S. Hispanic population identify as Puerto Rican, Cuban, Salvadoran, Dominican, Guatemalan, Colombian, Honduran, Ecuadorian, or Peruvian [54]. In 2020, the Hispanic population comprised 18.7% of the U.S. population [51]. As such, they are the largest ethnic minority group in the United States. By 2060, Hispanics are expected to represent 31% of the U.S. population [55]. They are also a young group, with a median age of 29.8 years [51]. In 2019, the three states with the largest Hispanic population growth were Texas (2 million), California (1.5 million), and Florida (1.4 million); these three states have the largest Hispanic populations overall [52]. When involved in the care of Latinx/Hispanic individuals, practitioners should strive to employ personalismo (warm, genu- ine communication) and recognize the importance of familismo (the centrality of the family). More flexible scheduling strate- gies may be more successful with this group, if possible, and some patients may benefit from culturally specific treatment and ethnic and gender matching with providers. Aspects of Latino culture can be assets in treatment: strength, persever- ance, flexibility, and an ability to survive. Native American Patients The Native American population is extremely diverse. According to the U.S. Census, the terms “Native American,” “American Indian,” or “Alaskan Native” refer to individuals who identify themselves with tribal attachment to indigenous groups of North and South America [56]. In the United States, there are 574 federally recognized tribal governments and 324 federally recognized reservations [57]. In 2020, it was reported that there were 7.1 million Native Americans in the United States, which is approximately 2% of the U.S. population [57]. By 2060, this number is projected to increase to 10.1 million, or 2.5% of the total population [57]. In general, this group is young, with a median age of 31 years, compared with the general median age of 37.9 years [58]. As of 2018, the states with the greatest number of residents identify- ing as Native American are Alaska, Oklahoma, New Mexico, South Dakota, and Montana [59]. In 2016, this group had the highest poverty rate (26.2%) of any racial/ethnic group [58].
23
EliteLearning.com/Dental
Powered by FlippingBook