Cultural Competence in Refugee Health Care

Lance A. Rasbridge, PhD

Coordinator, Refugee Outreach Program Parkland Hospital

Lance.Rasbridge@phhs.org

Culture

• Definition- “complex whole…” • Individuals are part of many different

cultures • Influences an individual’s health beliefs,

practices, behaviors, and even outcomes of medical treatments

Competence

• Acknowledgement of the importance of culture

• Knowledge is not encyclopedic • Ongoing, not static • Based on the fundamental of cultural

relativism

Why is Cultural Competence in Health Care Important?

• Reduce barriers to access • Improve adherence to treatment • Improve health outcomes • Eliminate health disparities • Ethics- Patient-centered care

Caveats

• Diversity within all cultures, be careful of stereotyping

• Culture is dynamic, especially in the process of acculturation

• Be prepared to negotiate or suggest alternatives to undesirable practices

Southeast Asian Refugees

• Cambodians • Laotians • Vietnamese • Hmong, Montagnards

• Burmese ethnic

minorities • (Bhutanese)

Southeast Asian Medical Beliefs and Practices- Etiology

1. Spiritual- Buddhist, folk 2. Natural- balance, humours,

yin/yang 3. Western- biomedical

Buddhism

• Symbols

“Thanakaa”

• Betel nut

• Nutrition

Coining

Cupping

Pinching

Traditional medicines

Chinese medicine

Postpartum practices

Biomedical setting