Cultural Responsiveness:Healthcare

presented by

SASKATOON OPEN DOOR SOCIETY

Funding provided by

PRESENTATION OUTCOMES

Following this presentation, you will be able to:

• Deepen your understanding of SODS, culture, and cultural responsiveness.•Understand the impact of culture and cultural responsiveness on individuals and systems - Why does it matter?• Review your own cultural beliefs and behaviors so you can broaden your cultural responsiveness to other people’s cultures. • Be able to reflect on personal assumptions about newcomers, people, and communities in order to recognize the importance of how cultural responsiveness impacts all relationships• Develop a diversity perspective - understanding the developmental process of becoming a culturally responsive person• Understand the development of a culturally responsive perspective to promote cultural diversity and mutual respect• Apply the new understandings to your personal and professional life

PRESENTATION OUTLINE

Topic 1: Saskatoon Open Door Society Topic 2: Immigration, newcomers and Saskatoon Topic 3: Culture: An overview Topic 4: Cultural responsiveness:

What is cultural responsiveness? Why does cultural responsiveness matter? 5 Myths of cultural responsiveness How do you become culturally responsive? What is the connection between culture, cultural responsiveness and relating to other people?

Topic 5: Cultural responsiveness and healthcare Cultural Responsiveness and healthcare: Summary Cultural Responsiveness and healthcare : Questions, comments

SASKATOON OPEN DOOR SOCIETY

Mission Statement

The Saskatoon Open Door Society exists to welcome and assist refugees and immigrants to become informed and effective participants in Canadian

society and to involve the Saskatoon community in their hospitable reception and just acceptance.

NEWCOMERS, IMMIGRATION AND SASKATOON

Newcomers and Saskatoon

• As of the 2011 National Household Survey, there were 27,355 immigrants living in Saskatoon – 10.7 per cent of the total population. As of 2011, there were slightly more newcomers in Saskatoon than self-declared Aboriginals.• Saskatchewan welcomes approximately 10,000 12,000 newcomers a year, approximately ‐6,000 of whom arrive in Saskatoon. Slightly more newcomers settle in Saskatoon than Regina.• Immigrants to Saskatchewan are primarily working age individuals, with 71.5 per cent of new permanent residents falling between 15 and 60 years of age in 2011.• The Asia/Pacific region was the largest source region from which immigrants to Saskatchewan arrived in 2011 (6,558 immigrants or 73 per cent of the total).• The majority of immigrants to Saskatchewan aged 15 years and older who reported their skill level, are professionals or have skilled and technical trade/vocational training.• In 2011, 63.4 per cent of total immigrants to the province had received a trade certificate, a diploma or university degree (Bachelor’s, Master’s or Doctorate), and 55 per cent of those persons had attained a Bachelor’s degree.

• Philippines• India• China• Pakistan• Bangladesh• Ukraine

o Ethiopiao Iraqo Karen/Burmao Somaliao Bhutano Eritreao Sudan

NEWCOMERS ARE FROM…

Immigrants• Anyone that migrates from

their country or region of origin to a different country or region.

• This movement can be voluntary or coerced.

Refugees• Anyone that migrates from their

country or region of origin for fear of persecution.

• At the same time, feels that they will be unable to return to that area for fear of further persecution.

10

Understanding Immigration

CULTURE

How do you define culture?

Why does it matter?

Culture is the system of shared beliefs, values, customs, behaviors, and artifacts with which the members of society use to understand their world and one another. (NCCRESt, 2012)

“Culture plays a role not only in communicating and receiving information, but also in shaping the thinking process of groups and individuals. An approach that acknowledges, responds to, and celebrates fundamental cultures offers full, equitable access to belonging and full participation to people from all cultures.”

—Education Alliance, Brown University, 2006

Activity #1: What is in your cultural backpack?

CULTURE

Edward T. Hall

Cultural “Iceberg”

VISIBLE CULTURE consists

of the “symbols,

language, dress, customs,

foods, dance, music, and

behaviours which can be

seen or observed.”

(Hinkle, 2001)

INVISIBLE CULTURE consists of the “socio-cultural beliefs and assumptions that most people are not even aware of.”

(Hinkle, 2001)

Activity #2: Based on your experience, what are some of the beliefs and assumptions that you might have about the following cultures?

• Canadian• Syrian• Indigenous (Aboriginal)• American• Ukrainian• Chinese• Somalian

CULTURE

“High Context” vs. “Low Context” Cultures

• Hall (1976) describes as being either high or low context cultures

• High – have strong interpersonal bonds and extensive networks with members of their in-group.

• Low – compartmentalize their personal relationships; they prefer lots of background information

“High Context” vs. “Low Context” Cultures

Intercultural Communication

High Context Culture: Asian, African and Natives of Canadian and Americans

• Less focus on verbal interactions • More focus on nonverbal

interactions • Often use indirect style • More reliant on hierarchies • Implicit: Context is more

important • Silence/long pauses are valued

Low- Context Culture: Mostly Anglo-European Americans

• More focus on verbal interactions • Less focus on nonverbal interactions

• Mainly use direct style • Value equal status • Explicit: words are more important

• Silence is viewed incompetent & uncomfortable

Activity #2: What differences will knowing cultural differences in communication make to your personal relationships? Professional relationships?

CULTURAL RESPONSIVENESS

Cultural Responsiveness: What is it?

“Cultural responsiveness is the ability to learn from, and relate respectfully with people of your own culture as well as those from other cultures.” - (National Council for Cultural Responsiveness in Education, 2013)

Activity #3: Self-assessment• What are your perceptions of people from different racial or ethnic groups? With language or dialects different from yours? With special needs? What are the sources of these perceptions (e.g., friends, relatives, television, movies)?• Have you experienced others’ making assumptions about you based on your membership in a specific group? How did you feel?• When you were in school, how often did social relationships develop among students from different racial or ethnic backgrounds in the classroom and in the school? What was the nature of these relationships?

Source: Adapted from Bromley (1998).

Why does cultural responsiveness matter?

•Research on culturally responsiveness in any profession has found that people are more engaged in learning and learn more effectively when the knowledge and skills taught are presented within a context of their experience and cultural frames of references (Au & Kawakami, 1994; Gay, 2000; Ladson-Billings, 1995).

•Culture refers to the ways of living; shared behaviors, beliefs, customs, values, and ways of knowing that guide groups of people in their daily life and are transmitted from one generation to the next. Culture affects how people learn, remember, reason, solve problems, and communicate; thus, culture is part and parcel of peoples’ intellectual and social development.

— Education Alliance, Brown University, 2006

What are the key “myths” of cultural responsiveness?

•Myth #1: Cultural responsiveness is a new and special type of perspective that is relevant only to low income, urban people of color.•Myth #2: In communities with diverse cultural populations, only people of color are capable of demonstrating the essential elements of a culturally responsive approach.•Myth #3: Cultural responsiveness is a “bag of tricks” that minimizes the difficulty of relating to people of color.•Myth #4: Cultural responsiveness requires people to master the details of all the cultures of people represented in the community.•Myth #5: Cultural responsiveness reinforces stereotypes about people of color because this approach categorizes and labels people based on their race and ethnicity.

Irvine, J. J. & Armento, B. J. (2001)

How do you become culturally responsive?

• Develop cultural self-awareness• Appreciate the value of diverse views• Avoid imposing your own values on others• Examine your own interactions for cultural bias• Build peoples’ cultural strengths• Discover peoples’ primary cultural roles• Learn what you can about various cultures• Accept your own naiveté

Activity #4: How might we integrate specific life experiences of people into our daily work and learning processes?

What is the connection between culture, cultural responsiveness and relating?

Culture is the context for everything. (Saskatoon Public Schools)

Perceived Behaviour Possible Cultural Source

Person avoids eye contact. Casting the eyes down may be a demonstration of respect.A smile may be a gesture of respect, meant to avoid offence in difficult situations.

There are significant differences among cultures with respect to personal space. There may also be taboos associated with certain parts of the body (top of the head, soles of the feet, etc).

Cooperative group work is not common in all cultures. People may be unaccustomed to collaboration.

Person smiles at seemingly inappropriate times.

Person shrinks from physical contact or interacts at an inappropriately close distance to others.

Person does not participate actively in group work.

CULTURAL RESPONSIVENESS AND HEALTHCARE

• How health and illness are defined• Beliefs about what causes disease• What diseases are stigmatized and why• Types of health promotion activities engaged in by individuals

and families• The experience and expression of illness and pain• Who one seeks advice and/or help from regarding health and

illness• The experience individuals have with healthcare providers• How treatment options are understood and followed• The perception of rehabilitation services of chronic disease

condition

Culture determines…

Cultural Responsiveness & Health Care

• The Culture of Western Medicine Meliorism – make it better Dominance over nature – take control Activism – do something Timeliness – sooner than later Therapeutic aggressiveness – stronger=better Future orientation – plan, newer=better Standardization – treat similar the same

Cultural Responsiveness & Health Care: “Western Medicine”

• Obvious Manifestations:– Religion– Ethnicity (Race?)– National Origin (language)– Gender

Cultural Responsiveness & Health Care: What it “looks like”

• Less Obvious Manifestations:– Age– Education– Educational Status– Mobility (including handicaps)– Previous experience with Healthcare system

Low Context “Western” High Context “Asian/African” Make it Better Accept with grace Control Over Nature

Wait and see Do Something

Standardize – Treat Everyone the Same

Intervene Now

Strong Measures

Plan Ahead – Recent is Best

Balance/Harmony with Nature

Cautious deliberation

Individualize – Recognize differences

Take life as it comes – Time honoured

Gentle approach

Cultural Responsiveness & Health Care

Culture is a very complex concept made up of many factors.

The “Culture Iceberg”: “Visible” and “Invisible”

Cultural competence is a continuum from cultural destructiveness to cultural

proficiency

There are 6 fundamental patterns of cultural differences

Cultures can be broadly grouped into “Low” (Western) and “High” (Asian/African)

groupings which present different approaches to healthcare

Cultural Responsiveness and Healthcare has both “obvious” and “less obvious”

manifestations

Cultural Responsiveness and Healthcare takes into account culture, language, country

of origin, High/Low societies

Cultural responsiveness and healthcare: Summary

What have you learned about cultural responsiveness and healthcare?

What is the biggest surprise?

What difference will understanding cultural responsiveness and

healthcare make in your work life?

What difference will understanding cultural responsiveness and

healthcare make in your relationships with people?

What difference will understanding cultural responsiveness and

healthcare make in your relationships with newcomers?

Cultural Responsiveness and Healthcare: Questions/Comments

Thank you for your time!This presentation is supported by