How racial disparities in heal

How racial disparities in health fit into the larger patchworkof our society. How do these issues affect our understanding ofracism in general? What is the impact of cultural diversity onhealth promotion and disease prevention (HPDP) efforts?


The institute fo medicine (IOM) in its landmark report unequaltreatment: Confronting racial and ethnic disparities in health careidentified two causes of health care disparities: Health caresystmes and discrimination at the patient/provider level defined asbiases, prejudiices, streotyping and uncertanity in clinicalcommunication and decision making.

Cameron Jones theoretical framework is used to  defineracism and disparities in health care. According to Jones, thereare 3 levels of racism

  • Institutionalized racism
  • Personally-mediated racisim
  • Internalized racism

Institutionalised racism: defined as dofferential access togoods, services and opportunities by race, includes differentialaccess to health insurance, which is described as a majorcontributing factors to communication disparities betweenAfrican-American and their physicians

Personalized racism: is defined as prejudice(differentialassumptions about the abilities, motives,and intentions of othersaccording to thier race) and discrimination (differential actionstowards others according to their race). Prejudice anddiscrimination may manifest as disrespect,poor service and failureto communicate effectively

Internalized racism: as the acceptance by members of stigmatizedraces of negative messages about their abilities and intrinsicworth. Internalized racism can have many  manifestations,including helplessness, self-devaluation and limiting one’s rightto self-determination and self-expression

2.Health promotion and Disease prevention and culture

Culturally congruent care is sometimes different from values andmeanings of professional health care system. Discovering patient’svalues, meanings, beliefs,of individuals and communities. Effectivehealth care needs to integrate the cultural values and beliefs ofindividuals, and communities

Cultural competence is the process of acquiring specificknowledge , skills and attitudes to ensure delivery of culturallycongruent care.This process have 5 inter-locking components

1.cultural awareness; An in-depth self examination of one’s ownbackground, recognising biases, prejudices, and assumptions aboutother people

2.Cultural knowledge: Obtaining sufficient comparitive knowledgeof diverse groups including their indigenous values, their healthbeliefs , care practices , world view and biocultural ecology

3.Cuktural skills: being able to assess social,cultural,andbiophysical factors influencing treatment and care of patinets

4.Cultural encounter: engaging in cross-cultural interactionsthat provide knowledge about other culture and opportunities foreffective intercultural communication development

5.Cultural desire: the motivation and commitment to caring thatmoves an individual to learn from others , accept the role asleaner, be open and accepting of cultural differences and build oncultural similarities

Specific knowledge skills and attitudes are required in thedelivery of culturally congruent care to individuals andcommunities.Health care workers who provide culturally competantcare bridge cultural gaps to provide meaningful and supporive carefor patients.

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