Department
of Health and Community Services
MULTICULTURAL HEALTH
HCSV &
MCGS 328-01 Spring 2009
Tuesdays/Thursdays
12:30-1:45 pm
Professor: Dr.
Office: 637 Butte
Hall Office
Phone: 898-6310
Mailbox: 607
This course will focus on the impact
of cultural variables on health and illness.
Further, this course will focus on those problems that affect African
Americans, Latinos, American Indians, and Asian Americans. The effects of history, health beliefs and
practices, and socioeconomic status on the health of different ethnic
populations will be addressed. The
emphasis in the reading collections is on changing perceptions, giving voice,
and addressing issues of racial discrimination. Current and potential
strategies to improve health care delivery to these groups will be explored. We
will often discuss topics that are sensitive, but critical, to cogent
discussions about race, ethnicity and health. Each of you is asked to be
mindful that we are a diverse group and that each person deserves your respect.
Required Text:
Kline, M. V. & Huff, R. M. (2008). Promoting Health in Multicultural
Populations: A Handbook for Practitioners. 2nd Edition. Sage
Publications
Required: Functional
The CRAAP Test
(a way to analyze the appropriateness of website for use in academic papers):
http://www.csuchico.edu/lins/handouts/evalsites.html
A. The student will discuss the effects of history, cultural
assimilation patterns, and health beliefs and practices upon the health status
of underrepresented ethnic groups in the
B. The student will evaluate the effectiveness of the health
delivery system in meeting the health needs of major ethnic groups in the
C. The student will describe the nature and extent of health
disparities between U.S. Whites and non-Whites.
D. The student will examine health agencies and organizations
that are responsive to the needs of multicultural groups in the
E. The student will analyze the various cultural, social,
political, environmental and economic forces with impact the health of
F. The student will compare the effects of several major health
concerns common to ethnic groups in the U.S: infant mortality, AIDS, heart
disease, cancer, drug abuse, etc.
G. The student will assess the effect of prejudice and
discrimination upon the health and the delivery of health care services to
underrepresented groups in the
H. The student will identify personal stereotypical thinking,
common prejudices, and ethnocentrism and its negative impact upon the health
and delivery of services to ethnic groups in the
I. The student will examine one's own cultural backgrounds and
world view as related to communication with others.
J. The student will identify assets and strengths within
K. The student will develop cultural sensitivity (awareness of
differences) and become culturally competent (skillfully interact with other
ethnic/cultural groups). The student
will articulate a personal vision for improving or enhancing the health status
of communities of color in the
A. Attendance
Attend
each class, contribute to class discussions, and participate in planned activities. Attendance will be recorded. More
than 2 absences will result in a penalty of a reduction of 1/3 final letter
grade for each class period missed.
Our academic schedule is based on Western Christian
religious/cultural traditions, for example we do not meet on Sundays,
Christmas, Easter, etc. This can create
an additional burden on those students who practice other religious/cultural
traditions because they must either miss class, ask permission to miss class,
or miss important religious/cultural ceremonies and events. Please do not
hesitate to inform me of an expected absence required to follow the tenets of
your faith &/or culture. This absence will not be officially recorded as
such. However, any required academic work should be submitted in advance and
will be considered late if not submitted by the due date.
There are
articles assigned per week. For each article there are questions that must be
answered. The articles and questions are on
1.
Your name,
article #s & titles
2.
Typed,
single-spaced answers to the assigned article questions.
3.
Your reflection regarding ONE article per weekly assignment
(especially how it affects your previous opinions or professional life).
C. Exams (120 & 100 pts each)
Participate in 2 exams at the appointed time. The
examinations will be multiple choice and/or essay. Make up exams will only
be given under dire emergencies with prior approval and with documentation and
are administered during finals week at your professor’s convenience. See
D. Panel
Project (120 pts)
Students will be assigned to panel groups to understand
peoples of diverse cultures and to find ways health
educators/administrators/health care professionals can most effectively serve
their clients.
o
Panel groups
will present a 60-minute presentation on one assigned ethnic group. Everyone must participate equally to the
overall presentation. The panel should
consider itself as a whole and not as segmented parts to insure completeness
and avoid duplication in the oral presentation.
The focus of your research relates to health professionals and how we
may best serve. Consequently, what
information makes this culture different from the dominant culture? What are the experiences and assets of this
culture relative to the dominant culture? Determine what exceptional data we
need to know. IMPORTANT! See more detailed instructions in Section II of this
syllabus.
D. Cultural
Event (15 pts)
Attend a
non-western cultural/ethnic public event in the
Course
Evaluation
Panel project 120
Articles 125
Exam #1 120
Exam #2 100
Cultural Event 15
Total 480
B+ = 88
- 89% C+ = 78
- 79% D+ = 67
- 69%
A = 94
- 100% B = 84
- 87% C = 74
- 77% D = 64
- 66%
A- = 90
- 93% B- = 80
- 83% C - = 70
- 73% F = 63%
or less
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Date |
TOPIC
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ASSIGNMENTS |
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1/27 |
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1/29 |
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2/3 |
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2/5 |
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2/10 |
Race & Ethnicity |
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2/12 |
Race & Ethnicity: The power of a Myth |
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2/17 |
RP 5-6 |
Chapter 2 |
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2/19 |
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2/24 |
RP 7-8
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Chapter 3
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2/26 |
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3 /3 |
RP 9-10
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3/5 |
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3/10 |
Culture and Health
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3/12 |
Exam 1
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SPRING BREAK |
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3/24 |
Cultural
Competency |
RP 11-12 |
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3/26 |
Religious
Minorities |
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3/31 |
No
class: Cezar Chavez Day
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4/2 |
American Indian health
issues panel
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RP 13-14 |
Chapter
17 |
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4/7 |
Native Hawaiian health issues panel
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RP 15-16 |
Chapter
25 |
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4/9 |
African-American health issues
panel
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Chapter
13 |
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4/14 |
Latino
health issues panel |
RP 17-18 |
Chapter 9 |
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4/16 |
People with Disabilities |
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4/21 |
Pilipino American health issues panel |
RP 19-20 |
Chapter 21 |
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4/23 |
Chinese American health issues
panel
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4/28 |
Japanese American health issues panel
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RP 21-22 |
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4/30 |
Asian Indian health
issues panel
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5/5 |
Southeast Asian health issues panel
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RP 22-23 |
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5/7 |
Class cancelled
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5/12 |
Gender
& Sexual Minorities health issues
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RP 24-25 |
Cultural event reflections due |
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5/14 |
Commitments to Cultural Competence
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5/19 |
Exam 2: 2 – 3:50 pm
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Section II:
Expanded Panel Project Instructions
Panel Project
(120 pts)
Students will be assigned to panel groups to understand
peoples of diverse cultures and to find ways health
educators/administrators/health care professionals can most effectively serve
their clients. Panel groups will plan a 60
minute presentation on assigned ethnic groups. Everyone must participate equally to the
overall presentation. The panel should
consider itself as a whole and not as segmented parts to insure completeness
and avoid duplication in the oral presentation.
The focus of your research relates to health professionals and how we
may best serve. Consequently, what
information makes this culture different from the dominant culture? What are the experiences and assets of this
culture relative to the dominant culture? Determine what exceptional data we need
to know. The groups follow:
1. Black Americans 4.
Asian Indian Americans 7.
Japanese Americans
2. Latino/Mexican Americans 5.
South East Asian Americans 8.
Chinese Americans
3. American Indians or Alaskan Natives 6.
Native Hawaiians 9. Filipino Americans
Panel project content:
1. Identify
ethnic groups and sub-groups:
history (when, why and how they come to the
2. Evaluate
general health data by age groups (children, adults, elders): provide a SYNTHESIS of epidemiological characteristics,
general health, morbidity and mortality (e.g. leading causes of death, or areas
where there are significant differences across ethnicities). Be sure to provide COMPARISON data between
your minority group and other ethnic groups/general population.
3. Analyze a
specific health problem AND one culturally focused health care/education
program that addresses this problem/group. Each group member must choose a different health issue to research and
present. The emphasis should on WHY this is a problem must be
addressed, NOT on the disease process.
DO NOT just provide generic disease etiology and prevention information
4. Identify
beliefs and practices of health, disease and illness, both traditional and
adaptations. Are cultural healers available? Are they used? What belief system is used in healing? How
has acculturation affected these practices?
5. Describe the
current health care delivery: encounters with the mainstream, barriers to
treatment and services. Is Western
medicine and treatment accepted? To what
extent? When is Western treatment sought
(if at all)? Are services
available? Is there self treatment in
this community? Are there fears,
barriers, miscommunication surrounding Western medicine? How can these barriers
be overcome or reduced?
6. Describe the
traditional family lifestyle including roles of women and men, and the role of
elders. Are traditions changing in this country? What are the effects of acculturation? What intergenerational changes are taking
place? What is the effect of their
traditions (especially female/male roles) regarding health treatment and
education? How can health professionals
adjust to reach this community?
7. Ethnic
interview: Each person must
interview an individual representing your selected ethnic group. If you are of
the ethnic group, interview someone of your ethnicity that you suspect may have
had different life experiences than you. As a minimum, ask them questions
regarding the following: their ethnic background, country of origin, what they
do to maintain health, what remedies are used for common health problems, and
their views of physicians, hospitals, and medicines. Share with them what you learned in your research
and ask them what they think should be presented. How does their background affect their
beliefs concerning health and illness?
Which beliefs and practices are health preserving? Which may be harmful? Write up a summary of your results and add
how their beliefs have influenced your health beliefs and behaviors. Which beliefs are similar to yours? Where do your beliefs differ from theirs and
why? Submit a thank you note (addressed and
stamped) with your presentation.
Panel Project
Format:
There are several
components to this project:
a)
A one-hour
group oral presentation using Power Point, plus poetry, music, artifacts,
etc. As a group you will divide up the required demographic and cultural
content (see 1-7 above), plus each group member will write/present on a health
topic (#3 above). Use music, examples of clothing, food (keep it simple – no
buffet lines!), to enhance our experience of your ethnic group’s culture. These could include: poetry, music, or
visual art. Be sure to have brief
biographical information about the artist (name, year created &/or years
artist lived, country of origin).
b)
An individually
written extended, detailed outline (paper) of your portion of the group
presentation. Minimum 4 pages single-spaced
typed from each group member. This must be referenced thoroughly and
accurately using at least 4 professional (peer-reviewed or governmental agency)
sources IN ADDITION TO class sources. Wikipedia is NOT allowed! Please also submit an electronic copy of
your paper via VISTA
c)
Ethnic interview
– individually conducted and evaluated interview. Submit with paper and
include in your presentation where appropriate.
d)
A
group-developed informational handout accompanying your presentation for
all class members on the day of your presentation (make 38 copies). This should
be a one page (2 sided) condensed
version of your entire panel project which is distributed at the beginning
of your presentation. Make these as
dense and thorough as possible – these are to be used as exam study
notes/guidelines on your panel.
e)
A presentation
timeline/outline submitted to instructor on day of presentation.
f)
A
group-developed attractive, organized binder that includes all detailed
outlines, Power Point slides, interviews, and any other materials associated
with your project/presentation.
g)
Member contribution
and participation evaluation. This is due on the day of your
presentation. Please submit in individual envelopes or stapled/taped shut to
ensure confidentiality
Bring this culture into the classroom; surround us with the
colors, music, spirituality, scents, food, history, experiences, clothing, and
pride of this culture. Some ideas:
·
YOU MUST integrate
poetry, music/lyrics, traditional stories, famous speeches, or video
clips. (Bring your own portable CD player – the classroom systems are not
reliable!). The idea is to get away from a purely data based presentation and
highlight the experiences and voices of the ethnic group.
·
Other ideas to
bring your presentation to life:
o
Food – keep it
simple, though – no buffet lines!
o
Visit an
ethnic community, attend a celebration, church, etc. and tell us what you
saw. Take some pictures (ask
permission!);
o
Describe of
holidays and ways they are celebrated.
o
Accomplishments
of a person(s) of this ethnicity who has become well-known.
o
Teach us (or
invite a guest presenter to) a traditional healing practice (yoga, etc.), or a
traditional dance, game or prayer.
Panel Project Grading
60 points: Oral Presentation Criteria: Adequate group coverage of objectives,
material well organized, student appeared to have good knowledge of subject,
topics selected were relevant to ethnic group, presentation made sense,
questions satisfactorily answered, student showed interest in topic, student
made subject interesting, contribution will improve knowledge base in HCSV 328,
content was new information, creativity, use of overheads, films, music, art,
healthy food, etc. Quality of classroom handout. Quality of and adherence to
timeline.
40 points: Detailed outline (paper): had good content and was well written, referenced correctly and adequately,
use APA documentation style quality of sources.
10 points: Individual contributions to panel as
measured by confidential peer evaluations:
member was organized, member was motivated, a good participant, attended
all group meetings, contributed to your work, was dependable, contributed
equally to the panel
10 points: Quality
of Interview and quality of interview summary. Thank you note & stamped
envelope.
NOTE: presentation grades will not be recorded until all
evaluation forms are received.
EXAM
1
1. Understand the concept of “culture”
in general – what is it, how does it develop, what is it composed of, how does
it act on individuals, what institutions comprise culture, what is the
relationship between the individual, institutions, and ‘culture’.
2. Know Slonim’s 5 basic criteria for
defining a culture.
3. Understand the concepts of
“ethnicity” and its relationship to culture and what has been known as “race”
and “minority”.
4. Understand the concepts of
acculturation, bicultural, assimilation. Understand the relationship between
acculturation and assimilation.
5. Understand “ethnocentrism” and how
it affects health promotion.
6. Know the differences between
cultural awareness, cultural knowledge, cultural skill, cultural encounter.
7. Understand the concepts related to
ethnosensitivity, including cultural relativism.
8. Understand the differences in
communication styles and how they impact interpersonal communication.
9. What process do Kreps and Kunimoto
recommend?
Understand
the western bio-medical model of disease and be able to compare (in general)
other models of disease. This includes concepts of explanatory models, what
causes disease (Illness causality), different (general) methods of healing.
Study the traditional models of health care delivery of the different ethnic
groups presented in this chapter.
Chapter 3: Ethics of Health
Promotion Intervention in Culturally Diverse Populations
1. Understand the concepts of ethics,
morality, bioethics, ethical traditional, ethical competency.
2. How have various health
organizations incorporated the concept of culture in their codes of ethics?
3. Understand the Kachingwe-Huff model
of culturally proficient and ethical practice. How does “conviction” play a
role?
4. What is the first thing
practitioners must understand?
Chapter 5: Health Disparities in
Multicultural Populations: An Overview
1. Understand the social roots and
determinants of health disparities.
2. How do the authors argue that we are
compelled to address health disparities?
3. Understand (basics) the Model of
vulnerability
4. Know the spectrum of infant
mortality across ethnicity.
5. Know the spectrum of self-reported
general health status by ethnicity
6. Know the spectrum of obesity across
ethnicity
7. Understand the “inverse care law”
8. Know the spectrum of health
insurance coverage and having a regular source of care across ethnicity.
9. Understand how health education
contributes to and also has the potential to reduce health disparities.
This
chapter provides a framework for assessing the culture of a community. It is a
little overwhelming. I don’t want you to get bogged down in the details, but
you do need to have a vision of what these components are and how they might
impact the individual and health and seeking healing. You need to know and
understand the factors involved (e.g. demographic variables of age, gender,
etc.; cultural characteristics of ethnic identity, cosmology, time orientation,
etc.; Health beliefs such as explanatory models, etc). I would create a dense
outline to understand these various components – these are critical to becoming
a culturally competent practitioner, educator, administrator, therapist, etc.
Chapter 8: Tips for the
practitioner: health promotion in the context of culture
This
chapter is a review and synthesis of the concepts of culture and cultural
competency from previous chapters. Use it as a review for these issues. For
example, how does culture effect how people interpret the source (and therefore
treatment) of disease? How does this effect health care seeking behavior? What
do you need to know about cross-cultural communication to be culturally
competent?
Student Outcome Assessment
(based on the Competency-Based Framework
for the Professional Development of Certified Health Education Specialists, The
National Commission for Health Education Certification, Inc.)
1. Assess individual and community needs for health education
(Resp I).
-Research
health of selected ethnic group by completing a panel project.
-Interview
member of selected ethnic group and complete a summary.
2. Implement health education programs (Resp III).
-Present a
group panel project and exhibit competence.
3. Act as a resource person in health education (Resp VI).
-Use the
computer and data bases effectively to meet research requirements.
-Establish
a consultative relationship with a health agency and prepare a culturally
relevant brochure/pamphlet for that
agency and their clients.
4. Communicate health education needs, concerns, and resources
(Resp VII).
-Present effectively to a group using multiple audio-visual aids and culturally relevant tools or icons.
-Be
prepared to discuss the selected readings by preparing notecards.
-Identify local, regional, and national agencies that serve
communities of color to be presented on your brochure/pamphlet.
-Evaluate effective ways to bridge
services and communication between providers and consumers of health care.
5. Have knowledge, skills, and beliefs related to the heath
care delivery system.
-Discuss, describe, and analyze the impact of politics and economics on the health care delivery system and be able to participate in influencing political decisions. Emphasis will be on undocumented immigrants, the impact of current demographics, and the historical discontent of communities of color.
-Be able to apply laws and
regulations that impact health care organizations.
-Discuss the major ethical issues
that are affecting health care and be able to articulate your own beliefs.
6. Describe the roles, responsibilities and functions of
various services within healthcare organizations and their quality of services.
-Identify
creative ways to provide services to underserved populations.
-Identify
effective health services.
7. Be able to develop program plans, including defining
problems in appropriate terms, setting goals and objectives, using statistical
data, interpreting published data, researching issues, developing alternatives,
and evaluating results and impacts. Describe research limitations and biases of
ethnic data.
Be able to
work in a team and conduct peer evaluations.
1. Panel project (keep YOUR OWN copy of the full presentation on
a CD!)