A Multicultural Approach to Health Care Delivery:

When “good”, “fair” and “equal” ≠ “same”

Andrea Monroe,

Diversity Consulting and Training

andreaucsc@yahoo.com / 831.459.7519

Course: Social Justice / Professor Melanie Dupuis

UC-Santa Cruz, May 10, 2007

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Warm up: How would YOU respond?

• Review the scenario (see handout)

• In groups of 4, discuss how you might respond to this client.

• Group will be asked to share their perspectives following role play

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Learning outcomes:Today we’ll think and talk about..

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1. What does a “multicultural approach” to social justice issues look like? Why would it be useful in regards to health care? Education? Other arenas?

2. What are key concepts and components regarding the goal of multiculturalism, i.e., multicultural competency?

3. What are the strengths and limitations of embracing a multicultural approach?

Overview

• Introductions/warm-up/role play:

The impact of culture on health care & outcomes

• Learning outcomes for today

• Key concepts & components: Framework for learning and teaching multicultural competency

• Comparison to past and other approaches: “Even the mice were white”

• Wrap-up & your feedback

What is a“multicultural” or “diversity” approach

to social justice issues?

• “Resist” assumptions “that there is only one correct or normal way to understand and structure relevant areas of life” (Parekh)

• “Color-blindness” seen as an “ill-founded” and impossible goal (Fanelly, p 263)

• Recognize difference between members of a political vs cultural community (Kymlicka)

What is a“multicultural” or “diversity” approach?

• Endorse “politics of recognition” (Taylor) -- people are social beings with differing cultural values based on experiences, traditions, customs, etc

• Recognize that “good/best/fair” practices and process will look different for diverse cultural groups – replace “golden rule” with “platinum rule” (Edith Ng, UC-Berkeley). Examples?

• Recognize that true/successful multicultural organizations are equally committed to cultural diversity and social/political equality (Hardiman, Jackson, U-Mass Amerherst)

Concepts & components:Framework for learning and teaching

multicultural competency

• Types of organizations and goals: Monocultural…diverse…inclusive….multicultural

• EEO/AA laws, policies and practices --- necessary but not sufficient

• Components of multicultural competency: Do I choose to be ASKED?

Components of Multicultural Competency: Do I choose to be ASKED?

• Aware

• Skilled

• Knowledgeable

• Energized

• Desiring

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Awareness:Necessary (not sufficient) for multicultural competency

If you can’t see that your own culture has its

own set of interests, emotions, and biases,

how can you expect to deal successfully

with someone else’s culture? Dr. Arthur Kleinn, Harvard Medical School

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(1) Timeline of cultural “ah-ha’s” –Draw a timeline, dividing your life into 4 equal time periods. Reflect and note on your timeline: When (age) and how did you learn about cultural and social differences? Privilege, prejudice and discrimination? Were your learning experiences positive or negative? Life changing? How did others around help you make sense of what you experienced?

(2) Family cultural autobiography: Take time to interview family and community members about the multicultural history and experiences within each group. When and why did your family settle where they did? What kinds of cultural diversity exists within your own family, immediate and extended? What were your parents and grandparents experiences with people from diverse cultures? How did they deal with (and teach you to deal with) cultural/social diversity, privilege/oppression, and related issues?

Awareness building exercises

Comparison to past and other approaches: “Even the mice were white”…

Legacy of the past:

Monocultural approaches to health/science research

“Color blind” health care delivery:

What would it look like? Strengths & limitations

Multiculturally-competent health care delivery:

Is it realistic and sustainable? Strengths & limitations

Summary

Embracing a multicultural approach

…is labor and time intensive –- requires more and diverse “human” resources, continuing education and training (bilingual skills, communication conflict resolution skills), and sufficient time for collaboration.

…forces choices between efficiency, expediency and inclusiveness; “majority rule” no longer sole process for decision making. Requires innovative, patient and courageous leadership and “follower-ship”!

…requires an ability to tolerate and thrive amidst constant change and ambiguity.

…requires a commitment to ongoing, lifelong (and humbling) personal work – you’re never “100% multiculturally competent”.

Wrap up / feedback

On the index card provided, please give (anonymous)feedback:

• What was most helpful about today’s presentation?

• What was least helpful or confusing about today’s presentation?

• What burning questions (1-2) do you leave with?

• How might you use the information presented today?