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Expert Delivers Strategies For Cultural Competence In Health Care; Sees Opportunity In Health Care Reform

Originally Posted: March 28, 2010

Albany - Dr. Grace Mose, an expert on cultural diversity and women's reproductive issues, delivered strategies for providing more culturally-competent health care services and sees the expansion of health care coverage to tens of millions of Americans as an opportunity for providers to forge new relationships among culturally diverse communities.

In a presentation this week to nearly 100 health and human service professionals from New York's Capital Region and hosted by Community Cradle, Mose partially attributed broad disparities in health among African Americans and African immigrants to a longstanding mistrust in the health care system among these underserved populations.

"Many blacks and immigrants believe the health care system doesn't work for them," said Mose. Enduring and largely unrecognized stereotypes ingrained in treatment services by well-meaning providers have caused many blacks to avoid seeking preventative health care services and many black women from seeking prenatal care, according to Mose. Employing hard-hitting statistics and personal anecdotes, Mose, who emigrated from Kenya to the U.S. in 1999, exposed what she called "astounding and mind-boggling" health disparities among black populations.

According to the Centers for Disease Control and Prevention (CDC), African Americans have more disease, disability, and early death than Caucasians. Blacks are four times as likely as whites to become obese and twice as likely to develop diabetes. White women, however, are more likely to develop breast cancer than black women, but black women are more likely to die from the disease. And, despite making up 13.5 percent of the population, blacks account for over 50 percent of all new H.I.V. cases.

To address these disparities, Mose delivered strategies for health professionals to provide more culturally-competent services in order to promote an unprecedented trust in the health care system among black populations. She called on providers to determine what each individual patient expects from the provider and what each patient considers successful treatment. "It takes more than goodwill to end discrimination," said Mose. "It takes awareness and walking the walk."

Mose outlined the priorities for health and human services professionals in working with culturally diverse patients and clients:

 • Accept and explore cultural variations.
 • Build a trusting relationship/partnership.
 • Teach the patient/client about his or her health.
 • Allow the patient to teach you about their needs and culture.
 • Empower your patient/client.
 • Critique yourself for biases and stereotypes and deal with them.

"When you meet a patient, you are only seeing the tip of the iceberg," said Mose, referring to the complex web of financial circumstances, unrecognized stereotypes, and cultural traditions in which people are enmeshed. "Respectful dialogue leads to learning for both the patient and provider." Mose also charged that patients need to be their own best advocates rather than being dissatisfied and avoiding seeking care.

The half-day program kicked off with panelists who have worked with African women in three African countries and have seen first hand the barriers that confront African women in their countries of origin. Later, several African and African American women related their personal stories and negative health care experiences to a captivated audience.

Mose acknowledged that it would be impossible for health care providers to learn everything about every culture, especially since cultures are constantly evolving. But, according to Mose, "embracing cultural competence skills will enable health care providers to work successfully with practically any community."

In her current capacity as director of Immigrant Women's Health Initiative of the Education Fund of Family Planning Advocates of New York State, Mose leads cultural-competency workshops for health care providers.

Dr. Mose is an expert on cultural diversity and women's reproductive issues. She is the author of "Thinking the Gusii Way: Insider Perspectives on Female Genital Mutilation (FGM)/Cutting and Strategies for Change." Dr. Mose has a Doctorate in Women's Studies and Anthropology from the State University of New York at Albany. She is currently directing the Immigrant Women's Health Initiative at Family Planning Advocates of New York State where she promotes cultural and linguistic competence among family planning providers.

Immigrant Women's Health Initiative, a project of the Education Fund of Family Planning Advocates, works with immigrant women and family planning providers to develop strategies to increase access to culturally and linguistically competent reproductive health services. Family planning clinics are often the sole source of health care for uninsured and underinsured women. Due to the numerous barriers faced by both immigrant women and providers in our health care system, these clinics are finding it challenging to fully address the needs of immigrant women.

For more information go to www.edfundfpa.org.

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