Health Care Cultural Competence Chapter

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Cultural Competence

The culture that I have chosen is Native Americans, which for U.S. government purposes are usually defined as Native Americans and Alaskan Natives. This is an umbrella group for all of the different tribes, and people descended from those tribes, so there can be significant cultural differences between the groups. This group often suffers from health care outcomes that are worse than those in the general population. The leading causes of morbidity/mortality among this group have been identified as motor vehicle accidents, suicide, firearms and homicide in order. While motor vehicle accidents are the highest cause among whites as well, the rate of such among Native Americans is more than double either whites or blacks. Suicide rates among Native Americans are nearly five times what they are for whites or blacks. Firearm rates are much higher than those of whites, but lower than those for blacks. The homicide rate is one-third that of blacks, but more than double the rate for whites (CDC, 2003).

There are several barriers within this cultural to seeking and receiving health care services. First, many live on reservations, where access to health care services is substandard. This is a situation in part caused by the fact that on-reserve health care is funded federally, and wages are lower than in adjacent off-reserve areas, leading to a shortage of health care professionals.

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Poverty is another issue that affects access to health care. Further, there is historical mistrust of government among this group, who are less likely to seek out health care as the result of this mistrust (Guadognolo, 2009).

In many instances, the cultural mistrust of health care is threefold. First, there is general mistrust of government. Second, there is mistrust in the quality of medicine that is generally available to members of this community, as it is often underfunded and substandard. Third, many Native Americans adhere to native healing traditions. They have been slower to convert to modern, Western medicine in some communities, as traditional medicine is a part of their cultural heritage and is held in some importance.

Native healing traditions often need to be incorporated into modern health treatment, as they will be sought anyway. Modern medicine often needs to be framed in terms of being a complement to indigineous healing traditions. This healing is different for each tribe, but incorporates a variety of elements including religion, spirituality, herbal medicine and rituals….....

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