aligning cultural competence and health equity · pdf file · 2017-09-19aligning...

Renée Branch Canady, PhD, MPA

CEO, MI Public Heath Institute MHVI Conference

August 7, 2015

Aligning Cultural Competence and

Health Equity: Engaging, Educating, & Empowering

4 Levels of Oppression and Change

Feelings, beliefs, values

Personal

Interpersonal

Institutional

Cultural

Actions, behaviors, language

Rules, policies, procedures, norms

Collective ideas about what is normal, true, right, beautiful

© VISIONS, Inc.

A System of Oppression

A Health Equity Lens Health Equity - A fair, just distribution of the social resources and social opportunities needed to achieve well-being.

Social Justice - The absence of unfair, unjust advantage or privilege based on race, class, gender, or other forms of difference

• Seeks out what is unfair in order to reverse or avoid it

• Aspires to apply justice in serving women and families

• Recognizes the impact of social resources on the care and

behavior of women and families

• Identifies and facilitates social opportunities for women and families to readily/easily attain well-being .

• Cultural Competency – a diversity model that

requires those providing the service to take on the responsibility for attending to issues of culture and diversity in the ‘helping relationship’.

• Definition – the ability to utilize culture in the resolution of a human need.

(adapted from James Green-Social Work)

Cultural Competency as Part of the Solution

“You have little power with those who feel your underlying contempt.”

Martin Luther King, Jr.

• Most models of Cultural Competency challenge us to consider our own biases and prejudices (or even preferences).

• It is difficult to respect the importance of culture in the lives of others if you are not in touch with your own culture.

Self Assessment

Conscious Competence

Unconscious Competence

Conscious Incompetence

Unconscious Incompetence

Purnell Model of Cultural Competence (A Self Assessment)

“Have you ASKED the right questions”

• Awareness • Skill • Knowledge • Encounter • Desire Josepha Campinha-Bacote,

“Teaching an old dog new tricks”

• Implicit Bias • Internalized Racism • Socialization and awareness https://www.youtube.com/watch?v=Ahg6qcgoay4 • Changing the narrative

“Treating everyone the same” when conditions are inequitable only reinforces the status quo

Seeing the Change & Being the Change:

Lillian Wald – An Example of Nursing Power and Influence

Seeing the Change & Being the Change

“It is very pleasant to return to my old home…In coming back to Rochester, I inevitably compare the physical advantage of the children who are brought to manhood and womanhood in this environment with those of the children with whom my lot in life has been cast

these many years.”

RECOGNITION

Seeing the Change & Being the Change

“Many years familiarity with the children's attempts to play in the streets has not made me indifferent to its pathos, which is not the less real because the children are unconscious of it. In the midst of the pushcart

market, with its noise, confusion, and jostling, the checker or crokinole board is precariously perched on top of a hydrant, constantly knocked over by the crowd and patiently replaced by the little children.”

ASSET & RESILIENCE

“ Over broken asphalt, over dirty mattresses and heaps of refuse we went... There were two rooms and a family of seven not only lived here but shared their quarters with boarders... [I felt] ashamed of being a part of society that permitted such conditions to exist...

What I had seen had shown me where my path lay.”

Seeing the Change & Being the Change

PASSION & INVESTMENT

“Be not weary in well doing, for in due season you will reap if you faint not.”

The Book of Galatians