Paving the way… because it truly is a journey… sometimes smooth… sometimes bumpy… sometimes fast and sometimes very, very slow. Sometimes we find ourselves asking “Are we there yet?” “Was that my exit?”
We are in search of what is equitable. A health disparity is a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.Health equity is the attainment of the highest level of health for all people. Achieving health equity requires everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities. Adopted from the OMHNPA
Culture is the integrated pattern of thoughts, communications, actions, customs, beliefs, values and institutions associated wholly or partially on racial, ethnic, religious, spiritual, linguistic, biological, socioeconomic, geographical or sociological characteristics. --Racial and ethnic groups include, but are not limited to, those defined in the US census and other communities. Religious and spiritual characteristics include beliefs, practices and support systems related to how an individual finds and defines meaning in their life.Biological characteristics include age, sex, sexual orientation, gender identity and physical ability or limitations. Geographical characteristics include where one resides, whether it be urban, rural or suburban, one’s country of origin or one’s environment and surroundings. Language characteristics – what language, what dialect, when and where did they learn it? What do they speak at home? Who do they speak Sociological characteristics include length of residency in the US, generation, gender, gender expression, political beliefs, perceptions of family and community, perceptions of health and well-being, perceptions/beliefs around diet and nutrition, occupational groups, military affiliation, education level, and family and household composition.
Today’s presentation will focus on the policy portion of this definition…
Cultural and linguistic competence – providing language access services – isn’t new…
So we have been talking about our journey and paving the way…
And why are we on this journey? because Communication is complicated… even when we speak the same language… Jay/Evan Fib & LieHoney, the trash is full.Doctor/Patient Do you drink alcohol, no, but sometimes I drink beer.Unfortunately we don’t all have capes or magic wands or even super powers to suddenly become “MEDICAL DE-JARGONIZERS” What we do have are policies, guidelines and best and promising practices.
This map comes from the National Conference of State Legislatures. I have included their website at the end of this presentation for those who are interested in exploring more. Since 2005, 35 states have created statewide strategic plans to address health disparities. Of the 35 states with plans:18 are legislative initiatives 16 states have plans that are initiatives of the Department of Health State of Pennsylvania has a plan created by a governor’s taskforce.
This is a table of contents from a document produced by the National Health Law Program. 50 states plus the District of Columbia all have legislation or policy in place in regards to language access services.
We are in search of what is compassionate – respectful - equitable.
The State Board of Medical Examiners shall prescribe the following requirements for physician training, by regulation, in consultation with the Commission on Higher Education: The curriculum in each college of medicine in this State shall include instruction in cultural competency designed to Completion of cultural competency instruction [] shall be required as a condition of receiving a diploma from a college of medicine in this State. A college of medicine which includes instruction in cultural competency [] shall offer for continuing education credit, cultural competency training which is provided through classroom instruction, workshops or other educational programs [] A person who received a diploma from a college of medicine in this State prior to the effective date of regulations [], as a condition of initial licensure by the board, to document completion of cultural competency training … A physician licensed to practice medicine in this State shall be required, as a condition of relicensure, to document completion of cultural competency training [] to the satisfaction of the board no later than three years after the effective date of this act.I will share some preliminary results from a New Jersey case study that illustrates some of the impact that this legislation has had.
This 2009 legislation adds a fifth mandate for continuing medical education in the area of cultural competency for licensing and renewals after Oct. 1, 2010. As now in effect: A licensee applying for license renewal shall earn a minimum of fifty contact hours of continuing medical education within the preceding twenty-four-month period.