Social Determinants of Health: Cultural Competence Is Not Enough

2016 ◽  
Vol 22 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Dorothy L. Powell
Keyword(s):  
Health Disparities ◽  
Nursing Students ◽  
Cultural Competence ◽  
The United States ◽  
Cross Cultural ◽  
Cultural Immersion ◽  
Quality Health Care ◽  
Immersion Programs ◽  
Quality Health ◽  
High Quality Health Care

In our nation of rapidly growing diversity and increasing cross-cultural interactions, cultural competence has been recognized as critical for reducing health disparities and improving access to high-quality health care. However, more than a decade of experience in establishing, developing, and implementing cultural immersion programs for nursing students in the United States and in developing countries has convinced this scholar that although cultural competence is of critical importance, many other factors need to be examined and kept in mind as we continue to take on the monumental challenge of eliminating health disparities. This article presents the background and context of current efforts to eliminate health disparities and points out some other key considerations that will be vital in achieving the desired outcome.

Response to Dr Stone

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 850-851
Author(s):  
Howard A. Pearson
Keyword(s):  
Nurse Practitioners ◽  
Cost Effective ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Quality Health Care ◽  
Quality Cost ◽  
Health Maintenance ◽  
Effective Care ◽  
Quality Health

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.

scholarly journals Defining high quality health care

2009 ◽  
Vol 27 (4) ◽  
pp. 411-416 ◽  
Author(s):  
Matthew R. Cooperberg ◽  
John D. Birkmeyer ◽  
Mark S. Litwin
Keyword(s):  
Health Care ◽  
High Quality ◽  
Quality Health Care ◽  
Quality Health ◽  
High Quality Health Care

The Benefits and Challenges of Becoming Cross-Culturally Competent Counseling Psychologists

2006 ◽  
Vol 34 (1) ◽  
pp. 147-172 ◽  
Author(s):  
P. Paul Heppner
Keyword(s):  
Cultural Competence ◽  
Cultural Context ◽  
Counseling Psychology ◽  
The United States ◽  
Knowledge Bases ◽  
Cross Cultural ◽  
Culturally Competent ◽  
Mental Health Needs ◽  
Different Populations ◽  
Counseling Psychologists

The central thesis of this article is that focusing on cross-cultural competence will enhance both the science and the practice of counseling psychology. Developing cross-cultural competence is a lifelong journey, replete with many joys and challenges, that will (a) increase the sophistication of our research, (b) expand the utility and generalizability of the knowledge bases in counseling psychology, (c) promote a deeper realization that counseling occurs in a cultural context, and (d) increase not only counseling effectiveness but also the profession’s ability to address diverse mental health needs across different populations around the globe. In the future, (a) counseling psychologists will be expected to have an array of cross-cultural competencies, which emphasizes the need to systematically train students to acquire such competencies, and (b) counseling psychology will no longer be defined as counseling psychology within the United States, but rather, the parameters of counseling psychology will cross many countries and many cultures.

scholarly journals Social Distancing and Incarceration: Policy and Management Strategies to Reduce COVID-19 Transmission and Promote Health Equity Through Decarceration

2020 ◽  
Vol 47 (4) ◽  
pp. 536-539 ◽  
Author(s):  
Brandy F. Henry
Keyword(s):  
Health Equity ◽  
Management Strategies ◽  
The United States ◽  
Quality Health Care ◽  
Potential Health ◽  
Behavioral Health Disorders ◽  
Quality Health ◽  
History Of ◽  
Prison Populations ◽  
The Impact

Incarcerated people are at disproportionately high risk of contracting COVID-19. Prisons are epicenters for COVID-19 transmission, including to the community. High rates of preexisting health conditions, limited access to quality health care, and inability to social distance make it impossible to reduce the impact of COVID-19 in prisons. Due to a history of compounded social determinants, incarcerated populations are disproportionately composed of people of color and people with stigmatized behavioral health disorders. Rapid decarceration is needed to promote health equity. Historical mass decarceration events demonstrate feasibility to rapidly release large groups of people while maintaining public safety. Iran and Ireland have released substantial portions of their prison populations by transitioning people to home confinement. In the United States and Uganda, some jurisdictions have reduced new incarcerations through policies that decrease arrests. These policies must be globally expanded to contain the epidemic, and its potential health consequences, while addressing health equity.

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