Working with Diverse Populations: Cultural Competency

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Working with Diverse PopulationsCultural
Competency
Roxanne Felix Edmonton Mennonite Center for
Newcomers rfelix_at_emcn.ab.ca
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Today

• Who is Alberta today?
• Diversity - Why Account for Vulnerable
  Populations?
• Culture
• Cultural Competence
• the first three steps

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What is Diversity?
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Canada Who are we?

• 18.4 of the Canadians population of 2001 was
  foreign born
• Only one other country has a higher foreign born
  proportion of its population (Australia- at 22)
• Source Annual Report to Parliament on
  Immigration 2005 Citizenship and Immigration
  Canada, p.7

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Canada Who will we be?

• By 2011, Statistics Canada projections indicate
  that all of Albertas labour market growth will
  be through immigration

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Alberta Who are we?

• The visible minority population in Calgary and
  Edmonton is about 25 1
• By 2001, Calgary had become the 4th most
  ethnically diverse urban area in Canada6

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Alberta -Who are we?

• Alberta is the 4th most popular destination for
  immigrants and refugees (about 16 000 per year).
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• 90 of immigrants settled in one of five cities
  Calgary, Edmonton, Red Deer, Lethbridge and
  Medicine Hat. 2

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Alberta Who are we?

• 98 000 children (13.3) in Alberta live in
  poverty 3
• Aboriginal children, visible minority and
  immigrant families are two to three times as
  likely to be living in poverty 3
• Poverty -- 46 of immigrants and refugees in
  Edmonton are living in poverty, of whom 60 are
  working poor (Vibrant Communities, 2003).

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Edmonton who are we?

• In 2005, 5,670 immigrants came to the City of
  Edmonton.
• Over the past 5 years, Calgary has received twice
  as many immigrants as Edmonton
• 2004 figures for Immigration by City (Alberta)
• Edmonton - 29.2
• Calgary - 56.5
• Source Alberta Human Resources and Employment
  Alberta Profiles Immigrants in the Labour force.
  Feb/2006
• Source  New Canadians and Visible Minorities -
  Edmonton Social Plan  Business Planning
  Strategic Services of the City of Edmonton
  Community Services - May 2006

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Internal Migration due to Economic Opportunities
in Alberta

• Many immigrant and refugee families from eastern
  and central Canada moved to Edmonton this summer

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Who is a Refugee?

• A person who is outside his/her country of
  nationality or habitual residence has a
  well-founded fear of persecution because of
  his/her race, religion, nationality, membership
  in a particular social group or political
  opinion
• 1951 Convention relating to the Status of
  Refugees

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Immigration to Alberta by Immigrant Class, 2004
Source IMM Immigration Data from Citizenship and
Immigration Canada (CIC) - Landing File, Second
Quarter 2005 Version
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two streams of refugees

• Refugee claimants landed in Canada and their
  dependants landed from abroad (70)
• LSC Pakistan, China, Sri Lanka, Columbia,
  Zimbabwe
• Government assisted and privately sponsored
  refugees (30)
• LSC Afghanistan, Columbia, Sudan, Ethiopia

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The journey from home country to Canada The
Immigrant Refugee Experience (fr. MCHB)
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In fact Alberta is Diverse

• Visible ways
• race, gender, disability, age
• Less visible
• culture, religious beliefs, socio-economic
  status, sexual orientation, geographic location

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Diversity

• Diversity is a framework of social inclusiveness
  .7
• Diversity is about recognizing and valuing
  difference, as a resource and a reality of every
  day life. 4

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So what?

• A number of these diverse groups (Aboriginal,
  disabilities, visible minorities, low
  socio-economic status) have higher rates of
  health related problems compared to the rest of
  the Canadian population
• lower life expectancy, higher infant mortality,
  higher rate of suicide
• lower rates of cervical or breast cancer
  screening, higher rates of smoking other
  unhealthy practices

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Health Inequities

• systematically puts groups of people who are
  already socially disadvantaged (for example by
  virtue of being poor or disenfranchised) at a
  further disadvantage with respect to their
  health
• Good health is essential to wellbeing and to
  overcoming other effects of social disadvantage 5

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What do we do about Health Inequities
Focus on changing mainstream programs and
services
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What do we do about Health Inequities
Involve the vulnerable communities meaningfully
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What do we do about Health Inequities ?
Remember Interventions can be considered
successful only when they are at least as
effective for the most vulnerable as for the
least.
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Just remember

• Human service organizations that engage in the
  process towards diversity competency need to
  view themselves as learning institutions.
• They need to tolerate and expect ambiguity, to
  try new things, to ask questions, to revise
  assumptions and to take risk.
• (Cultural Comptency a Self-Assessment Guide for
  Human Service Organizations, Cultural Diversity
  Institute, 2000).

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Working Against Health Inequities
One Strategy Become Culturally Competent
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What is culture?
One way that Albertans are diverse
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Being Culturally Competent

• Knowledge, attitudes, skills and protocols that
  allow an individual or system to render services
  across cultural lines in an optimal manner. It
  permits individuals to respond with respect and
  empathy to people of all backgrounds. 9

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Being Culturally Competent

• Complex set of skills
• Today first set
• Be aware that you have a culture
• Be aware that culture affects everything
• Overcome the Golden Rule Platinum Rule
  (Bennett, 1979)

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Step One
Be aware that you have a culture.
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Culture

• Totality of ideas, beliefs, values, knowledge,
  norms, communication styles and way of life of a
  group of individuals who share certain ethnic,
  historical, linguistic, racial, religious and
  social background. It is complex and
  dynamic. 8
• (Department of Public Health Sciences,
  University of Toronto)

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Culture can be .

• Nationality
• Ethnicity

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Culture can be .

• Regional
• Language
• Gender
• Age
• Physical Ability

• Sexual Orientation
• Religion
• Politics
• Class
• Organizational
• Functional

Anything that leads people to interact more
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Culture can be .

• Urban vs. Rural
• Having Kids
• Smokers vs. non-smokers
• Living with an extended family

• Marathon runners
• OTHER??

Anything that leads people to interact more
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Being Aware

• Think of two cultural groups with which you
  identify.
• What stereotype about one of these cultures does
  not apply to you personally?

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Cultures
Gender
Nationality
Religion
Rural
Ethnicity
Occupation
Western Canada
Age
Language
Ability
Class
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Step Two
Be aware that culture affects everything.
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Culture affects

• Non-Verbal Communication
• Verbal communication
• Formality
• Conversational style
• Pitch
• Linear vs. Circular

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Communication Styles
Wasting time, scattered
Brusque, rude
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Culture Affects

• Sense of Time
• Sense of Space
• Friendships and Family Relationships
• Authority and Decision-Making
• Beliefs about causes of illness

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Culture will then affect

• Learning style
• Compliance
• Relationship with you as a professional
• Trust
• What kind of information they share

Health Outcomes
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Cultural awareness

• recognition that the basic ways of learning,
  behavior and ways of thinking and perceiving are
  culturally conditioned 8

Leads to better practice whatever your
profession might be
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Step Three
Overcome the Golden Rule Use the Platinum Rule
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Cross-Cultural Interaction

• Cross-cultural interaction are present any time
  two persons talk and listen to one another, since
  no two persons have lived identical lives nor
  have identical backgrounds
• CIDA, 1986

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The Platinum Rule

• Golden Rule Assumption of similarity
• Platinum Rule Assumption of differences

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The Platinum Rule

• Golden Rule Assumption of similarity
• Platinum Rule Assumption of differences
• Do unto others as they would have done unto them
  OR
• At least be aware of how people want to be
  treated and be prepared to explain why youre
  not doing it
• (Bennett, MJ 1979)

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Review

• Diversity
• Culture
• Cultural Competency

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Step One

• Be aware that you have a .

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Step Two

• Be aware that culture affects

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Step Three

• Overcome the Golden Rule and use the

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Ask not what disease the person has, but rather
what person the disease has.William Osler, MD
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Contact Information

• If you want more resources (websites, articles,
  books etc.) or want the references used in this
  presentation
• Roxanne Felix
• rfelix_at_emcn.ab.ca
• 780-423-9517