Addressing Multicultural Issues

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Addressing Multicultural Issues

• Enrique Caballero, MD
• Wendy Santis, MS
• Joslin Diabetes Center
• Affiliated Programs 18th Annual Meeting
• October 27, 2008

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What is Cultural Competence?
The knowledge and interpersonal skills that
allow providers to understand, appreciate, and
work with individuals from cultures other than
their own. It involves an awareness and
acceptance of cultural differences self
awareness knowledge of patients culture and
adaptation of skills. American Medical
Association
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Minorities in the US

• The nations minority population reached 100.7
  million in 2007
• The minority population in the U.S. is larger
  than the total population of all but 11
  countries
• Minority populations will become majority by 2042

U.S. Census Data
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U.S. Census Data, Released MAY 17, 2007

7/1/05 Population 7/1/06 Population Change 7/1/05 to 7/1/06 of Total Population
7/1/05 Population 7/1/06 Population Change 7/1/05 to 7/1/06 of Total Population
White Alone or in Combination 241,837,199 243,825,488 0.82 81.44
AFAM Alone or in Combination 39,718,528 40,240,898 1.32 13.44
AIAN Alone or in Combination 4,453,026 4,497,895 1.01 1.50
Asian Alone or in Combination 14,447,663 14,907,198 3.18 4.98
NHPI Alone or in Combination 991,067 1,007,644 1.67 0.34
Latino 42,872,091 44,321,038 3.38 14.80
AFAM-African American, AIAN-American Indian and
Alaskan Native, NHPI Native Hawaiian and
Pacific Islander
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Global Projections for theDiabetes Epidemic
20032025
EUR
NA
48.4 M 58.6 M ?21
SEA
23.0 M 36.2 M ?57.0
39.3 M 81.6 M ?108
WP
EMME
43.0 M 75.8 M ?79
19.2 M 39.4 M ?105
AFR
7.1M 15.0 M ?111
SACA
14.2 M 26.2 M ?85
World 2003 194 M 2025 333 M ? 72
2003 2025
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Model for Cross-Cultural Care A Patient-Based
Approach
Tools and skills necessary to provide quality
care to any patient we see, regardless of race,
ethnicity, culture, class or language proficiency.
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Models

• LEARN Listen, Explain, Acknowledge, Recommend,
  Negotiate
• BATHE Background, Affect, Trouble, Handling,
  Empathy
• ETHNIC Explain, Treatment, Healers,Negotiation,
  Intervention,Collaboration
• ESFT Explanatory model, Social risk, Fears,
  Treatment

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The Latino Diabetes Initiative

• Our goal
• Improve the lives of Latinos affected by diabetes
  or at risk for the disease through culturally
  oriented patient care, education, outreach and
  research

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LDI Culturally Oriented Care
Patient Education Program
Outcomes Evaluation System
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Asian American Diabetes Initiative
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Current Projects

• Continuation of Diet Study
• Expansion of the Asian Clinic
• Larger scale community outreach
• Development of culturally and linguistically
  appropriate educational materials in various
  languages
• Enhancement of AADI website

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THANK YOU