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Addressing Language and Culture Differences in Health Care Settings
Health care encounters can be stressful, compromising a patient’s ability to fully engage and understand. This is particularly challenging for patients who are limited-English proficient (LEP) and not able to speak, read, write or understand English at levels appropriate for successful encounters in healthcare settings. To provide quality care to the increasing number of LEP patients from different cultural backgrounds, health care practices have to bridge that communication gap with linguistically and culturally appropriate services
Racism and Health I: Pathways and Scientific Evidence
This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of nondominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities, and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health-damaging psychological responses, such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioral patterns that increase health risks
Racism and Health II: A Needed Research Agenda for Effective Interventions
This article reviews the empirical evidence that suggests that there is a solid foundation for more systematic research attention to the ways in which interventions that seek to reduce the multiple dimensions of racism can improve health and reduce disparities in health. First, research reveals that policies and procedures that seek to reduce institutional racism by improving neighborhood and educational quality and enhancing access to additional income, employment opportunities, and other desirable resources can improve health. Second, research is reviewed that shows that there is the potential to improve health through interventions that can reduce cultural racism at the societal and individual level. Finally, research is presented that suggests that the adverse consequences of racism on health can be reduced through policies that maximize the health-enhancing capacities of medical care, address the social factors that initiate and sustain risk behaviors, and empower individuals and communities to take control of their lives and health. Directions for future research are outlined