Cultural competency as it intersects with racial/ethnic, linguistic, and class disparities in managed healthcare organizations.

Culture in and of itself is not the most central variable in the patient-provider encounter. The effect of culture is most pronounced when it intersects with low education, low literacy skills, limited proficiency in English, culture-specific values regarding the authority of the physician, and poor assertiveness skills. These dimensions require attention in Medicaid managed care settings. However, the promise of better-coordinated and higher quality care for low-income and working-poor racial/ethnic populations--at a lower cost to government--has yet to be fully realized. This paper identifies strategies to reduce disparities in access to healthcare that call for partnerships across government agencies and between federal and state governments, provider institutions, and community organizations. Lessons learned from successful precedents must drive the development of new programs in Medicaid managed care organizations (MCOs) to reduce disparities. Collection of population-based data and analyses by race, ethnicity, education level, and patient's primary language are critical steps for MCOs to better understand their patients' healthcare status and improve their care. Research and experience have shown that by acknowledging the unique healthcare conditions of low-income racial and ethnic minority populations and by recruiting and hiring primary care providers who have a commitment to treat underserved populations, costs are reduced and patients are more satisfied with the quality of care

Latino Health Status

Health status data for Latinos have become increasingly available, and significant progress has been made in data collection methods over the past decade. This chapter provides an overview of national data on morbidity and mortality among Latin populations in comparison with such data on African Americans and Whites. The writing f this book takes place at the outset of a major shift in national health policy. Launched in January 2000 (see United States Department of Health and Human Services, 2000),, the national disease prevention and health promotion agenda for the year 2010 have an overarching goal of eliminating disparities

Beyond role strain: Work–family sacrifice among underrepresented minority faculty

Objective This study describes the perceived work demands and family caregiving obligations associated with work–family life among URM faculty and the coping strategies used to negotiate the integration of roles. Background Past research on families focuses primarily on professional majority-culture families and often fails to include traditionally and historically underrepresented minority (URM) families. The study of how URM professionals negotiate work and family obligations and economic and institutional constraints remains relatively absent in the family science discourse. Method In-depth individual and group interviews (N = 58) were conducted with US-born African American, Mexican American, and Puerto Rican faculty at research universities. Results The overarching theorizing anchor that grounded the themes was sacrifice. Three themes emerged: excessive work demands/role strain; commitments and caregiving obligations to family of origin and nuclear family; and few coping strategies and resources to maintain a balanced life. Conclusion This analysis offers insight into the multiple factors that affect the experiences of URM academics in their workplaces that deeply influence work roles and self-care and its impact on family roles. These data fill a gap by applying alternative frameworks to explore the work–family nexus among racialized groups. Implications New research frontiers are offered to study the work–family nexus for URM faculty and how higher education can respond to alleviate excessive work demands and work–family life conflicts.https://doi.org/10.1111/jomf.1286

Early career Latinas in STEM: Challenges and solutions

Mexican, Puerto Rican, and Central American Ancestry (MPRCA) individuals represent 82% of US Latinos. An intergenerational group of MPRCA women and allies met to discuss persistent underrepresentation of MPRCA women in STEM, identifying multi-level challenges and solutions. Implementation of these solutions is important and will benefit MPRCA women and the entire academic community