RespectingRespecting Differences,Differences, CelebratingCelebrating DiversityDiversity Understanding and Working with Health Care Clients and Students from Other Cultures Kern Resource Center 5801 Sundale Avenue Bakersfield, CA 93309 (661) 827-3266 (661) 827-3304 (fax) www.health-careers.org October 2005 ○○○○○○○○ 2 ○○○○○○○○○○○○○○○○○○○○○ Respecting Differences, Celebrating Diversity: This project is supported by Carl D. Perkins Vocational Education Act of 1998 funds (Title 1, Part A, Section 112), P.L. 105-332, administered by the California Department of Education. The activity which is the subject of this handbook is supported in whole or in part by the U.S. Department of Education and the California Department of Education. However, the opinions expressed herein do not necessarily reflect the position of either the U.S. Department of Education or the California Department of Education, and no official endorsement by the U.S. Department of Education or the California Department of Education should be inferred. Understanding and Working with Health Care Clients and Students from Other Cultures ○○○○○○○ 3 Contents Basic Information Introduction ___________________________________________________________________________________ 7 Immigration Facts ______________________________________________________________________________ 7 Legal Status _________________________________________________________________________________ 8 Countries of Origin ___________________________________________________________________________ 8 English Language Proficiency ___________________________________________________________________ 9 Refugees ____________________________________________________________________________________ 9 Working with Health Care Clients from Other Cultures _______________________________________________ 10 Clients Who Speak Little or No English __________________________________________________________ 10 Culturally Competent Health Care ______________________________________________________________ 12 Suggestions for Culturally Competent Patient Interaction __________________________________________ 14 Cultural Concerns in Caring for the Dying Patient ________________________________________________ 17 Working with Latino/Hispanic Clients ___________________________________________________________ 17 Working with Asian Clients ____________________________________________________________________ 19 Working with Middle-Eastern Clients ___________________________________________________________ 20 Religion and Health Care _______________________________________________________________________ 21 Buddhism ________________________________________________________________________________ 22 Islam ____________________________________________________________________________________ 22 Confucianism _____________________________________________________________________________ 23 Taoism ___________________________________________________________________________________ 23 Complementary and Alternative Medicine __________________________________________________________ 25 Working with Students _________________________________________________________________________ 26 Immigrants and English Language Learners in California Schools _____________________________________ 26 Latinos in California High Schools ______________________________________________________________ 27 What’s in a Name? ___________________________________________________________________________ 27 Culturally Competent Teaching _________________________________________________________________ 28 Conclusion ___________________________________________________________________________________ 32 References and Resources ________________________________________________________________________ 33 Countries of Origin for California’s Largest Immigrant Groups Latin America Mexico ____________________________________________________________________________________ 39 El Salvador _________________________________________________________________________________ 49 Guatemala __________________________________________________________________________________ 57 Eastern Asia China _____________________________________________________________________________________ 67 South Korea ________________________________________________________________________________ 79 Japan ______________________________________________________________________________________ 87 ○○○○○○○○ 4 ○○○○○○○○○○○○○○○○○○○○○ Respecting Differences, Celebrating Diversity: Contents, cont. Southeast Asia Philippines _________________________________________________________________________________ 99 Vietnam ___________________________________________________________________________________ 107 Laos _______________________________________________________________________________________ 115 Thailand ___________________________________________________________________________________ 125 Cambodia __________________________________________________________________________________ 133 Other Countries India ______________________________________________________________________________________ 145 Iran _______________________________________________________________________________________ 153 Armenia ___________________________________________________________________________________ 163 Russia _____________________________________________________________________________________ 169 Basic Information Introduction Immigration Facts Working with Health Care Clients from Other Cultures Religion and Health Care Complementary and Alternative Medicine Working with Students Conclusion ○○○○○○○○○○○○○○○○○○○○○○○○ 6 ○○○○○ Respecting Differences, Celebrating Diversity: Understanding and Working with Health Care Clients and Students from Other Cultures ○○○○○○○ 7 Introduction Virtually every health care professional and educator in California encounters immigrants Virtually every health care as a regular part of the day’s work. Whether these interactions are positive or negative, professional and educa- satisfying or frustrating, depends at least in part on the knowledge and understanding the tor in California encoun- ters immigrants as a regu- health care professional or educator brings to the encounter. We all have good days and bad lar part of the day’s work. days in which we meet the full range of clients and students, but even on the worst of days Whether these interac- with the most recalcitrant client or unresponsive student, understanding where that client tions are positive or nega- or student is coming from will almost always contribute to a positive outcome. tive, satisfying or frustrat- This handbook provides basic information about the countries from which California’s ing, depends at least in largest immigrant groups come. As of the 2000 census, Hispanics—both immigrants and part on the knowledge California-born—made up 32 percent of our state’s population, with the majority of new and understanding the immigrants coming from Mexico. According to the 2003 American Community Survey, health care professional nearly 10 million California residents have Mexican heritage. Together with Asians and or educator brings to the encounter. other groups, the various minority Californians combine to outnumber white residents. With the nation’s largest immigrant population, California is a microcosm of what the entire United States is projected to look like in 2050, when Hispanics are expected to make up nearly one-fourth of the nation’s residents and Asians close to 10 percent. In 2002, the population of Los Angeles was 44 percent Latino and 12 percent Asian, and more than 100 languages were spoken by students in the city’s schools. Health care professionals and educators need to equip themselves with information that will help them meet the challenge of working with immigrants, non-English speakers, and English language learners competently and compassionately. Rather than viewing im- migrant clients and students as problems, with increased knowledge we may come to appre- ciate the contributions they make to our nation—which is, after all, made up almost entirely of immigrants. The Center for Religion and Civic Culture at the University of Southern California observed, in a recent report on immigrants in Los Angeles, that these new arriv- als have much to share: “Anchored in community, immigrants know something about ex- tended family ties, the value of community, and the importance of preserving a cultural heritage while contributing to the new society.” Immigration Facts In 2004, the foreign-born in the United States, some 34.2 million people, accounted for 12 percent of our total population. Fifty-three percent of the immigrant population was born Much of the United States at some time belonged to in Latin America, 25 percent in Asia, 14 percent in Europe, and 8 percent in other regions. other nations, most nota- U.S. citizens are some of the most fortunate people in the world. Except for Native bly Mexico, which for Americans, we all are the descendants of immigrants, a fact that we tend to overlook in our centuries counted Califor- dealings with more recent arrivals to our nation and state. Much of the United States at nia and other Western some time belonged to other nations, most notably Mexico, which for centuries counted states as part of its terri- California and other Western states as part of its territory. The fact that we live in the richest tory. and most powerful nation in the world should not blind us to the