Cultural competence in nursing curricula: how are we doing 20 years later?
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In the second of a two-part series looking at differences in health care provided to minorities and immigrants, Healthcare Benchmarks looks at what some facilities and organizations are doing to address and prevent racial discrimination in health care. This will be of great importance in the future, considering that by 2030, 40% of the U.S. population may be made up of minorities. A recent survey found that one in five African-Americans have had a serious incident of discrimination in a health care setting.
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OBJECTIVE: There is a large disparity in health status between the indigenous peoples of the US Associated Pacific compared to any population in the USA. The research process that has been supported by US academic institutions and federal agencies has been limited in its ability to address the disparate health issues and may be part of the problem. We define culturally competent research and review approaches to developing competency in cross-cultural research with indigenous Pacific Islander populations. DESIGN: This is a descriptive review of the investigators' experience in the Hawaii MEDTEP Center experience and of the experience of others conducting research with the indigenous people of the Pacific Islands. RESULTS: Culturally competent cross-cultural research with the indigenous peoples of the Pacific requires an understanding and application of indigenous peoples' paradigms of health, knowledge, science, and research. It is not sufficient to train more indigenous Pacific Islanders to do more Western-style research. Unraveling the complex health situation and determining the changes that need to be made is dependent on the dominant culture engaging the indigenous Pacific populations in a way that bridges cultural paradigms. CONCLUSION: Positively affecting the disparity of health in the indigenous populations of the Pacific is, in part, dependent on employing an indigenous-peoples-centered model of research. The model can have application to the study of indigenous peoples in other parts of the world.