FREE ESSAY ON CULTURAL BARRIERS WITHIN HEALTHCARE

CULTURAL BARRIERS WITHIN HEALTHCARE

According to Health Resources Services Administration, sixty-five to seventy-five percent
of all patients seen in a non-profit healthcare clinic live below the poverty level.
Providing effective health care to low income families requires an understanding of the
potential cultural barriers, which may be faced. These barriers include social, language,
religion, and technological issues. The majority of our patients from foreign cultures
are Hispanic or Asian. Due to this fact, we will discuss the barriers of dealing with
those from Hispanic and Asian Cultures, and offer possible solutions to overcome these
obstacles effectively. 
The number of immigrants entering the United States has been rapidly increasing over the
last few years. For instance, the number of Asians in the United States has grown to more
than 9 million in 1996. In 1996, there were over 28 million Hispanics in the United
States, and the numbers are only increasing. The rapid growth of these two cultures in
United States has made overcoming cultural barriers crucial in managing a non-profit
healthcare clinic. 
A predominate social barrier in dealing with those from the Asian culture is their
reluctance to disclose personal information to anyone outside of their family. Due to
this, they may not be honest and forth coming in giving physicians or other medical staff
personal or critical information needed for their treatment. When it comes to healthcare
for Asian women, they do not seek out medical care for Gynecological exams because they
feel it is an invasion of their body and considered improper and very humiliating for the
women. Differences between Asian culture and the American culture are the majority of
health issues of Asians are not often addressed in the American health care system.
However, the Asian culture is not the only culture that is facing social and economic
barriers to healthcare.
With the numbers of immigrants increasing, what can we do to ensure that our clinic will
be able to address the social and economic issues of all patients? First, we will need to
hire someone to act as a cultural liaison, who not only has knowledge about the differing
cultures, but can also speak the language. Second, we will need to address these issues
and barriers with our clients to successfully seek out ways to eliminate any future
barriers we may face. Our educational programs will address issues that range from
preventing sexual diseases, use of birth control, and understanding your body all the way
to addressing the needs of children. We plan to make our clinic accessible to all
low-income families by assuring our potential clients that we are not interested in their
legal status, but in the health of their families. We believe by making the clinic's fees
based on a schedule of one's income, that we are making healthcare affordable for
everyone. 
The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (1996 Welfare
Act") was the major overhaul of the welfare system that many Americans were looking for
to decrease the many who are taking advantage of their hard earned money. One of the main
points in the welfare reform legislation deters non- citizens from applying for public
assistance. Even if they are eligible, they may fear that receiving public benefits will
make them inadmissible or deportable. The many health problems that are prevalent in the
Hispanic population are due to lack of adequate health care programs available to
non-citizens. Due to that lack of citizenship, they are ineligible for federal health
assistance programs such as Medicaid, even if their incomes are low enough to qualify.
The lack of availability of health care in the Hispanic population is mainly due to their
citizenship status; even with low incomes, Hispanics are ineligible for health care
programs such as Medicaid. 
Non-profit health care clinics do not fall under the Public Charge Law, they are exempt
from having to verify immigration status, even if they provide a federal, state, or local
public service, and they may not be penalized for not verifying immigration status. State
and local governments may not impose verification requirements on such organizations. To
be exempt, an organization must be both nonprofit and charitable. With over 600 community
and non-profit health centers around the United States, the undocumented populations are
assured good quality care without having to worry about being turned into the INS. One of
the first types of health center being excluded from the Public Charge Law were Federally
Qualified Health Centers (FQHC) with the average number of undocumented aliens served a
month being 4,316, at the cost of only $3,258 for all (Bureau of Primary Health Care). 
Another common barrier between cultures is the difference in language. According to the
1990 United States Census Bureau, almost 2,300 people in Oklahoma over the age of 18 do
not speak any English. Over 48,000 of Oklahomans are Spanish speaking. One problem
language barriers create is the inability of the patients to communicate with the
physician. Often, the physician is unable to clearly understand the symptoms the patient
is describing. According to Charles Warren, an anesthesia technician at Mercy Health
Center, only 8% of the doctors in the hospitals are multilingual. The breakdown in
communication between the doctor and patient can multiply the possibilities of a
misdiagnosis. This can cause harm to the patient and make doctors vulnerable to
malpractice lawsuits. Another danger, associated with a language barrier, is the
possibility of the patients misunderstanding the doctor's instructions for the
medication. 
A solution for this would be to provide an interpreter to assist the doctor while
treating this patient. Many healthcare facilities, such has Mercy Hospital, have a
variety of employees who are multilingual, so they may be called upon to provide
translation between and doctor and a patient. The hospital's MIS (Medical Information
System) tracks these employees. One option currently available is known as a translator
box. It is a service available where the attending physician calls an 800 number and is
connected with the interpreter company, the physician informs the company what language
he/she needs, and within minutes an interpreter for that particular language is online
and ready to assist the physician as needed. 
Another problem is if the patient cannot read or speak English, they cannot understand
the forms they must fill out in order to receive financial assistance for healthcare. The
government or insurance agencies that require these forms should distribute these forms
in needed languages to all health care facilities, or make them available on a website
where the language needed can be chosen and then the forms can be printed.
A non-profit health center must have a strategy for dealing with religious barriers. For
instance, the Mexican cultural mainly practices Catholicism and attends mass regularly.
Catholic doctrine states, "Direct action to prevent the possibility of human life is
impermissible in all circumstances, both when a person is living, dying, or yet to be
conceived. Thus contraception may not be used because it is direct action against the
possibility of life". Catholicism even goes so far as to publish an online directory
called "Ethics and Meds". In "Ethics and Meds", they offer books that can be purchased
like "Ethical Principle In Catholic Health Care" which adds the point that the Catholic
Church wants its congregation to follow guidelines set by the Church. The physician who
is legally and morally bound to follow a set standard in providing health care will
provide the patient with the needed information regarding birth control. The
responsibility should rest, however, on the patient to inform the physician about their
religious beliefs regarding birth control
Society usually looks towards a licensed doctor to get advice and heal us. When dealing
with the Asian person who practices Buddhism, they must take into account that some
strands of this religion have a potential for incorporating religion into their beliefs
of healing and restoration of health, for example; healing of the soul, and Acupuncture
and Bowen Therapy may be two of those ways to heal the soul. Using acupuncture releases
the energy channels by putting pressure on a diseased area. Doctors or a therapist uses a
needle to prick the skin regulate and correct the flow of energy in the body. The second
one is Bowen Therapy, a subtle muscle/nerve/ connective tissue technique. Unlike massage
and other manipulations that try to force a change, Bowen simply resets the body to heal
itself. The results are profound and lasting, and usually apparent within two or three
sessions. A clinic may want to incorporate these different services for its Buddhist
patients. 
When dealing with these two different religions a non-profit health care clinic must find
different ways of helping the patient. The patient needs to be forthright in mentioning
how they need to be treated. For instance, a practicing Catholic needs to mention to the
doctor that they will not need any information on birth control or family planning. A
practicing Buddhist should mention they use holistic medicine. The doctor needs to take
the initiative to learn about the religious issues so that he/she can practice, or employ
a licensed alternative practitioner to provide these services.
Today's medical technology, if available and used properly, can be a huge benefit in
operating and managing a low-income healthcare center. Doctor's skills, along with the
latest medical technology have accounted for saving many lives. Many of the Latino
counties are considered third world countries and the people there often do not have
access to the latest advances in medical technology. Most are not aware they exist. Many
times a person of the Latino culture will not seek medical assistance due to the fact
they believe there is nothing the doctors can do for them. Many low-income Latinos suffer
for a long time with ailments that can result in permanent effects and even death. Not
being aware of the latest advances in medical technology, many feel they are better off
attempting to treat themselves with a homemade remedy. These remedies are often
ineffective and can even make matters worse.
Medical education programs that inform people of advances in medical technology need to
be more readily available for patients. These programs inform the patients of the
benefits of today's medical technology, and educate them on the numerous ways the doctors
can treat the patients effectively. In doing this, patients from less advanced cultures
are often willing to seek medical attention promptly. Often a doctor who went to medical
school in a third world country is not instructed in the latest in medical technology. In
extenuating circumstances, these doctors are allowed visas to the United States as long
as the doctor works in an area, which is designated as a HPSA (health physician shortage
area). These doctors, not being aware of the technology available to them in the United
States, often rely on older and less effective methods of treating patients.
In conclusion, we have addressed the social, language, religion, and technological
barriers facing a non-profit health care center that affect the Hispanic and Asian
cultures. We have also provided solutions to overcome those barriers in providing health
care. If non-profit health care centers will incorporate the resolutions, they would be
able to effectively provide quality health care to the Asian and Hispanic population. 
Works Cited
1. Factors Affecting the Health of Women of Color, http://www.4women.gov/owh/pub/woc/
hispanic.htm
2. Karen A. Woodrow and Jeffrey S. Passel, Post-IRCA undocumented immigration to the
United States: "An Assessment Based on the June 1988 CPS", p. 53, 
3. Bean, Edmonston, and Passel, Undocumented Migration to the U.S. Washington, The RAND
Corporation 1990
4. Miller, Theodore Jr., Holistic Health, "Medical Irony at Its Best",
http://reikimaster.net/holistic
5. National Catholic Bioethics Center, Ethical Principle in Catholic Health Care,
http://www.nbcenter.org/cubs_ethicalpriciple.html