Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Cultural Issues in Pediatric Care
Pediatricians live and work in a multicultural world. Among the world's 7 billion people residing in over 200 countries, more than 6,000 languages are spoken. As the global population becomes more mobile, population diversity increases in all countries. In the United States, sources of ethnic and cultural diversity come from indigenous cultural groups such as Native Americans and Alaskan and Hawaiian natives, groups from U.S. territories such as Puerto Rico, recent immigrant groups, those whose heritage originates from the African diaspora, as well as others whose families and communities migrated to the United States from Europe and Asia generations ago but who have retained cultural identification. U.S. census estimates suggest that in 2016, almost 40% of the U.S. population self-identified as belonging to a racial/ethnic group other than non-Hispanic white. Recent immigrants comprise 13.5% of the U.S. population, but if U.S.-born children of these immigrants are included, 27% of the population are either new immigrants or first-generation Americans. Immigrants from China and India account for the largest groups coming to the United States, followed by those from Mexico. This national and international diversity allows for a heterogeneity of experience that enriches the lives of everyone. Much of this diversity is based on varied cultural orientation.
What Is Culture?
The concept of culture does not refer exclusively to racial and ethnic categorizations. A common definition of cultural group is a collective that shares common heritage, worldviews, beliefs, values, attitudes, behaviors, practices, and identity . Cultural groups can be based on identities such as gender orientation (gay/lesbian, bisexual, transgender), age (teen culture), being deaf or hearing impaired (deaf culture), and having neurodevelopmental differences (neurodiversity; neurotypical and neuroatypical). All these groups to a certain extent share common worldviews, attitudes, beliefs, values, practices, and identities.
Medical professionals can also be considered as belonging to a specific cultural group. Those who identify with the culture of medicine share common theories of well-being and disease, acceptance of the biomedical and biopsychosocial models of health, and common practices and rituals. As with other cultural groups, physicians and other healthcare professionals have a distinct language and share a common history, the same preparatory courses that must be mastered for entrance into training for the profession (a rite of passage). Medical professionals subscribe to common norms in medical practice. Young physicians learn a new way to describe health and illness that requires a new common vocabulary and an accepted structure for communicating a patient's history. These common beliefs, orientations, and practices are often not shared by those outside medicine. Therefore, any clinical interaction between a healthcare provider and a patient can be a potential cross-cultural interaction —between the culture of medicine and the culture of the patient—regardless of the race or ethnicity of the participants. A culturally informed and sensitized approach to clinical communication is a fundamental skill required of all medical professionals, regardless of the demographic makeup of one's patient population.
Culture and Identity
We are all members of multiple cultural groups. Our identification or affiliation with different groups is not fixed or unchangeable. With whom we self-identify may depend on specific situations and contexts and may change over time. A gay Latino physician may feel, at different times and in different situations, greatest affinity as a member of Latino culture, a member of the culture of medicine, a minority in the United States, or a gay man. An immigrant from India may initially feel great connection with her Indian culture and heritage, which may wane during periods of assimilation into American cultural life, then increase again in later life. Culturally informed clinicians should never assume that they know or understand the cultural identity of a person based solely on perception of ethnic, racial, or other group affiliation.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here