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A Dialogue on Cultural Competencyfor Health Advocates and Health Educators*
2011 Wisconsin State Prevention ConferenceChula Vista Resort, WI Dells, Wisconsin
June 14, 2011
Presented by:
Michael CampbellProject Manager
WAATPN
Leonor RosasProgram Director
WHLTPN
Isaiah Brokenleg*Epidemiologist
WNATN
Viluck KueProject Coordinator
AATPNW
Kevin ReederProgram Administrator
WTPPN
* Presentation developed by Isaiah Brokenleg, Epidemiologist with the Great Lakes Inter-Tribal Council, Inc. Lac du Flambeau
Vision Mission and Goal StatementsVision:
Optimal health and health equity for all, while respecting the unique cultural and religious roles of
tobacco.
Mission:The mission of WHEALTH is to promote health equity by preventing and eliminating tobacco abuse with specific
focus on communities of color and people living in poverty.
Goals:By 2015, reduce tobacco abuse rates by at least 5% (from 2007 baseline) in the African American, Hispanic/Latino, Native American, Southeast Asian and Low
Socio-Economic Status communities.
By 2015, raise awareness about tobacco and its role(s) in health disparities, through a 30% increase in community outreach.
Recognizing the health inequities and financial costs associated with achieving these goals, WHEALTH will identify resources/funding streams to accomplish our mission.
Workshop Goals
• Increase participants’ understanding of cultural competency concepts and theories.
• Explore ways to integrate ethnic and low SES culture into health prevention efforts.
• Engage in thought provoking dialogue.• Have fun!
Color Blindness Quiz
SESSION OUTLINE
Mini Lecture and Panel Discussion
SESSION OUTLINE
JEOPARDY!
SESSION OUTLINE
Stages and levels of Cultural Competency
SESSION OUTLINE
Generalities
One Idea of Self
External Self
Internal Self• Conscious• Subconscious
SelfIdentities
Life Experiences Culture
Other Factors
Creation/Recreation of Self
Identities and Parts of Our Identities
Visible Invisible
Historical/Generational Trauma
Generational/Historical Trauma
Intergenerational or multi-generational trauma happens when the effects of trauma are not resolved in one generation. When trauma is ignored and there is no support for dealing with it, the trauma will be passed from one generation to the next.
Aboriginal Healing Foundation 1999
Generational/Historical Trauma
Culture, Customs, Language, Love and
Heritage
Culture, Customs, Language, Love and
Heritage
Culture, Customs,
Language, Love and
Heritage
Generation Generation
Generation Generation
Generational/Historical Trauma
Photo courtesy of George W. Brown, Jr. Chippewa Museum in Lac du Flambeau
NATIVE AMERICAN
The Great Depression– The stock market collapse of October 29, 1929 marks
the beginning of our historical economic downfall.– With millions of Americans unemployed, The trauma
of the Great Depression has shaped economic status in our country.
– The Dust Bowl of 1931 marks the period of severe drought in which “farmland turned to dust” (Schwartz, 2004, p. 7).
Source: Schwartz, E. (2004). The great depression, Super power: Americans Today. pp. 26-41. Retrieved from EBSCOhost.
Generational/Historical TraumaLow SES Population
• Latin-Americans have experienced historic trauma since the Spanish Conquest.
• A sense of cultural misplacement still echoes in Hispanic populations living in United States.
Generational/Historical TraumaHispanic/Latino Population
The Hmong, a mountain people of Laos, were U.S. allies during the Vietnam war. A noble, friendly folk with a 4000-year-old culture, they are the object of a genocidal campaign by the communist Laotian and Vietnamese governments.
Generational/Historical TraumaAsian American Population
Slavery• The social condition of slavery has been
transformed into a symbolic condition affecting all the descendants of slaves.
• Slavery is a site of memory for African-Americans, a memory requiring constant reflection and re-interpretation. It is an historic event present in every African-American’s consciousness.
• Various questions recur among African Americans seeking to interpret themselves.
Source: Ron Eyerman’s Cultural Trauma: Slavery and the Formation of African-American Identity
Generational/Historical TraumaAfrican American Population
Culture, Customs, Language, Love and
Heritage
Suicide, Violence, Abuse, Addiction, Hopelessness, Fear, Shame, Depression, & Anxiety
Generation Generation
Generation Generation
Loss of Language, Religion, Land,
& Culture; Abuse, Adoption, Death,
& Genocide
Generational/Historical TraumaNATIVE AMERICAN
Symptoms of Generational Trauma
Symptoms of
Historical Trauma
Depression
Anxiety
Isolation
Loss of Sleep
Anger
Fear and Distrust
Violence & Suicide
Addiction
Loss of Concentration
Shame
Discomfort around certain people
People’s Theory“Individualism and loss of community and culture make us sick.”
Compromised Health in Low SES populationsAlthough legislation was passed during the Great Depression to assist those being hit hardest by the economy, a lack of resources contributed to compromised health in poor communities.
Source: Schwartz, E. (2004). The great depression, Super power: Americans Today. pp. 26-41. Retrieved from EBSCOhost.
People’s TheoryLow SES Population
• Cultural loss, adaptation to US cultural standards, stress and isolation affects Hispanic/Latino Health.
• In 2009, 14.5% of adult Hispanics smoke. From the same population, about 20% of high school use tobacco (1).
• By 2010, almost a quarter of the adult Hispanic population living in Wisconsin smoke (2).
– Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2000—2009. Morbidity and Mortality Weekly Report 2010;59(33):1063—8 [accessed 2011 Jan 26].
– Centers for Disease Control and Prevention. Current Smoking among Adults by Demographic Characteristics. – State Highlights 2010, Wisconsin. [Accessed 2011 Feb 28].
People’s TheoriesHispanic/Latino Population
Horrible suffering endured by the Hmong since they were abandoned by the U.S. in 1975• The Hmong are faced with many psychological challenges as they strive
to maintain their culture.• Missionary's attempts to convert Hmong families to Christianity
highlights the pressures confronting refugees adapting to a new environment.
• The effects of their trauma are extreme in the Sudden Unexplained Nocturnal Death Syndrome, a mysterious phenomenon that causes Hmong men to die in their sleep.
Source: Between Two Worlds: The Hmong Shaman in America
People’s TheoryAsian American Population
The Breakdown of the Family Structure and the Culture’s Health
• African culture is rooted in the theory that it takes a village to raise a healthy child.
• But families were torn apart and the village has been destroyed. Families were forced to redefine cultural norms.
• As a result:– Low birth rate– High infant mortality– Metabolic Syndrome
People’s TheoryAfrican American Population
Slivers of Social Justice
Intersecting IdentitiesSexuality
Ethnicity
Socio-Economic
Status
ReligionGeneration
Country of Origin
Language
We All Have Bias and Prejudice
Bias Prejudice
Life Experiences
Society
Upbringing
Oppressive & Destructive
Delivery of Services
Interactions with Others
When Our Bias and Prejudice Affects…
“Moving Walkway” Model (Beverly Tatum)Social JusticeOppression
Equality Acceptance
Tolerance Ignorance
Apathy Prejudice
Discrimination Violence
Conclusion
• We are shaped by our environment. • It’s important to be aware of the role that
historical/generational trauma plays today and how it affects our prevention efforts.
• By understanding our own biases and prejudices, we can eliminate the harm that they can cause.
Panel Discussion (Q & A)
Contact the WHEALTH PartnersWisconsin Native American Tobacco NetworkTeresa BarberProgram [email protected]
Asian American Tobacco PreventionNetwork of WisconsinViluck [email protected]
Wisconsin African AmericanTobacco Prevention NetworkLorraine LathenProgram [email protected]
Wisconsin Tobacco Prevention & Poverty NetworkKevin ReederProgram [email protected] ext. 2176
Wisconsin Hispanic/LatinoTobacco Prevention NetworkLeonor RosasProgram [email protected]
