General Research Issues

This Journal of General Internal Medicine article uses the survey method to “examine associations of patient ratings of communication by health care providers with patient language (English vs. Spanish) and ethnicity (Latino vs. white).”

This Medical Care Research and Review article uses the literature review method to lay the foundation for a conceptual model of cultural competency’s potential to reduce racial and ethnic health disparities.

This Health Affairs article provides “an in-depth analysis of what language-assistance programs look like in practice.” It is meant for purchasers, policymakers and researchers to identify ways to cross the language chasm by learning from the experiences of fourteen linguistically competent health plans.

This Public Health Reports article uses the literature review method to “develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care.”

“To determine if professional medical interpreters have a positive impact on clinical care for limited English proficiency (LEP) patients,” researchers did a systematic literature search to find that “published studies report positive benefits of professional interpreters on communication (errors and comprehension), utilization, clinical outcomes and satisfaction with care.”

This Health Affairs article provides a physician’s narrative on an interpreter mediated consultation with a limited English proficient patient and the effects of the interpreters on the quality of healthcare given.

This Journal of General Internal Medicine article uses the interview method to “determine whether patients who encountered language barriers during an emergency department visit were less likely to be referred for a follow-up appointment and less likely to complete a recommended appointment.”

This American Journal of Psychiatry article uses the interview method and content analysis of eight audiotaped psychiatric interviews to evaluate possible distortions that could result from interpreter-mediated psychiatric interviews. This is only an abstract.

This Medical Care article compares the benefits of traditional interpretation with the interpreter physically present (control) with that of remote-simultaneous interpretation with the interpreter linked from a remote site (experimental) using the measures of number of physician and patient utterances, quality of interpretation and participants’ preferences. This is only an abstract.

In this New Federalism: National Survey of America’s Families article, The Urban Institute studies the well being of children in immigrant families using the measures of family environment, physical and emotional health, and access to needed services.

This academic article uses the survey method to determine if the language barrier correlates negatively with effective healthcare, patient satisfaction or medication compliance in a teaching hospital serving the Hispanic community.

This Journal of General Internal Medicine article uses both the survey and interview method to “examine patient satisfaction and willingness to return to an emergency department (ED) among non-English speakers.”

This Journal of the National Medical Association article uses a study population of third year medical students to “assess medical students’ knowledge in cultural competence to identify training areas for curriculum development.” This is only an abstract.

This Journal of Emergency Medicine article, they “evaluated language (English vs. Spanish) as a variable in compliance with follow-up appointments from emergency department (ED) referrals and compared it with four other socioeconomic variables.” This is only an abstract.

This UCLA Center for Health Policy Research article assesses the problems, due to language, HMO enrollees have “accessing health care services and receiving quality treatment” in both the public and private spheres.

This American Journal of Public Health article uses the survey method to correlate the language of interview (Spanish/English) to health status, access, satisfaction with care, and barriers to care in the state of Arizona.

This Medical Care Research and Review article uses the interview method to assess the correlation between the level of English proficiency & socio-demographic characteristics and the number of previous physician visits. Available as an abstract.

This Kaiser Commission on Medicaid and the Uninsured article “provides an overview of migrant and seasonal farmworkers and the health challenges they face and considers options for improving their health coverage and access to care.”

This Journal of General Internal Medicine article uses the survey method to determine the degree of patient and physician satisfaction when utilizing various language interpretation techniques.

This document provides a protocol and tool for health care organizations and systems to assist them in conducting a cultural competence self-assessment.

This research paper uses the interview and observation methods to “describe the experiences of Thai Immigrants concerning the Health Care System in the U.S” and “provide insight into the use of health services by immigrants in the U.S.”

This Health Services Research article compares the effect of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the health insurance of low-educated, unmarried foreign-born women and their children with that of native-born families with the same characteristics. It also measures the validity of the “chilling” hypothesis, which states that immigrants responded to the fear associated with the law rather than the law itself.

“Recognizing the challenges associated with caring for increasingly diverse patient populations, a new Joint Commission on Accreditation of Healthcare Organizations (JCAHO) report recommends national strategies designed to help hospitals overcome language and cultural issues in care delivery, AHA News Now reports.”

This article’s objective is to determine the frequency, categories and potential clinical consequences of errors in medical interpretation. It found that “errors in medical interpretation are common, averaging 31 per clinical encounter, and omissions are the most frequent type. Most errors have potential clinical consequences, and those committed by ad hoc interpreters are significantly more likely to have potential clinical consequences than those committed by hospital interpreters.”

“A study published in the April issue of the International Journal for Quality in Health Care finds that patients with limited English proficiency (LEP) treated in U.S. hospitals are more likely than their English-speaking counterparts to experience adverse events that result in physical harm.”

“The National Institutes of Health (NIH) awarded $850,000 to California-based translation technology firm Fluential for the creation of an interpretation system to help nurses better serve patients with limited English skills, the San Jose Business Journal reports.”

“An issue brief released by the Robert Wood Johnson Foundation’s (RWJF) Expecting Success: Excellence in Cardiac Care initiative suggests that collecting data on patients’ race, ethnicity and primary language is a critical step in hospital efforts to enhance care quality and reduce racial and ethnic disparities, AHA News Now reports.”

“A study published in Pediatrics suggests that pediatricians rarely use professional interpreter services when treating patients with limited English proficiency (LEP), United Press International reports.”

“Ethnopharmacologic research has revealed that ethnicity significantly affects drug response. Genetic or cultural factors, or both, may influence a given drug’s pharmacokinetics (its absorption, metabolism, distribution, and elimination) and pharmacodynamics (its mechanism of action and effects at the target site), as well as patient adherence and education.”

This report distributed by the Congressional Budget examines how state and local governments spend relatively little on health care costs and other services for unauthorized immigrants.

Researchers conducted a study among children in New York City to investigate associations of childhood lead poisoning with birth and residence in a foreign country. After controlling for housing characteristics and child behaviors such as eating non-food items, data suggested that foreign-born children were five-times more likely than U.S.-born children to have elevated blood lead levels.

This report compares limited-English-proficient Hispanic adults to the group most similar to them, English-proficient Hispanic adults, and also compares English-proficient Hispanic adults to the white non-Hispanic population. Key findings include educational and health insurance disparities, as well as disparities in usual source of care and health care utilization.

The purpose of this study was to compare satisfaction among Spanish-speaking mothers who did and did not use telephonic interpreters during pediatric visits, and to examine resident physician attitudes about telephonic interpreter use.

Eliminating Health Disparities: American Medical Association (AMA) Website

Study found that minority and low-income women in Los Angeles County are more likely to have limited access to healthcare and struggle with chronic diseases, according to a new report by the Department of Public Health

Immigrants in the US, How well are they Integrating into Society by Tomas R. Jimenez

What is Project MUSE? Project MUSE is a unique collaboration between libraries and publishers, providing 100% full-text, affordable and user-friendly online access to a comprehensive selection of prestigious humanities and social sciences journals. MUSE’s online journal collections support a diverse array of research needs at academic, public, special and school libraries worldwide. Our journals are heavily indexed and peer-reviewed, with critically acclaimed articles by the most respected scholars in their fields. MUSE is also the sole source of complete, full-text versions of titles from many of the world’s leading university presses and scholarly societies. Currently, MUSE provides full-text access to current content from over 400 titles representing nearly 100 not-for-profit publishers

The mother of a gay teen, who gained national attention after he posted a tearful video about being bullied, said she and her 14-year-old son are grateful for the outpouring of support.

Why diversity efforts fail and how to make them succeed Washington Post Article The big idea: How can companies stop spinning their wheels and make real progress toward diversity and inclusion?

This short, animated movie — featuring the “YouToons” — explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Learn more about how the health reform law will affect the health insurance coverage options for individuals, families and businesses with the interactive feature “Illustrating Health Reform: How Health Insurance Coverage Will Work.”

In a powerful speech on Saturday, January 28th, Department of Housing and Urban Development (HUD) Secretary Shaun Donovan made history when he unveiled HUD’s LGBT Equal Access policy-a new rule that will protect more than 5.5 million people across the country from discrimination in public housing and Federal Housing Administration (FHA)-insured mortgages

The Safest Generation website was created by Safe Kids as a Child Passenger Safety outreach program to reach 11 and 12 year olds. The goal is to give preteens the tools they need to make safer choices in and around cars. Visit www.safestgeneration.org for more information. Safe Kids USA has additional preteen and teen information for technicians and car safety tips for parents of preteens and teens on its website (www.safekids.org).

Health Disparities Cause Financial Burdens for Families, Communities and Health Care System . WASHINGTON—Health disparities are creating economic burdens for families, communities and the nation’s health care system. Across the country, infant mortality and chronic diseases continue to affect people of color at rates far higher than those for whites.

Susto (fright), nervios (nerves) and ataque de nervios (attack of nerves) are idioms of distress widely experienced amongst Hispanic Americans, often associated with psychiatric disorders. This study explores understanding of these idioms of distress and attitudes to help seeking amongst indigenous Spanish and Hispanic American residents in Spain

Washington, DC – the National Quality Forum (NQF) Board of Directors has endorsed 12 quality measures focused on healthcare disparities and culturally competent care for racial and ethnic minority populations. “Accurate and meaningful metrics to measure care quality for populations adversely affected by disparities are critically needed,” said Laura J. Miller, FACHE, interim CEO of NQF. “These endorsed measures will be instrumental in promoting equitable, high-quality, and compassionate care for all populations across the healthcare delivery system.”

Online-only: Rural residents more likely to be obese, study finds Donya Currie Underscoring the importance of community-based interventions that target people where they live, a recent study found rural residents are more likely to be obese than city dwellers. Based on an analysis of data from the National Center for Health Statistics, the study used measured heights and weights rather than self-reported data. Researchers found nearly 40 percent of rural residents were obese, compared to about 33 percent of urban residents.

AMERICA’S INVISIBLE CHILDREN Latino Youth and the Failure of Justice By NEELUM ARYA with FRANCISCO VILLARRUEL, CASSANDRA VILLANUEVA, and IAN AUGARTEN Foreword by JANET MURGUÍA and JUAN SÁNCHEZ Campaign for Youth Justice/National Council of La Raza (2009) Provides information and statistics on Latino youth involvement in the justice system, including the overrepresentation of this population in the system and the disparities that exist in their treatment while incarcerated.

Support and resources for South Asian lesbian, gay, bisexual, transgender and queer individuals, families, and friends Call 908-FOR-DEQH (908-367-3374) for free, confidential, culturally sensitive peer support, information and resources. We provide a safe and supportive ear for callers to share concerns, questions, struggles or hopes through conversations with trained South Asian peer support volunteers.

“Lifting Latinos Up By Their Rootstraps”, Moving Beyond Trauma Through a Healing Informed Framework For Latino Boys and Men National Latino Fatherhood and Family Institute (2012) This document emphasizes the need to integrate “La Cultura Cura,” or cultural-based healing, in efforts to address gang involvement, teen pregnancy, school failure, and poverty within Latino and other communities of color. “La Cultura Cura” approach involves the restoration of cultural identity as the foundation of well-being for individuals, families, communities, and society through a multi-generational process of learning or remembering the positive values of one’s “roots.”

Toolkit for Practitioners/Researchers Working with Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) Runaway and Homeless Youth (RHY) National Resource Center for Permanency and Family Connections (NRCPFC) This toolkit was developed for practitioners/researchers working with LGBTQ RHY, recognizing the diversity of the LGBTQ RHY population. It outlines specific evidence-based and evidence-informed programs, practice models, and assessment/evaluation tools as well as cultural competence standards of care training curricula for staff and youth

CDC Health Disparities and Inequalities Report — United States, 2011

How the Powerless Access Power Immigrants make significant gains in influencing political system Political affiliation aside, research shows that immigrants, especially when they organize and vote, are influencing the political discussion overall, not just electing Democrats. #According to immigration experts, the right to vote is a key motivating factor when immigrants choose to become citizens, instead of just holding on to their green card.

Most Mass Murderers Aren’t Actually Mentally Ill Adam Lanza, killer of 20 children and seven adults, including his mother, is a mass murderer – he murdered a large number of people in a short time in one place. He then committed suicide in a classroom. Ending your life or having the police shoot you dead is often part of the mass murderer’s plan – as opposed to the serial killer who usually tries to escape the police and kills repeatedly, not in a single strike. http://worldcrunch.com/tech-science/after-newtown-why-most-mass-murderers-are-actually-not-mentally-ill/adam-lanza-sandy-hook-killer/c4s10454/#.UNNGvCOeF_J#ixzz2HOHq9b7l

Most Mass Murderers Aren’t Actually Mentally Ill Adam Lanza, killer of 20 children and seven adults, including his mother, is a mass murderer – he murdered a large number of people in a short time in one place. He then committed suicide in a classroom. Ending your life or having the police shoot you dead is often part of the mass murderer’s plan – as opposed to the serial killer who usually tries to escape the police and kills repeatedly, not in a single strike.
Most Mass Murderers

Census Bureau Releases 2012 State Population Estimates The Census Bureau released estimates Thursday indicating North Dakota’s population jumped 2.2 percent between July 2011 and July 2012, nearly three times the national rate. The state, fueled by an oil boom creating thousands of jobs, is the nation’s fasting growing. Other states experiencing the largest percentage increases were predominantly in the South and western U.S. They include Texas (1.7 percent), Wyoming (1.6 percent), Utah (1.5 percent) and Nevada (1.4 percent)

Promoting appropriate use of physicians’ non-English language skills in clinical care: Recommendations for policymakers, organizations, and clinicians. Many physicians speak one or more languages other than English, and studies show that patients with LEP who receive care from a bilingual physician have better adherence, lower emergency department use, and higher satisfaction with care. Yet, physicians are extremely heterogeneous in their non-English language skills, ranging from those who speak “a little” of a second language based on high school classes or travel to those who received their medical training in a non-English language. There is little detailed guidance for physicians on the most appropriate ways to use their non-English language skills. A new report from the Commission to End Health Care Disparities explores these complex issues and provides practical guidance to clinicians, care delivery organizations, and health care systems. It also provides a framework for future research on how physicians can best use their non-English language skills to provide safe, high quality care for patients with LEP

Hiring managers and HR professionals at some elite professional services companies are often more focused on hiring people who share the same hobbies or personalities as them than on hiring people who would do the best work, according to a researcher at Northwestern University in Evanston, Ill. “Employers really want someone they can bond with, who they will feel good around,” says Lauren A. Rivera, an assistant professor of management and organizations and sociology at Northwestern University. “As a result, employers don’t necessarily hire the most skilled candidates.” Rivera conducted 120 interviews with professionals involved in undergraduate and graduate hiring in elite U.S. investment banks, law firms and management consulting firms in what she says is the first empirical investigation of whether shared culture between employers and candidates matters in hiring.

*Seth M. Holmes PhD, MD*, *University of California – Berkeley* Abstract This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep medical professionals from seeing the social determinants of suffering of their unauthorized migrant patients. These barriers lead clinicians inadvertently to blame their patients – specifically their biology or behavior – for their suffering. This paper challenges the focus of mainstream cultural competency training by showing that it is not the culture of the patient, but rather the structure and culture of biomedicine that form the primary barriers to effective multicultural health care.

VDH’s , Office of Minority Health and Health Equity is very excited to share that the enhanced National CLAS Standards and The Blueprint, their accompanying guidance document, has recently been released. The launch event was held on April 24, 2013 at the Henry J. Kaiser Foundation’s Barbara Jordan Conference Center. The enhanced National CLAS Standards have a broader reach to address the importance of cultural and linguistic competency at every point of contact throughout the health care and health services continuum. Specifically, the Standards’ conceptualization of culture, audience, health, and recipients were expanded.