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Diversity in Aging: Ethnogeriatrics

We have been benefactors of our cultural heritage and victims of our cultural narrowness.
-Stanley Kripper, psychologist

Everyone is influenced by our individual culture, ethnicity, history, values, and beliefs. These variables influence every aspect of our lives, including our health and wellness practices. This rich tapestry of diversity is evident in history, adds brilliance to art and literature, and is apparent in the people within our community.

The interrelationships among aspects of diversity have a major impact on how we age and on our support system. For years, aging studies in the U.S. focused mainly on Caucasian/White Americans. In recent years, the research focus has broadened. Sheer numbers may be a driving force behind this trend as the census data [1] and projections indicate significant change:

 

U.S. Population 2000 2050
White Americans 83.5% 64.2%
Hispanic/Latino 5.6% 16.4%
African-American 8.1% 12.2%
Asian/Pacific Islander 2.4% 6.5%

A “one size fits all” approach to health and health care is not an option! Recognizing the need to include culture and ethnicity as a research/practice branch, the American Geriatrics Society (AGS) coined the term ethnogeriatrics. As defined by AGS, this component of geriatrics considers the “influence of ethnicity, and culture on the health and well-being of older adults.” [2]

There is great cultural diversity and variation between people classified as minorities as well as differences among the current majority. For example, Hispanic or Latino populations may include Mexican-Americans, Puerto Ricans, Cubans or those from the Dominican Republic, or South or Central America, perhaps representing 22 different countries. Due to these differences, it is incumbent on health care and social services professionals to provide culturally sensitive care.

Self Assessment

To determine your level of cultural sensitivity, consider how you would answer the questions below. [3] These questions are intended to increase your awareness about the role that your individual culture plays in your attitude and beliefs.

  1. What stigmas are associated with the sociocultural group that I most closely identify?
  2. How has the group in which I grew up/ live in, influenced the dominant values I now hold?
  3. How do my perceptions differ from those people who come from other cultural backgrounds?
  4. Do my health care practices differ from conventional Western medicine practices (i.e. herbs, folk remedies)?
  5. How might my belief about alternative/ complimentary health care practices influence my work?
  6. What is my attitude toward people, especially older adults…
  • who have difficulty with the English language?
  • who have an accent or are difficult to understand
  • who have a cultural background different from my own
  • who are immigrants?

Call for Cultural Competence

Faculty members from the Stanford Geriatric Education Center offers strategies to help reduce cultural barriers within organizations. Embracing these strategies is an important step to providing culturally competent health care.

  • Hire ethnically diverse staff
  • Provide adequate interpreter services
  • Train staff on history and culture of clients, cultural competencies
  • Assess literacy and provide culturally appropriate verbal and written information
  • Understand who health decision makers are in the culture [4]

Evelyn’s Picks – Recommended Resources:

Culturally and Linguistic Appropriate Services Standards, from The Department of Health and Human Services, Office of Minority Health: This website includes the fourteen standards for CLAS along with a variety of additional resources regarding cultural competency.

The Stanford Geriatric Education Center: This website provides a comprehensive training module on culturally sensitive geriatric care and is an excellent source of ethnogeriatric information. Stanford also offers an ethnogeriatric IQ quiz which is helpful.

The Office of Minority Health: Health disparities affecting minorities will continue to be apparent and may increase unless solutions are found to address both current and anticipated challenges. Visit the OMH website for further information and resources regarding this important topic.

Book: Spector, R.E. (2004). Cultural Diversity in Health and Illness. 6th Ed. Upper Saddle River, NJ: Prentice Hall.


Resources:

  1. US Census Bureau. (January 2000). 
  2. Position Statement of Ethnogeriatrics, American Geriatrics Society. (2003, 2006).  
  3. Miller, C. (2004). Nursing For Wellness in Older Adults. New York: Lippincott, Williams, & Wilkins.
  4. Yeo, G. (2005). Our Ethnogeriatric Imperative

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

For more information:

Go to the Senior Health health topic.