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LEARNING OBJECTIVES

  1. Explain how culture and cultural frameworks relate to holistic approaches to girls’ and women’s health and health care.

  2. Explain cultural identity and how cultural identities intersect to influence health.

  3. Discuss how girls’ and women’s health, health behaviors, and health care delivery are influenced by cultures related to sexual orientation, gender identity, race, ethnicity, and religion.

  4. Improve communication with girls and women from various cultural backgrounds and health literacy using culturally sensitive techniques.

  5. Utilize various models to improve care when a cultural issue needs to be identified and resolved during a clinical cultural encounter.

INTRODUCTION

Culture plays a role in every aspect of life, especially health care. Each culture has a set of beliefs, behaviors, and expectations.1 A girl or woman chooses to what extent she follows her cultural norms, which can change over time and during acute illness and health care encounters. Generally, health care providers have seen cultural encounters as race, ethnicity, and religion issues; however, other cultures such as sexual orientation, gender identity, age, functional ability, political beliefs, profession, etc. influence health care behaviors and decision making and must be considered together. Therefore each girl or woman is multicultural, so an intersectional approach incorporating all her cultures is important to provide holistic health care.

In this chapter, the concepts of culture, intersectionality, and health care are discussed. Models to help health care providers become more culturally sensitive and develop cultural humility are presented. As a women’s health textbook, sexual minorities and gender identity cultures will be explored from social, health outcome, health disparities, and health service perspective, with medical treatment for transgender people discussed in Chapter 26. Next race, ethnicity, and religious cultures will be explored; however, the reader should integrate these concepts with each girl’s and woman’s other cultures. Lastly information about culturally sensitive health care practices and health literacy will be introduced to improve interactions of girls and women with health care providers during health care encounters when cultural differences between the two parties exist, that is, creating a clinical cultural encounter.

Patient Case (Part 1)

Mrs. Chao is a 70-year-old Chinese woman, with her 40-year-old son at the community pharmacy.

Subjective Information

Chief Concern: “Hello, I need my medications.”

Pharmacist Encounter: The pharmacist introduces herself by reaching out to shake Mrs. Chao’s hand and looks directly at the patient to maintain good eye contact and gain trust. Quickly, the pharmacist recognizes that Mrs. Chao does not speak English and asks the son to interpret. The son states he prefers written information which will help his mother take the medication when they get home. The pharmacist insists on maintaining some connection with the patient and again asks the son to interpret. Reluctantly the son interprets, and while counseling the patient to take the pain medicine four times a day as needed, the pharmacist notices Mrs. Chao make a grimace on her face. ...

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