Category Special Observance   Show all

• Optimizing Health for Immigrant Populations: When One Thing Stands, Another Thing Stands Beside It

  

  By Yewande Oladeinde, Ph.D.
  National Institute on Minority Health and Health Disparities
  Posted June 10, 2024

  Most immigrants have frames of reference or ways of knowing based on their immigrant experience that confer certain health advantages in positive and unique ways, often known as the “healthy immigrant effect” or the “immigrant paradox.” To better understand the rationale behind why and how immigrants seek care, we need to know “what are those things that stand and what are the other things that stand beside them," as immigrants try to navigate a fragmented health care system that was not built for them.

  The quote referenced above by Nigerian novelist Chinua Achebe refers to the "reality of a cultural multiverse rather than a cultural universe." As public health professionals, we often think about developing and implementing sustainable interventions that will lead to improved health outcomes. As noble as this may sound, many public health professionals design interventions that fail to consider the cultural contexts within which the behaviors and practices they are trying to change are formed and from which they thrive. Failure to do so leads to interventions that are unsustainable at best and, at worst, ineffective.

  Dr. Yewande Oladeinde wearing traditional Nigerian gele head wrap made with aso-oke fabric and dress made with ankara fabric.

  Highlighting Cultural Assets

  Immigrant Heritage Month is about celebrating diversity and one's cultural heritage. It’s also about highlighting the cultural assets people bring to their health that can then be used to develop programs that end disparities while optimizing health for all people.

  Take the story of Kemi, for example, a first-generation immigrant woman rooted in the Yoruba culture of Nigeria and an American anchored in the African American experience. Kemi has lived in the United States for over two decades despite spending her formative years in her home country of Nigeria. To remain connected to her Nigerian roots, she and her family are active members of a cultural organization for Nigerians in her community. Even though Kemi has lived in the United States for over two decades, she is very much rooted in her Yoruba culture.

  Kemi was experiencing symptoms of extreme fatigue, a feverish feeling, and other flu-like symptoms. At the time when she was experiencing these symptoms, she wanted to see a doctor, but she heard the news of how nobody was allowed to accompany loved ones to the hospital. People were asked to literally drop off their loved ones to an unknown fate and leave them there. Because of this rule, Kemi decided to stay home and have her loved ones care for her.

  Kemi called her mother in Nigeria to inform her about her symptoms and to ask for the agbo, a Yoruba term for a medicinal herbal remedy that is commonly used for feverish conditions. Her mother gave her the names of the herbs she needed, the specified quantities, and the preparation instructions. Her husband tried to purchase the medicinal herbs recommended, but many of them were unavailable in the United States. Kemi’s mother shipped the agbo remedy from Nigeria. Kemi drank a 4- to 8-ounce cup of the medicinal herbs each day. After about two weeks, her symptoms abated.

  Prior to this incident, Kemi used Western allopathic medicine often. However, when she was in a dire health situation, and some of the allopathic treatments recommended to her were not working, she knew she had to rely on “those other things that seek to stand beside that one thing,” such as traditional cultural practices and values related to healing that sustained prior generations, and reliance on the wisdom and divine power of one’s mother.

  When Kemi’s friends spoke to her about possibly seeking care as her symptoms got serious, she stated, ”What is the point of going to the hospital and being subjected to trial-and-error treatment when I can rely on what mothers and grandmothers in my culture have used for several generations that worked for them?” She relied on her cultural identity and the value of what had worked for previous generations. This is one of the reasons why it is important to build and maintain trust with the medical community and between people from other racial and ethnic minority communities, as cultural factors may influence their perceptions of health and uptake of recommended guidelines of care.

  As we continue to celebrate our diversity and cultural heritage this month, we must remember to:

  • Pay attention to the perceptions that feed people’s beliefs and the broader contexts where these perceptions emerge and from which they thrive. People’s perceptions, be they sociocultural, political, or historical, do not emerge from a vacuum.
  • Keep indigenous ways of knowing, which have helped our ancestors thrive. Chinua Achebe's quote speaks to the essence of multiple ways of knowing, which often coexist within an individual and may sometimes complement or oppose more popular views.
  • Understand that there is no singular worldview or universal belief that resides within an individual, and trying to silence other narratives or beliefs would be detrimental to addressing pressing health challenges faced by immigrants in the United States.
  • Encourage and empower alternate perspectives of people from other cultures, the things they value, and the unique qualities they acknowledge while leveraging their assets for optimal health.

  Yewande Oladeinde, Ph.D., is a social and behavioral science administrator in the Division of Clinical and Health Services Research at NIMHD. Her research focuses on understanding the role culture plays in shaping people’s perceptions of health and illness, and how it influences their choices and their behaviors, with a goal of implementing culturally and contextually appropriate interventions. Dr. Oladeinde was born and raised in Lagos, Nigeria, and she is from the Yoruba ethnic group.

  Dr. Oladeinde writes periodically for a local Maryland newspaper and aspects of this story were previously published there.

• Be the Source for Better Health

  

  By CAPT Tarsha Cavanaugh, Ph.D., M.S.W., LGSW
  Office of Minority Health
  Posted April 26, 2024

  

  We are nearing the end of National Minority Health Month (NMHM), an annual observance led by the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH). NMHM is a time for us all to reflect on the role we can play in advancing health equity and eliminating health disparities in racial and ethnic minority and American Indian/Alaska Native populations.

  This year the theme Be the Source for Better Health: Improving Health Outcomes Through Our Cultures, Communities, and Connections, emphasizes the role social determinants of health (SDOH), cultural competency, and humility play in advancing health equity.

  At OMH we are committed to furthering this effort by providing resources that support federal and community-based partners’ provision of quality, equitable, and respectful care and services that acknowledge the diverse cultural beliefs, practices, and linguistic preferences among the populations we serve.

  But let’s talk more about what health disparities are and how you can Be the Source for Better Health in your community.

  Understand Health Disparities

  Health disparities among minority communities are persistent and multifaceted. We define them as “differences in health that are closely linked to the social determinants of health (SDOH).” SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

  One of the many ways OMH works to address these disparities is through the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. The Standards are a roadmap for improving the quality of care by providing equitable, understandable, and respectful care and services that pay keen attention to diverse cultural health beliefs and practices, preferred languages, health literacy, and communication styles.

  By tailoring services to an individual's cultural and language preferences, you can help bring about positive health outcomes for diverse populations.

  Be a Wellness Champion

  Wellness Champions are federal and community partners committed to addressing the root causes of health disparities while advancing holistic approaches to achieve optimal health within racial and ethnic minority and American Indian/Alaska Native communities. Through education, outreach, and policy advocacy, they serve as trusted messengers empowering individuals to take charge of their health and navigate healthcare systems effectively.

  One type of Wellness Champion OMH supports is Community Health Workers (CHWs). CHWs often live within the communities they serve and broaden community connections to valuable health resources. They advocate for specific population needs (i.e., housing, food security), coordinate care at all levels, provide basic health screenings, and much more.

  While CHWs are a great example of Wellness Champions, it is important to remember that anyone can be a Wellness Champion committed to promoting good health habits with your friends, family, and local community.

  Embrace Self-Care and Self-Compassion

  Encouraging self-care and self-compassion in both the populations we serve but also for ourselves is also an important element of achieving health equity. But equally as important is understanding that we all have unique health needs when it comes to these practices. Each person’s ‘healthiest self’ is different and influenced by SDOH.

  Take the time to reflect on your personal wellness in areas such as your lived environment, relationships, and emotional health. Utilize resources like the NIH Your Healthiest Self: Wellness Toolkits to embrace self-care while navigating your whole-health journey and encourage others to do the same. Better understanding the knowledge gaps in our own health empowers us to seek out resources or trusted partners that can help improve our health status.

  Embracing self-care or compassion practices, through activities such as mindfulness, exercise, or creative expression has the potential to nurture resilience and improve your well-being.

  Conclusion

  National Minority Health Month calls upon us to recognize the intersecting factors that contribute to poor health outcomes and work to overcome these barriers. When all receive quality, equitable, and respectful care and services that are responsive to our cultural health beliefs and practices, preferred languages, economic and environmental circumstances, and health literacy levels, the health and well-being of our families, communities and nation will soar.

  Let’s keep working together in NMHM and beyond to Be the Source for Better Health for populations we serve by advancing sustainable policies, programs, and practices that work towards eliminating health disparities and prioritize the achievement of health equity.

  Resources

  U.S. Department of Health and Human Services. Healthy People 2030.

  Office of Minority Health. National CLAS Standards. U.S. Department of Health and Human Services.

  Bureau of Labor Statistics. Community Health Workers. U.S. Department of Labor.

  National Institutes of Health. Your Healthiest Self: Wellness Toolkits. U.S. Department of Health and Human Services.

  CAPT Tarsha Cavanaugh, Ph.D., M.S.W., LGSW, is Principal Deputy Director at the Office of Minority Health.