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Encyclopedia of Health and Medicine

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cultural <strong>and</strong> ethnic health-care perspectives 243<br />

threatening the child with harm should he or she<br />

say anything to others about the abuse.<br />

It is crucial that anyone who suspects a<br />

child is being abused, regardless <strong>of</strong> the<br />

person’s relationship to the child, notify<br />

a health-care provider or other authority.<br />

Many communities have anonymous<br />

telephone hotlines for reporting<br />

suspicions <strong>of</strong> child abuse.<br />

Detection <strong>and</strong> Intervention<br />

All communities have child protection agencies<br />

<strong>and</strong> legal mechanisms to safeguard the well-being<br />

<strong>of</strong> children. Most states require health-care<br />

providers, educators, <strong>and</strong> other adults who have<br />

frequent interactions with children to report any<br />

suspicions or signs <strong>of</strong> child abuse. Child protection<br />

authorities then investigate the situation <strong>and</strong> may<br />

remove, temporarily or permanently, an endangered<br />

child from an abusive environment or situation.<br />

The longer the child remains in the abusive<br />

situation, the more serious <strong>and</strong> long-lasting the<br />

physical <strong>and</strong> especially emotional consequences.<br />

The safety <strong>and</strong> health <strong>of</strong> the child is the priority<br />

in circumstances <strong>of</strong> neglect <strong>and</strong> abuse. However,<br />

because not all neglect <strong>and</strong> abuse is purposeful,<br />

parent education programs that teach PARENTING<br />

skills as well as nonabusive methods to manage<br />

child discipline <strong>and</strong> the stress <strong>of</strong> parenting may<br />

help a parent or caregiver change his or her<br />

behavior such that it becomes appropriately nurturing<br />

<strong>and</strong> supportive.<br />

See also CULTURAL AND ETHNIC HEALTH-CARE PER-<br />

SPECTIVES; DOMESTIC VIOLENCE; ELDER ABUSE; FACTI-<br />

TIOUS DISORDERS.<br />

cultural <strong>and</strong> ethnic health-care perspectives<br />

Awareness <strong>of</strong>, respect for, <strong>and</strong> accommodation <strong>of</strong><br />

the traditions, beliefs, <strong>and</strong> customs <strong>of</strong> diverse cultures<br />

<strong>and</strong> ethnicities within the conventional practice<br />

<strong>of</strong> medicine. Factors may include language<br />

(non-English speaking), immigration status, views<br />

about doctors <strong>and</strong> personal privacy, <strong>and</strong> the influence<br />

<strong>of</strong> religious or spiritual beliefs as they relate<br />

to the reasons for illness <strong>and</strong> the role <strong>of</strong> treatment.<br />

The American model <strong>of</strong> medicine encourages<br />

shared participation between health-care<br />

providers <strong>and</strong> patients. This model expects<br />

patients to question what they do not underst<strong>and</strong>.<br />

People from some cultures may expect the<br />

provider will choose the appropriate therapy <strong>and</strong><br />

are reluctant to ask any questions. In other cultures<br />

families make decisions about health care,<br />

sometimes without participation from the person<br />

who is receiving the care. These factors influence<br />

patient compliance—whether the person carries<br />

out the treatment the doctor or other health-care<br />

provider recommends. The American model <strong>of</strong><br />

medicine also has a relative openness about personal<br />

privacy <strong>and</strong> the sanctity <strong>of</strong> the body, facets<br />

<strong>of</strong> health care that are <strong>of</strong>ten distressing or <strong>of</strong>fensive<br />

to people <strong>of</strong> other cultures who may refuse<br />

diagnostic or therapeutic procedures unless<br />

providers are able to accommodate their customs<br />

<strong>and</strong> beliefs.<br />

Cultural competency is now part <strong>of</strong> education<br />

<strong>and</strong> training for many health-care pr<strong>of</strong>essionals in<br />

the United States, including physicians, physician<br />

assistants, nurses, dentists, <strong>and</strong> allied health staff.<br />

Nearly all hospitals have translators available to<br />

overcome language barriers. About 18 percent <strong>of</strong><br />

the population in the United States speaks a primary<br />

language other than English, <strong>and</strong> cultural<br />

<strong>and</strong> ethnic minorities collectively make up about a<br />

third <strong>of</strong> the US population.<br />

See also AYURVEDA; GENERATIONAL HEALTH-CARE<br />

PERSPECTIVES; NATIVE AMERICAN HEALING; SPIRITUAL<br />

BELIEFS AND HEALTH CARE; TRADITIONAL CHINESE MEDI-<br />

CINE (TCM).

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