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Diversity and Inclusion

A work-in-progress resource for faculty, students, and administrators on creating more inclusive and diverse classrooms.

Wildwood

Full Text available via Interlibrary Loan

Diaz, J. (2007). Wildwood. The Brief Wondrous Life of Oscar Wao (pp. 51). New York: Riverhead Books.

Full Text available via Interlibrary Loan

Garden, R. (2013). Distance Learning: Empathy and Culture in Junot Diaz’s “Wildwood”. Journal of Medical Humanities34(4), 439-450.

Un Poquito

Full Text for Upstate Users

Ferguson, W. (2008). Un Poquito. Health Affairs, 27(6), 1695-1700. http://dx.doi.org/10.1377/hlthaff.27.6.1695

Abstract: Language is the currency of health care. Exchanging information, expressing emotion, instructing patients, and providing health education all occur through the medium of language. In the United States, traditionally this perspective was clear but of little importance: everybody spoke English. Today that circumstance is rapidly changing, with high levels of immigration into this country from all quarters of the world. Although English remains the principal language of the givers of care, it is not the language of many recipients of care. Now issues of linguistic ability, appropriate interpretation, telephonic “language lines,” and patient privacy are all in play in ways they never were before. Physician Warren Ferguson, speaking for legions of well-intentioned caregivers, sets the stage in his essay by reprising his career-long effort to learn Spanish well enough to make his Spanish-speaking patients and himself comfortable in exam-room dialogue. Then Nataly Kelly, a veteran Spanish-English interpreter, shares her experiences about provider sensitivity, patient vulnerability, and telephone interpreting. She is an active eavesdropper—and involved participant—in the practice of bilingual medicine, and her insights are many.

Palliative Care for Latino Patients and Their Families

Full Text for Upstate Users

Smith, A., Sudore, R., & Pérez-Stable, E. (2009). Palliative Care for Latino Patients and Their Families. JAMA, 301(10), 1047. http://dx.doi.org/10.1001/jama.2009.308

Abstract: Latinos account for 15% of the US population, a proportion projected to grow to 30% by the year 2050. Although there is tremendous diversity within this community, commonalities of language, beliefs, attitudes, and behaviors unite Latinos, making them more similar than different. Differences by national origin, although important, are attenuated when immigrants come to the United States, dominated by an English-language, Anglo-centric culture. For non-Latino and non−Spanish-speaking clinicians, communication barriers and cultural misunderstandings can impede the care of dying Latino patients and their families. We present the case of a young, pregnant, Spanish-speaking woman from Central America diagnosed with a fatal leukemia. As illustrated by this case, Latino immigrants face a number of external challenges to optimal end-of-life care: (1) geographic distance as well as political and economic realities often separate patients from their valued families; (2) undocumented immigrants are frequently uninsured and fear of deportation may create a barrier to accessing health services; (3) language and literacy barriers; and (4) concerns about discrimination. Other Latino issues that may be more pronounced in end-of-life settings include cultural themes and religious and spiritual influences. We recommend that professional interpreters must be used for discussions about goals of care with Spanish-speaking patients and families or when negotiating conflict between the patient, family, and the health care team. Concrete suggestions are provided for clinicians in working with interpreters, eliciting culturally based attitudes and beliefs, and implementing universal strategies for clear health communication.