Cultural Humility Alliance

Multicultural Integration Executive Summary 

Born and raised in Haiti, one of the advantages of immigrating to the United States 20 years ago is the opportunity to meet people from diverse cultural backgrounds, and to get to know them, and to learn from them. Seattle, where I intend to practice as a naturopathic doctor and midwife, was listed in 2021 by the Seattle Times as the “fifth fastest-diversifying big city of the decade” from 2010 to 2020; and the “39th most most racially diverse city of the United States” (Balk, 2021). With racial diversity comes the need for culturally competent care ready to provide equitable care to the population. “Cultural competence in health care addresses the disparities that people of racially and culturally diverse backgrounds often experience. It can ensure all patients get the care they need to live healthier lives” (Tulane University, 2023). Cultural competency has been in the center of almost all conversations and efforts aiming to solve the black maternal health problem in the United States. “Compared to any other racial or ethnic group, Black women experience the highest rates of nearly all of the Centers for Disease Control and Prevention”s (CDC) severe maternal morbidity indicators. Black women in the U.S. are 2 to 4 times more likely to die from pregnancy-related complications than White women in the U.S. (U.S. Commission on Civil Rights, 2021). Providing culturally and linguistically competent care to pregnant people has been mentioned by many, as a solution to the issue (U.S. Department of Health and Human Services Office of Minority health, 2021). But one thing that is rarely addressed is the fact that even among the Black community, there are people from different cultural backgrounds. And as you will see later in one of the following pages, even among people from the same country, there are sometimes a few cultural differences based on regional and tribe origin. Putting all Black people under the same umbrella with the assumption that all Black people have the same needs that can be addressed under a “one-size-fit-all” does not seem to work. This is why it may need to add the notion of individualized care to cultural competency, for more realistic results.

In this virtual space, I am sharing for now my experience with someone from Togo, and several people from Kenya. This is my first step toward getting to know my community better. My next step will be to attend more culturally diverse local events, to get to know new people. While I did not set into stone yet the type of populations that I want to serve, and mostly, the type of populations that will welcome me, a Black provider with a foreign accent, I am inclined to strengthen my relationship with the immigrant Black community of Seattle, to see if I can be of service to them. By doing so, I hope to add to this virtual space in the future more cultural exchanges with people from other countries, and to make it a place where interested people can go to learn about their neighbors from the community. That would be my third step toward increasing cultural competence in the community. A fourth step that I intend to implement is to start offering free health conferences in places where immigrant Black people meet such as churches and neighborhood events. A fifth action that I can take is to organize YouTube educational sessions where I invite people from different cultures to talk about their background, their challenges, and what they hope to receive from their community to make them feel more at home, and from their healthcare providers to feel valued and taken care of.

As we say in Haiti, “L’union Fait La Force”, which can be translated as “Together we are stronger”. By stepping out of what I know, to explore other cultures, I believe that I will be able to build stronger bonds in the community, to be an element of solution in making my local community stronger, and in improving Black maternal health in the Greater Seattle area.

Sheila Mary, MD, ND, MPH

Bastyr University Midwifery Student, Class of 2025

Citations:

Balk, G. (2021). Settle Ranked as the fifth fastest-diversifying big city of the decade. Seattle Times. Retrieved from: https://www.seattletimes.com/seattle-news/data/seattle-ranks-as-fifth-fastest-diversifying-big-city-of-the-decade/

Washington State Department of Health. (2010). Cultural competency in health services and care. Retrieved from: https://doh.wa.gov/sites/default/files/legacy/Documents/Pubs//631013.pdf

Tulane University. (2021). How to improve cultural competence in health care. Retrieved from: https://publichealth.tulane.edu/blog/cultural-competence-in-health-care/#:~:text=Cultural%20competence%20in%20health%20care%20addresses%20the%20disparities%20that%20people,need%20to%20live%20healthier%20lives.

U.S. Commission on Civil Rights. (2021). 2021 statutory enforcement report. Retrieved from https://www.usccr.gov/files/2021/09-15-Racial-Disparities-in-Maternal-Health.pdf

U.S. Department of Health and Human Services Office of Minority health. (2021).  Providing culturally and linguistically appropriate health care services in maternal health care can help to reduce disparities. Retrieved from: https://minorityhealth.hhs.gov/Blog/BlogPost.aspx?BlogID=3283