Page 50 - Cultural Competence in Health Education

28 Cultural Competence in Health Education and Health Promotion

There are many epidemiological disparities among African Americans that are
related to this group ’ s disproportionate share of heart disease. Numerous studies of
African Americans consistently document differences in their access to care for heart
disease and stroke. Study findings consistently suggest that African Americans are

unfailingly less likely to receive diagnostic angioplasty and catheterization, pharmaco-
logical therapy, and invasive surgical treatment for heart disease and stroke than are non -
Hispanic whites with similar disease characteristics (Mayberry, Mili, & Olifi , 2002).
The most promising preventive strategies target risk factors for cardiovascular
disease (CVD) morbidity, mortality, and disability. These prevention programs target
the conditions research has suggested are associated with CVD: having high blood
pressure, having high cholesterol, smoking tobacco, being overweight, and being
physically inactive. Again, for the two major cardiovascular disease killers, heart
disease and stroke, health educators are in an excellent position to improve patient
outcomes. They can convey critical health care information in a way that is culturally
relevant and sensitive. The health educator can communicate during routine offi ce vis-
its that patients need to be screened for risk factors associated with CVD, and once
risk factors are identifi ed, he or she can provide individual and group classes that tar-
get smoking cessation, the importance of taking medications for hypertension, proper
nutrition and exercise, stress reduction, and other heart - healthy behavioral modifi ca-
tions. Increasingly, these health education efforts are being conducted in schools and
in the workplace and are also being supported by community - based groups, churches,
and community partners such as the American Heart Association and other voluntary
health agencies.

HIV and AIDS

HIV is now the fifth leading cause of death for people in the United States aged 25 to 44
and the leading cause of death for African American men aged 35 to 44 (CDC, 2007d).
Racial, ethnic, and sexual minorities have been disproportionately affected by the HIV/
AIDS epidemic in the United States. The disparities in pediatric HIV infection are most
dramatic. Although non - Hispanic black children compose approximately 15 percent of
the total child population, they represent almost 60 percent of all pediatric AIDS cases
(Child Health USA, 2006). Two factors driving the increasing rate of new infections in
minority communities are the growth of HIV infections in women transmitted through
heterosexual contact and the spread of infection through injection drug use.
The goal of Healthy People 2010 is to eliminate these disparities by implementing
strategies that focus on high - risk populations ’ knowing their HIV status and receiving
appropriate counseling and treatment, on providing early access to health care and
anti - retroviral drugs for at least 75 percent of people with HIV/AIDS, and on educat-
ing health care providers to target women and children on the Medicaid program with
prevention and treatment strategies.
Health educators often have the linguistic and cultural competence to ensure that
HIV/AIDS educational materials are provided to the community in languages other
than English, in forms that populations with low levels of health literacy can understand

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