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Increasing the cultural competence of health care providers serving Minnesota's diverse populations
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Common health equity issues for Asian Indians populations
Cultural competence is the ability to recognize and understand the role culture plays in health care and to adapt care strategies to meet patient needs.
Get to know patients on an individual level. Each person’s preferences, practices, and health outcomes are shaped by many factors. Generalizations in this material may not apply to your patients.
The term “Asian Indian” was introduced by the U.S. Census Bureau to avoid confusion with “American Indian.”
Asian Indians in Minnesota
Asian Indian Minnesotans were born in India or have one or more parents who were born in India. More than 38,000 Asian Indians live in Minnesota. People have been emigrating from India to the U.S. since the 19th century. Early Asian Indian Minnesotans were mostly agricultural workers. From the mid-20th century on, most Asian Indian Minnesotans have been skilled professionals in academia, science, and technology.
Most Asian Indian Minnesotans speak English. Of those who speak an Asian Indian language in addition to English, 85 percent report that they speak English “very well.” India is a highly diverse country, with more than 122 different languages spoken all over the country. The most common Asian Indian languages spoken in Minnesota are Hindi, Gujarati, Urdu, and Bengali.
Asian Indians in Minnesota face several disparities in health outcomes and care delivery compared to the overall population. Some health issues are biologically tied to race.
More data on disparities in health and healthcare for Asian Indians
Social determinant disparities
Social determinants of health are economic and social conditions that influence the health of people and communities.
Many aspects of the Asian Indian Minnesotan culture today reflect the culture of the general U.S. population. Asian Indians in the U.S. may be Hindu (51%), Christians (various denominations) (18%), or Muslim (10%). Indian culture is patriarchal and families often are multi-generational, with grandparents sharing residence in the joint family system.
Most Indians do not like to negate, so they might say yes to things when they want to say no. A side to side head movement (usually in the form of a figure eight) typically indicates an affirmative response and is not to be confused with head shaking for no. Older Indian women generally do not engage in physical contact with males, such as with handshakes. Touching with feet or shoes is considered highly rude.
Diets vary tremendously depending on what region of India someone originates from. Northern Indians consume more meat, Southern Indians consume more sea food, and western Indians are often vegetarians. Approximately 40 percent of Indians are vegetarians. Hindus revere cows considering them sacred. They may take severe offense if offered beef. Traditionally, consumption of alcohol is frowned upon in Indian society. The traditional diet of Asian Indians in Minnesota is diverse; some aspects are healthful and some high in saturated fats and sweeteners, potentially contributing to obesity and obesity-related conditions. Many acculturated Asian Indians have replaced traditional meals with fast food, contributing to an increase in obesity, diabetes, and hypertension. For poorer Asian Indian Minnesotans, financial constraints often means consuming a diet based on inexpensive fast food and processed foods that are high in carbohydrates, sweeteners, and salt.
The Asian Indian Minnesotan attitudes towards U.S. medicine today generally reflect the attitude of the general U.S. population. Home treatments and remedies like massage and herbal medicines may be preferred by older Asian Indian women, while a physician is sought out only for serious illnesses. Asian Indian elders may practice Ayurvedic medicine, the traditional Indian system of medicine, as a means of preventing and treating illnesses.
Some data show how perceived discrimination may adversely affect obesity intervention outcomes targeted towards Asian Indians in the U.S.
Approximately one in five of all adults in the U.S. experiences mental illness in a given year. Disaggregated data on mental health is not widely available for Asian Indians, as compared to other Asian subgroups or the U.S. population as a whole. Some data shows rates of depression increasing in the Asian Indian population.
End of life
When discussing end of life issues with any patient, health care providers need to understand preferences based on personal and family views.
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