Introduction
Welcome! From Heritage to Health: An Art–Centered Approach to Cultural Competence (H2H) is a multi-year project that highlights the ways in which storytelling and the arts can inform the diverse practices of medical professionals. It is aimed at bringing healthcare providers closer to patients, using various art forms and stories as a bridge between western “medical practices” and personal beliefs, traditions and faiths. This tool kit introduces this initiative by highlighting the central themes and ideas of H2H; showing you some compelling videos in which artists offer their insightful perspectives on healthcare; and by inviting viewers like you to access the resources and the two accredited e-learning courses, “Concepts of Culturally Sensitive Care” and “Welcoming Patients to Your Practice.” The links appear below. To date Concepts of Culturally Sensitive Care has been viewed by 5,997 learners, and 3,311 CE certificates have been awarded. Welcoming Patients to Your Practice has been viewed by 6,397 learners and 3,221 CE certificates have been awarded. From Heritage to Health is a joint venture of the Nurse Practitioner Healthcare Foundation and City Lore. We gratefully acknowledge the funding for this project received from the National Endowment of the Arts and the Westchester Medical Health Network Center for Regional Healthcare Innovation. H2H includes a learner needs assessment, public and professional presentations, eLearning courses, and other forms of educational outreach that enhance cultural competency in healthcare. Programs to date have addressed concepts of cultural health, applying cultural health concepts in clinical practice, and – coming soon! – an arts-centered approach to issues in death and dying. Special thanks to folklorist Naomi Sturm for introducing us to a number of the participating artists. Here are some extraordinary artists whose wisdom and practice we showcase as examples of how the arts and storytelling can inform cultural competence.
Rationale
The growing diversity of the U.S. population makes it challenging for the healthcare team to adequately address the specific needs of each diverse group of patients. Health professionals and their patients often come from different cultures and speak different languages, both verbally and non-verbally. This makes it difficult to offer healthcare solutions that will be acceptable to patients from differing cultural backgrounds. Individuals’ beliefs relating to health and spirituality in many of the world’s cultures are conveyed through the arts – not as they are experienced in books or movies, but as they are lived and incorporated into daily lives. Through stories, poems, pictures, sculpture and other art forms, the arts are a way to engage people in non-threatening ways. Using the arts to engage the patient and communicate takes out the barriers of medical terminology and language differences. It provides a common platform to establish rapport and communication that does not negate patients’ health beliefs or alienate them in the process. Encouraging creative expression and utilizing it in medical practice is a way to further healing of the patient’s physical, mental and spiritual self. In this video, sculptor, folklorist and outreach coordinator for Hudson River Healthcare discusses the value of the arts in healthcare.
Healthcare and the Arts
“In Western Medicine,” says Sierra Leone poet and storyteller, Kewulay Kamara, “the central metaphor is the pill. In Africa, it is the story.” H2H encourages medical practitioners to consider and value the healing strategies and non-harmful home remedies that patients bring with them to the doctor’s office or hospital. In this video, master storyteller and cancer survivor Annie Lanzillotto tells a story about garlic in the hospital, and discusses home remedies with a group of promotores (health outreach coordinators) at Hudson River Healthcare in Peekskill, New York.
Western Medicine Takes on Garlic and Other Home Remedies
Our two e-learning courses also cover role of a patient’s faith in the healing process. In this video Annie discusses the role of faith in situations in which the doctors and medical professionals tell the patient that there is nothing more they can do.
Keep the Faith
https://youtu.be/-pz8cQnwmis H2H also aims to encourage hospitals and other medical settings to undertake arts initiatives that can both provide comfort and inspire patients. The AIDS quilt is perhaps the most famous example. This video presents a compelling mural arts initiative undertaken by Hudson River Healthcare encouraging the community to engage with the healthcare system. Project Director Karen Allen discusses how the mural not only brings people to the healthcare center, but also fosters their physical and mental wellbeing.
A Healthcare Arts Initiative
Toolkit
Below are links to two accredited eLearning courses developed through this project, and links to other resources – articles, websites, videos, poems, etc. that will expand your understanding of cultural aspects of health. These resources will also sensitize you to the wide diversity of cultural beliefs related to health and inspire new ways of working with patients.
eLearning Courses- 2022 Update
In a novel approach to cultural competency training, these two courses use illustrations from music, sculpture, painting, poetry, dance, hip-hop, and other art forms, and stories from folklorists of varying cultural backgrounds, to raise awareness of the need to employ cultural sensitivity in care delivery. The two accredited courses provide a practical “how to” set of guides, and offer participants continuing education credits. Course #1, Concepts of Culturally Sensitive Care focuses on the underlying concepts of culturally sensitive care: cultural humility, knowledge of various cultures, narrative competency, and structural competency or system “savvy.” Concepts are presented in a compelling way, with videoclips, images, and stories that enliven and inspire the content. The course will take about 60 minutes to complete. Heritage to Health: Concepts of Culturally Sensitive Care (ID #6142 /W20-68A) Activity Link: https://www.mycme.com/heritage-to-health-concepts-of-culturally-sensitive-care/activity/6142/ Course #2, Welcoming Patients to Your Practice, highlights the key skills needed to reach out and engage patients in their care in a sensitive manner. Respect and rapport, eye contact, accepting faith-based beliefs, appropriate touch, active listening, and avoiding ethnocentric responses are all highlighted through the artists’ lenses and works. The course will take about 60 minutes to complete. Heritage to Health: Welcoming Patients to Your Practice (ID #6193 /W20-68B) Activity Link: https://www.mycme.com/heritage-to-health--welcoming-patients-to-your-practice/activity/6193/ Continuing education credit is available for completion of each course.
Other Resources: Resources are listed by content area and topic.
Concepts of Cultural Health
Art & Well-Being: Toward A Culture of Health by Arlene Goldbard This is a comprehensive guide, developed by the non-profit United States Department of Arts and Culture (USDAC), to understand a culture of health, the role of social determinants of health, and how art-based interventions can ensure well-being. Art & Well-Being includes a framework for understanding a culture of health, one that responds equally to all individual and community needs. Looking at the social determinants of health—such as race, class, and gender—it demonstrates how social justice is the single greatest factor in ensuring well-being. It features three detailed case studies, dozens of project descriptions, and hundreds of links to powerful arts projects, research resources, and detailed accounts for those who want to go even deeper. (Click Here) Birth and Rebirth on an Alaskan Island: The Life of an Alutiiq Healer Joanne B. Mulcahy Birth and Rebirth on an Alaskan Island offers the fascinating story of Mary Peterson's life, from her experience growing up within the traditional society of Akhiok to her work as a teacher, a community health aide, a mother, a grandmother, and an Alutiiq midwife and healer. This article explains how a patient's cultural background affects how he or she experiences illness. (Click here) Transcultural nursing: how to avoid stereotyping by reaching a deeper understanding of your patient's cultural preferences. (Click Here) This site has a range of educational materials related to cultural aspects of health. (Click Here) Take this quizlet about cultural diversity! (Click Here)
Clinical Application of Cultural Health
Nursing is complicated by cultural differences among patients - this article discusses how to vary methodology according to those differences. (Click Here) Religious Diversity: Practical Points for Healthcare Providers. (Click Here)
Aging
Understand how deeply ingrained some common cultural beliefs are in older patients. (Click Here)
Touch
This article discusses how physical contact varies by culture. (Click Here) An overview of cultures that dislike physical contact the most. (Click Here) Nurses: when should you touch? How often? More important, whom and what can you touch? (Click Here)
Asian Cultural Health
This article gives an overview of traditional Asian health beliefs and healing practices. (Click Here) An excellent article and video presentation on best practices for working with Asian patients. (Click Here) This article explains the cultural values of Asian patients and their families. (Click Here)
Latino/Hispanic/Mexican Cultural Health
Remedios: The Healing Life of Eva Castellanoz by Joanne Mulcahy (San Antonio, Texas: Trinity University Press, 2010) A biography examining the maxims, faith, and enduring struggle of a celebrated curandera. For more than a decade, Joanne Mulcahy worked with Eva Castellanoz to capture her astonishing and sometimes harrowing life story from a poor farm worker in the Rio Grande Valley to a life of dignity and recognition. Remedios covers Eva’s experiences as a Mexican American curandera, or healer, curing everything from acne and susto (fright), to insomnia and “the evil eye.” Advancing Cultural Competence in the Public Health and Health Care Workforce, a webinar offering a structural competency approach to Latino/a health disparities. (Click Here) An colorful and interesting slideshow highlighting health and illness beliefs among Hispanic and Latino cultures. (Click Here) This article discusses how to better communicate with the Mexican/Latino patient. (Click Here) This article explains curanderismo and healing practices among Mexicans and Mexican Americans. (Click Here) This article gives an overview of the Hispanic/Latino population - the largest minority group in the United States. (Click Here)
Muslim Cultural Health
This article examines cultural competence in nursing Muslim patients. (Click Here) The Crescent of Care: a nursing model to guide the care of Arab Muslim patients. (Click Here)
Arab Cultural Health
An overview of Arabic cultural values. (Click Here)