Abstract
The increasingly diverse population presents challenges that require building a Culture of Health through Mindfulness into Action (Vergara's methodology). Previous studies suggest (Vergara, 2016a; Vergara, Wallace, Du, Marsick, Yorks, Gordon et al., 2016b; Vergara, Parks, Reyes, Tamariz, 2016e; Vergara, Tjernstad, Mac Quarrie, Tamariz, 2016f) that Mindfulness into Action (MIA) disrupts unconscious bias and facilitate a cultural humble stance that gives the potential to foster taking a perspective during this modern fast paced dynamics in life with chronic stress. Chronic stress refers to high stress sustained over extended periods of time. Chronic stress occurs among adults, but among young people more frequently, and it is more closely related to maladaptive health behaviors and mental health problems, than acute stress, or episodic triggers of stress (Leonard, Gwadz, Ritchie, Linick, Cleland, Elliott, & Grethel, 2015; Carter, Garber, Ciesla, & Cole, 2006). Children in poverty are more likely to experience both chronic and acute stress than their affluent peers (Almeida, Neupert, Banks, & Serido, 2005). Ross recognizes that removing bias and understanding the cultural patterns creates greater equity; however, disparities persist (2014, p. xii). Health People 2020 (HP 2020) was developed by the U.S. Department of Health and Human Services, and commits to eliminating the “range of personal, social, economic, and environmental factors” that prohibit a person from attaining health, and implement policies that “achieve health equity” for all Americans. Braveman states that health equity means “no one is denied the possibility to be healthy” (2014, p. 6). The 2012 Institute of Medicine report highlights a need to reduce health disparities by identifying various “intervention strategies to improve health outcomes in vulnerable populations”, highlights persistent and significant gaps between the quality of health care people should receive, and the quality of care they actually receive (p. 76). Currently, there is great disparity in health as we address external factors, however an additional approach that addresses factors from within is needed to build a culture of health. Dees describes about how beliefs about health and disease vary across cultures, ethnicities, races and faiths (2007, p. 34). However, it is common for people to have an ethnocentric approach regarding health. An ethnocentric approach can be a source of conflict. “Belief regarding health, illness and healing vary among different cultures” (Dees, 2007, p 35). Chakkarath (2009) suggests that Western psychological concepts no longer are the only valid scientific concepts inside the discipline. Further, he suggests that psychology as a discipline can only profit from an indigenous approach because it can introduce traditions of thought and alternative empirical and theoretical approaches that can both challenge and contribute to psychology's universalistic orientation. For that reason, by paying attention to our wholeness and factors from within, the Mindfulness into Action methodology includes indigenous practices from America, Africa, and Oceania (Vergara, 2016b).
TopIntroduction
To support efforts to build a culture of health, this research aims to identify learning outcomes and methods for developing culture-general capabilities that apply in any intercultural setting (from studies done in Norway, USA and Ecuador). Health is a basic human right and an overarching goal of Healthy People 2020 in the United States is to provide every person with the same opportunity to stay healthy, regardless of race, ethnicity, gender, economic conditions, social status, environment, and other socially determined factors. Healthy People 2020 was developed by the U.S. Department of Health and Human Services, to commit to eliminating the “range of personal, social, economic, and environmental factors” that prohibit one from attaining health, and implement policies that “achieve health equity” for all Americans. Healthy People 2020 observed that disparities in health are in groups of people who have “experienced greater social or economic obstacles to health” because of “their racial or ethnic group, religion, socioeconomic status, gender, age, mental health, physical disability, sexual orientation or gender identity, or other characteristics historically linked to discrimination and exclusion”. Having these characteristics linked to discrimination and exclusion produces chronic stress. Chronic stress refers to high stress sustained over extended periods of time. Chronic stress occurs among adults, but among young people more frequently, and it is more closely related to maladaptive health behaviors and mental health problems, than acute stress, or episodic triggers of stress (Leonard, Gwadz, Ritchie, Linick, Cleland, Elliott, & Grethel, 2015; Carter, Garber, Ciesla, & Cole, 2006). Children in poverty are more likely to experience both chronic and acute stress than their affluent peers (Almeida, Neupert, Banks, & Serido, 2005).
Brennan-Ramirez, Baker, and Metzler state that inequitable distribution of sociocultural determinants of health, explains in part why some Americans are healthier than others (2008, p. 4). Braverman describes sociocultural determinants of health as the societal conditions and psychosocial factors (external factors), such as opportunities for employment, access to health care, hopefulness, and freedom from cultural bias that have an impact health (2014, p. 6). Currently, we are addressing external factors as a way to have an effect regarding disparities in health. Dees describes about how beliefs about health and disease vary across cultures, ethnicities, races and faiths (2007, p. 34). However, it is common for Western people to have an ethnocentric approach regarding health. An ethnocentric approach can be a source of conflict. “Belief regarding health, illness and healing vary among different cultures” (Dees, 2007, p 35). This chapter is proposing to build a culture of health through addressing factors from within, by using the methodology called Mindfulness into Action. Chakkarath (2009) suggests that Western psychological concepts no longer are the only valid scientific concepts inside the discipline. Further, he suggests that psychology as a discipline can only profit from an indigenous approach because it can introduce traditions of thought and alternative empirical and theoretical approaches that can both challenge and contribute to psychology’s universalistic orientation. For that reason by paying attention to our wholeness, the Mindfulness into Action methodology includes indigenous practices from America, Africa, and Oceania (Vergara, Wallace, Du, Marsick, Yorks, et al., 2016b).
Key Terms in this Chapter
Implicit Biases: Unconscious, and unintentional words and actions that convey stereotypes and prejudice.
Unknown Behavior: Behaviors that are embedded in our subconscious that associated with the fundamental way of thinking and perceiving the social process in various social settings.
Mindfulness into Action: It is a methodology that combines indigenous practices with organizational learning techniques and facilitates a dynamic interplay of self-knowledge (suspending bias), skill (communication), disposition (cultural humility) and, self-efficacy to perform successfully in culturally diverse situations.
Unconscious Bias: Unconscious bias is universal. Unconscious biases are prejudices we have but are unaware of. They are “mental shortcuts based on social norms and stereotypes.”
Microaggressions: Frequent, subtle indignities expressed in relation to one’s gender, race, sexual orientation, or otherwise marginalized social position.
Action Research: Research initiated to solve an immediate problem or a reflective process of progressive problem solving led by individual.
Cultural Humility: Attitude that is characterized by respect for others and a lack of superiority.
Chronic Stress: Chronic stress is the response to emotional pressure suffered for a prolonged period over which an individual perceives he or she has no control.
Cultural Competency: Set of academic knowledge that allows individuals to increase their understanding of salient aspects of new and unfamiliar cultures, and thus effectively operate in different cultural contexts.
Social Conditioning: Diverse cultural characteristics that have a pervasive influence over all aspects of our everyday experience, including “perceptions of, and interactions” with others.