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by Kirsten Brown
The son of a coal miner,
Richard Greenlee, Ph.D., grew up in Southeastern Ohio in the
midst of the Appalachian countryside. Now the chairman of the
Ohio University Department of Social Work, he travels across the
state of Ohio educating child welfare agencies to the culture of
his childhood memories. Similarly, Greenlee will discuss with
OU-COM’s future doctors how to better treat Appalachian
patients through a better understanding of their culture in his
presentation, “Appalachian Cultural Competence,” Tuesday, April
18, from noon to 1 p.m. in Grosvenor West 111. His presentation
is a part of Minority Health Month.
Greenlee cites Daniel G. Bates
and Fred Plog’s definition of culture as “the use of shared
beliefs, values, customs, behaviors, and artifacts that a member
of a society use to cope with their world and with one another,
and that are transmitted from generation to generation through
learning.”
This definition also
specifically applies to Appalachian culture.
“I want to talk about
Appalachian beliefs, values, customs and behaviors that are
passed down and how Appalachians use them to cope with their
world,” he explains.
An Appalachian upbringing also
affects attitudes toward professionals, such as medical and
counseling professionals.
“I will explain how that
affects the way physicians work with Appalachian families,”
Greenlee says. “I will talk about the styles of parenting,
traditions, the roles that fathers and mothers play and some of
the challenges that Appalachian youth face.”
To address this issue,
physicians should have a firm appreciation of what cultural
competence entails, Greenlee says.
“Cultural competence would be
the notion that, first, you have to be self-aware of your own
culture and how you interact with others,” he explains.
“Everyone comes in with their own cultural perspective. It is
important that they understand their own and how that will fit
or not fit with other people’s cultural perspective. This
enables a professional to demonstrate the skills needed to
operate cross-culturally with other individuals and families.”
The manner by which medical
professionals work with Appalachian patients can help facilitate
or hinder a good working relationship between them, Greenlee
says.
“The rapidity of the medical
personnel sometimes creates a sense of alienation on the part of
the Appalachian,” he says. “The client can feel like they are
not being treated like a human being.”
Some Appalachian core cultural
values include perspectives on independence, individualism,
personalism, familism, a religious world view, neighborliness, a
strong sense of place and avoidance of conflict.
One particular relevant example
of avoidance of conflict depicts a scenario in which an
Appalachian patient outwardly agrees to follow his doctor’s
instructions, despite inward reservations. As a result, the
Appalachian politely consents but leaves his doctor’s office
without any intention of sticking to the prescribed orders.
“So that is a problem, because
you think that they are onboard with you,” Greenlee says. “The
physician has to create a very trusting relationship in which
the patient can tell how he or she really feels.”
To establish this trust,
professionals should use certain intervention approaches and
practice considerations, Greenlee says.
“In fact, a physician might
want to call to check in with the patient and say, ‘Are you sure
you really feel comfortable with this? Because you can tell me
if you aren’t, and we will work something different out for
you,’” Greenlee suggests.
Physicians should also
understand the importance of the core value personalism in
dealing with their Appalachian patients, Greenlee says.
“If the patient feels like they
are just another number, they will not like working with the
physician,” he explains, “so I think it is even more important
to ask these patients about their personal lives.”
Greenlee currently serves as
president of the Ohio chapter of the National Association of
Social Workers and served as president of the Tri-County Mental
Health and Counseling Services Board from 2001 to 2003. He has
received several awards, including the 2004-2005 Presidential
Teaching Award and the 2003 Rita Gillick Mental Health Advocate
Award. His research interests range from rural poverty and
communities to substance abuse and mental health.
Drawing from this extensive
research, Greenlee’s lecture will shed some light on the
strengths and stereotypes surrounding the culture of the
Appalachia.
“There are unfortunately a lot
of negative stereotypes,” he says. “So I will spend a lot of
time trying to get people to walk in the shoes of Appalachian
people.”
The Minority Health
Month series continues April 26 with Cora Munoz, Ph.D.,
Department of Nursing at Capital University. The final speaker
in the series will be Ronald Myers, M.D., founder, president and
medical director of Myers Foundation Christian Family Health
Centers. Myers will present “The Challenge of Providing Health
Care to the Poor” April 28.
- 30 –
News for
the week of
April
17
– April 22
Anderson Minority Health Month
lecture cancelled
News for
the week of
April
10
– April 15
News for
the week of
April 3
– April 8
News for
the week of
March 27
– April 1
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