threatening the child with harm should he or she
say anything to others about the abuse.
It is crucial that anyone who suspects a
child is being abused, regardless of the
person’s relationship to the child, notify
a health-care provider or other author-
ity. Many communities have anony-
mous telephone hotlines for reporting
suspicions of child abuse.Detection and Intervention
All communities have child protection agencies
and legal mechanisms to safeguard the well-being
of children. Most states require health-care
providers, educators, and other adults who have
frequent interactions with children to report any
suspicions or signs of child abuse. Child protection
authorities then investigate the situation and may
remove, temporarily or permanently, an endan-
gered child from an abusive environment or situa-
tion. The longer the child remains in the abusive
situation, the more serious and long-lasting the
physical and especially emotional consequences.
The safety and health of the child is the priority
in circumstances of neglect and abuse. However,
because not all neglect and abuse is purposeful,
parent education programs that teach PARENTING
skills as well as nonabusive methods to manage
child discipline and the stress of parenting may
help a parent or caregiver change his or her
behavior such that it becomes appropriately nur-
turing and supportive.
See also CULTURAL AND ETHNIC HEALTH-CARE PER-
SPECTIVES; DOMESTIC VIOLENCE; ELDER ABUSE; FACTI-
TIOUS DISORDERS.
cultural and ethnic health-care perspectives
Awareness of, respect for, and accommodation of
the traditions, beliefs, and customs of diverse cul-
tures and ethnicities within the conventional prac-
tice of medicine. Factors may include language
(non-English speaking), immigration status, views
about doctors and personal privacy, and the influ-
ence of religious or spiritual beliefs as they relate
to the reasons for illness and the role of treatment.
The American model of medicine encourages
shared participation between health-care
providers and patients. This model expects
patients to question what they do not understand.
People from some cultures may expect the
provider will choose the appropriate therapy and
are reluctant to ask any questions. In other cul-
tures families make decisions about health care,
sometimes without participation from the person
who is receiving the care. These factors influence
patient compliance—whether the person carries
out the treatment the doctor or other health-care
provider recommends. The American model of
medicine also has a relative openness about per-
sonal privacy and the sanctity of the body, facets
of health care that are often distressing or offen-
sive to people of other cultures who may refuse
diagnostic or therapeutic procedures unless
providers are able to accommodate their customs
and beliefs.
Cultural competency is now part of education
and training for many health-care professionals in
the United States, including physicians, physician
assistants, nurses, dentists, and allied health staff.
Nearly all hospitals have translators available to
overcome language barriers. About 18 percent of
the population in the United States speaks a pri-
mary language other than English, and cultural
and ethnic minorities collectively make up about a
third of the US population.
See also AYURVEDA; GENERATIONAL HEALTH-CARE
PERSPECTIVES; NATIVE AMERICAN HEALING; SPIRITUAL
BELIEFS AND HEALTH CARE; TRADITIONALCHINESE MEDI-
CINE(TCM).cultural and ethnic health-care perspectives 243