Cultural identity can affect how service members and their families engage with their health care providers. A recent Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) webinar addressed these impacts and how health care providers can help minimize them.
Our Diverse Military
Like the larger American population, those who serve their country in the military represent an intersection of people from every race, class, gender and sexual orientation.
However, the military differs in many ways from the general population. There is less job-related segregation within the services and service members enjoy universal benefits regardless of their cultural background. The military also has policies aimed at supporting and enforcing equal treatment of service members. Despite this, problems with equal treatment exist within the military.
Disparity Affects Health Care
Webinar presenter Shelley M. MacDermid Wadsworth, professor of Human Development and Family Studies at Purdue University, discussed how people within certain groups experience worries that more privileged groups do not. These can range from trouble with economic stability to struggling to find proper health care.
Minority service members are less likely to receive screening, but may be more vulnerable to posttraumatic stress disorder, owing in part to race-related stress, according to some health care studies.
At the Department of Veterans Affairs, minority service members are less likely to have injuries judged as service-related. They are also more likely to opt out of treatment because they feel uncomfortable with their provider. Another study of military health care indicates that service members of certain sexual identity groups may have trouble finding an appropriate provider.
“It may be difficult to get certain kinds of treatment or to find a clinician that is well prepared to treat issues that they may have,” MacDermid Wadsworth said.
Members of minority groups may also face challenges that add an extra burden to their day-to-day lives, including:
- Micro-aggressions: Casual acts that degrade an individual based on cultural background. Often made by members of a different cultural group who do not perceive their actions as harmful, despite their negative impact.
- Implicit bias: The tendency we all have to make snap judgments on an individual based on a cultural factor. For example, reading a resume in a different way depending on the applicant’s gender or race.
- Minority stress: A high level of stress within certain cultural groups due to stereotypes and discrimination.
These stressors can create an environment where service members feel less comfortable seeking health care.
“These things are not necessarily intended to be stressful or offensive, but may have a cumulative impact,” MacDermid Wadsworth said.
Find a Way to Connect
Be aware that others may have different life experiences than you do, depending on their cultural backgrounds. An awareness of these differences and a willingness to reach out and listen to others can give you an idea of how to better accommodate them. Every stage of the process of seeking and receiving care offers an opportunity to engage more effectively with members of ethnic or cultural minority groups.
“Be a welcoming, engaging and supportive colleague no matter what the characteristics of your service member, coworker or friend might be,” MacDermid Wadsworth said.
Health care providers can seek advice and assistance from members of minority cultural groups. Doing so may help you identify areas where you can improve interactions with patients.
MacDermid Wadsworth cautioned against assuming that people will always want to act as cultural educators or pre-supposing something about a cultural group prior to asking. She recommended asking in a way that makes it clear you are open to listening and learning.
According to MacDermid Wadsworth, people want to connect with those who are trying to help them – a genuine connection not filtered through biases.
Materials for the webinar, “Outreach and Support to Military Families: Ethnic/Cultural Considerations,” are available online. Visit the DCoE webinar page for more content on psychological health and traumatic brain injury.