Uncategorized March 27, 2021

Cultural Competence 101 for the Chiropractor – Charmaine Herman, MA, DC

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Welcome to ChiroSecure’s weekly show Chiropractic, Connecting People and Communities with this week’s host Dr. Charmaine Herman as Dr. Herman says, and I quote, As an associate professor at Life University and the practicing chiropractor doing upper cervical work. I will be sharing my experiences as a Cultural Competence Trainer with the chiropractic community. And now here’s Dr. Herman.

Thank you, Dr. Stu. Hello everyone. This is Dr. Charmaine Herman at Agape Upper Cervical Health Center in Alpharetta, Georgia. I’m excited about our first session today of cultural competence for the chiropractor CC 101. So let’s go ahead and get started and talk about Colton a little bit about cultural competence, not initially, but we’re going to actually start moving into that topic in later episodes. But initially I want to talk about our goals for today. So our goals for today are let’s move on onto the next slide. All right. So our goals for today is going to be the introduction. I’ll go. I’m going to talk to you a little bit about who I am. I’m also want to talk to you today about a little bit back, uh, back background behind cultural competence, as far as where I’m concerned, and I’m going to move into revealing what this is cystic say about our profession and why cultural competence is a great skillset for a doctor of chiropractic.

So let’s move to the next slide again. My name is Dr. Charmaine Herman. I am originally from St. Andrew’s Jamaica. That’s where I was born. My family immigrated to the United States in 1969. Um, I actually became a naturalized citizens of the United States in 1993. I went to the various schools in New York and my education goes into Tuskegee university in Alabama. And then I graduated from the university of South Carolina with degrees in biology history, a master’s in history and certification in women’s studies. From there, I started working for the department of health in South Carolina, and I worked there for 10 years as a laboratory certification officer, as well as a cultural competence trainer in 2005, I attended Sherman college straight chiropractic at the time and graduated in 2009 with my doctor of chiropractic today. I’m a college professor at life university. I teach in the college of college of chiropractic as well as have a practice here in Alpharetta, Georgia, that I opened in 2013 with my husband.

So to the next slide, I have various roles at life university that come in contact with the need for cultural competence and diversity issues. Again, I said, I’m associate professor in the college of, in the division of clinical sciences. I’m also secretary for the diversity committee. Uh, I work as chiropractic liaison to the office of diversity equity and inclusion. I’m also the developer of the cultural competence training module that the office of diversity equity and inclusion uses on campus. And I’m also a trainer for that work. Um, in addition to that, I am the co-advisor for the student American Cairo black chiropractic association, our life university chapter on campus. And I’m a member of the black affairs council at LACC university. So let’s move on again to the next slide where I can get more into where cultural competence became part of my life. Well as a, um, employee for the South Carolina department of health, some issues occurred and I had have to become privy to working in regulations.

When we get a regulation, we have to Institute within the state, which can be sometimes challenging based upon culture. For example, the directive came down that burning rubber was no longer allowed. So working for a state agency, I’m glad I was not one of those officers who had to do this, but a lot of officers had to go up into the mountain areas of South Carolina to inform people who’ve lived there for generations, that they will no longer allow to burn a rubber. Uh, this was not a happy situation. Many of our officers were met with rifles and threatened for trespassing, um, because there was something missing in their, um, communication with the people that lived in that area. We also had the issue with, um, our home health nurses being receiving quite a bit of complaints because they tended to call their patients by their first name, which is considered very disrespectful, especially in many African American communities.

So there were a lot of complaints coming in because of our officers and our nurses doing their job, but again, not doing it in a way that could have been culturally competent taken in account the cultures that they were actually working with. So the directive next came down that each department had to be trained in cultural competence. So they asked for volunteers and I volunteered and was trained to be a cultural competence trainer for my department. So that’s how I initially got into cultural competence at the state agency level, as far as being involved in cultural competence as a chiropractor, no one ever mentioned that to me as I wasn’t a student, but it so happened that my love for research kind of pointed me in that direction. So in the next


Discuss how I actually started doing research on one topic and stumbled upon an article written by Dr. Claire Johnson and Dr. Bart green, entitled diversity in the chiropractic profession preparing for 2050. This article really, um, peaked my curiosity as far as what they were saying that we as chiropractors need to do to be prepared for 2050. So this is where I read this article and it started to talk about cultural competence, his conclusions on the next slide. I talk about this articles, conclusions. The conclusions were that the chiropractors were way behind gender and race diversity compared to other health practitioners. We were way behind the numbers, especially as our population was growing. There were not enough chiropractors in a diverse, um, in diverse numbers is not enough female chiropractors when they compared us to the other health professionals. And their final conclusion was that the chiropractic profession urgently needs to develop and implement strategies to address issues of diversity and cultural competence in order to prepare for the inevitable changes by the year 2050.

So again, these were things that peaked my attention because having been a cultural competence trainer, having, having been a woman of color and understanding the importance of diversity and the need for diversity, uh, and my position many times, I’m the only woman or the only woman of color in many meetings. When I worked for the department of health, when I went to EPA meetings and things like that, I saw that quite a bit as well as when I was at, at, um, Sherman college and in my undergraduate education. So I understood the importance for diversity in the professional field. So in the next slide, I’m going to discuss just what happened next, because my curiosity got piqued so much that I, um, applied for a grant. So the office of research and scholar Scholastic activity on campus, and I was given a research grant to research the whole idea of cultural competence and that research article, our research was entitled educating the 21st century doctor of chiropractic a two-year study to research the design pilot and evaluate the feasibility of integrating cultural competence into the doctor of chiropractic curriculum at life university.

And that was pretty interesting just to start doing that retreat research. It’s a two year process. I’m still writing information, learning more. As I continue through the process, though, the grant has been finished, I’m still still working on this project. So I’ve used that information to feed into the information I’ll use to work with you guys, as far as why cultural competence is going to be important as we move forward in the doctor of chiropractic profession. So the next slide, I want to talk about the numbers. What do the statistics say about chiropractic? Where are we as a profession? Um, how can we do better and what areas do we need to, but to, to do better in, so onto the next slide, when we look at our numbers, our numbers are definitely increasing looking at the numbers from the federal chiropractic licensing board, uh, who actually gets all the numbers from the state chiropractic licensing boards.

We can see the number of chiropractors that are licensed in our country continues to increase. In 2000. We were at 80,000 doctors of chiropractic in 2017. We’re at 96,000 doctors of chiropractic. That’s not a lot when you look at the scheme of our population, but we definitely see our numbers are going up the 2000, 19, 2020 numbers. However, it’s still being tallied. So I don’t have a final number on that, but at my last count, it was at 91,000 doctors of chiropractic. So with COVID, some things have, um, um, a lot of other agencies haven’t reported as well as they could have as they have done in the past. So hopefully in the near future, we’ll find out the final numbers for 2019, 2020. I do want to make a comment that the board of chiropractic examiners in most States, if not every state do not take an account, the gender or the race of the chiropractor, that’s registered for a license there.

So that’s some data that actually is missing that we can actually use when looking at our numbers as doctors of chiropractic serving our country in the next slide, I’ll look at some data coming from the national Institute of health, where they talk about how many people have actually seen chiropractors in the last 20 years, I would say from 2002, up until 2017, according to their data, 8.4% of the United States adults. That’s about 19.4 million have used chiropractic or osteopathic manipulation between 2002 and 2012 in also 9.5 United States. Adults use chiropractic, I’m sorry, use yoga between 2002 to 2012. When we look our chiropractic numbers in 2012, 9.1, us adults actually use the chiropractor. And in 2017, it was up to 10.3% of adults in the United States actually use chiropractic. One thing was documented in their research was that non-Hispanic white adults were more likely to use yoga, meditation and chiropractors compared to Hispanic and non-Hispanic black adults.

So even the NIH is looking at how our numbers affect all communities in our country. On the next slide, I want to discuss where we are as far as our percentage by gender. And if we look at our presenters of chiropractics by gender, that number is definitely increasing. Now at this data came from the NBC, the national board of chiropractic examiners practice analysis of chiropractic, um, document that they just released for 2020. You can obtain this on their website and BCE that orgy, and they are looking at these numbers. We’ll adjust those from the doctors that participated in the surveys that they sent out in 2019. So it’s not a large number of chiropractors. It’s not the 92,000 chiropractors that have been surveyed to look at these numbers, but it’s a smaller, um, research that, that shows that we still see increasing numbers of female chiropractors in reference to male chiropractors into in 1991, we had 86.7% male chiropractors, 13.3% female chiropractors.

In 2019, we have 67% male chiropractors and 31% female chiropractors. So the numbers have definitely come closer together with female chiropractics being about half the number of male chiropractics co-occur chiropractors. We also see that with, um, enrollment in chiropractic colleges at life university, our enrollment is about 51 49 male to female, as far as enrollment of chiropractic students, male to female. So we do see that changing and having changed over the time. So let’s move on to the next slide and talk about a percentage of chiropractors based upon race. Um, these are separate data. Um, one is from the study that I read in 2019 with Dr. Johnson and Dr. Green. And that shows that 10%, I’m sorry, 85% of chiropractors were white compared to, um, 0.8% at the time being black or African-American, um, 1% being Hispanic or Latino. I’m sorry. Two point I’m sorry.

2.6% is being Asian and 4% being 0.4% being African-American in 2019. Again, this number comes from the NBCE research study. Um, I’m sorry for chiropractic that they did it for 2020, and they found that 90.8 of their respondents to their survey were white chiropractors. 1.6% were black or African-American. Um, 3% were Hispanic or Latino. 2% were Asian or Pacific Islanders, 1% native American, and 1.7% were other compared to the 10.2% of other back in 2012. So our, the numbers are changing, um, for African-American chiropractors. It seemed to have doubled, but again, the sample size is not, again that 96 or 92,000 chiropractors listed on the faculty. I’m sorry to the federal chiropractic licensing board site. So again, it’s a smaller sample size, but again, we’re seeing again, the majority is still going to be the white chiropractor in the United States because of the numbers that are already there on the next slide.

It shows that the most common race, ethnicity, and gender combination for college of chiropractic graduates in 2016 also showed that white males received 1098 chiropractic degrees, white females, 694 chiropractic degrees, and our Hispanic Latino male received 89 degrees from the 89 degrees from the deck from the college of CA from colleges of chiropractic. So again, um, this again matches pretty much our population, what the numbers look like. I always, what was the big deal between, um, why we needed to have a change in the number of people that we see, because I think that’s going to be important, uh, not a big deal, but I, it was always concerning to me. How many people have actually seen a chiropractor? Cause I know when I was growing up, I never saw a chiropractor. I never saw a chiropractic office. I didn’t know what a chiropractor was till I was a late in my thirties and I already had a master’s degree before I actually knew what a chiropractor was as someone else had to introduce them to me.

So when we talk about our numbers and who we see, I go back to a quote from BJ Palmer. And on the next slide we did Palmer talks about, uh, seeing the world, regardless of who or who the person is or how they look VJ said, give me a spine, not a color of the skin, but give me a spine. And I’ll set the world on fire. That was an amazing comment from him. And I wanted to see, have we actually started to set the world on fire. We see 10% of the population. Um, how much of that population have we seen in other who are in other communities, um, underrepresented communities in our country. So on the next slide I go into talking about just that from that previous research study with Dr. Johnson, Dr. Green, they actually looked at those numbers and they found that chiropractors in 2012.

So 12.5% of white, the white population, as far as being part of that 10% back then. Um, but we’re seeing negative as far as other communities, especially minority communities, net negative 11.7% blacks. And African-Americans five negative 5.2 Hispanic, Asian negative 2.4 and native American negative 0.5. So there is a definite disparity, as far as us bringing chiropractic to the world, as far as the patients that we actually see and careful. So moving on to that, I said, well, they’re talking about what’s going to happen in 2050. So based upon the 2010 us census, the numbers of our population are definitely shifting. So what we’re looking for in 2050 is a decrease in the minority population, I’m sorry, in the majority population and increase in the, in the minority populations. So what we see here is estimated at 51% white Americans, 24% Hispanic, Latino Americans, 12% African-American or black Americans, 8% Asian Pacific Islanders, and 2% eight native Americans.

So we’re seeing a shift in our population that there is estimating by 2050 that our minority populations are going to be called emerging majority populations because they’re going to have larger increases in their growth. So looking at this information, I go into the next side. It tells me that chiropractors, we need new skillsets. We need new to help us reach the emerging majority that are coming into the world, being born into the world who have no idea what chiropractic is even with 96,000 chiropractors or 91,000 chiropractors. So few people actually know what chiropractic actually is. So this is going to be an important time for chiropractic to consider advanced training, whether cultural competence training or the diversity training, even global marketing in order to better reach the masses of people who need to know the advantages and the benefits that chiropractic can give them. So this is just the beginning of, um, this, these episodes of teaching.

So in the next episode, so on the next slide, I’m going to get more into exactly what cultural competence is not. And I do that because I’ve found even in training, people have preconceived notions of cultural competence. So I like to go and explain the exactly what it is not. And then we can get into actually what it is. I also want to talk about culture. I want to define culture and defined what is culture. Let’s talk about that and have that conversation. So that’s all for today. So hopefully you’ll join me for the next episode next month, or I’ll talk more about chiropractic and what cultural competence actually is. So thank you for your time and especially thank you to ChiroScure for actually offering these opportunities next week, stay tuned for doctor and core for cash. Who’s going to speak to you about his experience in our chiropractic community. Thank you again and have a great day.