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    Mullan (2005) reports an estimated 1.5 million legal and illegal immigrants are arriving in our country each year. Greater than 40 % of immigrant children live in low-income families. Immigrant children enter the healthcare system insured or uninsured and require our care. Industriousness and the desire to escape poverty pull families apart; children may either be left behind in the home country to be cared for by relatives till they can be sent for or left home alone while both parents work. This creates opportunities for adolescent children to be recruited by gangs. Gangs provide a community for troubled teens (Mullan).

    It can not be denied that today's healthcare practitioners have a predominately Caucasian, Judeo-Christian background who are being asked to provide culturally competent care to a wide spectrum of cultures which can't all be familiar to the practitioner. Also, the model of professional healthcare education has a similar background. It is imperative that the practitioner acknowledge personal limitations and lack of knowledge in order to be open to information from alternative sources.

    Flaskerud (2007) commented on Nightingale's dilemma in Crimea as well as the current relationship with cultural competence and health disparities. Health disparities can be reduced by focusing on risk reduction, vulnerability reduction, and protection and promotion of human rights. Allowing clients to have inclusion in planning and carrying out healthcare promotes social power and status. Nurses must heed the evidence of positive outcomes and involve clients in designing their own health care programs (Flaskerud).

    In recognizing the need to provide culturally competent care, the North Carolina Division of Social Services adopted the family group conferencing model as a treatment model to fit diverse client communities (Waites, Macgowan, Pennell, Carlton-LaNey, & Weil, 2004). This model seeks to be guided by traditions, worldviews, and strengths of individual cultural groups. Focus groups were conducted with three different cultural groups: African Americans, American Indians, and Latinos. Each group reported positive feedback with the program. Participants of the program felt an increased likelihood of success due to family ownership of the solutions.

    The role of elders was an important factor in family group conferencing. However, in the Latino/Hispanic families this could be a challenge if the family is recent immigrants (Waites, et al., 2004). Elders may live in other countries. In the case of Youda, and his family, this approach could be considered as they have an extended family present in this country.


    Flaskerud, J. H. (2007). Cultural competence: What effect on reducing health disparities?
    Issues in Mental Health Nursing, 28(4), 431-434.

    Mullan, F. (2005). Immigration pediatrics. Health Affairs, 24(6), 1619-1623.

    Waites, C., Macgowan, M. J., Pennel, J., Carlton-LaNey, I., & Weil, M. (2004).
    Increaseing the cultural responsiveness of family group conferencing. Social
    Work, 49(2), 291-300.

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