Academic journal article Journal of Cultural Diversity

Overcoming Barriers to Diversity in Chiropractic Patient and Practitioner Populations: A Commentary

Academic journal article Journal of Cultural Diversity

Overcoming Barriers to Diversity in Chiropractic Patient and Practitioner Populations: A Commentary

Article excerpt

Introduction

Increasing the diversity of practitioner and patient populations has been identified as a worthy goal in the chiropractic profession. The term diversity was used to represent differences in race, sex, sexual orientation, economic status, ethnicity, religion and other life circumstances. Diversity has been the subject of a few chiropractic papers (Johnson et al, 2012; Johnson and Green, 2012; Hammerich, 2014) and was the theme for the 2012 Association of Chiropractic Colleges/Research Agenda Conference (ACC/RAC). This goal would seem to fit with the growing public health involvement of the profession (American Public Health Association, 2012) as well as the idea that health care providers should be involved with social justice (Green and Johnson, 2010). Now that the majority of chiropractic teaching institutions exist outside the United States (World Federation of Chiropractic, 2012), diversity in chiropractic will be increasing in patient and practitioner populations throughout the world as a whole, but within the United States, the diversity in the profession does not match the population at large. (Chronicle of Higher Education, 2010; Christensen et al, 2010; Callender, 2006; Mackenzie et al, 2003; Graham et al, 2005; Su and Li, 2011; United States Census Bureau, 2011; Johnson and Green 2012; Whedon and Song, 2012)

The authors and conference speakers have offered some solutions. Most illuminated elements of different cultures as well as strategies for teaching and practicing in ways that were sensitive to those differences. Short summaries of the invited speakers to the above-noted conference were published in a paper, (Johnson et al, 2012) and showed sensitivity and insight into dealing with an increasingly diverse population in one-on-one or small group settings. Similarly, the papers on diversity in chiropractic largely focussed on individual or small group interactions. (Hammerich, 2014; Johnson and Green, 2012) In 2012, the overarching accrediting body for chiropractic teaching institutions, the Councils on Chiropractic Education International (CCEI) held a meeting to discuss strategy. In the summary document subsequently published, the only mention of diversity was in point 5 of the objectives: "Promote continuous improvement of model international educational standards, while recognizing the existence of educational, cultural, and jurisdictional diversities." (Phillips, 2012)

It was surprising that the focus of these scholarly endeavors was almost entirely on the microcosm of an individual dealing with another individual or small group. With one exception, there was no mention of the macrocosm of profession-wide policy or national law that may have potentially important ramifications for diversity within the chiropractic and other health care professions. Johnson and Green (2012) did mention leadership and policy issues in a list of action points. They suggested that the profession create a position paper on diversity, incorporate diversity issues into leadership, develop a process by which diversity beyond race and sex can be measured in the workplace, create culturally competent leadership policies and environments, and establish health care reform activities. (Johnson and Green, 2012) These policy level changes are ambitious, and may be quite challenging to accomplish.

Diversity is a concept that does not enjoy universal endorsement in the United States, as will be shown below. Chiropractors must work to combat inequality and bigotry in society at large, not just in their offices and classrooms. Consideration should be given to politics on the local, state and federal level. The government's involvement, or lack of it, can have a profound effect on access to healthcare, as well as the education that helps create new healthcare providers from people who are born and raised in disadvantaged communities. In addition, racism at all levels, personal, institutional, and societal, have negative influence on a wide variety of health indicators, and thus may be considered a public health issue. …

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