Advocacy Plan
My advocacy plan for Ethiopians in the U.S. is a community advocacy interventions. I will discuss with other counseling students and other healthcare professional on best practices when working with Ethiopian clients. In particular how to best use their strong cultural value in spirituality in the healthcare field. I chose this image because it makes me feel more relaxed about the topic. Instead of teaching a lecture hall full of people it is a more relaxed discussion among individuals. I think this topic will be difficult for some healthcare professions to understand because it goes against the discourse surrounding western medicine. This picture represent how I believe these healthcare professionals can come to understand how to merge spirituality with their healthcare services. At first it was hard for me to understand how or why someone would want spirituality in their healthcare but after sitting down and having discussions and asking these questions it was very easy to understand.
Servant Leadership
The servant leadership project that I am designing focuses on incorporating spirituality in to the healthcare of Ethiopian-Americans. Spiritual healing and prayer was the most frequently used treatment strategy of Ethiopian-Americans (Chaumba, 2011). Health education programs that incorporate the beliefs of spiritual healing or prayer could benefit Ethiopian-Americans by creating a more comfortable space for them to receive healthcare and a more confidence in the effectiveness of the treatment (Chaumba, 2011). I agree with this finding because this was a topic that was brought up in 2 of the 3 interviews I conducted as well. The students I spoke with believe that their spirituality is so central to their core identity that they would like to have in incorporated in to their healthcare as well. The servant leadership plan would be to talk to Ethiopian spiritual leaders to better understand their spirituality and how to incorporate it in to healthcare and then share those findings with fellow counseling students and other healthcare professionals. I feel excited about this topic. I believe learning more about spirituality of others and incorporating that in to a healthcare setting would be beneficial to my own learning as well as the health of others. The photo is of an Ethiopian Orthodox church and I think the colors capture my feelings of excitement about learning more about spirituality. I think this topic is very interesting because it goes against what one would think of as traditional western healthcare. Western healthcare tends to separate spirituality and healthcare but this group is asking for the opposite. This is a new way for me to think about healthcare as well so I am interested in learning how one does incorporate spirituality into it. This picture is representative of my learning in that it shows something that is new to me. Seeing a church with bright beautiful colors instead of the usual more subdued colors is new to me just as learning to incorporate spirituality in to healthcare is new to me.
Strengths-Based Needs
The most effective treatment strategies for Ethiopians who do seek out healthcare involve some level of spiritual or religious treatment as well as traditional medicine (Chaumba, 2011). It was also reported that Ethiopian culture strongly emphasizes Orthodox Christianity which can be tied back to Ethiopia adopting the religion in the 4th century, long before Europe (Habecker, 2012). Religion is also the primary means by which Ethiopian immigrant parents pass down aspects of culture to their second-generation children (Goitom, 2017). All three of these articles points towards religion being central to the Ethiopian culture and way of life. Health professional working with Ethiopian clients should use the Ethiopian cultures strong identification with religion and spirituality in order to better serve clients by incorporating spiritual and religious treatment alongside of traditional medicine. I feel empowered about the understanding of how important religion is to Ethiopian culture. The image captures my feeling because it shows a stethoscope on a bible capturing the essence of using religious beliefs within the healthcare system. I think this topic is very interesting. I think it is important to treat others how they want to be treated and this picture represents the part of the Ethiopian population who want religion or spirituality to be more involved in their healthcare. This topic was especially interesting for me because as someone who is not religious the areas of religion and healthcare or medicine seemed very distinct and separated to me. It was originally hard for me to support involving religion in healthcare but after learning more my beliefs have changed. I now see the benefit in incorporating religion and spirituality in healthcare, especially if it is something that will help the client. This picture shows my learning in that religion and healthcare are more connected than I had thought and can work together side by side.
Systemic Challenges
Two articles that show the systemic challenge to healthcare faced by Ethiopian immigrants are Immigrants And Health Care: Sources Of Vulnerability and Health Status, Use of Health Care Resources, and Treatment Strategies of Ethiopian and Nigerian Immigrants in the United States (Chaumba, 2011;Derose, Escarce, Lurie, 2007). Both articles show that Ethiopian immigrants and immigrants as a population have less access to proper healthcare than non-immigrant populations. Chaumba finds that recent immigrants who are insured are almost as disadvantaged the uninsured in access to healthcare, which is a result of limited knowledge of U.S. health systems, language, and cultural beliefs (2011). This finding was previously supported by Derose et al. as well as the finding that rural areas with high immigrant populations also receive poor healthcare due to health centers being less well equipped and a lack of funding (2007). I agree with both of these articles and issues regarding Ethiopian immigrants because they both point out issues with our health system that are supported using data. I also believe our health systems were created by wealthy white men and because of that are best suited to help wealthy white men. I feel angry about this topic because I believe equal access to healthcare is a human right. I think that this is a larger issue because it affects no only Ethiopian immigrants, but all immigrants. In a country made up of immigrants we need to ensure that all immigrants have equal access to healthcare to keep this country and its people healthy. The image captures my thoughts and feelings because it shows the traditional red cross which I associated with good equal healthcare for all people but at the same time it is shattered showing that the traditional view is not strong enough anymore and the system must evolve to reach all people. The image represent learning because previously I thought that healthcare was something that all people had access to. I have learned since then that many people do not have access due to a multitude of reasons from lack of information about the U.S. health system to health centers in certain areas being funded less than others. This learning is represented in the picture by the red cross being my previous understanding and then the red cross shattered being my new understanding shattering my old understanding of the issue.
References:
Chaumba, J. (2011). Health status, use of health care resources, and treatment strategies of Ethiopian and Nigerian immigrants in the United States. Social Work in Health Care, 50(6), 466-481. doi: 10.1080/00981389.2011.581999
Derose, P. J., Escarce, J. J., Lurie, N. (2007). Immigrants and health care: Sources of vulnerability. Health Affairs, 26(5), 1258-1268. doi:10.1377/hlthaff.26.5.1258
Annotated Bibliography
Isralowitz, R., & Reznik, A. (2014). Ethiopian origin high-risk youth: A cross-cultural examination of alcohol use, binge drinking, and problem behavior. Journal of Ethnicity and Substance Abuse, 13, 179-184. doi: 10.1080/15332640.2013.853016
The premise of this study was to examine Ethiopian youth by comparing substance use patterns and behavior with other high-risk youth populations. The literature in the first section gave a background and a definition for on binge drinking rates of youths. The paper also uses literature describing the situation of Ethiopian youth and the difficulties they face. The sample included 57 Ethiopian, 176 former Soviet Union and 193 Israeli origin youth in a drug treatment program. They were asked to complete The Substance Use Survey Instrument (SUSI) consisting of 31 questions about background characteristics, substance use patterns and problem behaviors. The study found that a majority (93.8%) of the interviewed youth reported lifetime alcohol use. Ethiopian youth had the highest rates of last 30-day beer or liquor use. Soviet Union origin youth reported drinking earlier in their life at a higher rate. Ethiopian youth were more likely to have been in a serious fight and report poor school achievement and dropout. Implications that are most important for my paper are that Ethiopian youth present a higher drinking rate even among other at-risk youth. It will also be important that the substance use behavior is associated with an elevated chance of related behaviors such as, fighting, academic decline, and dropout. I would question the authors choice to only administer the survey in a drug treatment program as this is not representative of Ethiopian youth as a whole. In addition, the small sample size of Ethiopian youths involved lowers the external validity of the study. Finally, it is also mentioned within the study that underreporting alcohol use exists within self-report.
Chaumba, J. (2011). Health status, use of health care resources, and treatment strategies of Ethiopian and Nigerian immigrants in the United States. Social Work in Health Care, 50(6), 466-481. doi: 10.1080/00981389.2011.581999
The purpose of this study was to better understand health status, use of healthcare resources and treatment strategies among Ethiopian and Nigerian immigrants in the U.S. and then to determine if there are any differences between the two groups. The author uses previous literature to show the past understanding of the health of African immigrants. This research is outdated and focuses on African immigrants as a whole and not a specific country. However, the author does draw cite a research study investigating mental health in Ethiopian immigrants that would be relevant to this project (Kibour, 2001). Another relevant study explores why Ethiopian immigrants decided to immigrate to the U.S. (Reimers, 2005). Overall the research is focused on African immigrants as a whole and does not give a comprehensive background on Ethiopian or Nigerian immigrants. This study employed a cross sectional survey that was completed by 198 Ethiopian and 164 Nigerian immigrants. Interviews were conducted over the phone or in-person and the survey included demographic information, pre-migration experiences, health measures, and economic and housing experiences. The main results of the study were that Ethiopian and Nigerian immigrants reported low levels of poor physical or mental health. Ethiopians were more likely to report ever feeling sad or depressed and having experienced persecution outside the U.S. Both populations reported low levels of use of health care resources. Finally, the most often reported treatment strategy for both groups was spiritual healing and prayer. Implications relevant to my project would be a better understanding of mental health issues and popular treatment strategies for Ethiopian immigrants. I believe this study was well put together and gave a good background on the use and understanding of healthcare and health problems. It does not show the effectiveness of treatment strategies but does point me in the direction of spiritual or religious treatments. The information in this study will be relevant in establishing issues facing the Ethiopian population in the U.S. I would have liked looked deeper into how the treatment strategies impacted the health of the sample if I were to replicate the study.
Habecker, S. (2012). Not black, but Habasha: Ethiopian and Eritrean immigrants in American society. Ethnic and Racial Studies, 35(7), 1200-1219. doi:10.1080/01419870.2011.598232
The purpose of this article was to explore the Habasha identity and how immigrants from Ethiopia and Eritrea are navigating race relations in Washington DC. In the early parts of the article the author cites research establishing the growth of Ethiopian and Eritrean immigrants in the U.S. She also covers different theories of immigration such as assimilation theory, cultural pluralism and segmented assimilation. This cited research will not be relevant to my project outside of using it to better establish patterns of assimilation and the demographics of Ethiopians within the U.S. The author takes her data from a one-year ethnographic study conducted among six groups of first-generation African immigrants in the Washington D.C. area. The author also interacted with 50 other Ethiopians and Eritrean immigrants and relied on semi-structured interviews, informal conversation, watching and listening to gather her data. One of the main conclusions of this study was that Ethiopians challenge traditional American racial categories by defining themselves as a separate non-black ethno-racial category with a strong emphasis on their Semitic roots. The study also found a strong pursuit of displaying the attributes of a ‘model minority’ and remaining relatively isolated. This study will give a better understanding of the Ethiopian people and their goals and cultural values. It also gives a good background and question template for future interviews with Ethiopians. This article does not use a large sample size for its interviews and it relies on non-scientific models of questioning. However, it does provide a glimpse into the goals of Ethiopians as stated by the people themselves.
Ebrahim, N. B., Davis, S., & Tomaka, J. (2016). Correlates of condom use among Somali and Ethiopian immigrants in the U.S. Journal of Immigrant and Minority Health, 18, 1139-1147. doi: 10.1007/s10903-015-0244-7
The purpose of this study was to identify the psychosocial determinants of male condom use among Somali and Ethiopian immigrants in the U.S. in order to begin designing an effective intervention to reduce HIV infection. No previous research cited in the paper was relevant because this is the first study examining these factors in the Somali and Ethiopian immigrant population. In this research article the data collection was a cross-sectional study completed by 205 participants. Fifty of those were Somali and 155 were Ethiopian. The study found that participants were neither for nor against condom use. Self-efficacy was the strongest cognitive factors associated with intention to use condoms. The most meaningful implication for my project is that self-efficacy was the strongest factor associated with intention to use condoms. When designing interventions I will focus on increasing self-efficacy in order for the intervention to be most effective. The study did not use a randomly selected participant group which lowers the external validity of the study. I would also be interested to learn how self-efficacy plays a role in other potential risk taking behaviors.
Goitom, M. (2018). “Bridging Several Worlds”: the process of identity development of second-generation Ethiopian and Eritrean young women in Canada. Clinical Social Work Journal, 46, 236-248. doi:10.1007/s10615-017-0620-y
This purpose of this paper was to explore the social and cultural experiences of Ethiopian and Eritrean young women and their process of identity development. The author cited previous studies that identified the specific sources of stress among Ethiopian and Eritrean immigrants (Yakushko, 2010). Goitom also cites previous research to give the reader a better understanding of immigration and acculturation process which will be useful to review. Finally, Goitom frequently cites previous research she has done focused on Ethiopian and Eritrean immigrants that would be relevant to my project. This study was a qualitative study that used in depth interview processes that allowed participants to narrate their own stories. 20 Ethiopian and Eritrean youth were interviewed. Questions focused on participants experiences with continuity of identity while maintaining traditional culture. The main finding of this paper was that complexities in family relationships was an interrelated concepts that impact the social and cultural experiences of the Ethiopian and Eritrean immigrants. Parent-youth relationships moderate the association between participants experiences with cultural discrepancies and conflict. The implications of this study for my project are a better understanding of the Ethiopian family make-up and the cultural factors that impact them. I can also use some of the stories and experiences shared to shape questions that I can ask participants in my project. The study had a small non-random sample so the external validly is low. I am also concerned that the author only focuses on the responses of the women in the sample. I would have liked to heard the responses of the men as well. I think this study will be very relevant because it provides an in-depth understanding of problems facing Ethiopian immigrants as well as citing other relevant research to look into.