According to Byng (2008) the use of power and the policies introduced by the United States government, in combination with the backlash of the September 11th attacks, and other extremist terrorist activities, have together created a high level of misunderstanding and of resentment against people of the Muslim faith in the United States. As a result, they suffer from a high level of discrimination, and resulting social inequality. One of the areas in which this is most visible is their access to, and treatment during, medical care. According to Stubbs (2003), following September 11th the Muslim population became the most ostracized race in America, and have been stereotyped, social speaking, in an extremely negative way. The FBI identified, in the 2001 annual report of hate crimes in America, that there was a 1600% increase in hate crimes against Arab individuals, or persons perceived to be Muslim than there was in the previous year, and that this trend, while slowing has continued to demonstrate higher than otherwise explainable levels of violence, including verbal and physical abuse since the September 11th attacks (Stubbs, 2003). This level of animosity impacts every aspect of Muslim-American life, up to and including quality of and access to healthcare. Through the matched integration of representative photography, and related empirical research, the following paper will describe the current sterotypes of the Muslim-American population, and the impact that these perceptions have to the health of Arab-American populations.
This lack of cultural competency is extremely visible in the delivery of emergency medical care for Muslim-Americans. According to researchers Ezenkwele & Roodsari (2013), a high level of cultural competency is key to delivering quality medical care in any situation, but is of critical importance in the emergency medical setting, were time is often of the essence, and because refugees and immigrants often use emergency departments as their primary access point for medical care. In pursuit of determining the level of cultural competence as it relates to providing care for the Muslim-American population, Ezenkwele & Roodsari (2013) worked to compile a comprehensive database of articles related to providing care to Muslim citizens. The research concluded that points of significance included modesty, the significance of gender roles, the concept of God and his will for a person’s life, the family structure in Mulslim culture, and its direct link to concepts of sexual purity and abstinence, religious demands, including the need to both pray and fast with strict observance to religious customs or schedules, dietary needs related to religious observation, and the idea of cleanliness (Ezenkwele & Roodsari, 2013). The study then attempted to construct a succinct set of guidelines for ED departments to use in overcoming the barriers related to these points.
Another of the most prominent areas of failure to provide appropriate care to the Muslim population is related to the misunderstanding of treatment of, and beliefs of women in the population, and their access to women’s health related services. A study by Reitmanova and Gustafason (2008) considered the maternity health care needs and the barriers to appropriate prenatal and delivery related services for immigrant women. The study qualitatively considered, through intense one-on-one interviews the needs, beliefs, and care received by pregnant women in the hospital OB setting .The women reported consistent discrimination and insensitivity, with not only a lack of understanding, but a willful refusal to accept the religious and cultural practices that women adhere to regarding the perceived sanctity of their bodies (Reitmanova and Gustafason, 2008). They cited a need for both culturally and linguistically appropriate access to medical care, and develop diversity sensitivity in the organization s that Muslim women, who are pregnant, can receive the level of care and support they need (Reitmanova and Gustafason, 2008). A similar study by Simpson and Carter (2008) used phenomenology to consider the care outcomes and experience of Muslim women seeking care in rural areas. Three themes were discovered in the course of study, including a perceived lack of power on the part of the patient, insensitivity as it related to both gender and religion, and feeling like a stranger, whose needs were not heard. The study, like that of Reitmanova and Gustafason (2008), found that increased education and sensitivity was needed among healthcare providers in order to ensure that they could meet the religious and cultural needs of Muslim women without the sense of animosity or flippancy currently experienced (Simpson and Carter, 2008).
In addition to, or as a result of, this lack of understanding, compassion, and even outright display of animosity, Muslims have increased risk factors for and tendency toward developing mental health issues. A study, by Abu-Ras and Abu-Baser (2009) closely examined the link between sociocultural variables and display of depression and postraumatic stress disorder (PTSD), especially as it related to Aram and Muslim Americans, in the years following the September 11th attacks and the increased social animosity toward the members of Muslim culture in America. The study used a multiple regression statistical analysis to determine what factors most contribute to mental health issues, including depression and PTSD, and found that age, education, marital status, access to support and a support community and children all impacted the prevalence of the cited conditions (Abu-Ras and Abu-Baser, 2009). Findings more specifically found that Muslim Americans are coping with a high level of trauma resulting from discrimination, violence, and ongoing impact of being ostracized within their larger communities. The writers determined that medical practitioners need to be educated in order to help Muslim American’s coping with these issues in a nondiscriminatory way and in a way that promotes larger cultural, or community acceptance for, and support of members of the Arab culture, and Muslim background (Abu-Ras and Abu-Baser, 2009).
This evidence clearly demonstrates that there is a lack of understanding and a lack of compassion for mulsim popualtions in the current healthcare system. There needs to be increased education of medical professionals, and increased pressure from health care leadership to ensure that the needs identified are being met, so that the nearly 2.2 million Muslim Americans in this nation are being adequately treated within the medical system (Ezenkwele & Roodsari, 2013). This includes not only creating a greater understanding of the cultural barriers to care, and increasingly building protocols for adapting care to meet those cultural demands, but perhaps more significantly overcoming the bias against providing culturally appropriate care, and a greater level of empathy, and investment in meeting the needs of this ostracized element of American citizenry. Only this can ensure that the wellbeing of those individuals impacted is protected and adequately served by the American healthcare system.
References:
Abu-Ras, W., & Abu-Bader, S. H. (2009). Risk Factors for Depression and Posttraumatic Stress Disorder (PTSD): The Case of Arab and Muslim Americans Post-9/11. Journal Of Immigrant & Refugee Studies, 7(4), 393-418. doi:10.1080/15562940903379068
Byng M. Complex Inequalities: The Case of Muslim Americans After 9/11.American Behavioral Scientist [serial online]. January 2008;51(5):659-674. Available from: Academic Search Complete, Ipswich, MA. Accessed April 30, 2016.
Ezenkwele, U. A., & Roodsari, G. S. (2013). Cultural Competencies in Emergency Medicine: Caring for Muslim-American Patients from the Middle East. Journal Of Emergency Medicine (0736-4679), 45(2), 168-174. doi:10.1016/j.jemermed.2012.11.077
Reitmanova, S., & Gustafson, D. L. (2008). “ They Can’t Understand It”: Maternity Health and Care Needs of Immigrant Muslim Women in St. John’s, Newfoundland. Maternal & Child Health Journal, 12(1), 101-111. doi:10.1007/s10995-007-0213-4
Simpson, J. L., & Carter, K. (2008). Muslim Women's Experiences With Health Care Providers in a Rural Area of the United States. Journal Of Transcultural Nursing, 19(1), 16-23. doi:10.1177/1043659607309146
Stubbs, J. K. (2003). THE BOTTOM RUNG OF AMERICA'S RACE LADDER: AFTER THE SEPTEMBER 11 CATASTROPHE ARE AMERICAN MUSLIMS BECOMING AMERICA'S NEW N S?. Journal Of Law & Religion (Journal Of Law & Religion), 19(1), 115-151.
