Archives: Dr. Kendra Flores-Carter

By Dr. Kendra Flores-Carter

Phillipians 1:6 reads “that the one who began a good work among [us] will bring it to completion by the day of Jesus Christ” Today I hear the word cultural humility in every meeting, conference, and seminar I attend. Diversity and inclusion seems to be a leading theme for many organizations trying to restructure their administration to meet the needs of marginalized populations. As a marginalized person of Color it is amazing to see all of the strategic planning around having a culturally diverse approach in program innovation, development, and implementation. But as always I have questions on how organizations can competently and effectively incorporate cultural humility in their program development.

Cultural humility refers to the attitudes and practices of working with individuals, groups, and families with a presence of humility. Additionally, it means taking a stance that is other-oriented rather than self-focused. Furthermore, it means investing in learning, communicating, offering services, and making decisions that considers the cultural dynamics of marginalized population intended to serve. Moreover, having a concrete understanding that in order to proceed with any type of program development or program planning an organization must be prepared to consider all these factors before moving forward to fulfill their targeted goals around program development to truly serve marginalized communities.

For many organizations and businesses its easy to include an inclusion and diversity clause in a policy or mention the idea of practicing cultural competency. However, practicing cultural humility is easier said than done. I say this because I seeso many programs today that are targeted towards helping and assisting marginalized populations but I rarely see people of Color in the forefront of creating those programs. How can businesses and organizations create diversity and inclusion programs without the voices of the people the programs are design serve?It’s quite baffling to me to see programs created time after time without the input of the intended population.

To truly exercise cultural humility organizations needs to take into account the lived experiences of the people they provide services too. The stark reality is that many leaders in organizations tend to believe the stereotypes about marginalized groups. Sometimes these biased beliefs are based on what was socially learned or what is shown in the mainstream media. Often times those realities are far from the actual true experiences of marginalized populations.

As a society it is important to understand that from the moment we are born we are socially programmed to believe a set of ideas about certain groupsof people. Sometimes even if it’s not the intent these ingrained beliefs are what controls or influence the decisions made as leaders of organizations. Therefore, it is very important that organization leaders check their biases and ensure that they facilitate an environment where all voices are heard when creating programs that serves communities or color.

Building programs that are targeted towards marginalized population should always includethe voices of those populations. When theirvoices are missing it leaves room for programs to becreated based on biased stereotypical beliefs rather than true facts. Likewise, assumptions are often made about marginalized groups based on media or social conditioning beliefs rather than getting evidence from a qualitative standpoint.Yancu & Farmer(2017) theorized the need for internal practices that leads organizations to have greater cultural awareness, reduced implicit cultural biases, and increased sensitivity to the power dynamics in cross-cultural interactions. Basically, if organizations are open to those principles program development would be much more inclusive.

I believe that practicing cultural humility is God’s working within our souls to give us authentic love and kindness towards others. Most importantly God want us to consider others before ourselves. In the end cultural humility could definitely be an asset to leaderswho may have come from privileged backgrounds with little to no understanding of the experiences of marginalized populations. When we know better we do better but we have to make that lifelong commitment to always be self-aware of our own biases before making decisions that affects the lives of othersthat are not like us.

By Dr. Kendra Flores-Carter

My life pre-motherhood was filled with “pure niceness.” Over the years, I built amazing high school and college friendships as well as fostered strong mentorships with outstanding individuals that genuinely cared about my well-being. Even though everything in life was good for me there was always the occasional encounter with people that just questioned my Black existence in their spaces. Often times the judgment came from people who didn’t look like me. Most often it was stares of disdain or silent whispers with rolling eyes. My mother worked very hard to instill confidence in me so I was rarely bothered by other people dismissal or disapproval of me as I grew into the woman I am today.

I do recall the first time I was called the “N word”by a patient I provided services to in a public setting. I wasn’t shocked because up until it happened I was waiting for that day to come.That was the day I could finally say someone actually blurted out loudly what others were thinking silently. I remember thinking to myself “Wow” I was finally called the “N” word in real life. Prior to this I was called it through looks of “disdain” and “why are you here” I wasn’t bothered by it and I went about my regular life but I now had the first-hand experience of being boldly discriminated against because of the color of my skin.

It wasn’t until I became a mother that people’s perception of me became a significant deal. I guess in some ways I now saw myself in my children. My children was me and I was them. So my experiences was now their experiences. Childbirth sharpened all my protective factors and heightened my defenses against discrimination and racism. This experience brings me to a very important topic in the healthcare community surrounding childbirth and Black women. The Center for Disease Control (2019)approximates that 700 new and expectant mothers die in the U.S. each year, and an additional 500,000 women experience life-threatening postpartum complications. More than half of these deaths and near deaths are from preventable causes, and a disproportionate number of the women suffering are black.Black women are three to four times more likely to die from a pregnancy related complication when compared to any other races.Additionally, in 2013, the infant mortality rate for non-Hispanic Black infants was more than twice the rate of non-Hispanic White infants, 5.06 deaths per 1,000 live births for White infants, and 11.11 deaths per 1,000 live births for Black infants (Matthews, MacDorman, & Thomas, 2015). According to Sudano & Baker (2006) maternal sociodemographic characteristics, physical health, and behavioral factors contribute to the disparity; however, these factors only partially account for the racial disparity in preterm birth. Racial disparities in birth outcomes in the United Stated are a significant public health issue.Furthermore, the preterm birth-related to infant mortality rate is three times higher among non-Hispanic Black women compared with non-Hispanic White women, 601 preterm-related deaths per 100,000 live births among Black women versus 179 preterm related deaths per 100,000 live births for White women (MacDorman, 2011).

Reflecting on these statistics I ask these questions: Are Black women and babies dying because of the color of their skin? Are Black women and infants dying because of racist healthcare providers? Are they dying because of systemic or institutional racism? To answer these questions it will help to understand that institutional or systematic racism refers to the policies and practices that contribute to structural barriers and the differential access to good, services, and opportunities by race (Jones, 2000).According to Williams & Mohammed(2013) racism and race-based health disparities for Black women contributes to differential quality of care or access to care within the health care system. Black women report experiences of racial discrimination and being treated differently by health care providers, clinic staff, and others during prenatal care (De Marco, Thorburn, & Zhao, 2008). Consequently,there is evidence to suggest an association between racism and the care Black women receives from healthcare providers. Clearly based on the research being a Black woman in the United States is tough. However, being a pregnant Black woman comes with some additional layers of discrimination, racism, and even death as a childbirth complication.

As a Black woman I can honestly say that I never in my life experience discrimination or racism until I migrated from Belize to the United States of America. Coming to the U.S. was a serious wake up call. Being born in Belize a land that accepted my existence from the moment of my birth. Surrounded by healthcare providers who supported my entire existence in the world and work diligently to see me succeed from birth. Giving birth for my mother was completely different when compared to my experience in the United States. As I look back at both of our child bearing and child birth experiences I realize just how much disparities exist for Black women in the U.S. when compared to Black women in other countries. Like many other Black women today in the United States my journey was filled with judgment, neglect, and lack of authentic empathy for the vulnerabilities of pregnancy and postpartum.Having the opportunity to see pregnancy and child birth experiences from a different perspective have definitely heighten my awareness of the differences faced by Black women as it relates to the healthcare services they receive in the United States. It’s definitely unfortunate that maternal and infant mortality continues to be a significant public health concern in the United States. While in 3rd world countries with significant lack technology and experts in maternal fetal medicine manages to have lower maternal and infant mortality rates across all sectors of the population. It’s certainly important for healthcare systems to begin to look into the systemic issues related to racism within their institutions. This is truly the only way to improve child birthing outcomes. The goal should be to help all women have equity in the experiences that surrounds pregnancy and childbirth. The only way this could be achieve is for healthcare organizations to take an honest look at the quality of care being provided to people of color and hold healthcare providers accountable for discrimination and racist practices and behaviors towards consumers. In the future I hope to see some improvements in the statistics related to maternal and infant mortality.

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Lab Link 

Maternal Health Lab :: Labs :: Center for the Study of Human Behavior :: College of Behavioral and Social Sciences :: California Baptist University 

CBU > College of Behavioral and Social Sciences > Center for the Study of Human Behavior > Labs > Maternal Health Lab Maternal Health Lab. The research conducted in this lab focuses on maternal child health and maternal mental health, particularly among racial and ethnic minority women.

calbaptist.edu   

I recently attended a Maternal Health Summit where presenters and attendees discuss ideas on how to support immigrant families and children born to immigrant mothers. As I pondered on some of the ways I could help, I realized that it was a very emotional topic for me personally. Like many immigrant women, my mother came to the United States to provide a better life for her children. As a researcher in maternal child and women’s health my observation of what is happening today with parents being detained, I can only ponder on the implications for this hurtful and painful action and its effect on a child’s development. 

Research indicates that a child’s separation from their parent, when planned or unplanned, can cause significant stress; in some cases it is very traumatizing. I know this first hand because recently my daughter became overly stressed at school because she overheard a conversation about deportation with Immigration and Customs Enforcement (ICE) from a classmate. As a parent I try my best to be transparent. My children are aware that I and their father are both immigrants from Belize. My oldest daughter came home crying asking if her dad and I were going to get deported. The look on her innocent face made me so upset and scared for her as she grows up in this perils of immigration reform in America.

Fortunately for my daughter, we were able to calm her nerves because we let her know that, yes, we are indeed immigrants, but we are in the United States legally so she had no reason to be worried. This, however, is not the case for many American children who go home every day questioning their parents about their immigration status. Recently on the news I saw children crying because their parents were detained at their worksites. One young child worrying about how she would get her next meal or when she would see her father, the family’s breadwinner, again. As an immigrant mother with 3 American children I could never imagine dropping off my children for their first day of school and going to work for the day only to be picked up for deportation. This is a daily heartbreaking reality for many innocent American children born to immigrant mothers.

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Knowing this new reality for many American children, I began looking at a few articles that explored separation around immigration. One study implied that such sudden and unplanned separations could lead to disruption of eating and sleeping habits, sadness, anger, guilt, and anxiety in children (Chaudry et al., 2010). Besides these serious emotional consequences, children often suffer from an instantaneous loss of income, particularly in instances where the primary breadwinner is detained. Other studies implied that subsequent economic instability can have severe consequences to the child’s well-being (Barajas, Philipsen, & Brooks-Gunn, 2008; Leventhal & Brooks-Gunn, 2004). Poverty is associated with a number of negative social conditions, such as inadequate education and delayed cognitive development, which are crucial to success later in life (Ceballo, McLoyd, & Toyokawa, 2004). These poor American children are now in distress overload; they are in fear and being traumatized during the most important stages of development. When compared to their peers they are now most likely to have poorer life outcomes. 

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Matthew 18:3-6 reads 3 “Truly I tell you, unless you change and become like little children, you will never enter the kingdom of heaven 4 Therefore, whoever takes the lowly position of this child is the greatest in the kingdom of heaven. 5 And whoever welcomes one such child in my name welcomes me. 6 If anyone causes one of these little ones -those who believe in me- to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.” 

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Children are supposed to be the light of the world. Their innocence bring joy and laughter to our homes. Today, Immigrants are being portrayed as if they are sucking the sweets of America which, in most cases, is absolutely false. The take away from the summit, in my interpretation, is that American children born to immigrant women are at higher risk to be separated from their mothers which is an injustice. It is not okay to do this to the little gifts that God has blessed us with on earth.

As the scriptures implied, those who turn a blind eye or are complicit and causes little ones to stumble will deal with the wrath of our God. Our future is our children and we should not be okay with what is happening today in America. Families should not be torn apart and children should not have to worry about their next meal or when they will see their parents again. 

Now let’s hear your thoughts…

If you had the opportunity to work on immigration reform as it relates to separation of families. What would be some suggestions on how we could approach this issue? 

Many of the children who’s families are being deported are American. What do you believe will happen to these children as they grow older? 

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