Lance D. Laird

Muslim patients and health disparities in the UK and the US

This article provides a framework for understanding how Muslim identity, and the current social and political contexts in which it is shaped, affects the health of Muslims in the UK and the US, and the quality of health care they receive. Key medical and public health literature that addresses health concerns related to Muslim communities in the UK and the US is reviewed. Few data exist specific to health disparities for Muslim minorities. However, the article focuses on emerging studies concerning the consequences of “Islamophobia” for the physical and mental health and health care of Muslim families and children. We argue that, despite substantive structural differences in the health care systems of the UK and the US, social structural and political forces play similar roles in the health of Muslim children in both countries. Finally, we call for significant cultural and institutional adjustments in health care settings and further research studies to provide specific data to address health disparities for these growing and diverse populations.

How Muslim and Non-Muslim Chaplains Serve Muslim Patients? Does the Interfaith Chaplaincy Model have Room for Muslims’ Experiences?

Chaplaincy is typically practiced within the contexts of the Jewish and Christian traditions, and little attention has been paid to the influence of the Islamic perspective of nursing and caring. Therefore, many Muslim patients might not receive appropriate care for their religious and spiritual needs, especially as they relate to daily religious practices and worship, medical ethics, and end-of-life treatment choices. This study examined Muslim and non-Muslim chaplains’ approaches to pastoral care used with Muslim patients in New York City hospitals. The study used in-depth interviews with 33 Muslim and non-Muslim chaplains. The results indicate areas of both convergence and divergence.

Religion and Healing

Religion influences values, moral experience, and social organization, as well as concepts of health, illness, dying, and death. Medical and public health models often indirectly export a Western cultural model that misrepresents both religious traditions and practical health orientations. This article considers distinctions between religion and spirituality, and between mechanistic and social determinant approaches to religion and healing. Building on the meaning-centered model of patient care proposed by medical anthropologists, the challenge remains to integrate religiously informed healthworlds with models and practices of public health and medicine in ways that do justice to all.

Finding Spirits in Spirituality: What are We Measuring in Spirituality and Health Research?

What are we asking when we ask about spirituality? When research subjects check survey boxes for “religiosity” and “spirituality” measures on health surveys, those of us who use them often assume that these responses indicate a relationship with—or reaction against—normative, conventional, Protestant-shaped religious practice and experience. We present a qualitative interview study of 13 low-income mothers with a history of depression, analyzing their descriptions of spiritual and religious coping practices. On the basis of a focused analysis of four mother’s narratives, we argue that conventional survey answers may frequently hide more than they reveal about people’s cultural, religious, and idiosyncratic experiences with ghosts, spirits, magic, and haunting presences that are relevant, sometimes integral, to illness and healing. We demonstrate that listening to participants’ narratives challenges researchers’ unconsciously normative assumptions and ought to help us reshape our understanding of the ways spirituality and religion influence health in a hyperdiverse society.

Cultural Citizenship and Belonging: Muslim International Medical Graduates in the USA

Abstract This paper explores how a predominantly immigrant interview sample of 62 Muslim physicians articulate their cultural citizenship and sense of “belonging” in the USA. Many Muslim physicians who have come as international medical graduates (IMGs) share the challenges, obstacles, and assets of their IMG peers. Yet within the context of rising Islamophobia after the September 11 (9/11) attacks in the USA, immigrant Muslim physicians encounter “racialized” religious discrimination in the workplace and in local communities. This paper examines how this group actively builds a sense of belonging at multiple levels through the family, community, ethnic and religious institutions; and “represents” Islam in the USA and abroad. We also suggest that integration into the American medical profession facilitates cultural citizenship, and perhaps the “disciplining” of Muslim IMGs into broader American society.

The Cultural Basis for Oral Health Practices among Somali Refugees Pre-and Post-Resettlement in Massachusetts

Background. Oral health disparities related to socioeconomic status have been well described in the U.S., but oral health among refugee groups has not been well characterized. This article examines oral health among Somali refugees in Massachusetts. Methods. Eighty-three (83) participants were purposively selected for an in-depth, open-ended interview related to oral health. Results. Older individuals associated use of the stick brush with the Islamic practice of cleansing before prayer. When unable to find stick brushes in the U.S., many adopted the Western toothbrush. Parents expressed concern that their children had adopted U.S. practices of brushing with a toothbrush only once or twice a day. Conclusions/implications. Somali oral health practices have changed following arrival to the U.S., but the underlying model for oral health care remains rooted in Islam. By acknowledging the value of traditional practices, dentists may communicate the value of Western preventive and restorative dentistry, and recommend approaches to integrating the two.

Design of the integrative medical group visits randomized control trial for underserved patients with chronic pain and depression.

BACKGROUND Given the public health crisis of opioid overprescribing for pain, there is a need for evidence-based non pharmacological treatment options that effectively reduce pain and depression. We aim to examine the effectiveness of the Integrative Medical Group Visits (IMGV) model in reducing chronic pain and depressive symptoms, as well as increasing pain self-management. METHODS This paper details the study design and implementation of an ongoing randomized controlled trial of the IMGV model as compared to primary care visits. The research aims to determine if the IMGV model is effective in achieving: a) a reduction in self-reported pain and depressive symptoms and 2) an improvement in the self-management of pain, through increasing pain self-efficacy and reducing use of self-reported pain medication. We intend to recruit 154 participants to be randomized in our intervention, the IMGV model (n=77) and to usual care (n=77). CONCLUSIONS Usual care of chronic pain through pharmacological treatment has mixed evidence of efficacy and may not improve quality of life or functional status. We aim to conduct a randomized controlled trial to evaluate the effectiveness of the IMGV model as compared to usual care in reducing self-reported pain and depressive symptoms as well as increasing pain management skills.

Acculturation and a Potential Relationship with Oral Health Outcomes Among Somali Refugees in Massachusetts

This paper explores the relationship between acculturation and oral health in a study of Somali refugees. This cross-sectional survey included structured surveys and dental examinations of a convenience sample of 439 Somali adults living in Massachusetts. Associations between an acculturation scale and: (1) lifetime history of caries and (2) access to oral health services were calculated. In bivariate analyses, many individual questions in the scale were associated with outcomes. In multivariate analysis, speaking English (OR 0.5, CI 0.28–0.84) was associated with better access to, and utilization of, dental health services while reading American books and newspapers in English was associated with increased lifetime history of dental disease (OR 2.6, CI 1.1–6.0). As specific elements of acculturation have different relationships with oral health among Somali refugees, a summary acculturation scale may have limited utility. Ongoing efforts to remove language barriers may improve oral health.

Care Transitions From Patient and Caregiver Perspectives

PURPOSE Despite concerted actions to streamline care transitions, the journey from hospital to home remains hazardous for patients and caregivers. Remarkably little is known about the patient and caregiver experience during care transitions, the services they need, or the outcomes they value. The aims of this study were to (1) describe patient and caregiver experiences during care transitions and (2) characterize patient and caregiver desired outcomes of care transitions and the health services associated with them. METHODS We interviewed 138 patients and 110 family caregivers recruited from 6 health networks across the United States. We conducted 34 homogenous focus groups (103 patients, 65 caregivers) and 80 key informant interviews (35 patients, 45 caregivers). Audio recordings were transcribed and analyzed using principles of grounded theory to identify themes and the relationship between them. RESULTS Patients and caregivers identified 3 desired outcomes of care transition services: (1) to feel cared for and cared about by medical providers, (2) to have unambiguous accountability from the health care system, and (3) to feel prepared and capable of implementing care plans. Five care transition services or provider behaviors were linked to achieving these outcomes: (1) using empathic language and gestures, (2) anticipating the patient’s needs to support self-care at home, (3) collaborative discharge planning, (4) providing actionable information, and (5) providing uninterrupted care with minimal handoffs. CONCLUSIONS Clear accountability, care continuity, and caring attitudes across the care continuum are important outcomes for patients and caregivers. When these outcomes are achieved, care is perceived as excellent and trustworthy. Otherwise, the care transition is experienced as transactional and unsafe, and leaves patients and caregivers feeling abandoned by the health care system.

Meeting Jesus again in the first place : Palestinian Christians and the Bible

Palestinian theologians seek to free their people from exclusive notions of election and promise through approaches to scripture that draw on the experience of the Israeli occupation. Scripture may be used as a weapon of oppression, but it may also inspire a commitment to justice, the restoration of right relations between Israelis and Palestinians.