Reaching Out to Minority Colleagues and Patients

By Rodrigo Muņoz, M.D.
APA President

It can be safely argued that the Pilgrims were a minority among the many groups that inhabited colonial America in what later became the United States of America. Since then, the trend-or at least the perceived trend-has been toward the creation of a homogenous U.S. population, one in which immigrants from every corner of the world have been expected to leave behind their unique cultural heritage, yield to America's melting-pot forces, and reemerge as "Americans."

Although the United States has never been a true melting pot, this image was reinforced by world change and technological advancements that helped the country grow into a global power. Relying on the labor and entrepreneurial drive of waves of immigrants wanting to make a better life for themselves and their families, America appeared to become more than the sums of its parts: Wasn't it greater than the many nations from where its people had come?, Americans asked.

The Erie Canal, begun in 1817, contributed to the creation of industrial centers that eventually stretched from New York to Chicago. With California's joining the union in 1850, the U.S. extended from sea to shining sea. The building of the railroads led to even more growth, not only in commerce but also in communication. Around the turn of the century, the invention of the automobile, airplane, and radio appeared to reduce the size of the world, eventually bringing home the lesson that events in one part of the world can have a huge impact on other parts of the world. After two world wars, the United States knew that a national policy of isolationism was unrealistic, but the forces toward the creation of cultural separation from other nations continued to grow.

In the last two decades, the pendulum has made an important correction in the other direction. We are beginning to appreciate that requiring those who wish to be considered "true" Americans to take on a neutral persona is not only a demeaning exercise for the individual but also a shortsighted strategy for the country. The cultural heritage that each one of us brings to the United States, whether we trace our ancestry to the Mayflower crossing or a more recent journey, strengthens national resources by giving us an expanded repertoire of languages, skills, and capacities to function effectively as citizens in a multicultural society and as workers in a global economy. Recognizing and appreciating our nation's multiethnic diversity is also in keeping with America's long-valued emphasis on the importance of the individual. Rather than fearing neighbors who are different from us, the new sensibility invites us to appreciate and make use of those differences.

In recent years, we've begun to see the results of increasing population diversification. Major cities are becoming aware of and building on their growing diversity. These are some of the strong regional centers that are now emerging in the U.S:

Atlanta, with an African-American majority, is the headquarters for a number of organizations with worldwide interests, such as the Centers for Disease Control and Prevention, CARE, CNN, and Coca Cola.

Los Angeles, a center for tourism and the film industry, has a large Hispanic population and an active interest in Latin America.

Northern California has a growing Asian population and is a major center of the computer industry. Seattle, Houston, and Charlotte are other centers with well-defined characteristics. My home state of California is in the vanguard of demographic shifts that many other states will eventually witness. As recently as 1970, almost 80 percent of the state's residents were non-Hispanic white. By 1990 only 57 percent of the state's residents were non-Hispanic white; Hispanics made up 26 percent of the state's population, African Americans, 7 percent, and Asians, 9 percent.

At APA, we have a twofold interest in the diversity of the American population: We need to be able to provide high-quality psychiatric care to all people residing in the United States, and we need to ensure that all psychiatrists, regardless of demographic characteristics or sexual orientation, have an equal voice in APA.

Below, Edward Hanin, M.D., chair of APA's Council on National Affairs, describes APA's new Plan for Action on Minority Issues and Concerns, approved in July by the Board of Trustees. I believe it represents a major step forward for APA.