Multicultural Health, Miscellaneous, College Term Papers.com


		Data Bases
		• Custom Term Papers • Free Term Papers • Free Research Papers • Free Essays • Free Book Reports • Plagiarism?

		Links
		• Top 100 Term Paper Sites • Top 25 Essay Sites • Top 50 Essay Sites • Search 97,000 Papers @ DirectEssays.com • Search 101,000 Papers @ ExampleEssays.com • Search 90,000 Papers @ MegaEssays.com

		Free Essays
		• Term Paper Sites • Chuck III's Free Essays • Free College Essays • TermPaperSites.com • My Term Papers • Get Free Essays • Essay World • Planet Papers

Search Lots of Essays

Back to Subjects - Miscellaneous

Multicultural Health

Multicultural Health Multicultural Health and the Professional Caregiver NUR 384: Dimensions of Professional Nursing Practice Given the magnitude of health costs, both financial and in terms of human suffering, it is essential that preventive interventions be developed and/or enhanced. Nurses, physicians, and other helping professionals are in a good position, by virtue of their training, to add to such preventive efforts. Health is defined as a condition of physical, mental, and social well being and the absence of disease or other abnormal condition. It is not a static condition; constant change and adaptation to stress result in homeostasis (Mosby’s Medical and Nursing Dictionary, 1994 p. 742). The fact that we can improve our health and extend our lives by changing our behaviors (i.e., eating well, exercising, not smoking, and reducing stress) supports the incorporation of health education, and prevention programs into a broad variety of settings. The purpose of this paper is to give the status of multicultural health on several diseases, and to give factors that influence multicultural health. Rationale for studying different cultures will be given and recommendations will be given for future research. The promotion of health has been primarily a White middle-class phenomenon (Gottlieb and Green, 1987). It is critical that minority groups are included in preventive care, particularly because racial/ethnic minority group members are likely to suffer from higher mortality and morbidity than are White Americans. Although some differences in health status observed across groups can be directly attributed to characteristic lifestyles and habits of living, factors such as prejudice, fear, and stereotyping may further isolate certain groups from mainstream care…. Treatment planning may be flawed through simply failing to account for cultural and lifestyle influences that ultimately reduce the effectiveness of interventions or treatments (Alcorn, 1991, pp. 334-335). Statistics will now be given to highlight differences in mortality and morbidity for various groups with respect to different diseases and health risk factors. In the United States, the 1990 death rates for stroke were 28% for White males and 56% for Black males, 24% for White females, and 43% for Black females. In 1990, coronary heart disease death rates were 1.3% higher for Black males than White males and 29.4% higher for Black females than White females. It is important to note, however, that of those with coronary heart disease, 88.2% are White, 9.5% are Black, and 2.4% are of other races (American Heart Association, 1993). Livingston (1993) noted that young Black American men are particularly vulnerable to high blood pressure: “Overall, more than 10% of Black American male children, 1% of Black American female children, and no White female children or male children had systolic blood pressure greater than 140 mmHg” (p.134). Livingston focused primarily on the relationship between stress and hypertension and specifically on the sources of tension for young Black men in the United States. Racial differences in hypertension are clearly related to socioeconomic status (Kotchen, Kotchen, and Schwertman, 1974). Cancer rates differ dramatically among various races in the United States. Because Blacks are less likely to have early diagnosis and intervention, Whites have higher 5-year survival rates than Blacks when all types of cancer are considered. Blacks have significantly higher rates of incidence and mortality than Whites in multiple myeloma and in cancers of the esophagus, uterus, cervix, stomach, liver, prostate, and larynx. Hispanics have lower incidence and mortality rates than do White or Black Americans for all cancers (American Cancer Society, 1993). African Americans have a higher incidence of cancers that may be caused, in part, by smoking (i.e., cancers of the esophagus and larynx). According to the U.S. Bureau of the Census (1993), there are differences by gender and race in the prevalence of substance abuse. Although much of the literature focuses on the disproportionate number of racial minorities that abuse certain substances, there are other substances that Whites abuse more than do racial minorities. Cultures also vary with respect to the degree that they are willing to acknowledge substance abuse. African Americans tend to become ill from cigarette smoking at younger ages than do Whites, even though they smoke fewer cigarettes per day than do Whites. This seems to be because African Americans prefer menthol cigarettes, which have higher tar and nicotine levels. In 1991, 58.1% of U.S. males and 44.3% of U.S. females reported using alcohol at least once a month, with the total population figure being 50.9%. In terms of race, 52.7% of Whites, 43.7% of African Americans, and 47.5% of Hispanics used alcohol regularly. There is a very high incidence of alcohol abuse among Native Americans (Rowell and Kusterer, 1991). This has been viewed as one effect of a 500-year history of contact with and domination by Europeans. When the use of substances by Native Americans increased in response to disease, genocide, and relocation, the once very clear definitions of acceptable and unacceptable behavior became blurred. Widespread alcohol abuse weakened the concept of personal responsibility. Parents who were abusers found it difficult to hold their children responsible for their own problems with alcohol. A cultural standard of “taking care of one’s own” and not seeking outside professional assistance contributed to a pattern of alcohol and drug use within entire families (Rowell and Kuster, 1991). Marijuana use in 1991, 6.3% of males and 3.4% of females abused marijuana, and 4.5% of Whites, 7.2% of African Americans, and 4.3% of Hispanics abused marijuana. Cocaine was also abused at different rates by different groups. Although no ethnic/racial group abused all three drugs (alcohol, marijuana, cocaine) consistently more than any other group, men abused all three of these substances more than women (U.S. Bureau of the Census, 1993). Inner-city males and females are at higher risk for HIV infection than non Inner-city dwellers due to the higher prevalence of IV drug abuse and unprotected sex (Mays and Cochran, 1988). According to the Centers for Disease Control and Prevention (1993), White males accounted for 54.6% of AIDS cases among men, African Americans accounted for 28.2%, Hispanics for 16.2%, Asians for .68%, and Native Americans for .21%. Among women, White women accounted for 50.8% of AIDS cases, African Americans for 31.4%, Hispanics for 16.7%, Asians for .67%, and Native Americans for .21%. Among African American men and women, most AIDS cases result from exposure to intravenous drug use. This also holds for White men and women, but among White men the majority of AIDS cases result from sexual contact with men (Centers for Disease Control and Prevention, 1993). The factors that contribute to the high mortality and morbidity rates among minorities are complex. Socioeconomic status and cultural beliefs and practices including socialization and dietary patterns may influence the incidence and progression of disease. Research has shown that socioeconomic status (SES) is related to incidence of illness and mortality rates. Gottlieb and Green (1987) discussed the conditions related to poverty that are associated with poor health: (a) stress due to noisy and/or overcrowded conditions, (b) lack of meaningful work, (c) prejudice and discrimination, (d) absence of social support, and (e) polluted and/or unsanitary environments. Minorities are overrepresented in the lower SES group. Because people of low SES tend to be less educated and lack insurance coverage, they are less likely to seek medical help, and when they do, the medical care they receive may be of poor quality. It is common for people who lack insurance coverage to utilize emergency rooms as their only source of health care. Consequently, health care is haphazard, and these individuals are less likely to be screened for diseases, less likely to receive preventive care, and more likely to ignore early symptoms of disease (Tanney, 1991). In addition to SES, cultural values, beliefs, and practices may influence individuals’ decisions to seek medical help (Uba, 1992). Uba (1992) reported that Southeast Asian refugees underutilized the American health care system despite the high, disproportionate numbers of health problems, including serious illnesses such as tuberculosis, malnutrition, intestinal parasites, and hepatitis B. Even when individuals seek medical treatment, there may be a lack of compliance or a failure to follow directions. Individuals may expect an instant cure or may mistake diagnostic methods, such as X-rays, for the intervention (Uba, 1992). Poor communication between health providers and patients also compromises medical care for racial/ethnic minorities. Deference to medical professionals, lack of bilingual health care providers, and desire to avoid embarrassment may inhibit people from asking necessary questions. A lack of understanding of different cultures on the part of health care providers and a history of receiving inappropriate advice also may be barriers to seeking help. An understanding of a patient’s culture is just as important for effective health care as is knowledge of physiological and psychological aspects. The caregiver should also be aware of the possible effect of hospitalization on the patient. The sudden change into the hospital culture may create a kind of culture shock that will affect well-being patterning and response to nursing intervention (Uba, 1992). Health care providers can encourage health prevention and health care behaviors only through the implications of culturally sensitive programs and behaviors. Professional and societal interventions are critical to the enhancement of minority health, with that, I recommend that programs and clinics must include minority health professionals (e.g., counselors, doctors, nurses, health educators) to cope with the problems and make health care “more available” for the minorities. Also, in order for intervention and prevention efforts to be effective, care-giving professionals must consider cultural issues. Health care training programs should provide students with (a) knowledge about different cultures; (b) knowledge of how health behaviors are influenced by cultural norm and expectations; (c) opportunities to become more multiculturally sensitive through course work, practice, and internships; and (d) knowledge of culturally visible health care interventions. Programs that adhere to these recommendations may increase the likelihood of developing health care professionals who are flexible and sensitive. Cultural beliefs and values affect how individuals maintain their health and respond to symptoms when a health problem arises, whether they seek treatment, and the type of treatment they seek. Communication between patients and health personnel and compliance with medical treatments and recommendations may be thwarted by cultural practices. Diet, sexual activity and practices, and the use of substances are also influenced by culture. Health care professionals must be aware of the effect culture plays in health behaviors in order to (a) deliver effective services, (b) develop culturally sensitive health programs, and (c) engage in research that is generalizable to groups other than the dominant culture. Finally, training programs must emphasize the role culture plays in order to train culturally sensitive and aware health care professionals. Bibliography: Alcorn, J. D. (1991). Counseling psychology and health applications. The Counseling Psychologist, 19, 325-341. American Cancer Society. (1993). Cancer facts and figures 1993. Atlanta. American Heart Association. (1993). Heart and stroke facts: 1994 statistical supplement. Dallas. Centers for Disease Control and Prevention. (1993). HIV/AIDS surveillance report. Atlanta. Gottlieb, N. H., and Green, W. L. (1987). Ethnicity and lifestyle health risk: some possible mechanisms. American Journal of Health Promotion, 2, 37-45. Keitel, M. A., and Kopala, M. (1994). Health counseling. In J. L. Ronch, W. Van Ornum, and N. C. Stilwell (Eds.), The counseling source book. New York: Crossroad. Kotchen, J. M., Kotchen, T. A., and Schwertman, N. C. (1974). Blood pressure distributions of urban adolescents. American Journal of Epidemiology, 99, 315-324. Livingston, I. L. (1993). Stress, hypertension, and young black americans: the importance of counseling. Journal of Multicultural Counseling and Development, 21, 132-142. Mosby’s medical, nursing and allied health dictionary (4th ed.). (1994). St. Louis, MS: Mosby Year Book Inc. Rowell, R. M., and Kusterer, H. (1991). Care of HIV-infected native american substance abusers. Journal of Chemical Dependency Treatment, 4, 91-103. Tanney, F. (1991). Counseling psychology and health psychology: some suggestions for a burgeoning area. The counseling psychologist, 19, 392-395. Uba, L. (1992). Cultural barriers to health care for southeast asian refugees. Public health reports, 107, 544-548. U. S. Bureau of the Census. (1993). Statistical abstract of the united states (113th ed.). Washington, DC.

Word Count: 1778