Multicultural Health Essay 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% .