NSG 4076 Week 2 Project Health Promotion and Clinical Prevention
Culture is an essential component of human life. People from different backgrounds have diverse cultural values, beliefs, and practices. The variation can be seen in how people do their things, respond to events, and believe in the existence of supernatural beings. Nurses play critical roles in implementing interventions that promote the provision of culturally appropriate care to patients. Outcomes that include patient satisfaction and empowerment are achieved when culturally appropriate patient care is given. Therefore, the purpose of this paper NSG 4076 Week 2 Project Health Promotion and Clinical Prevention is an examination of a cultural assessment of an individual I interacted with over the last few days.
You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:
- Minority Health: http://www.cdc.gov/minorityhealt/index.html
- Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html
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Cultural Assessment
The cultural assessment was conducted with a Latino male, Mr. X. Mr. X’s country of birth is the USA. His parents’ country of birth is Cuba. They migrated to the USA 30 years ago for better working opportunities. Mr. X reported that they live in a healthy environment with a dense population. The population is middle income. He reported that the family’s income is adequate to sustain its needs. He had never been into the military. He is single. He acknowledged that Latino culture has significantly affected how he relates with others in his personal and professional capacities.
Mr. X asserted the vital role of communication in his culture. He noted that his community uses both verbal and non-verbal communication methods to enhance communication effectiveness. He preferred being called a specific name, which is his family identifier. Mr. X denied any challenges in speaking the English language. As a result, he finds it easy to express himself to others. Mr. X also noted the use of non-verbal communication skills such as touch to communicate emotions. He reported that he finds expressions of love, empathy, and kindness appropriate. Mr. X raised the importance of personal space in his culture and the need for the protection of his cultural values, beliefs, and practices in the care process.
Mr. X reported the existence of unique family roles and organizations in the Latino culture. Accordingly, an individual is assignedthe role of making decisions in the family. Mr. X’s father is the key decision-maker in the family. Males also perform unique roles that differ from those of females. Females undertake housekeeping roles such as cooking and ensuring children learn the required values while males perform roles such as finances, looking for food, and educating children. However, most of the roles have lost relevance in the modern world due to globalization. Mr. X recognized the importance of ethical behaviors such as abusing drugs and engaging in prostitution. Mr. X acknowledged diversity in sexual orientation despite it being contrary to his cultural norms.
Mr. X raised some workforce issues common in his culture. One of them is the tradition of having Latinos working in restaurants and engaging in manual work, which has affected their socioeconomic status in society. However, the increase in educational attainment in the country has increased Latino access to better employment opportunities. Mr. X noted the importance of loyalty and time management in Latino culture, as they contribute to professionalism in any role. He denied any issues in expressing himself in his workplace since he was brought up in the USA.
Mr. X denied any history of allergies to medicines. However, he noted his increased predisposition to health problems such as obesity and hypertension due to genetics. He denied any history of chronic illness. Mr. X was positive towards the use of healthcare services. He seeks medical care for any health problems. He believes that the disabled should receive assistance in achieving their health-related needs.
Mr. X reported that Latinos value healthy living. They discourage involvement in unhealthy lifestyles and behaviors that include alcohol abuse and eating unhealthy debts. Mr. X is a nonsmoker, drinks alcohol occasionally, and does not abuse any other drugs. He also reported that he engages in physical activities regularly to promote his health. He also uses seat belts and protective measures that include condoms to prevent sexually transmitted infections.
Mr. X acknowledged a low level of awareness of nutrition issues among Latinos. As a result, they are highly predisposed to lifestyle problems such as obesity, diabetes, and hypertension. Mr. X noted that he eats healthy, balanced diets. He is not selective on the foods he takes. Mr. X further acknowledged the importance of pregnancy and childbirth in the Latino culture. They perceive children as a source of family blessings and wealth. He also noted that people from his culture support the use of modern contraceptives. Pregnant mothers are prohibited from engaging in risky behaviors such as intensive activities to minimize the risk of harm. Pregnant mothers should be provided with adequate support to ensure positive birth outcomes.
Mr. X also reported unique practices related to death in his culture. Accordingly, people are expected to wail when a person dies. Family members and friends are important in consoling the bereaved in times of death. Men should demonstrate strength by not crying when someone dies while women are allowed to cry aloud. In terms of spirituality, Mr. X reported that he is a Christian. He engages in religious practices such as singing and praying to God. He acknowledged the importance of freedom of religion to the population.
In terms of healthcare practices, Mr. X noted that Latinos engage in activities that contribute to their health such as eating balanced diets and seeking healthcare services. He denied support for organ donation, as it was contrary to his cultural beliefs. He reported utilizing healthcare services from healthcare providers for health problems. However, he preferred male healthcare providers to females since he feels confident expressing his health issues to a male provider. He denied utilizing care services from healers. He at times uses alternative medicines to manage ailments.
Implication for Health Practices
The results of the health assessment have implications for health practices. One of the implications is the increased need for culturally appropriate healthcare services for patients. Healthcare organizations and providers should focus on providing care that aligns with the diverse cultural needs of their patients to promote their empowerment and satisfaction with the offered care (Choi & Kim, 2018). It also raises the need for the provision of opportunities that contribute to cultural competence among healthcare providers. Healthcare organizations should provide training opportunities to their staff to equip them with the knowledge and skills in providing high-quality, safe, and efficient culturally appropriate care. The last implication to health practices is the increased need for further studies to determine cultural influences on healthcare(Sharifi et al., 2019). The research will inform the adoption of evidence-based interventions in healthcare.
Conclusion
Purnell Model is an effective tool for use in cultural assessment in healthcare. It provides a holistic understanding of the actual and potential needs of the patients and interventions needed to address them. The results of the cultural assessment increase nurses’ understanding of how to enhance culturally appropriate care for diverse populations. Therefore, healthcare institutions should strive to implement interventions that enhance cultural safety and appropriateness in the patient care process.
References
Choi, J.-S., & Kim, J.-S.(2018). Effects of cultural education and cultural experiences on the cultural competence among undergraduate nursing students.Nurse Education in Practice, 29, 159–162.
Sharifi, N., Adib-Hajbaghery, M., &Najafi, M. (2019).Cultural competence in nursing: A concept analysis.International Journal of Nursing Studies, 99, 103386.
African Americans are the second largest minority group in the U.S accounting for approximately 13.4% of the total population (Yearby, 2020). African Americans are burdened disproportionately by obesity among other related conditions like diabetes, cancer, and heart disease leading to increased morbidity and mortality rates as compared to the whites. Several social determinants of health such as the wage gaps, unethical housing policies, and substandard education and healthcare have contributed to the health disparities experienced by African Americans (Colen et al., 2018). Consequently, African Americans have a history of mistrust in the medical and research community which serves as a barrier to seeing a primary care physician or taking part in health promotion research. As such, strategies aimed at engaging African Americans in health promotion programs need to take into consideration cultural appropriateness when developing and implementing appropriate health promotion initiatives. The purpose of this paper is to analyze the health disparities among African Americans and the possible health promotion activities appropriate for this population.
Social Determinants of Health
African Americans are faced with several challenges undermining their access to quality care services, hence the increased morbidity and mortality rates. Such challenges are categorized in terms of socioeconomic status, and environmental hazards among other barriers to accessing healthcare services such as unaffordability of care services and lack of health insurance coverage. The majority of African Americans have a low socioeconomic status with an increased rate of unemployment, low education level, poverty, and poor housing among others. As of 2019, approximately 93.3% of African Americans earned at least a high school diploma, with 22.6% attaining a bachelor’s degree or higher (Colen et al., 2018). This number is quite less as compared to the white counterparts. The low education status among this population contributes towards the adoption of an unhealthy lifestyle promoting the risks for chronic conditions such as obesity, heart disease, and cancer.
The U.S. Census Bureau reported that approximately 21.2% of black Americans as compared to 9% of whites were living at the poverty level in 2019 (Bassett & Galea, 2020). The level of unemployment among African Americans was also reported to be 7.7% as compared to the 3.7% among the whites. Such factors contribute to increased risk of environmental hazards such as unavailability of clean water, poor air quality, and poor environmental hygiene. Concerning the affordability of healthcare services, insurance coverage among the blacks in 2019 was 55.9% for private health insurance and 43.5% for Medicaid or public insurance. All these factors contribute towards the high prevalence of chronic diseases among black Americans, as a result of reduced access to healthcare services and adoption of an unhealthy lifestyle.
Mortality and Morbidity Risk Factors
According to the 2019 Census Bureau projections, the life expectancy at birth for black Americans was reported to be approximately 77 years, with 74 years for men and 79.8 years for women (Yearby, 2020). Consequently, the death rate among this vulnerable population was generally high as a result of numerous health complications. Studies show that Black Americans suffer a great burden with a higher prevalence of diabetes, heart diseases, cancer, and HIV/AIDS as the main contributing factors towards the high morbidity and mortality rates.
In 2018, the U.S Department of Health and Human Services(HHS), Office of Minority Health (OMH) reported that African Americans were twice as likely as whites to die from diabetes. Additionally, it was also reported that African Americans had a 60% chance of being diagnosed with diabetes (Bassett & Galea, 2020). The high prevalence of diabetes among this minority group is associated with several risk factors such as overweight and obesity, cigarette smoking, high cholesterol, and hypertension.
The HHS reported that African Americans were 30% more likely to die from heart disease in 2018, as compared to whites (Yearby, 2020). Despite this vulnerable population having a 40% likelihood of being diagnosed with hypertension, they also face the greatest challenges of being unable to seek treatment as a result of the barriers explained above. This promotes complications such as stroke which is one of the leading causes of death among African Americans. Common risk factors promoting the prevalence of heart disease among blacks include overweight and obesity.
Additionally, the American Cancer Society, in 2019, reported that black Americans have the highest number of deaths and shortest rates of survival as compared to any other racial and ethnic group in the United States for most cancers (Bassett & Galea, 2020). The high death and morbidity as a result of cancer are mainly associated with several risk factors such as consumption of unhealthy foods, lack of physical exercise, and inability to access healthcare facilities to promote routine screening.
Lastly, according to the CDC, black American people also account for the highest portion of newly diagnosed cases of HIV as compared to other ethnicities and races. These disparities continue to grow among this minority group due to factors such as HIV stigma, racism, barriers to healthcare access, and poverty (Bassett & Galea, 2020). Appropriate health promotion programs must be put in place, concerning each of the four leading causes of death, to promote the health and wellbeing of black Americans.
Health Promotion Activities
By working side by side with community partners responsible for delivering services to African Americans and healthcare providers who are members of the African American communities, several health promotion interventions can be developed based on the identified socioeconomic risk factors contributing to the health disparities in addition to the barriers to healthcare utilization. Such health promotion activities will be aimed at facilitating coordination of care services and implementation of evidence-based interventions to address health disparities such as diabetes, heart disease, cancer, and HIV/AIDs reducing the morbidity and mortality rates among this population (Fletcher et al., 2018).
Health promotion interventions delivered in hair salons and barbershops for African Americans have displayed great effectiveness in reducing the risk factors and promoting the health outcome for overweight/obesity-related chronic diseases such as diabetes, heart disease, and cancer. Interventions addressing lifestyle modifications associated with obesity, heart disease, and diabetes are required while balancing the appropriateness of the desired outcome (Carey et al., 2018). Such interventions include advocating for environments and policies supporting healthy lifestyles such as engaging in physical activity and healthy eating, increasing public awareness of the symptoms and treatment measures for these health disparities, promoting access to appropriate resources for people suffering from these conditions, and monitoring of their effects. Consequently, it is important to educate the community members regarding the dangers associated with smoking, and the appropriate measures that can be taken to promote smoking cessation to promote the health and well-being of African Americans.
Additional health promotion activities include coming up with cancer screening programs to promote early diagnosis and management of the most common types of cancer present among African Americans (Rock et al., 2020). Lastly, appropriate health promotion activities to reduce the burden associated with HIV/AIDs include empowering the community with adequate knowledge regarding HIV to avoid stigmatization, promoting safe sexual intercourse by championing the ABC program (abstain, be faithful, and use of condoms), and promoting the routine screening of the disease.
Conclusion
African Americans are faced with several health disparities associated with socioeconomic inequalities among other factors. Studies show that this minority group experiences increased morbidity and mortality rates as a result of common chronic conditions such as diabetes, heart disease, cancer, and HIV/AIDs. These conditions are attributed to common risk factors like overweight/obesity, cigarette smoking, sedentary lifestyle, unhealthy foods, low education level, inability to access healthcare services, poverty, unemployment, and environmental hazards such as air pollution. As such, the development of appropriate health promotion activities among African Americans must focus on this risk factor to promote the health and well-being of this population.
References
Bassett, M. T., & Galea, S. (2020). Reparations as a public health priority—a strategy for ending black-white health disparities. New England Journal of Medicine, 383(22), 2101-2103. DOI: 10.1056/NEJMp2026170.
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of hypertension: JACC health promotion series. Journal of the American College of Cardiology, 72(11), 1278-1293. DOI: 10.1016/j.jacc.2018.07.008
Colen, C. G., Ramey, D. M., Cooksey, E. C., & Williams, D. R. (2018). Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination. Social Science & Medicine, 199, 167-180. https://doi.org/10.1016/j.socscimed.2017.04.051
Fletcher, G. F., Landolfo, C., Niebauer, J., Ozemek, C., Arena, R., & Lavie, C. J. (2018). Promoting physical activity and exercise: JACC health promotion series. Journal of the American College of Cardiology, 72(14), 1622-1639. DOI: 10.1016/j.jacc.2018.08.2141.
Rock, C. L., Thomson, C., Gansler, T., Gapstur, S. M., McCullough, M. L., Patel, A. V., … & Doyle, C. (2020). American Cancer Society guideline for diet and physical activity for cancer prevention. CA: a cancer journal for clinicians, 70(4), 245-271. https://doi.org/10.3322/caac.21591
Yearby, R. (2020). Structural racism and health disparities: Reconfiguring the social determinants of health framework to include the root cause. The Journal of Law, Medicine & Ethics, 48(3), 518-526. DOI: 10.1177/1073110520958876.