Introduction

Individuals of diverse cultural backgrounds create a rainbow of colors and cultures that impact health care. The advancement of technology, travel, and communication systems has allowed increased contact between people of many different cultures (Hitchcock, Schubert, & Thomas, 2003). The United States is a unique nation, created from a blending of many native and non-native peoples: Non-white residents made up 30.9% of the total population in 2002. Minorities and other ethnic and racial groups increased at a rate of 43.2% over the last 10 years compared with a 3.5% growth rate for whites during the same period. Many of these individuals have limited access to health care, speak English as a second language, and have incomes below the federal poverty line (Ndiwane et al., 2004). Never before has there been such a wide mix of ethnicity, race, culture, and nationality.

___________________________ "Today's healthcare professional must provide a level of care that meets the guidelines of cultural competence and respects different cultural values and cultural belief systems." ___________________________

This diversity of cultures and peoples has a powerful impact on the delivery of health care services, our understanding of disease and illness, and the challenge it presents to health care providers. Today's health care professional must provide a level of care that meets the guidelines of cultural competence and respects different cultural values and cultural belief systems. Only when we provide this level of care will we be able to truly care for patients; to advocate for them appropriately, thoughtfully, and sensitively; and to demonstrate that we are clinically as well as culturally competent (Breier-Mackie, 2007).

For the first time, the traditional health care system in the United States (biomedicine) is accommodating other diverse systems of care rather than requiring them to assimilate into its culture. This fundamental shift calls for all health care providers to become culturally competent. This is even more important when health care providers and clients use complementary and alternative modalities (Leonard, 2001).

Diversity in America  

There are 210 nations represented in the United States. The U.S. census for 2000 allows for approximately 66 different racial and ethnic category combinations. The growth in culturally diverse populations in the United States is dramatic (Office of Minority Health [OMH], 2001).

_______________________ "Individuals of diverse cultural backgrounds create a rainbow of colors and cultures that impact healthcare." _______________________

The percentage of the United States population that is white has decreased since the 1970s, due partly to increasing numbers of Asian Americans and Hispanic/Latino immigrants and partly to a higher population growth rate among blacks/African Americans (Luckmann, 1999).

 

According to the OMH (2001, p. 17),

The cultural issues that impact health care delivery are complex: they include thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups... By understanding, valuing, and incorporating the cultural differences of America's diverse population and examining one's own health-related values and beliefs, health care organizations, practitioners, and others can support a health care system that responds appropriately to, and directly services the unique needs of populations whose cultures may be different from the prevailing culture.

The diverse population of the United States and the resulting cultural mix are the result of many factors, including the following (Dossey, Keegan, & Guzzetta, 2000):

• the climate, food availability, and resources of a particular area
• migration patterns determined by climate, environmental conditions, political, and economic situations (such as famine, political uprising, or overpopulation)
• changing social roles of women
• changing value orientations and beliefs (including changes in beliefs about humankind's relationship to nature and to other persons)
• technology
• communication patterns and methods
• diverse health care beliefs

 

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