Health Promotions Among Diverse Populations
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“The United States has become increasingly diverse in the last century. According to the 2010 U.S. Census, approximately 36 percent of the population belongs to a racial or ethnic minority group” (Centers for Disease Control and Prevention, 2015). This increase of racial and ethnic diversity in the U.S., as well as the challenge to eliminate disparities in the health status of people of diverse backgrounds, demands that we provide culturally appropriate health education and health promotion to everyone (Edelman, Kudzma, & Mandle, 2014, p.221). Reducing the health disparities in this country needs to come from a national level, but this does not mean that nurses can’t play a vital role in helping reduce them. As of 2013, there are approximately 54 million Hispanics living in the U.S., which makes up nearly 17% of the U.S population, making Hispanics the largest ethnic minority group (CDC, 2015). This particular minority group is perhaps more exposed to health disparities in this country than any other ethnic group. The health of any population is largely influenced by its social and economic factors, and the health care services it receives.
When examining the health status and health disparities of the Hispanic population, there are a multitude of barriers that prevent them from obtaining quality care. One of the major barriers that affects their health status is language. Approximately 33% of Hispanics state that they are not fluent in English (U.S Department of Health and Human Services Office of Minority Health, 2014). Limited proficiency in English affects Hispanics’ ability to seek and obtain health care and reduces access to health information in the media. Other major factors include lack of access to preventive care and lack of health insurance. “It is significant to note that Hispanics have the highest uninsured rates of any racial or ethnic group within the United States” (OMH, 2014). Having no insurance leads to greater out-of-pocket expenses that many are unable to afford, which leads to people forgoing medical attention and care even when they are in need. The inability to pay these out-of-pocket expenses is due to the low economic status of this group.
“In 1999, 23 percent of Hispanics lived in poverty, compared with 8 percent of non-Hispanic whites” (Escarce, Kapur, 2006). Other notable barriers for this group are the lack of education and the amount of this particular population that are undocumented immigrants. All of these factors combined lead to a decrease in the health status of this population and an increase of health disparities. Many of the major health problems faced by this population are preventable, but due to their inability to get proper care, their health problems continue to rise. Heart disease and diabetes are some of the leading causes of death for Hispanics in this country. Both of which are often times preventable. However, factors such as no insurance or lack of knowledge about these diseases prevent them from seeking medical attention. Obesity is also a major problem for this ethnic group. Again, lack of knowledge about healthy food is a factor, but also because so many of this population is living at or below the poverty line the only available foods for them are cheap unhealthy foods, which not only leads to obesity, but again ties in with the increase of heart disease and diabetes in this culture.
Health promotion in the Hispanic population can vary greatly, and cultural beliefs can have a major impact. The older Hispanic population tends to carry beliefs that illnesses are a punishment for past deeds, which can inhibit their belief that they have control over ones own health and the ability to improve such. In order to promote health promotion in this population, it is important for health care providers to be culturally sensitive as well as culturally competent. Presenting information in a way that is relevant to this group and maintains their values and beliefs is imperative to achieve desired outcomes. An approach that encompasses all three levels (primary, secondary, and tertiary) of health promotion can be seen in the innovated workplace intervention described in the readings of Health Promotion Throughout the Life Span where a program was developed to reduce cardiovascular risk in a group of Hispanic women (Edelman, Kudzma, & Mandle, 2014, p.221).
This particular program focused on teaching a group of low-income, immigrant women that were only Spanish speaking about how to prevent heart disease, which is a prominent health problem in this population. The primary intervention was teaching them about the importance of reducing salt and fats in their diet and increasing physical activity. The second level of prevention could be seen by the screenings conducted to monitor their weight and blood pressure. For the members of the group that were already in a hypertensive range, the continuance of monitoring blood pressure and the addition of classes and blood pressure clinics even after the end of the study provides an example of tertiary prevention. Overall education appears to be one of the most effective tools in health promotion prevention for this minority group.
“Health education involves not only providing relevant information but also facilitating health-related behavior change” (Edelman, Kudzma, & Mandle, 2014, p.221). Focusing on each level of prevention and approaching this program in a culturally sensitive and appropriate manner resulted in significant improvement in the participants’ overall health and understanding of cardiovascular disease and shows how education can greatly impact the health status of this population. As the increase of minority groups continue to grow in this country, so must the efforts to reduce health disparities and increase the health status of everyone. Understanding the cultural, socioeconomic, and sociopolitical barriers to health in addition to providing culturally based programs can help this disadvantaged group overcome some of their health concerns.
Centers for Disease Control and Prevention (2015). Minority Health. Retrieved from
Edelman, Carole, Elizabeth Kudzma, Carol Mandle. Health Promotion Throughout the Life Span, 8th Edition. Mosby, 2014. VitalBook file.
U.S Department of Health and Human Services Office of Minority Health (2014) Profile: Hispanic/Latino Americans Retrieved from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=64 Escarce, J. J., & Kapur, K. (2006). Access to and Quality of Health Care – Hispanics and the Future of America – NCBI Bookshelf. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK19910/