In this in-depth exploration, we delve into the implications of personal cultural backgrounds on health disparities, particularly within the context of Arab American and American Muslim communities in the United States. The author, a graduate student pursuing a degree in Nursing, draws from their own experiences as part of a cross-cultural family hailing from Saudi Arabia. Their journey to the United States sheds light on the impact of cultural habits, dietary practices, and lifestyle choices on health outcomes.
The study highlights the significance of acknowledging cultural diversity within healthcare practice and system, as it greatly influences the patient’s perception of illness, treatment, and adherence to medical advice. Family dynamics, with a particular focus on extended and joint families, play a critical role in shaping healthcare decisions. The eldest male family member often assumes the role of the decision-maker and spokesperson, emphasizing the collective interests and honor of the family over individual preferences.
Health disparities among Arab American and American Muslim populations are examined, including a higher risk of cardiovascular diseases, hypercholesterolemia, and high blood sugar levels, often exacerbated during Ramadan fasting. Dietary restrictions, cultural norms, and familial structures contribute to these disparities. These communities face challenges in accessing and understanding Western healthcare systems, leading to a need for tailored patient education and healthcare training.
The study underscores the importance of effective strategies for healthcare providers working with cross-cultural patients. These strategies include developing cultural competence, active listening, asking open-ended questions, staying nonjudgmental, and enhancing communication skills. In a culturally diverse healthcare landscape, these approaches are vital to ensure patients from all backgrounds receive equitable and culturally sensitive care.
An Examination of Culture on Health Disparities
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Transcultural Nursing Theory
Examination Culture on Health Disparities
An Examination of Culture on Health Disparities
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Defining my social status
I am a graduate living now in United States to pursue my Post graduation in Nursing.
According to social status, we are middle class family. There are three main social
statuses: Upper, middle and lower class. We live as a joint family. My family is very
large consisting of 11 members which may be defined as Kinship. We love each
other and united.
Effects of Personal culture of origin and analysis of cultural habits on health
My family lives in Saudi Arabia. I have Middle East ethnic background and now live
in United States. Settlement patterns and migration from Middle East to United
States commenced only in late 19th century after the commencement of World War
II. A census study by U.S government revealed that Saudi Arabians lived almost 42
out of 50 States in U.S. Due to the escalating number Saudi families in US many
educational institutions and academies are opened to support these cross cultural
background students. As hailing in a cross cultural background, my cultural habits
have been observed to have numerous health disparities as American Muslim and
Arab American.
As discussed above, my family is lives as community. We are totally 11 members.
My father is a retired business man. My family taught me the virtues and principles of
life like love, care, unity and politeness. I know the value of communication and so I
easily survive in a foreign land. With the cross cultural and religious setting, routine
lifestyle and dietary effects have been observed.
More than 80% of female Asian Immigrants have been found to have breast cancer
due to their heredity and genetic changes. There is strong rise in breast cancer
among Arab American females due to inherited background. This is due to the
cultural characteristics of Middle Eastern females which makes them to early
diagnosis of breast cancer by physical examination of breasts. Practise of
consanguineous marriages among Muslims have increased the rate of congenital
disorders among them. Decrease in the birth outcomes have led to the economic
deprivation among Muslim people which is a vital reason for hereditary and genetic
diseases. Although, Middle easterners duly respect Western Medicine but the
cultural customs seriously affect their health. This is because of honor (Sharaf) who
is the head of family. According to Islamic custom, contacting a health care provider
for drug addiction, venereal disease and pregnancy is shameful. A study by Mellon
An Examination of Culture on Health Disparities
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et al (2013) have highlighted that culture is the main hindrance for genetic testing
and screening of breast cancer.
According to the earlier study in Michigan State, Arab Americans have been
observed with 20 percent of risk for cardiovascular diseases than other ethnic
population. This is due to the increased rate of hypercholesterolemia among Arab-
Americans. Studies from Washington have reported than 37.6 percent of Arab
Americans have been observed with Hypercholesterolemia in Washington. The
reasons for possessing such health disparities are reduced amount of physical
activity, increased hypertension and improper diet. Culture and religion holds more
responsible for this. Since few traditional customs of Muslims include Dietary
restrictions must not be offered by Muslim patients. Foods that have vanilla essence
must be prohibited. Animal Fats that are not slaughtered by halal must be strictly
avoided. The dietary practise is important reason for hypercholesterolemia since
Arabs significantly possess higher intake of Non-vegetarian foods than vegetarian
foods. Increased amount of triglycerides can be found in both halal foods and non-
halal foods. Also beef have higher amount of triglycerides which can cause
hypertension and hypercholesterolemia. According to Lance et al (2007) have
suggested that fasting that has been undertaken by Muslims during Ramzan month
severely affects the health status of diabetes patients. Health care providers advice
that fasting right from dawn to dusk easily complicates the drugs, diet and sleep
regimen. This fasting may cause temporary dehydration, increased weight loss, lack
of concentration. Hypertension and Hypercholesterolemia are largely experienced by
Arab-Americans due to their cultural dietary and lifestyle practise. The above two
bad health conditions can cause Diabetes and Coronary heart diseases. A survey
study in South East Michigan by Hatahet et al (2002) have highlighted that Arab-
American population have increased amount of LDL cholesterol, high blood sugar
levels. The authors have pointed out that most of the women participated in the
study are overweight and Obese. The study have sharply demarcated that lifestyle of
the emigrants may be the chief reason for the increased risk of coronary heart
diseases.
Describe the aspects of health care practice, systems related to this culture,
and health care disparities of this culture.
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Every culture has health system of their own in order to explain the cause of illness
and treatment for the same. Western countries have high sophisticated technologies
to combat adverse and new variants of microbial and other diseases. The degree to
which patients distinguish on patient education in respect to their own cultural
significance for them may possess significantly philosophical consequence on their
response to information offered to them and their compliance to follow it. Asians and
Pacific Islanders have been found as greatest ethnic group living in the United
States. There are various important cultural customs, attitudes and beliefs among
Asians that every nurses should be sentient of. The joint or extended family system
of living has vital effect on health decisions since the elder most male in the family is
generally decision maker and spokesperson for all kinds of issue. The interests and
honor of the family are more important than those of individual family members.
Eldest family members are duly respected, and their influence is frequently
unquestioned. Among Asian cultures, preserving the unity, love and synchronization
is a great value; so consequently, there is a sturdy accent on avoiding conflict and
direct confrontation. Due to respect for authority, incongruity with the
recommendations of health care professionals is avoided. However, lack of
disagreement does not indicate that the patient and family agree with or will follow
treatment recommendations. These attitudes and beliefs seeds only for adverse
conditions like hypertension, hypercholesterolemia and high blood glucose during
their Ramadan fasting for 40 days (Reem et al 2014).
Strategies to work with cross cultural patients:
• Developing knowledge of the cultural practises and beliefs of the patients you
care for.
• Be always attentive to the body language of the patient, lack of response, or
expressions of anxiety that may signal that the patient or family is in conflict
but perhaps hesitant to tell you.
• Inquire about the patient’s culture and his or her family using open-ended
questions to gather maximum information about their assumptions and
expectations.
• Stay nonjudgmental when given information that reflects values that differ
from yours.
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• Practise a good value of communication to the patients and also find about
suitable ways to make easy communication within families and between
families and other health care providers (McLaughin & Braun 1998).
Examine health care disparities in this culture in a chosen topic and
population
Health care disparities can be described as the variations while providing health care
and its quality that imitate biases in response to the socioeconomic status of the
family, cultural and ethnic background and educational qualifications. Various health
care providers experience challenges to offer the medical facts and information in
order to conduct educational programs to specific cultures. The training programs to
educate on how to communicate with people who differ in ethnicities for health care
can greatly help in this scenario. These types of training modules for health care
providers that cuddles chief components of self-awareness and self-reflection, help
nursing students to strongly emphasise on discovering where patients are ‘‘coming
from’’ and working with patients hailing from cross cultural or cross religious settings
that makes sense to them and is not in conflict with their culture or beliefs. Arab
Americans and American Muslims are two various kinds of populations existing in
United States. In case of language barriers, non verbal communication may be very
assistive to maintain ideal patient-nurse relationship. Recent immigrants must be
assessed for language comprehension or otherwise interpreter has to be chosen so
as to monitor patients with proper care. Medical interpreters should be proficient in
both languages, understand medical terminology, and importantly understand
general cultural issues like family structures and roles. An interpreter of the same
gender is preferable, especially in discussing sensitive and intimate topics such as
sexual relationships. When a professional medical interpreter is not available, the
preferred alternative is a healthcare worker of the same cultural/religious background
who does not have a personal relationship with the patient (Maya et al 2005).
Arab/Muslim women patients will feel very much comfortable if the individual
healthcare provider or team informs its arrival for check up prior entering her room,
thus allowing few minutes for female patients to cover her. A notice can also be
positioned on the patient’s hospital room door requesting for knocking and awaiting
response before entering; this is necessary for a Muslim patient in hijab because a
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woman would need time to cover her body and her hair. In addition, Muslim women
specifically and Arab women in general do not tolerate unnecessary exposure of
their bodies (Maya et al 2005). These practises have been barriers for screening and
diagnosis for breast cancer since long time ago. So, conducting education and mass
training programs among those populations may greatly help them to avoid
healthcare disparities.