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Teaching about diversity is synonymous with a quality education in health care. The focus on diversity is not a separate aspect of quality teaching in and of itself. Rather, it is a key attribute for the development of clinical reasoning skills. However, incorporating diversity concepts into the curricula of the health professions may be more difficult for many faculty than delivering pathophysiology content. Moreover, ethnically diverse minority and underserved vulnerable populations require health care professionals that are knowledgeable of components inherent in the delivery of their health care. To achieve the goal of integrating diversity concepts into existing courses requires institutional support and faculty commitment.
Over the past decades, there have been three emerging population trends in the United States. First, the minority population is increasing at higher rates than the white population (U. S. Census, 2001). Guhde's article in this issue of the Journal of Cultural Diversity highlights the growth of the Hispanic and Asian populations and the need to facilitate the progression and graduation of the English as a Second Language student. This article is significant because of the tremendous need for health professionals who are bilingual. In many urban hospitals and other health care delivery agencies, thirty to fifty percent of the patients may not speak English. Moreover, when demographic data are linked to health indicators, minorities are worse off than whites. For example, African Americans have the highest rate of cardiovascular disease in the world (USDHHS, 2000). Diabetes has reached epidemic proportions among Native Americans, African Americans, and Hispanics. African Americans, Asian Americans, and Hispanics have a disproportionate burden for cancer deaths compared to the white population. According to the Institute of Medicine (IOM), a key component that affects health disparities is cultural competency (IOM, 2002). Being culturally competent potentially improves care and may aid in reducing the burden of health disparities. Implementing fundamental change requires that health care professionals understand these disparities and make a personal commitment to make a difference.
A second trend in the United States is an increasing rate of poverty among its children. Access to care is a significant problem for low-income populations and contributes to disparities in health for this population. Providing health care to the nation's vulnerable populations is hampered by both a limited number of culturally competent providers as well as a significant shortage of health care providers (Aday, 2001). The current shortage has had a substantial impact on the ability of health service agencies to care for low-income underserved populations (Gornick, 2002).
The third trend is the under representation of minorities in schools of nursing and medicine. The lack of representation of minorities in these professional schools leads to a lack of diversity in the nursing and medical workforce. Studies indicate that minority nurses are more likely to work with minority populations and participate in community-based health promotion programs with vulnerable populations (AACN, 2002; Tucker-Allen, 1999). The article written by Fletcher et al provides a best practice model for the recruitment and graduation of ethnic minority nursing students. The national goal of increasing the diversity of the healthcare workforce is possible and more than an idea whose time is long overdue.
Journal of Cultural Diversity, Winter 2003
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