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In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

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Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
What are the health disparities that exist for this group? What are the nutritional challenges for this group?
Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
What health promotion activities are often practiced by this group? How Race And Ethnicity Influence Health Essay
Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?
Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

The concept of health and wellbeing has evolved since the dawn of human civilization. Once believed to be influenced by mystical or supernatural forces, modern scientists now agree on several key factors that undeniably determine the level of health and wellness of an individual. The goal of this paper is to examine the role of ethnicity in that determination, and to pay specific attention to how this affects Hispanic-Latino populations in America.How Race And Ethnicity Influence Health Essay

Defining the terms

A founding principle of United States domestic policy, as declared by Thomas Jefferson, is fairness through equality. These truths, in America, are held to be self-evident: that all men were created equal and are endowed with certain unalienable rights. Access to basic health care is now undoubtable one of these rights – as is evident by the Emergency Medical Treatment and Labor Act of 1986, the Americans with Disabilities Act of 1990, and the Patients’ Bill of Rights of 1995 (updated in 2010). Thus, health equality, in the United States, means equal access to health care services regardless of race, ethnicity, gender, age, sexual preference, economic status, education, or disability. Health equity, on the other hand, means that all individuals should deserve equal opportunities to lead full, healthy lives, and should deserve equal opportunities to the unalienable rights of life, liberty, and the pursuit of happiness. While equality was unanimously declared by the thirteen united States of America in 1776, equity – the very means to equality – is still somewhat a controversial issue, as is evident by disagreements over “Affirmative Action” and certain policies of the Affordable Care Act.How Race And Ethnicity Influence Health Essay

The term race has traditionally been applied to delineate groups of humans, along stereotyped morphological and phenotypic lines typically attributed to evolutionary sub-speciation or other such inherited group biology. Corresponding taxonomical attempts to classify human population divergence has resulted in several unsatisfactory ambiguities and inconsistencies. Problems with the concept of race and ascribing consistent racial nomenclature have led to alternative ways of thinking about human diversity.

The term ethnic is also used to demarcate groups of people. This concept was first used by sociologists to describe the waves of immigrant populations in and around the United Stated during the Great Depression (Marable, 2000). Ethnicity avoids some of the subjective complications associated with racial classification while retaining the ability to categorize natural anthropologic aggregates, by objectively allowing affiliates to self-identity group association; and unlike race, the concept of ethnicity recognizes that biological and cultural differences distinguish populations.How Race And Ethnicity Influence Health Essay

An ethnic group is a subgroup of a larger social system whose members “have common ancestral, racial, physical, or national characteristics and who share cultural symbols such as language, lifestyle, religion, and other characteristics that are not fully understood or shared by outsiders” (Andrews & Boyle, 1999, p. 59). Ethnic identities are fluid over time, reflecting how people think about themselves and external political forces (Nagel, 1994, p. 155). Ethnic groups feel similarities that not only bind their members together, but also separate them from other groups (Stark, 2004, pp. 257-258). Such similarities are often centered on a shared common history or distinctive culture that may be, but not necessarily, associated with nationality; and as such, ethnic identity, is often perceived as inherent, but is actually a phenomenon relative to the surrounding population. For example, whenever Columbian-American or Argentinian-American families take pride in their ethnic heritage, they may be focusing on their national roots; but, for example, families in Columbia may be focusing on their Afro-Colombian, indigenous, or gypsy (Romani) roots when they take pride in their ethnic heritage (Federal Research Division of the Library of Congress [FRDLC], 2010, p. 34).How Race And Ethnicity Influence Health Essay

About 33 percent of Americans self-identity as belonging to as ethnic minority (factfinder, 2008), and Latinos make up about 15% of the U.S. population and are the fastest growing minority – expected to make up nearly one-fourth of the population by 2050 (census.gov, 2014). Although many diversities exist among Hispanic populations, in vernacular dialog the terms Hispanic, Latino, and Spanish are frequently used interchangeably. Preferences for various ethnic terms change over time, and an increasing number of people are identifying themselves in terms of more than one ethnic tradition. For example, many people who are considered Hispanic or Latino by the Census Bureau are identifying themselves as Mexican-American, Cuban-American, and so forth. In fact, many people actually dislike the terms Hispanic and Latino because these are terms that the dominant culture has used to lump together groups that historically have not identified with one another and may have many strong dissimilarities; but if they had to choose, some people prefer the term Latino over Hispanic because they view Latino as recognizing the diversity of Latin American countries (Granados, 2000). Nevertheless, the term Hispanic has lately gained more acceptance, and was preferred by the majority of registered Latino voters (Granados, 2000).How Race And Ethnicity Influence Health Essay

Health inequities in ethnic groups

“Healthy People 2020” identifies five key domains of concern: economic stability, education, health and health care, neighborhood and built environment, and social and community context. Each of these determinants is comprised of several critical components. Factors related to economic stability are poverty, employment, food security, and housing stability. Education factors include high school graduation, enrollment in higher education, language and literacy, early childhood education and development. Elements related to social and community context are social cohesion, civic participation, perceptions of discrimination and equity, and incarceration/institutionalization. Health and health care is determined by access to health care, access to primary care, and health literacy. Finally, neighborhood and built environment variables are access to healthy foods, quality of housing, crime and violence, and environmental conditions (healthypeople.gov, 2015). Ethnic minority groups, immigrants, and non-English speakers are particularly vulnerable to these five areas.

One important aspect of the health inequalities among ethnic minorities is socioeconomic status (SES). Compared to high SES families low SES families are less educated, have less prestigious jobs, and have lower incomes. Low SES is associated with many developmental problems, including high infant mortality rates, poor school achievement, and a higher rate of behavioral problems (Gottfried et al., 2003). Because so many outcomes are associated with SES, it is one of the most frequently studied environmental variables.How Race And Ethnicity Influence Health Essay

The unavailability of opportunities, inaccessibility of health care, and disadvantageous occupational and discriminatory factors all contribute to health disparities in the ethnic groups. Education and income are inherently related, and both play parts in the limited opportunities some Hispanic-Latino face. Statistically, the risk for death, chronic diseases, and unhealthy behaviors vary inversely with income and education (Ramirez & de la Cruz, 2003). More than forty percent of Hispanics older than twenty-five have not graduated from high school, twenty-seven percent have less than a ninth grade education (Ramirez & de la Cruz, 2003), and only eleven percent have a bachelor’s degree (US DHHS, 2003). Hispanic-Latinos statistically earn less than non-Hispanic workers earn, and are more likely to live in poverty (Ramirez & de la Cruz, 2003). Even though 80 percent of Latinos are working, more than one-fifth of them live in poverty (Valdez & Posada, 2006). Hispanic-Latinos are more likely to work in service related occupations, are less likely to work in managerial or executive positions, and are more likely to be unemployed than non-Hispanic whites (Ramirez & de la Cruz, 2003). Because Latinos are primarily employed in low-wage, service related jobs, where health insurance and health benefits are mainly lacking, only one-fourth has employer-sponsored health insurance (Valdez & Posada, 2006). Hispanic-Latinos also have to contend with potentially discriminatory treatment and denial of opportunity during the job application, interview, and job offer process (Smedley, Stith, & Nelson, 2003). Additionally, some Hispanics have historically had to contend with housing discrimination, racial profiling, overt racism, legal discrimination, and other forms of systematic discrimination. As a result, available opportunities to equal health care are limited among the disadvantaged members of the Hispanic-Latino population.How Race And Ethnicity Influence Health Essay

Other sources of disparity for Latinos include language, poor health literacy, and undocumented immigration status. A systematic review, examining language barriers in health care for Latino populations, found that access to care, quality of care, and outcomes were all adversely affected (Timmins, 2002). Language is a major factor in health literacy. More than 70 percent of foreign-born Latinos are Spanish dominant, 26 percent of which need an interpreter during healthcare visits (Valdez, & Posada, 2006). One-third of Latinos have difficulty communicating with their doctor, and more than 60 percent have trouble understanding medication instructions (Valdez, & Posada, 2006). An examination of data from the Department of Health and Human Services on healthcare spending found that unauthorized immigrants spend disproportionately less on healthcare than legal and naturalized immigrants (an average of $140 per capita per year, compared to an average of $1,385 for U.S. natives) (Stimpson, Wilson, & Su, 2013).How Race And Ethnicity Influence Health Essay

Application to practice

Ethnic groups, as all other Americans, have a right to equal access to health care and equal non-discriminatory treatment. Nevertheless, every American has the liberty to exercise those rights as they see fit, and the freedom of expression to determine the lifestyle of their choosing in accordance with their beliefs. All of our personal preferences are based on our previous experiences. Our social values and individual choices are often formulated in the context of cultural heritage and traditional practice, and what one culture may consider normal may seem to be highly absurd to another. In the dynamic environment of healthcare delivery, there are only a few unqualified invariants: consent, confidentiality, full disclosure, and the refusal of care. These principals are the foundation of patients’ rights in America. Care must be given to respect the values and beliefs of other cultures, and not to inadvertently violate these basic principles threw ignorance or neglect.How Race And Ethnicity Influence Health Essay

Certain cautions must be considered when caring for ethnic minority patients. Firstly, when discussing ethnic groups, it is appropriate to refer to them by their ethnicity, but when addressing individuals, it is more respectful to refer to them by their ethno-American nationality (i.e., Mexican-American or Spanish-American as opposed to as either Latino or Hispanic). Secondly, it is important to practice with the understanding that certain socioeconomic barriers, that limit the access to care, are beyond the control of those they affect. It is essential that providers transcend their own personal beliefs and the common stigmas associated with low SES to deliver care non-discriminatorily without blame or judgement. A policy of education and empowerment is advised as many ethnic minorities may be unfamiliar with navigating the various fanatical options for funding care, may be unaware of the numerous points of access to care, and unaware of the benefits of a usual source of care. “Healthy People 2020” objectives to improve health and health care include increasing the number of people with insurance, increasing the number of people with primary care providers/ ongoing sources of care, and reducing delay in care (healthypeople.gov -a, 2015). Education and referral for anyone without insurance or a usual source of care is advisable. Fourthly, with non-English speaking patients it is essential to use a qualified medical translator. It is commonplace to have a family member or other staff member to translate when language is a problem, and while such remedies may be convenient, it is potentially an opportunity for miscommunication. As with all healthcare instructions, it is important to tailor the complexity of the language used to fit the level of health literacy of the audience, and subsequently determine their correct understanding with fallow-up questions. Lastly, immigration status is not relevant medical history question, and green cards are not required for medical treatment. Reporting of illegal immigrants in such settings is counterproductive to the community at large and is unadvisable. The common stereotype, of aliens avoiding healthcare for fear of deportation, is unfounded and should be dispelled given the opportunity.How Race And Ethnicity Influence Health Essay

The Hispanic-Latino population, as well as other ethnic groups, has long suffered from health disparities due to inadequate access to quality health care, limited socio-economic opportunities, and sources of disparity. The paradox of American domestic policy – the controversy over equity despite the emphasis on equality – in the delivery of health care to disenfranchised populations, is evident in the Hispanic-Latino population, and is an abject symptom of the fundamental misunderstanding among the relationship between welfare and opportunity. In the modern age of science, technology, and political stability heath inequities deserve equal treatment.

The policy makers are concerned with addressing or correcting imbalances that impact directly on ethnic minorities’ well-being, such as socioeconomic, health, housing, education, lifestyle and discriminatory factors. Aggleton (1990, p.5 as cited in Baggott, 2004) posited that health can be defined in two ways; ‘‘the positive approach, where health is viewed as a capacity or an asset, and the negative approach, which emphasises the absence of specific illnesses, diseases and disorders’’. Similarly the World Health Organisation (1946 as cited in Baggott, 2004) defined health as ‘‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’’. This definition is significant in that it highlights physical as well as mental aspects of health while emphasising the ‘positive sense’ as in Aggleton’s definition of health. According to Giddens (2009, p.633) ‘‘ethnicity refers to the cultural practices and outlooks of a given community of people which sets them apart from others’’. Ethnic groups have different traits that set them apart from other groups, such as religion, dress style, language, and history. However, ethnic differences are learned to an extent there have been associations made with health for most of these minority groups. While there is nothing innate about ethnicity, it is central to group and individual identity and similarly important to the health professions who suggest there is a relationship between health and ethnicity. Giddens (2009) argues that this relationship is partial at best but concedes that there is a rather high incidence of illnesses among individuals or groups of ethnic origins. This essay will critically examine and explain the relationship between ethnicity and health.How Race And Ethnicity Influence Health Essay

NOW

In Britain as the 21st century progresses, its population composition of ethnic minorities is rapidly changing, despite Queen Elizabeth the 1st’s proclamation in 1601 that ‘negroes and blackamoors’ should be deported. She believed they were responsible in part for the social and economic dilemmas, such as famine and poverty (Haralambos & Holborn, 2000, p.199). In contemporary Britain this contentious issue has continued amongst a mass population about what they believe to be ‘Britishness’ when it comes to ethnic minorities. According to Stillwell & Van Ham, (2010) some see it as a disaster, which will lead to spatial segregation, communities breaking down and a burden to the health delivery system. Perhaps this could be explain why extreme right-wing parties such as the British National Party, which contests immigration and blames all social predicaments on ethnic minorities continues to attract support. While others will argue that this will be good in terms of diversity and see it as an opportunity for an integrated society (Stillwell & Van Ham, 2010).How Race And Ethnicity Influence Health Essay

There are various ways in which health and ethnicity are related. For example there are differences in population structures, education, genetics, generational and socioeconomic factors between different ethnic groups that impact differently on their health (Bardsley, Hamm, Lowdell, Morgan & Storkey, 2000). Prevalence of health related behaviours such as diabetes or cardiovascular disease to mention a few can be distinctively different for different ethnic groups, which indicates an association between ethnicity and health. However, Karlsen, (2004) posits that indicators or factors employed to investigate the relationship between ethnicity and health are likely to fail accounting for the central facets of ethnic minorities’ experiences which could influence health, especially the impact of socio-economic disadvantage, housing, poor health services, harassment and discrimination. As already mentioned above factors such as discrimination, socioeconomic, housing, education and the accessibility of health services have a direct impact and possible relationship between health and ethnicity.How Race And Ethnicity Influence Health Essay

In the UK alone, research indicates that at least one in eight from the ethnic minority group experiences some form of racial harassment each year. While two fifths believe that half of the British employers would decline to offer someone a job on the basis of their ethnicity. Ethnic minorities have been shown to experience repeated health and socioeconomic disadvantages than the majority ethnic group. This has a direct impact on the mental health of ethnic minority individuals who experiences such. In a study using data from the Health survey for England, (1999) plus a follow up study, the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) to explore relationships between interpersonal racism experienced, discrimination as perceived in wider society, occupational class and various indicators of physical and mental health for the diverse ethnic groups in England including minority and majority white groups. The results indicated that there were significant independent relationships found between each of the factors explored and health. Hence, from these results current assessments were urged to take into account the different forms of structural disadvantages experienced by ethnic minorities and the diverse ways in which racial expressions can impact on health (Kalsen, 2004).How Race And Ethnicity Influence Health Essay

However, there are a number of important but varied factors bearing on the health of ethnic groups and the overall population, which Stubbs (1993) argued that to understand these health patterns of ethnic groups there has to be a comparison with the host group (majority ethnic group). For instance, demographic, housing, lifestyle, socioeconomic and health service factors have a direct impact on the health of individuals (Baggott, 2004). Bannister (1901 as cited in Haralambos & Holborn, 2000) argued that an individual’s ethnic background contributes to whether or not they are at a decreased or increased risk of developing a certain disease (s). For instance, he was very critical of Jews and their lifestyle describing them as ‘‘Yiddish money pigs’’ who did not like taking baths hence, were prone to blood and skin diseases. Conversely, it is opined that Bannister in this instance was expressing his hostile feelings towards this particular ethnic minority group instead of advancing an evidence based argument for the association(s) of certain diseases and ethnicity. African-Caribbean and South Asians are more prone to developing diabetes than white Europeans. However, African-Caribbeans are far less likely to suffer from coronary heart disease than white Europeans which is more prevalent within the South Asians (Harding & Maxwell, 1997; Nazroo, 1998).How Race And Ethnicity Influence Health Essay

Suffice to say access to high quality health services is vital in sustaining a state of total physical, mental and social well being. According to Bunker, Frazier, and Mosteller (1994 as cited in Baggott, 2004), preventative measures such as screening, immunisation and medicine add at least 18-19 months to an individual’s life expectancy. A similar effect is also found when curative medicines are taken increasing the life expectancy by between 44-45 months. Generally this has not really happened with the ethnic groups as there are factors like discrimination and language barriers that impinge on the accessibility of health care. The social context in which ethnic minorities live and experience presents various challenges and disadvantages that will directly impact on their health negatively (Giddens, 2009). Pickett and Wilkinson (2008), argued that one’s health could be determined by the neighbourhood in which one lives, for example if a minority low status individual lives in a higher quotient vicinity of their own racial or ethnic group then their health is likely to be better than those that live in lower quotient vicinities, this is referred to as the ‘group density effect’. Conversely, Smaje (1995) posits that concentration of ethnic minorities into poor vicinities has an independent and direct bearing on their health.How Race And Ethnicity Influence Health Essay

Social structures for ethnic patterning in health show that African-Caribbean and Asians are more disadvantaged (Baggott, 2004). Harding and Maxwell’s (1997) study of the health of ethnics suggested that Indian, Pakistani and Bangladesh have a particularly high rate of diabetes and ischemic heart disease in comparison to other ethnic groups. This could be attributed to poor or overcrowded housing facilities amongst other factors already mentioned briefly above. Nazroo, (1998) from the findings of his study on the health of ethnic minorities agrees that Pakistani and Bangladeshi ethnic minorities experience high morbidity in comparison to other ethnic minority groups. He also found out that African Caribbean men had a lower mortality rate due to coronary heart disease, but were more prone to dying of a stroke compared to their counterparts including the majority ethnic group population. African-Caribbean and Asians ethnic groups do tend to record higher rates of hypertension, diabetes and are three times more liable to having renal replacement therapy compared to the ethnic majority population (Raleigh, 1997). The health of ethnic minorities as mentioned above can be negatively affected by socioeconomic factors such as, employment and employment conditions. The majority of ethnic minority groups work in hazardous occupations, receive poor remuneration with diminished prospects for career progression. Their employment relationships are akin to the bourgeoisie and proletariat relationship.How Race And Ethnicity Influence Health Essay

Bartley, Lynch, Sacker and Dodgeon (1998) suggest that the above findings of poor employment conditions and remuneration highlight the relationship between work conditions and high morbidity and mortality in ethnic minorities. Conversely, unemployment has an association poor health in that it cultivates financial hardship, stress, poor diet and living conditions. Factors such as socioeconomic disadvantages, poor housing, discrimination and poor health services create a knock on effect in one’s life cycle, ultimately exposing individuals to a host of disease and illnesses through a lack of equal opportunities. This leads to, anxiety, hypertension, depression and social isolation loss of one’s self esteem and purpose in life, which may result in the development of physical and mental health problems (Bartley, 1994 as cited in Naidoo & Willis, 2000).How Race And Ethnicity Influence Health Essay

However, Hull (1979) suggested that there is a correlation between migration and health. He attributed this to factors such as nature of symptoms and language barrier hindering ethnic minorities from accessing the right treatments because of the existing contextual cultural differences. Furnham and Bochner (1986) argue that if the host group does not offer any social support, and discrimination is displayed within vital institutions such as work environment, health, judiciary, and welfare. It creates more social stress resulting in mental illnesses for the migrating ethnic minorities. In addition Smaje (1995) links discrimination stressors to the psychological well-being as he suggests that racism has a bearing on differences in health between minority ethnic groups and the majority ethnic population.How Race And Ethnicity Influence Health Essay

According to Pilgrim and Rogers (1999) black ethnic minority groups have a relatively short life expectancy and often have the worst health amongst ethnic minorities. In addition to that they posit that black ethnic minorities who experience mental health issues are likely to be discriminated against, often being depicted as an added threat or risk compared to the majority ethnic group. The Ethnicity and Health Report (2007) suggested that ethnic minorities have a higher probability rate of being confined in psychiatry through the criminal justice system unlike through diagnosis from the health system compared to the host group, especially Afro-Caribbean and Black Africans. Giddens (2009) supports the above statement by positing that indeed ethnic minorities mostly afro-Caribbean and black Africans are more likely to be stopped by law enforcers than their white counterparts. This form of institutionalised racism by law enforcement agents and the whole criminal justice system has significant negative effects on minority groups’ psychological well being. Smith, Kelly and Nazroo, (2008) posited that racial discrimination, socioeconomic factors and policies that do not allow for equal opportunities and generally improve their existence within a host group could lead to a lasting effect on their mental and emotional health. In addition, injustice within the vital systems that provide help, health, work, and education further corrode ethnic minorities’ dilemma in terms of their physical and mental health (Smaje 1995).How Race And Ethnicity Influence Health Essay

Evidence provided from the Ethnicity and Health Report, (2007) indicating the disparities in mental health between ethnic minorities and the host group is to some extent contentious, given that a cosmic amount of data employed is based on treatment rates. Consequently, this research indicated that ethnic minorities, particularly Afro-Caribbean people have higher rates of psychosis which is seven times more compared to the host group. Kalsen, Nazroo, Mckenzie, Bhui & Weich (2005) from their research in the UK, on racism and mental health in ethnic minorities found that there was a significant relationship between racial discrimination and psychological well being. Indication from the results suggested there was a recurrence rate of psychosis annually of six per thousand for Bangladeshi people, ten per thousand for Indians, thirteen per thousand for Pakistani people, while they was sixteen per thousand for Afro-Caribbean people (Nazroo & King, 2002 as cited in Kalsen et al., 2005). Nazroo (1998) from his studies posits that ethnic minorities’ mental health is worse than that of the host group. His findings were based on comparisons of the rates of reported suicide and para-suicide cases. Furthermore, Afro-Caribbeans are much more likely to be diagnosed as schizophrenics than their white counterparts (Smarje, 1995).How Race And Ethnicity Influence Health Essay

Evidence reviewed in this essay has shown that there is a relationship between ethnicity and health (Kalsen, 2004). However, some of the evidence is contentious in that treatment rates were used to make a general assumption on ethnic minorities’ health (Ethnicity and Health Report, 2007). Evidence also suggests that indicators such as low-economic statuses, migration, and discrimination, poor access to health services, local area deprivation and high unemployment have a direct bearing on ethnic minorities and their health. It could be argued that the determinants of health vary between ethnic groups as a result of differences in genetic and socioeconomic factors which cannot be generalised across all ethnic groups. The evidence reviewed demonstrates differences in health across ethnic groups. These findings are important indicators of the need for investment programmes that are specifically targeted at improving the quality and quantity of health and other related services for ethnic minority groups. Future policies need to move away from a capitalist approach were ethnic minorities are exploited for their services with little reward and improvement of their social being. There should be a balance of socio-economic factors in-order to stimulate change and shape policies that improve accessing of quality health and related services such as education. They are fundamental to the health of both ethnic minorities and ethnic majority in modern day Britain. How Race And Ethnicity Influence Health Essay

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