The Unique Cultural Issues: Impact on the US Healthcare System

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Abstract

Culture remains a major aspect of humanity, especially in defining people’s day-to-day activities and way of life. This is mainly due to the fact that culture denotes one’s beliefs, values, and norms in the society, thus having a significant impact on life, holistically. When we question the behavior of individuals, character, self-esteem and their view of life, the uniform element, which manifests is culture, which is known to cut across the life of a person (Allen, 2012). Cultural differences exist in every society around the world, explaining why human beings are highly varied. While these variations may not have significance to some people, they have been known to have profound impact on certain areas of our economy, which directly or indirectly affect the country. Existing cultural disparities in the USA have been linked to poor health in some parts of the country, by limiting the people’s ability to access good healthcare in the country. In other cases, culture is known to play an imperative role especially among African Americans, thus shaping some health patterns (Meterko, Mohr & Young, 2004). Based on the impact of culture, it is doubtless that factors like race, ethnicity, language, and literacy have to be considered in order to provide better healthcare services to Americans.

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Introduction

For many years, healthcare has remained a major player in the economy of the United States. Issues surrounding the health of Americans have become major determinants of politics, in which the majority of Americans are interested in their leaders’ views towards healthcare. While healthcare is intertwined with a host of factors, which affect it negatively or augment the efforts of improving services, cultural disparities in the country cannot be overlooked. Healthcare services have largely been affected by a wide range of cultural factors in the country, some of which have been in existence for centuries, with efforts to deal with them bearing little or no fruits (Allen, 2012). This research paper mainly analyzes some of the unique cultural factors, which are common in America’s healthcare. Of great significance will be how these factors have impacted the health of people, together with possible ways in which their negative impact can be mitigated. Some of the cultural factors, which will be discussed include but not limited to language, race, ethnicity, and gender. Information used to compile this research paper will mainly be obtained from academic sources that are current and relevant to the topic of discussion.

Culture and healthcare

By the fact that culture is known to give the identity of people, it is doubtless that it equally has influence on healthcare, in terms of people’s beliefs towards healthcare giving, traditional healing, accessibility to health facilities, and response to drugs, which are administered by doctors, among others. These factors are common in the world, but very common in countries like the United States, which is a melting point of cultural diversity (Allen, 2012). In discussing some of these factors, it is important to note that it is not easy to change the identity of an individual even though healthcare can be more important than any other thing in the life of a person. It is therefore essential to understand how a given group of people perceive illness and how they respond in seeking healthcare services like insurance and treatment from health facilities across the country.

Notably, all cultures in America and around the world have health beliefs, which have been inherited, describing the cause of various illnesses, how they can be cured, and individuals who are allowed to be part of the process. This is quite essential in healthcare since some communities may have a divergent view of sickness, which does not appreciate the existence of professional medication and the need for professional examination in hospitals and other health facilities around the country (Wen, 2007). In particular, the manner in which sick people view patient education is imperative, with regard to have the information is related to their culture, and may affect their willingness to use the information. Even though America is ranked among industrialized societies, which view disease occurrence as natural and scientific, some groups of people may perceive disease as a supernatural phenomenon, which require cultural interventions like prayers and other rituals in order to restore the health of the sick (Wen, 2007).

Healthcare and Ethnic Background

As noted above, the United States is one of the countries of the world with leading cultural diversity, which has continuously affected its healthcare systems. Most of these cultural groups share a common identity, which defines who they are, regardless of what may be conventionally accepted by the rest of the family. For example Asian and Pacific Islanders are considered to be the largest ethnic group, according to the country’s demographic patterns. Members of these groups have cultural beliefs, which are supposed to be known to nurses and other caregivers (Wen, 2007). For instance, decisions within the family are usually made by the oldest male family member, and the interests of the family supersede those of an individual, regardless of the situation one could be going through. In general, the decisions of older members of the family are never questioned because of the high level of respect accorded to them, with a huge emphasis on avoiding conflicts. As a result, disagreements with decisions made by medical officers are highly avoided, even though this may not necessarily imply that the family and the patient are in agreement with the doctor (Wen, 2007).

In other cases especially among the Chinese, the status of a given family is highly significant. As a result, this affects the manner in which family members respond and view some diseases, affecting the mental capacity of a person. In such situations, where the illness limits a person’s self control, Chinese see it as a source of shame and guilt to the entire family (Garroutte et al., 2006). While this may be seen to be insignificant, most Chinese patients find it hard to discuss important symptoms of a mental disease with medical officers, due to the fear of being seen as a source of disgrace to the family. Consequently, Chinese patients may develop chronic mental disease to fatal stages, when it would have been possible to overcome the problem.

Americans from India and Pakistan equally have cultural beliefs, which are considered to be unique, even though they form part of the country’s sub-population. Most patients with these backgrounds usually avoid diagnosis of advanced mental illnesses, because the process severely limits a person’s chances of getting married (Garroutte et al., 2006). This therefore means that members of the family avoid revealing the true status of the patient, which may lead to the deterioration of one’s health, when the disease would have been easily managed during its early stages of development. On the other hand, health is viewed differently by Vietnamese, who use mystical approaches in explaining various illnesses, which affect people on a daily basis. They consider health as a perfect coordination between hot and cold poles, which are essential in regulating the functioning of the human body. Importantly, Vietnamese rarely believe in Western procedures of psychological counseling, especially in cases where one is required to disclose personal information (Garroutte et al., 2006). Even though this is the case, they are known to accept the treatment, only after trust from the medical expert has been gained. This means that it might take doctors longer to convince Vietnamese about their health status, which may lead to the worsening of the situation.

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Russians equally view U.S. healthcare with a certain level of mistrust. In most cases, Russians are known in maintaining an authoritarian relationship with care givers, while seeking treatment. As a result, free exchange of medical information and discussions does not exist, making it hard for patients to question physicians or freely explain their problems in order to receive relevant treatment (Garroutte et al., 2006). Russians mainly believe in a paternalistic approach, in which they are told what do by the medical practitioner and not asking about their intentions.

Race, Ethnicity and Healthcare

Morbidity and mortality rates vary widely across different American societies, with racial and ethnic minorities registering the highest percentage, resulting from chronic diseases. In explaining this, it can be argued that minority groups suffer the greatest financial burden and a wide range of limited physical activity. These chronic diseases are largely common among older adults, with highest figures being recorded among African Americans and Latinos, as compared to their White counterparts. Chronic diseases commonly addressed by the U.S. healthcare system include but not limited to diabetes, high blood pressure, cancer, asthma, obesity, and heart disease (Dayer-Berenson, 2010). Additionally, African Americans and American Indians are likely to be limited in several activities, like work, walking, and bathing, precipitated by chronic diseases listed above.

While chronic diseases can affect anybody regardless of their age, it is obvious that old adults are more vulnerable as compared to other younger members of the society. This is largely because of sedentary lifestyles and weakening immunity, among others. As the population of the United States continues to grow old, it has been projected that almost twenty percent of the country’s population will be elderly by the year 2050, thus increasing the likelihood of having a higher prevalence of chronic diseases (Miskimen, Marin & Escobar, 2003). Similarly, a considerable portion of these people will be racial and ethnic minorities, accounting to a total of thirty five percent of the elderly population, above sixty five years.

Besides the increasing risk of chronic diseases among minority groups in the United States, it is important to note that race and ethnicity has a role to play in determining one’s accessibility to healthcare. For instance, having a regular doctor, say family doctor or a usual source of health care, is paramount especially when that care is needed (Dayer-Berenson, 2010). People who are limited to these two are likely to miss crucial services, which may include but not limited to preventive services, management of chronic diseases, treatment, and diagnosis. In this line of thought, it is essential to note that health insurance cover is a major determinant of access to healthcare in the United States. Nevertheless, this seems to be a mirage as higher proportions of minorities compared to Whites lack health insurance cover and do not have a usual source of care.

Healthcare and Language

As a core element of culture, language is essential in every aspect of human life. In general, language is used as a channel of communication in order to facilitate conveyance of information to achieve desired goals effectively. Even though a good number of Americans speak English, there are those who are not fluent, and find it difficult to communicate. This is seen as a major barrier, especially in seeking medical attention in any part of the country and around the world. As a result, there is variation in the number of patients who receive certain medical services and procedures. Notably, Spanish-speaking Latinos are less likely to receive preventive care or visit a mental healthcare provider as compared to the Whites (Torres, Parra-Medina & Johnson, 2008). Additionally, the use of the available health services could be hindered in the event that there is no an interpreter to facilitate communication between the patient and the physician. In fact, almost half of the non-English speaking patients find it hard to access healthcare because of language barrier.

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Moreover, language and communication problems have been linked to patient dissatisfaction in the country, poor understanding and adherence to medical prescription, thus limiting the effectiveness of the services offered. Oftentimes, Spanish-speaking Latinos suffer a great deal and are less satisfied with healthcare, and likely to register problems as compared to English Speakers (Torres, Parra-Medina & Johnson, 2008). In essence, the kind of interpretation, which is given to a patient, plays a major role in affecting his or her satisfaction. As a result, patients who use professional and bilingual interpreters are likely to be more satisfied as compared to those who use unprofessional ones like family members, clerks or nurses. Language barriers in healthcare are closely related to education and literacy. In most cases, elderly patients with chronic diseases are expected to make decisions, regarding their conditions (Meterko, Mohr & Young, 2004). This becomes a serious problem and a cause of concern in cases where literacy level is too low. Such patients experience difficulties in understanding prescriptions, health education materials or insurance forms. As a result of low literacy level, especially among minorities, the U.S. has witnessed an increase in healthcare expenses.

Recommendations and Conclusion

From the above analysis, it is evident that American healthcare is faced with several cultural issues, which continue to hamper the country’s efforts in providing effective services to its people. These factors are mainly related to the race and ethnic backgrounds of Americans. Due to cultural diversity, people have conceived beliefs and attitudes towards healthcare, some of which negatively affect the role of physicians in attending to the sick. These also have shaped the people’s understanding of diseases and the need to seek medication from health facilities. The issue of language barrier equally hinders communication and the overall understanding of patients, from minority groups. In order to deal with these issues, strategies like cultural competence and teaching of English are necessary. Importantly, insurance policies ought to cover both natives and non-natives to eliminate cases of people who are not covered.

References

Allen, J. F. (2012). Health Law & Medical Ethics for Healthcare Professionals. Boston, MA: Pearson.

Dayer-Berenson, L. (2010). Cultural Competencies for Nurses: Impact on Health and Illness: Impact on Health and Illness. Burlington, MA: Jones & Bartlett Learning.

Garroutte et al., (2006). Cultural Identities and Perceptions of Health Among Health Care Providers and Older American Indians. JGIM: Journal Of General Internal Medicine, 21(2), 111-116.

Meterko, M., Mohr, D., & Young, G. (2004). Teamwork Culture and Patient Satisfaction in Hospitals. Medical Care, 42(5), 492-498.

Miskimen, T., Marin, H., & Escobar, J. (2003). Psychopharmacological research ethics: special issues affecting US ethnic minorities. Psychopharmacology, 171(1), 98-104.

Torres, M., Parra-Medina, D., & Johnson, A. O. (2008). Rural Hospitals and Spanish-Speaking Patients with Limited English Proficiency. Journal of Healthcare Management, 53(2), 107-120.

Wen, M. (2007). Racial and Ethnic Differences in General Health Status and Limiting Health Conditions Among American Children: Parental Reports in the 1999 National Survey of America’s Families. Ethnicity & Health, 12(5), 401-422.

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