Table of Contents

Dedication vii

Preface viii

Acknowledgments xi

About the Authors xii

Unit I The Foundations

Chapter 1 Introduction to Multicultural Health 2

Key Concepts and Terms 4

Diversity Within the United States 8

Cultural Adaptation 10

Health Disparities 12

Causes of Health Disparities 13

Legal Protections for Ethnic Minorities 21

Personal Health Decisions 24

Ethical Considerations 25

Summary 26

Review 27

Activity 27

Case Study 27

References 28

Chapter 2 Theories and Models Related to Multicultural Health 31

Theories of Health and Illness 32

Pathways to Care 37

Cultural Competence 39

Promoting Cultural Competence 42

Summary 48

Review 49

Activity 49

Case Study 49

References 49

Chapter 3 Worldview and Health Decisions 51

Worldview 52

Worldview and Medical Decisions 59

Worldview and Response to Illness 63

Summary 64

Review 65

Activity 65

Case Study 65

References 65

Chapter 4 Complementary and Alternative Medicine 67

History of Complementary and Alternative Medicine 69

Complementary and Alternative Health Care Modalities 73

Laws Affecting Cultural Practices and Health 86

Summary 88

Review 89

Activity 89

Case Study 89

References 90

Chapter 5 Religion, Rituals, and Health 92

Religion in the United States 94

Religion and Health Behaviors 96

Religion and Health Outcomes 100

Religion and Well-Being 106

Rituals 111

Summary 114

Review 114

Activity 115

Case Study 115

References 116

Chapter 6 Communication and Health Promotion in Diverse Societies 118

Health Communication 119

Delivering Your Health Message 128

Printed Materials 131

Public Health Programs 134

Evaluating Your Multicultural Health Program 137

Summary 145

Review 146

Activity 146

Case Study 146

References 147

Unit II Specific Cultural Groups

Chapter 7 Hispanic and Latino American Populations 149

Introduction 150

Terminology 150

History of Hispanics in the United States 151

General Philosophy About Disease Prevention and Health Maintenance 152

Healing Traditions, Healers, and Healing Aids 159

Behavioral Risk Factors and Common Health Problems 163

Considerations for Health Promotion and Program Planning 166

Tips for Working With the Hispanic Population 167

Summary 168

Review 169

Activity 169

Case Study 169

References 170

Chapter 8 American Indian and Alaskan Native Populations 173

Introduction 174

Terminology 175

History of American Indians and Alaska Natives in the United States 175

American Indian and Alaskan Native Populations in the United States 177

American Indian and Alaskan Native General Philosophy About Disease Prevention and Health Maintenance 179

Healing Traditions, Healers, and Healing Aids 184

Behavior Risk Factors and Prevalent Health Problems 192

Considerations for Health Promotion and Program Planning 195

Tips for Working With American Indian and Alaskan Native Populations 196

Summary 197

Review 197

Activity 197

Case Study 197

References 198

Chapter 9 African American Populations 201

Introduction 202

Terminology 202

History of African Americans in the United States 203

African Americans in the United States 207

General Philosophy About Disease Prevention and Health Maintenance 209

Healing Traditions 214

Behavior Risk Factors and Prevalent Health Problems 216

Considerations for Health Promotion and Program Planning 220

Tips for Working With the African American Population 221

Summary 222

Review 222

Activity 223

Case Study 223

References 223

Chapter 10 Asian American Populations 226

Introduction 227

Terminology 227

History of Asian Americans in the United States 228

Asian Americans in the United States 230

General Philosophy About Disease Prevention and Health Maintenance 231

Healing Traditions, Healers, and Healing Aids 238

Behavioral Risk Factors and Common Health Problems 238

Considerations for Health Promotion and Program Planning 240

Tips for Working With the Asian American Population 241

Summary 241

Review 241

Activities 242

Case Study 242

References 242

Chapter 11 European and Mediterranean American Populations 244

Introduction 245

Terminology 245

History of European and Mediterranean Americans in the United States 245

European and Mediterranean Americans in the United States 247

General Philosophy About Disease Prevention and Health Maintenance 247

History, Healing Practices, and Risk Factors for Three Subcultures 250

Behavior Risk Factors and Prevalent Health Problems for European and Mediterranean Americans 260

Tips for Working With European and Mediterranean American Populations 261

Summary 262

Review 263

Activity 263

Case Studies 263

References 263

Chapter 12 Nonethnic Cultures 266

Introduction 267

Introduction to the "Culture of People Suffering Discrimination" 267

History of Gay Americans in the United States 268

Introduction to People With Disabilities 274

Introduction to the Culture of Commerce 278

Consumers 278

Farmworkers 280

Introduction to People Who Are Recent Immigrants or Refugees 282

Summary 285

Review 285

Activities 286

Case Study 286

References 287

Unit III Looking Ahead

Chapter 13 Closing the Gap: Strategies for Eliminating Health Disparities 291

Strategies for Reducing or Eliminating Health Disparities 295

Summary 299

Review 300

Activities 300

Case Study 300

References 301

Glossary 302

Index 308