Subsistence economy
Diversity ■ 59
water are scarce, and the person suffers from chronically poor nutrition. These conditions all too often lead to high morbidity and accident rates, precipitating high health care costs, which, in turn, prevent the person from seeking health care services. Thus, there is an increase in sickness and poor production, in a cycle that has yet to be broken. Other barriers that are interrelated to this cycle are the lack of access to health care services, language issues, and transportation issues (Spector, 1979, pp. 148–152).
The issues of overcrowded housing, poor sanitation, inadequate nutrition, homelessness, and so forth that are part of the cycle of poverty have a profound and prolonged impact on the health status of people and in future generations.
This chapter has presented an overview of the major phenomena contribut- ing to the profound diversity existing within the United States— demographic; population and immigration; and poverty. Additional issues will be explored in more depth in the chapters relating to each of the major population groups described in Census 2010.
Go to the Student Resource Site at nursing.pearsonhighered.com for chapter-related review questions, case studies, and activities. Contents of the CULTURALCARE Guide and CULTURALCARE Museum can also be found on the Student Resource Site. Click on Chapter 3 to select the activities for this chapter.
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■ Internet Sources American Fact Finder. (2005–2009). Selected Characteristics of the Native and