The beliefs and values of the health care provider should not be forced on the patient.
7. The treatment plan and the reasons for a given treatment must be shared with the patient.
Black American Health Care Manpower
As seen in Table 11–4, it is evident that the numbers of Blacks enrolled in the health professions’ schools is well below the percentage (14%) of Black alone- or-in-combination population in the American society at large.
Recent nursing data are not included in the overall health professions’ enrollment data in Table 11–4. However, the National Sample Survey of Reg- istered Nurses for 2008 prepared by the United States Department of Health and Human Services (2010) provides relevant information regarding the demo- graphic profile of American Registered Nurses. It estimates that the registered nurse population in the United States in 2008 was 3,063,162, with 2,596,599
Table 11–4 Percentage of Black or African Americans Enrolled in Selected Health Professions Schools Compared with Non-Hispanic Whites: 2007–2008
Number Enrolled
Non-Hispanic Whites (%)
Black or African American (%)
Dentistry 19,342 60.6 5.9 Allopathic Medicine 74,518 62.4 7.2 Osteopathic Medicine 15,634 70.5 3.8 Optometry 5,556 60.3 3.1 Pharmacy 50,691 59.5 6.4 Podiatry 2,095 62.2 10.7 Public Health 22,604 59.3 11.7
Source: National Center for Health Statistics. Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD. 2011: Author, pp. 352–353. Retrieved from http://www.cdc.gov/nchs/, June 9, 2011.
HEALTH and ILLNESS in the Black Population ■ 287
registered nurses employed in nursing. Of this number, 83.2% were White (non-Hispanic) and 5.4% were Black/African American (non-Hispanic). Given that in 2010 the White alone population was 63% of the total population and Black/African American (non-Hispanic) people comprised 12.6% of the resi- dent population, this is a clear indication that there is no demographic parity in the percentage of Black/African American (non-Hispanic) people in nurs- ing. This demographic picture and the percentages in the tables demonstrate a situation that is an ongoing concern. Somnath and Shipman (2006), who reviewed a total of 55 studies, found that minority patients tend to receive bet- ter interpersonal care from practitioners of their own race or ethnicity, particu- larly in primary care and mental health settings, and that non–English speaking patients experience better interpersonal care, greater medical comprehension, and greater likelihood of keeping follow-up appointments when they see a language-concordant practitioner. They concluded their study by stating that “the findings indicated greater health professions diversity will likely lead to improved public health by increasing access to care for underserved popula- tions, and by increasing opportunities for minority patients to see practitioners with whom they share a common race, ethnicity or language.” They also stated that “race, ethnicity, and language concordance, which is associated with better patient-practitioner relationships and communication, may increase patients’ likelihood of receiving and accepting appropriate medical care” (p. 17).
RESEARCH ON CULTURE
A large amount of research has been conducted among members of the Black population. The study described in the following article is one example:
Wilson, D. W. (2007). From their own voices: The lived experience of African American registered nurses. Journal of Transcultural Nursing, 18(2), 142–149.
This phenomenological study describes the lived experiences of African American nurses who provide care to individuals, families, and communities in southeast Louisiana. The sample consisted of 13 nurses whose ages ranged from 40 to 62, with an average age of 49.53. Their nursing experience ranged from 8 to 39 years and they were educated in ad, diploma, and baccalaureate programs. Four of the informants had earned master’s degrees in nursing. The essential themes found in the study were that the participants’ experiences included con- necting with the patients through the delivery of holistic nursing care and “prov- ing yourself.” Holistic care included respect for the patients’ cultural backgrounds and the realization that in many ways they were vitally important in meeting the needs of the patients and families. They believed that they were also important in meeting the spiritual and religious needs of patients. The nurses also partici- pated in patient teaching and advocacy. The incidental themes included fulfilling a dream, being invisible and voiceless, surviving and persevering, and mentoring and role modeling. The author recommends that, if the nursing profession is to pro- mote nursing care that is congruent with the needs of culturally diverse patients, it must increase the representation of African American registered nurses.
288 ■ Chapter 11
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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 11 to select the activities for this chapter.
Explore MediaLink
Box 11–3: Keeping Up
It goes without saying that much of the data presented in this chapter may be out of date when you read this text. However, at this final stage of writing, it is the most recent information available. The following resources will be most helpful in keeping you abreast of the frequent changes in health care events, costs, and policies:
1. The National Center for Health Statistics publishes Health, United States an annual report on trends in health statistics. It can be retrieved from http://www.cdc.gov/nchs/hus.htm. Health, United States, 11 is not available, and Health, United States, 12 will be published in May, 2012.
2. Health-related data and other statistics are available from http://www.cdc. gov/DataStatistics/.
3. The Centers for Disease Control and Prevention aims to eliminate health disparities for vulnerable populations as defined by race/ethnicity, socio-economic status, geography, gender, age, disability status, risk sta- tus related to sex and gender, and among other populations identified to be at-risk for health disparities. Current, pertinent information is avail- able at http://www.cdc.gov/omhd/topic/healthdisparities.html.
HEALTH and ILLNESS in the Black Population ■ 289
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Somnath, S., & Shipman, S. (2006). The Rationale for Diversity in the Health Professions: A Review of the Evidence. Washington, DC: U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions. Retrieved from http://www.hrsa.gov/, July 6, 2011.
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Weissman, J.S., Betancourt, J. R., Green, A. R., Meyer, G. S., Tan-McGrory, A., Nudel, J.D., Zeidman, J. A., & Carrillo, J. E. (2011) Commissioned paper: Healthcare Disparities Measurement. National Quality Forum. Retrieved from http://www2.massgeneral.org/disparitiessolutions/z_files/Disparities%20 Commissioned%20Paper.pdf, March 14, 2012.
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