Lois A. Ritter, EdD, MS, MA, MS-HCA, PMP
Consultant, Health and Education
Donald H. Graham, JD, MA Attorney and Consultant, Human Services
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Library of Congress Cataloging-in-Publication Data Names: Ritter, Lois A., author. | Graham, Donald H., author. Title: Multicultural health / Lois A. Ritter, Donald H. Graham. Description: Second edition. | Burlington, MA : Jones & Bartlett Learning,  | Includes
bibliographical references and index. Identifiers: LCCN 2015048787 | ISBN 9781284021028 (pbk. : alk. paper) Subjects: | MESH: Cultural Competency | Culturally Competent Care | Cross-Cultural
Comparison | Ethnic Groups | United States Classification: LCC RA418.5.T73 | NLM W 21 | DDC 362.1089—dc23 LC record available at http://lccn.loc.gov/2015048787
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About the Authors
UNIT I The Foundations
Chapter 1 Introduction to Multicultural Health Key Concepts and Terms Diversity Within the United States Cultural Adaptation Health Disparities Causes of Health Disparities Legal Protections for Ethnic Minorities Personal Health Decisions Ethical Considerations Summary Review Activity Case Study References
Chapter 2 Theories and Models Related to
Multicultural Health Theories of Health and Illness Pathways to Care Cultural Competence Promoting Cultural Competence Summary Review Activity Case Study References
Chapter 3 Worldview and Health Decisions Worldview Worldview and Medical Decisions Worldview and Response to Illness Summary Review Activity Case Study References
Chapter 4 Complementary and Alternative Medicine History of Complementary and Alternative Medicine Complementary and Alternative Health Care Modalities Laws Affecting Cultural Practices and Health Summary Review Activity Case Study References
Chapter 5 Religion, Rituals, and Health Religion in the United States Religion and Health Behaviors Religion and Health Outcomes Religion and Well-Being Rituals Summary Review Activity Case Study References
Chapter 6 Communication and Health Promotion in Diverse Societies Health Communication Delivering Your Health Message Printed Materials Public Health Programs Evaluating Your Multicultural Health Program Summary Review Activity Case Study References
UNIT II Specific Cultural Groups
Chapter 7 Hispanic and Latino American Populations Introduction Terminology
History of Hispanics in the United States General Philosophy About Disease Prevention and Health Maintenance Healing Traditions, Healers, and Healing Aids Behavioral Risk Factors and Common Health Problems Considerations for Health Promotion and Program Planning Tips for Working With the Hispanic Population Summary Review Activity Case Study References
Chapter 8 American Indian and Alaskan Native Populations Introduction Terminology History of American Indians and Alaska Natives in the United States American Indian and Alaskan Native Populations in the United States American Indian and Alaskan Native General Philosophy About Disease Prevention and Health Maintenance Healing Traditions, Healers, and Healing Aids Behavior Risk Factors and Prevalent Health Problems Considerations for Health Promotion and Program Planning Tips for Working With American Indian and Alaskan Native Populations
Summary Review Activity Case Study References
Chapter 9 African American Populations Introduction Terminology History of African Americans in the United States African Americans in the United States General Philosophy About Disease Prevention and Health Maintenance Healing Traditions Behavior Risk Factors and Prevalent Health Problems Considerations for Health Promotion and Program Planning Tips for Working With the African American Population Summary Review Activity Case Study References
Chapter 10 Asian American Populations Introduction Terminology History of Asian Americans in the United States Asian Americans in the United States
General Philosophy About Disease Prevention and Health Maintenance Healing Traditions, Healers, and Healing Aids Behavioral Risk Factors and Common Health Problems Considerations for Health Promotion and Program Planning Tips for Working With the Asian American Population Summary Review Activities Case Study References
Chapter 11 European and Mediterranean American Populations Introduction Terminology History of European and Mediterranean Americans in the United States European and Mediterranean Americans in the United States General Philosophy About Disease Prevention and Health Maintenance History, Healing Practices, and Risk Factors for Three Subcultures Behavior Risk Factors and Prevalent Health Problems for European and Mediterranean Americans Tips for Working With European and Mediterranean American Populations Summary Review
Activity Case Studies References
Chapter 12 Nonethnic Cultures Introduction Introduction to the “Culture of People Suffering Discrimination” History of Gay Americans in the United States Introduction to People With Disabilities Introduction to the Culture of Commerce Consumers Farmworkers Introduction to People Who Are Recent Immigrants or Refugees Summary Review Activities Case Study References
UNIT III Looking Ahead
Chapter 13 Closing the Gap: Strategies for Eliminating Health Disparities Strategies for Reducing or Eliminating Health Disparities Summary Review Activities
Case Study References
To Gary and Samantha, for creating countless hours of laughter—lr
Your mind is like a parachute . . . it functions only when open. ~ Author unknown
Health care professionals work in a diverse society that presents both opportunities and challenges, so being culturally competent is essential to their role. Although knowing about every culture is not possible, having an understanding of various cultures can improve effectiveness. Multicultural Health provides an introduction and overview to some of the major cultural variations related to health.
Throughout this text, those engaged in health care can acquire knowledge necessary to improve their effectiveness when working with diverse groups, regardless of the predominant culture of the community in which they live or work. The content of this book is useful when working in the field on both individual and community levels. It serves as a guide to the concepts and theories related to cultural issues in health and as a primer on health issues and practices specific to certain cultures and ethnic groups.
New to This Edition
NEW! A Student Activity is added to each chapter to challenge student comprehension.
NEW! Two new Feature Boxes appear in each chapter—What Do You Think? and Did You Know?—to engage readers and enhance critical thinking.
NEW! Chapter 3, Worldview and Health Decisions, provides
information about the ways that worldview and communication affect health, the provision of health services, health care decisions, and communication.
Expanded! Reiki has been added to Chapter 4, Complementary and Alternative Medicine. Chiropractic care, homeopathy, hypnosis, and hydro-therapy, although important treatment modalities, were removed to keep the chapter focused on culturally based CAM modalities.
Expanded! In Chapter 5, Religion, Rituals, and Health, a section was added about the clinical implications of the relationships among religion, spirituality, and health.
Expanded! In Chapter 6, Communication and Health Promotion in Diverse Societies, tips for communicating with people with limited English proficiency have been added.
Expanded! Chapters 7 through 12 have new sections on worldview, pregnancy, mental health, and death and dying as they relate to the cultural group discussed in each chapter.
Expanded! Chapter 12, Nonethnic Cultures, has been expanded to include people with disabilities, immigrants and refugees, and the culture of commerce.
Expanded! In Chapter 13, Closing the Gap: Strategies for Eliminating Health Disparities, information about the Health and Humans Services Action Plan to reduce racial and ethnic health disparities and the National Stakeholder Strategy for Achieving Health Equality have been added.
Revised! Laws and ethics material is now integrated throughout where appropriate.
Revised! The model programs have been removed from Chapters 7 through 12 and an activity has been added for learners to conduct research and identify a model program themselves.
About This Book
Multicultural Health is divided into three units.
UNIT I, The Foundations, includes Chapters 1 through 6 and focuses on the context of culture, cultural beliefs regarding health and illness, health disparities, models for cross-cultural health and communication, and approaches to culturally appropriate health promotion programs and evaluation.
Chapter 1, Introduction to Multicultural Health, discusses the reasons for becoming knowledgeable about the cultural impact of health practices. It defines terminology and key concepts that set the foundation for the remainder of the text. The chapter addresses diversity in the United States and the racial makeup of the country, health disparities and their causes, and issues related to medical care in the context of culture.
Chapter 2, Theories and Models Related to Multicultural Health, addresses theories regarding the occurrence of illness and its treatment. Terms and theoretical models related to cultural competence are provided. Individual and organizational cultural competence assessments are included.