Race, ethnicity, and cultural influences

Abstract

Race, ethnicity, and culture are complex constructs which are frequently used interchangeably, are often poorly understood, and impact both health and the delivery of health care, especially among individuals with chronic illness. Unequal burdens of social adversities and environmental health threats contribute to disproportionate rates of morbidity and mortality among non-White populations and often represent a limited understanding of the social and cultural context and the unique strengths of these populations. To provide effective, coordinated care for diverse racial and ethnic populations, providers need to understand the integrated burden of chronic diseases at the provider, dyadic/communication, and organizational/health-care system levels. Although patients and providers may endorse open and honest communication, providers may not have effective communication skills and strategies to assist patients with the challenges of self-management. At the health-care system level, emerging strategies must extend to coordinated care team members in communities, such as community health workers, who are primed to reach racially and ethnically diverse patient populations with chronic illnesses.