DiversityNursing Blog

By Anna Gorman, Los Angeles Times
August 22, 2012

Black and Latino children were more likely than white children to be obese, witness gun violence and ride in a car without a seat belt, according to a study released Wednesday.

The study, published in the New England Journal of Medicine, found wide ethnic and racial disparities in health behaviors among fifth-graders in Los Angeles, Houston and Birmingham, Ala.

“The disparities were pretty substantial across so many different health indicators,” said lead researcher Mark Schuster, a Harvard Medical School professor and chief of general pediatrics at Boston Children’s Hospital.  “The breadth of the findings was striking to us.”

The researchers examined 16 health behaviors, including cigarette smoking, alcohol use, exercise habits, terrorism fears, bike helmet use and psychological quality of life.

Many of the behaviors carry potential for lifelong health problems, Schuster said. For example, researchers found that obesity rates were twice as high among black and Latino children, placing those children at increased risk for diabetes and heart problems. Black children were also more likely to be bullied, smoke cigarettes and drink alcohol than white and Latino youths.

Parents’ education and income played a critical role in the disparities, according to the study. Researchers also found that schools had a huge influence on children’s behavior, and that there were differences among schools even in the same neighborhoods.

Researchers interviewed more than 5,000 fifth-graders and their parents between 2004 and 2006. Schuster said the team focused on 10- and 11-year-olds because there was already significant research and public awareness about risky behaviors among adolescents.

“Finding disparities this young suggests that we have to start young to try to address them,” he said. “There is a strong likelihood that these disparities will persist unless we intervene to change them.”

Many researchers have studied patient--provider communication and documented the tensions and misunderstandings often seen in this important process. But these concerns are far greater when the patients are minorities or don't understand English well, and when healthcare providers aren't equipped to explain the intricacies of care to people whose cultural beliefs may make American medicine a mystery.

Award-winning filmmakers Maren Grainger-Monsen, M.D., and Julia Haslett explore these issues in a series of films called Worlds Apart, which document the experiences of minority Americans and patients from other countries in the U.S. health care system. This unique project, made with partial support from The Commonwealth Fund, dramatizes communication between patients and their doctors, tensions between modern medicine and cultural beliefs, and the ongoing burdens of racial and ethnic discrimination.

In this film, Alicia Mercado, a 60-year-old Puerto Rican woman, struggles to keep up with her chronic diabetes, hypertension, and asthma after being evicted from her apartment and suffering depression.

For more information on these films, please visit The Commonwealth Fund website at www.cmwf.org

Student at the UCLA School of Nursing start their nursing career with a high tech boost. As part of their ceremony to receive their white coats, this year they were also give iPod Touch devices preloaded with Medication and Diagnosis guides as well as a Spanish language dictionary and translation assistance. UCLA is determined to offer new grad nurses that are ready for "High Touch" care but within a "High Tech" environment.

 Nursing Reimagined. Nursing Redefined.

Meg Beturne MSN, RN, CPAN, CAPA
Denise Colon, RN
Baystate Health System, Springfield, MA

This article was submitted by Meg Beturne RN, MSN, CPAN, CAPA,  Assistant Nurse Manager @ Baystate Orthopedic Surgery Center in Springfield, MA.  Meg became a mentor and participated in "Baystate Health’s Diversity Leadership Initiative, Mentoring Across Differences" Program. A Dimensions of Diversity Exercise (copyrighted in 2011 by Washington Orange Wheeler Consulting firm http://wow4results.com) was offered as part of the Program.

The exercise is a puzzle that shows the complexity of mentoring across differences. Understanding how these differences have impacted us and others helps to create a container for meaningful dialogue. Consider how various differences could impact your mentoring relationship. To participate in this exercise, you identify a few  dimensions of diversity that have had an important role in impacting who you are, how others see you, and how you see the world. You then figure out how the dimensions shaped who you are personally and professionally. Finally, how might these dimensions impact your mentoring relationship? 

Meg, a Caucasian Catholic, mentored Denise who has a Latina background with strong family ties and a culture that is filled with traditions that are vital to her life and that of her family and extended family. Denise is Roman Catholic and she works to maintain a healthy balance between work and home as she has a young family. Here is their mentoring story…

Impact on Differences 

As I began the mentoring relationship with Denise, I realized the importance of recognizing and understanding the differences and similarities that existed between us. Equipped with this knowledge, I felt that we could tackle the complexities of mentoring across differences. The Dimensions in Diversity exercise offered the perfect opportunity to explore key, diverse components that have made us the women and nurses that we are today. To that end, we made this a priority and discussed it at our very first meeting and then confirmed our thoughts and feelings at our next time together.

It was interesting to realize that both of us equally valued traditions and observances, but from a different perspective. We both enjoy sharing the particulars of the holiday traditions through the years and reminisced on who was present, the activities that took place, the photos that were taken and the memories that were made and cherished by future generations. Denise however was vocal that many persons that she has interacted with over time do not have a real understanding of the ethnic backgrounds that are celebrated in the various holidays. That being said, there is a lack of appreciation from culture to culture on the meaning and purpose of observances involving family and relatives. I had to admit that since I had grown up in a small mill town in Connecticut that was homogenous with regard to ethnicity and religion (Caucasian Catholics), I was not exposed to comments, conversations or messages that demonstrated anything but allegiance to the existing cultural observances and inclusion of the small numbers of diverse ethnic and religious populations that resided close by.

Denise chose accent and dialect as another dimension of her diversity. She relayed the fact that many individuals and groups do not make an attempt to understand or accept anyone who speaks in a certain way. This scenario creates feelings of self-doubt. In addition, it allows feelings of rejection to creep in that ultimately results in further retreat into one’s own ethnicity which is considered supportive and safe. As a registered nurse, Denise has encountered many patients and caregivers from all corners of the globe. Working with a team of professionals, Denise has gained acceptance and recognition as a caring and compassionate care giver and over time, interactions and conversations have focused on quality care rather than on accent or dialect.

I then shared that communication was a vital personal and professional dimension that affects my life in so many ways. Even though my communication style is open, friendly and positive, I have learned that being a good listener is actually a more important skill. I found myself connecting with Denise’s story and promised myself to be even more in tune with people I meet on a daily basis who might sound different than me. In my own way, I will seek to eliminate self-doubt by encouraging others to use their native voices to raise questions, contribute ideas and feel reassured that they will be understood.

As I reflect on this meeting with Denise, I am amazed at the information that was willingly shared and the conversation which was free-flowing and enjoyable.  Most importantly, after completion of this exercise, I feel more prepared then ever to be the type of mentor that will enable Denise to move forward in both her professional career and her personal life!

A special thank you to Denise Colon, RN for her participation.