Freedom of religion became a reality for Native Americans in 1978, under the Carter Administration, 202 years after the Declaration of Independence (Russell, 1993).
The Civil Rights movement in the 1950s and 1960s brought with it increasing pride in one's cultural background.
In the 1970s, millions of Americans sat transfixed for several nights watching the television series Roots that chronicled the life of an African American family in the U.
S., from their ancestor's capture in West Africa to the present.
Some of these attempts to welcome and respect the Hmong has eased their adjustment into life in the United States and has led to improved health outcomes (Walker, 1996).
Thus, as the 21 century begins, the nation is rapidly becoming multicultural.
The article is divided into three sections: the first section is a brief review of how diversity has been treated in America; the second section focuses on cultural competence in nursing and suggests ways in which it can be achieved by individuals and systems; and the third section focuses on the challenges of using complementary and alternative practices within diverse groups as well as in the American mainstream.
century, the familiar biomedical health care "culture" must accommodate not only persons from diverse cultures, but also diverse systems of care.
This article addresses America’s experience with diversity and its legacy in today’s health indicators; it explores cultural competency and its achievement at the individual and system levels; and it discusses the use of complementary and alternative treatments that are a part of this health care "revolution." Nurses are challenged to shape this reform as did the founder of modern nursing 150 years ago.. Nurses can be crucial players in bringing about change at the health care system level.
System change will take time, persistence and patience, but cultural competence at the system level will result in improved health outcomes and greater satisfaction for patients and providers (Walker, 1996).
If this is true of other life forms, should it not be true of people as well? Government established health care for Native people as a right in perpetuity for ceding their land (Deloria, 1988), their health statistics remain the worst of any minority in the United States (U. The policy of separation of the races until the middle of the 20 century meant that African Americans did not participate in the benefits other Americans enjoyed. As a group, African Americans had no legal right to health care as did Native American people.
Our nation's history reveals various and divergent approaches to handling cultural differences ranging from destructive (genocide) to competent (De Loria, 1988). Today, the infant mortality rate (IMR) for African Americans is twice that for all races (Healthy People 2010, 1998).