Issues Impacting Health Care Delivery

 
 
 
 
According to Irvine, McPhee, and Kerridge (1), physicians, nurses, and other health care professionals and caregivers must be aware of and sensitive to the various cultural backgrounds of their patients and the different attitudes that patients from distinct populations may hold concerning health, wellness, disease, treatment, care, spirituality, decision-making, and other relevant concepts. Additionally, caregivers in the health field must be aware of their own cultural biases and the ways in which such biases can impact upon care delivery. Though it is not necessary for health service workers at all levels to uncritically accept all outlooks presented by patients, and while professionals in the field have a duty to ensure that the medical needs of their patients are addressed in keeping with professional practice standards and protocols, a trusting relationship between patients and caregivers is essential; such a relationship depends, in large measure, upon communication and understanding (1).

There is a growing recognition on the part of health caregivers that issues related to gender, culture, religious or spiritual belief and value systems, race/ethnicity, and sexual orientation directly impact upon patients' response to care and attitudes toward their presenting and other problems (1). Consequently, efforts have been undertaken to identify barriers to care delivery and strategies for overcoming the negative influence of these barriers (1). Schilder, Kennedy,


     
 
 
 
    

 

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r other therapeutic or surgical services (6). Race or ethnicity are well-recognized as sources of discriminatory treatment in many different institutional settings in the United States. Nernez, Bonham, Green-Weir, Joseph and Gunter (12) reported that a large and growing body of literature serves to document major disparities in health status, care access, and quality of care among racial and ethnic groups in the United States. A study undertaken by the Commonwealth Fund and the Health Resources and Services Administration (HSRA) revealed that a lack of insurance coverage is one major barrier to receiving good care that is encountered by members of racial and ethnic minority groups. Equally significant, however, was the revelation that when insurance is equitable in comparison to majority populations, ethnic or racial minorities suffer from disparities in quality of care. The United States Commission on Civil Rights (13) examined issues related to gender and race as these variables impact on health care delivery and access. In the case of race and ethnicity, the organization reported that there is also an intersection between gender and minority group status. Hispanic and African-American women are particularly vulnerable

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