In this section, we will address some concerns that may be relevant when interacting with patients from selected racial/ethnic groups. In particular, we will identify some important social and cultural aspects that may affect interactions and treatment adherence with individuals from certain backgrounds.

In this Website, we focus on four cultural groups in particular. These include African American / Blacks, East and Southeast Asians, American Indian and Alaska Natives, and Hispanics Latinos. These racial/ethnic groups represent the four largest population groups outside of White/Caucasian. Other groups important which you may wish to learn about include Asian Indians, Arab groups, and European immigrants. Please see the resources page for more information on these groups.

A word of caution . . .

The descriptions included herein are intended only as generalizations and not stereotypes. According to Galanti[3], the important distinction between these two tendencies is the intent of the information. With a stereotype, cultural trends become assumptions about the patient and no additional information is sought to see if the individual fits the trends. A generalization is simply a starting point for your understanding of the patient. What you know about the culture suggests common trends but further information is sought to see if it fits this individual.^[3]

Remember, there are tremendous differences among people of a given group – even within a single family. Thus, when interacting with any patient, it is critical to use these generalizations as a tool to learn more about the patient. They should not be substituted for seeking concrete and specific information from the patient regarding desires, preferences, lifestyles, etc.

The population of the United States and the Southwest is becoming increasingly diverse. One dimension of this diversity is the racial and ethnic composition of the population. As illustrated in Table 1 below, the state of Texas and Harris County have racial and ethnic diversity that exceeds that of the United States as a whole.^[18]

United States 2000 Hispanic/Latino Population and
Race Distribution for Non-Hispanic/Latino Population by Percentage

State of Texas 2000 Hispanic/Latino Population and
Race Distribution for Non-Hispanic/Latino Population by Percentage

City of Houston 2000 Hispanic/Latino Population and
Race Distribution for Non-Hispanic/Latino Population by Percentage

Note: The U.S. Census Bureau distinguishes between race and ethnicity. Race is indicated by self-reported classification of oneself as White, Black, American Indian or Alaska Native, Asian, Hawaiian or Other Pacific Islander, or other race. In addition to racial classifications, respondents are asked to self-identify whether they are of Hispanic/Latino ethnicity. Thus, all respondents have a racial identity but only a proportion are of Hispanic/Latino ethnicity in addition to their racial identification.

The population of the United States is becoming increasingly diverse. One indicator of this is the percent of the population that is foreign born, hence culturally diverse. US Census data reflect increased foreign born residence in Texas and, even more so, in Harris County that outpaces the national trend.^[19]

The demography of Houston, as with the Southwest and our nation as a whole, is rapidly changing.  As such, it is critical to understand cross cultural issues that may affect clinical encounters.

With so many diverse racial and ethnic groups in the US population, it can be difficult to identify what is considered a “culture” or a “special population.” The National Cancer Institute, identifies the following groups as “special populations” that have special needs and face higher morbidity and mortality rates^[20]:

• African American
   
• American Indian/Alaska Native
   
• Asian
   
• Hispanic/Latino
   
• Appalachian/Rural poor

The following sections include recommendations and considerations for four of these groups.  Please note that we do not wish to detract from the important cultural considerations that can be applied to patients of backgrounds not included, such as Asian Indian, Arabic, Appalachian or rural poor, etc.  For this website, however, we have chosen to emphasize those issues meriting consideration when working with African American, American Indian/Alaska Native, Asian (particularly East and Southeast Asian) and Hispanic/Latino patients.

Continue to African Americans