Multicultural Awareness in the Health Care Professions (review)

250 Review Multicultural Awareness in the Health Care Professions. Edited by Maria C. Julia , PhD. Boston: Allyn & Bacon, 1996, 210 pp., $41.00 (paperback). The United States is experiencing dramatic population changes, which, according to some demographers, will be comparable in order of magnitude with those brought on by the industrial revolution. At the center of these demographic changes is the fast growth of diverse ethnic population groups and the concomitant ethical, social, political, and economic implications of these changes as we make the transition toward the twenty-first century. The need for effective social support systems, including an effective health care system that serves and maximizes the health status and overall potential of an increasingly diverse population, is evident and is gaining increasing attention by human services organizations. Becoming muluculturally sensitive and multiculturally competent is a major challenge that health care professionals and health care provider organizations will face in the process of delivering health care services. Multicultural Awareness in the Health Care Professions by Maria C. Julia and colleagues was designed to serve as a desk reference for health care professionals to assist them in understanding the cultures of different ethnic groups with whom they interact in their daily practice. The book is organized into 10 chapters, preceded by a preface and an introduction that describe the need for this kind of reference, the organizational structure of the book, and a rationale for its conceptual framework. The first chapter presents a brief conceptual discussion of the role of culture in health care, with an emphasis on ethnocentrism, acculturation, and assimilation. The following 7 chapters are dedicated to discussing essential cultural and healthrelated aspects of African Americans, Amish, the Appalachian poor, Arab Americans, Hispanics/Latinos, Orthodox Jewish, and Native Americans. Each of these chapters include major themes of history and an overview of the ethnic group, patterns of acculturation and assimilation, the cultural group's conception of health and illness, cultural beliefs, illustrations of maternal and child health practices, and potential barriers to the formal health care delivery system. The 8th and final chapter concludes with a discussion of the multicultural challenge to health care. Each of these chapters includes a list of suggested readings and some of them include a glossary of cultural terms. There are few publications in the literature that address issues of multiculturalism and ethnicity in health care in the United States. In this regard, the authors of the book should be commended for presenting a collection of articles addressing key cultural and health-related issues pertaining not only to more "traditional " ethnic groups (e.g., African American, Hispanic/Latino, Asian American , Native American) but also to other ethnic groups rarely mentioned in the health care literature (e.g., Orthodox Jewish, Arab Americans, Amish). Rather than a comprehensive, in-depth discussion of multiculturalism and health for each of these groups, the book serves as a quick reference or primer for the reader interested on this subject matter. The glossaries included at the end of Journal of Health Care for the Poor and Underserved · Vol. 10, No. 2 · 1999 Torres et al. 251 some of the chapters provide useful information to the reader who wants to have a quick initial grasp on some typical terms and cultural traditions of ethnic groups. The suggested readings also provide an opportunity to direct the reader to other sources of information. However, the book has a number of limitations. Each of the authors presents their own perspective on their topic, with different foci and different points of emphasis. It is not that we disagree with the points of emphasis chosen by the authors but with the lack of common ground among the chapters. Even though the editor attempted to provide organizational structure and consistency across chapters, the book lacks a common organization, making it somewhat difficult for the reader to organize and synthesize all the information presented across groups. A concluding chapter synthesizing differences and similarities among groups may have taken care of this limitation. In addition, some chapters lack what we consider to be essential emphasis areas. For instance, the chapter on African Americans fails to explore the critical roles of family caregivers and extended familial dependencies for both the...