Culturally-sensitive health care is significant any society. With the population made up of a range of varying cultures, it should be noted that in the aspect of health care, there are many factors that need to be considered, from the health- and medical-related beliefs to issues prevalent in a specific population. Cuba has one of the most recognized health care systems in the world. In fact, Cuba has received commendations from the international sectors such as the World Health Organization for having one of the most effective, efficient and accessible health care systems in the world (Johnson, 2006).
Despite the noted “paradox” based on the fact that Cuba does not have as many resources, the country has managed to have a health care system that even beats the United States’. However, there are still some issues that need to be addressed such as the health profiles of the Cuban population and how the health care system affects these aspects. Health Strengths and Weaknesses Although Cubans can be regarded to have a significant amount of security when it comes to their health, they are still subject to many health issues.
The World Health Organization has enumerated the main diseases prevalent in Cuba such as tuberculosis, HIV/AIDS, and diabetes. Risk factors also include alcohol and tobacco consumption, undernutrition and overweight, and access to water and sanitation (2009). Overall, despite Cuba having an effective health care system, there is also of course the presence of stressors among the population. Responses to the social, economic and political environment are also found to create an effect in the well-being among the Cubans.
As a communist nation, the Cuban society does not have access to a substantial amount of opportunities to wealth-creation; although their needs are met, life in Cuba contrasts significantly with other nations. This paradox therefore demonstrates that although Cuba makes up for their competitive health care system, there are still the lack of resources and there is also of course the absence of opportunities available to them (Spiegel &Yassi, 2004). Hence, stressors include the economic and financial insecurities, in addition to adverse feelings towards the government especially for groups that do not agree with the social system.
This also reflects among Cuban-Americans who identified the Castro revolution as a part of their pre-immigration stress (De la Nuez, 2004). Despite these, among the main strengths among the Cuban population are companionship, identity and relations; this is to say that strong group support, typically achieved through family and friends, is considered as a source of well-being among the Cuban population. Cubans have very strong family ties, which is why such relations also go beyond the bloodlines; this is why one of the stressors among Cubans is broken family ties that may have resulted from the revolution.
For instance, many Cuban families have family members and relations in the United States, and this has served as a source of stress among some Cubans in the homeland (Alberts, 2005). One of the important support systems available among Cubans are co-ethnic and language support which is a way for them to deal with distress; a strong sense of ethnic identity is thereby found to be associated with less stressful conditions (Barnes & Aguilar, 2007; Cislo, 2008). Another important aspect in the coping mechanisms among the Cuban population is their continuous adherence to their cultural practices such as religion.
In addition, productive activities are also considered as an important means to increase life satisfaction (Sanchez, 2006), in addition to the cited socialization activities in the population which is why there were the identified risks in alcohol and tobacco consumption, and nutrition-related problems because of the high-fat diet (WHO, 2009). Based on these, the health strengths and weaknesses in the Cuban population can be attributed to the well-being of the members of the community.
Stressors are found in the challenges posed by economic, financial and political insecurities; hence, coping mechanisms include a great deal of socialization, from strong relations to socialization activities involving alcohol, tobacco and unhealthy food. Another important note is that the health care system is definitely a strength in the country; what makes this effective is that it integrates certain aspects of the traditional practices such as accommodations to herbal medicines which the government have made more accessible and affordable to its people (Johnson, 2006).
Health and Health Care Disparities Health and health care disparities have been sufficiently addressed in Cuba due to its effective health care system. Health care is accessible in the country, from the rich to the poor Cubans. Basically, disparities can be seen to be more present in the health aspect especially when it comes to addressing certain diseases. An interesting point cited by Spiegel and Yassin from Macintyre and Hadad (2002, as cited in Spiegel & Yassin, 2004, 81) is that Cubans “live like the poor and die like the rich”.
This is because the noted increases in disease patterns in the Cuban population are chronic non-communicable diseases such as heart disease and cancer. An added note in the aspect of health disparity is malnutrition and sanitation-relation issues. Although Cuba runs on a socialist system, the living conditions among the poorer Cubans do not give them substantial support in health and nutrition. This is to say although they can go to the hospital and receive competent health care, there are still areas in the country, especially in the poorer neighborhoods, where sanitation is a problem.
Access to proper food is another issue as not all Cubans can afford the substantial nutrients that they need (Spiegel & Yassin, 2004). There are also of course the fact that the Cuban population is ethnically/racially diverse; although all groups have access to health care, there has been a growing attention towards more competent approaches to health care as based on the specific needs according to age, race and ethnicity.
As an emerging issue the United States, it can be also said that such approach to health care should be also applied wherein certain ethnic groups have prevailing health issues as compared to others (Stone & Balderrama, 2008). Strategies for Reducing and Eliminating Disparities In order to reduce and eliminate disparities, strategies need to focus on health care providers getting the substantial training in responding to the health care needs of the population in supplement to the health care system. This is to say that although the Cuban health care system has services available to its peoples, there are still the health-related disparities.
The following strategies are based on the following aspects: • Advocating for a national health strategy and reforms that promotes health a more focused approach to health solutions such as paying attention to the shifts in the health trends, from the chronic to the communicable diseases. • Cultural and community-based awareness in health and health care practices, especially in areas where sources of health problems such as sanitation should be addressed. Continuous nutritional education and campaigns can be implemented to have a better and greater reach in the Cuban population.
Barriers in Providing Culturally Competent Care and Methods in Removing Barriers Barriers in the provision of culturally competent care can be pointed at the lack of culturally-sensitive philosophy in providing such services. Most training frameworks and policies fail to address the fact that patients have different backgrounds and needs, and at the same time, there are the inherent issues among the care providers in serving people from varying socio-economic and racial/ethnic conditions (Stone & Balderrama, 2008).
A means remove barriers is through education. Competent care should represent equality in treatment, and at the same time, vast knowledge on how to treat patients of different backgrounds, whether it is based on age, gender, and cultural, ethnic and racial considerations. Implications in Nursing Care The implications in nursing care in the delivery of culturally competent care include the expansion of nurses’ education and training and the nurses’ modified roles as health care providers.
This time, nursing also applies cultural and socio-economic specific practices when it comes to relating to patients and their families, in addition to taking note of ethnic backgrounds as contributory to patient assessment and treatment. References Alberts, H. (2005). Changes in Ethnic Solidarity in Cuban Miami. The Geographical Review, 95, 231+. Cislo, A. (2008). Psychological distress among Cuban and Colombian immigrants in Miami: Considering the roles of acculturation and ethnic discrimination (Dissertation, Florida State University).
Dissertation Abstracts International Section A: Humanities and Social Sciences, 69(2-A), 765. Johnson, C. (2006). Health as Culture and Nationalism in Cuba. Canadian Journal of Latin American and Caribbean Studies, 31, 91+. Stone, L. & Balderrama, C. (2008). Health Inequalities among Latinos: What Do We Know and What Can We Do? Health and Social Work, 33, 3+. Spiegel, J. & Yassi, A. (2004). Lessons from the margins of globalization: appreciating the Cuban health paradox. Journal of Public Health Policy, 25, 85–110. World Health Organization. (2009). Cuba. Retrieved 3 May 2009 from http://www. who. int/countries/cub/en/