According to the 2010 census, the racial and ethnic composition of Brooklyn comprise of Whites (39.5%), Hispanic (19.8%), African American (35.8%), Asian (11.3%), Native Americans (1.0%), and others (11.2%) (. This paper will focus on the Hispanic population. For the Hispanics, chronic liver disease is one of the leading causes of mobility and mortality. Although the causes of this condition are not conclusively established, some of the cases are caused by alcoholism, hepatitis Band C viruses and obesity (Setiawan e al. , 2016).
According to 2015 statistics, chronic disease was ranked the seventh leading cause of death among Hispanics. For Hispanic men, chronic liver disease is third ranked cause of death. It is estimated that men of Hispanic descent are 1.7 times more likely to die of chronic liver disease while for women they are 1.8 times more likely to die of chronic liver disease as compared to their white counterparts (Setiawan et al. , 2016).
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There are several interventions by the federal government to address this issue. The interventions include: assisting all the eligible Hispanics secure insurance coverage offered by the Affordable Care Act, promoting the use of community health workers to improve the health of Hispanics, leverage of the current programs to improve access to preventive health care, and better representation of Hispanics in health surveillance and research.
Cultural dimension
Unhealthy diet and lack of physical activity are some of the factors associated with the development of chronic liver disease. Some of the Hispanic culture practices make it difficult to maintain a healthy diet. The traditional Hispanic food is high in saturated fats and calories and this is one of the contributing factors (Setiawan et al. , 2016) . Moreover, the Hispanic family gatherings involves the urge to overeat. Refusing food in social functions is taken as impolite and unacceptable. Furthermore, Hispanic families in most cases take meals together and therefore it is difficult to modify diet for those with chronic liver disease. However, this aspect of eating together can be used to improve the eating habits of the whole family and this can help improve the overall health.
Disclosure of sexual orientation is one of the insensitive factors that is practiced in the health care facility. The disclosure leads to prejudicial behavior by the health care staff. The LGBT individuals face major difficulties while communicating with health care providers (Acquaviva, 2017). In addition, they experience fear of assumptions regarding their sexual orientation, shame when talking about their sexual orientation, and homophobia as a result of the health care staff’s reaction towards them (Acquaviva, 2017). This can be dealt with by making the sexual orientation section optional so the only those who are willing to share it out do so without having to make patients feel compelled to do so.
For the case of Sarah, some of the areas related to her age and identity include fear of assumptions about her sexual orientation, shame and fear of rejection, mental health issues due to depression. To promote an inclusive environment in this case some of the things to put in place would be to scan the environment to determine how it would feel for Sarah, offer her relevance health information regarding her status etc. Furthermore, establishment and implementation of proper assessment procedures that address the issue of sexual orientation and gender identity and a chance to give more explanation in written form.
References
Leading Health Risks, Diseases And Causes Of Mortality Among Hispanics In United States Of America (USA). (2008). The Internet Journal of Health, 8 (1). doi:10.5580/273c
Setiawan, V. W., Wei, P. C., Hernandez, B. Y., Lu, S. C., Monroe, K. R., Marchand, L. L., & Yuan, J. M. (2016). Disparity in liver cancer incidence and chronic liver disease mortality by nativity in Hispanics: The Multiethnic Cohort. Cancer,122 (9), 1444-1452. doi:10.1002/cncr.29922
Acquaviva, K. (2017). Sex, Gender, Sexual Orientation, Behavior, and Health. LGBTQ-Inclusive Hospice and Palliative Care, 22-37. doi:10.17312/harringtonparkpress/2017.03lgbtqihpc.002
