How the construct of gender or ethnicity can shape health behavior in either positive or negative ways

| July 12, 2019

The issue of the construct of gender and ethnicity  continues to dominate discourse in a variety of disciplines, including nursing. In nursing, the debate is on the role of gender and ethnicity construct on health behavior. While most essay writing companies will list this topic as one of those they can write about, very few will go a step further to provide samples of papers written on the topic. One of the reasons for this trend is the difficulties their writers face when searching for scholarly materials on the topic.

With properly training, professional competency, and diligence, it is easy not only to locate the sources but also to write high-quality papers that support one’s preferred perspective. Where more objectivity is called for, writers are called upon to let the direction of research trends dictate their standpoint. It takes advanced writing skills to synthesize research embodying different thematic perspectives, levels of analysis, and ideological inclinations.

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Question:

Discuss how the construct of gender or ethnicity can shape health behavior in either positive or negative ways. In your discussion you will need to provide examples in order to support your answer.

Introduction gives background to the topic and states precisely what the essay intends to cover.
Body of essay show evidence of critical analysis, synthesis and evaluation of relevant research literature.
Conclusion draws evidence together, does not over-generalize.
Well structured, logically sequenced presentation in appropriate English.
Correct referencing technique-APA6

Answer:

Title: Construct of ethnicity:  Positive and negative influence on health behavior

Introduction

The construct of ethnicity is of great relevance in the study of health behavior in different communities. An in-depth understanding of the relationship between ethnicity and health behavior is necessary in the analysis of how ethnic disparities translate into differences in health behaviors. There is an ongoing scholarly debate on the extent to which ethnic disparities are a reflection of health behaviors closely related to the prevalence of chronic diseases (Weber & Fore, 2007; Braun, 2002; Zsembik & Fennell, 2010; National Research Council, 1997; Winkleby, 1999b; Duelberg, 1992; Goff, 1997; Gutierrez-Ramirez, 1994; Winkleby, 2003; Geronimus, 1992; Krieger, 2001). In this debate, there is also immense interest in the way these disparities vary across health behaviors, gender, and age group.

In this debate, there are several assumptions that tend to be made, and sometimes subsequently challenged. For example, in the US, one of the assumptions is that the behaviors of populations of color are less healthy compared to those of white populations. Moreover, it is widely assumed that ethnic groups in the US are internally homogenous. These assumptions have tended to trigger many studies into the many health behaviors the people of different ethnic groups in the US engage in and how it impacts on their health.

Some of the most commonly health behaviors also double as risk factors. Some of these risk factors include smoking, poor diet, physical inactivity, lack of cancer screening practices, and high alcohol consumption. These health behaviors have a far-reaching effect on other risk factors for chronic diseases, particularly high cholesterol, diabetes, and hypertension as well as outcomes of chronic diseases such as stroke, cancer, and cancer disease. Winkleby (2010) points out that at present there is no complete understanding of the underlying causes of these health behaviors. However, there is a clear understanding that all these health behaviors are preventable and that improved health can be achieved if individuals pursue behavior change regardless of their age.

The present paper discusses the various ways in which ethnicity can shape health behavior in either positively or negatively. This paper argues that there are fundamental differences in health behaviors based on ethnicity, and that these differences account for differences in health outcomes among people in different ethnic groups. First, the paper discusses the nature of ethnic disparities in health behaviors in the US context. Then, evidence of ethnic variation in health outcomes is discussed with regard to the ways in which positive and negative health outcomes are experienced. On the basis of this evidence, explanation is sought on ethnic-specific health behaviors that may have brought about these positive or negative health outcomes.

The nature of ethnic disparities in health behaviors in the US

Different researchers have offered different explanations of ethnic disparities in individuals’ health behaviors. For some researchers, these ethnic disparities reflect differences that are based on inherent genetic factors (Krieger, 2003; Braun, 2002). However, a different point of view is that the disparities are as a result of a historical trend of ethnic discrimination (Geronimus, 1992). Those who point out to the trend of discrimination make reference to the prevailing trends in socio-economic status within specific populations before making comparisons on health behaviors. Through such comparisons, it is evident that in the US, Hispanics and Blacks are by far more likely to find themselves in poverty than white Americans. In terms of residential environments, Hispanics and blacks are more likely to reside in poor communities compared to whites. Such far-reaching differences have been observed to have a close-knit association with a number of both healthy and unhealthy behaviors for both the populations of color and the Whites (Winkleby, 2003).

There is also a prevalent view to the effect that ethnic disparities in health behaviors are a reflection differences in cultural values and norms. According to Winkleby (2003), this may particularly be the case for ethnic groups who have immigrated to the US in recent times. For instance Mexican Americans who were born in foreign lands before immigrating into the US may have much healthier exercise patterns and diets compared to their counterparts who were born and raised in the US.

Evidence of ethnic variation in positive and negative influence of different health behaviors

There is ample evidence showing that differences in health behaviors based on ethnicity account for a number of health advantages or disadvantages for people belonging to these ethnic groups. One of the most frequently given examples in this regard relates to the causes of deaths from three major chronic diseases: heart disease, stroke, and cancer. Although the number of deaths from these diseases is high in all ethnic groups in the US, there is considerable variation in the number of deaths based on ethnicity. For instance, in the US, death rates as a result of cardiovascular disease are higher within the black community than among Whites.

Similarly, the death rate as a result of stroke is strikingly higher for the Black community compared to the rest of the American population. As for cardiovascular disease, Winkleby (2003) notes that the higher death rates for Blacks begin at an early age and continue persisting for up to the age of around 65. Moreover, an interesting trend was observed since the mid-1960s with regard to death rates as a result of cardiovascular disease. Between the mid-1960s and early 1980s, there was a marked decline in the number of deaths as a result of cardiovascular disease. However, since the mid-1980s the number of blacks dying from this disease started rising at a higher pace than that of whites (Geronimus, 1992).

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On a different note, Winkleby (2010) observes that traditionally, death rates for cancer have been higher for blacks than Hispanics and whites. Compared to whites, cancer-related deaths have been 33 percent higher (Winkleby, 2010). However, during the past decade, blacks have experienced the largest decline in incidence of cancer-related deaths. According to Winkleby (2010), this decline may be attributed to a dramatic reduction in risk factors as well as better access to care and treatment.

With regard to Hispanics, past research has shown that death rates from cancer, cardiovascular disease, and stroke are lower than those of whites when analyzed from the age-standardized point of view. The only exception with regard to cancer rates for Hispanics is that this ethnic group experiences higher incidences of deaths relating to liver, stomach, gall bladder, and cervical cancer than the White American population (Gutierrez-Ramirez, 1994). On the overall, the mortality advantage for Hispanics is normally regarded as the ‘Hispanic Paradox’ owing to the higher obesity and diabetes despite the fact that their socio-economic status is lower than that of whites (Gutierrez-Ramirez, 1994).

Nevertheless, some researchers have questioned the Hispanic Paradox (Weber & Fore, 2007). For example, Goff (1997) reported that incidence of myocardial infarction was higher for both Mexican-American population than among the non-Hispanic white population. This finding reflected a finding similar to that of the risk factors observed within the Mexican-American population (Goff, 1997).

Explanation for ethnic variation in health outcomes: Focus on differences in health behaviors across ethnic boundaries

There is an ongoing debate on the extent to which differences in health behaviors based on ethnicity contribute to the variations in health outcomes. One of the areas of great research interest is smoking. According to the US Department of Human Services (2001), white women are likely to engage in heavy smoking more readily compared to Hispanic or black women. The other frequently explored issues include physical inactivity, excess weight, and poor diets. In this regard, the prevalence of poorer diets, physical inactivity, and excess weight among black women is higher than that of white women (Duelberg, 1992). As for white and black men’s health behavior as far as diet, physical inactivity, and excess weight is concerned, the differences are inconsistent (Duelberg, 1992).

The fact that there are higher death rates for blacks as a result of cardiovascular disease compared to whites is an important pointer to the role of poorer diets, physical inactivity, and excess weight. It is not a mere coincidence that the black population, particularly women, tend to have poor diets, physical inactivity, and excess weight. Such a tendency among the black community is an ethnicity-related health behavior that leads to higher deaths for cardiovascular disease.

The issue of alcohol consumption also constitutes a major risk factor that researchers dwell on in order to determine how ethnicity shapes individual’s health behavior either positively or negatively (Weber & Fore, 2007). In most studies, the main differences in this health behavior are observed in the comparison between Hispanic and White communities. Most ethnic groups within the Hispanic community are observed to heavier alcohol consumers than white men (Rogers, 1991). In all ethnic groups in the US, though, there is a more likelihood of heavier alcohol consumption among men compared to women. This is an ethnic construct that exposes men to the risk factor of alcoholism while rendering women free from this health behavior.

The same ethnic influences on health behaviors tend to extend to even children, young adults, and the elderly. In a study of 2,854 Mexican-American, 2,769 black, and 2,063 white young adults and children aged between 7 and 23, Winkleby, M. (1999b) found out that ethnic differences health outcomes. For instance, for Mexican-American and black girls, the levels of body mass index (BMI) are higher than those of white girls (Winkleby, 1999b). Moreover, for black boys, the level of intake of dietary fat energy was higher than that of white boys. These ethnic differences remained very significant even after adjustments were made for education and age of the household head. These differences are best explained from the point of view of differences in health behavior for each of the ethnic groups.

Similar interest has been expressed in literature despite lack of difficulties inherent in the process of obtaining nationally representative samples (National Research Council, 1997). In this research, old white individuals have the highest likelihood of ever having smoked. Among this number, however, more of them are likely to have quit the smoking habit then black individuals (National Research Council, 1997).

In a different study, Sunquist, Winkleby, & Pudaric (2001) examined whether ethnic differences in people’s health behaviors inherent in younger men and women persist among elderly persons. Such a study would form an excellent foundation for further research on the likelihood of ethnic-based health behavior to change due to inter-ethnic social interaction. On this basis, it would be helpful to find out whether there are any differences in health outcomes between elderly people who have stuck to the ethnic health behavior and those who have adopted new health behaviors.

In the study by Sunquist, Winkleby, & Pudaric (2001), which focused on Mexican-American, white, and black women aged between 65 and 85, the health behaviors investigated included abdominal obesity, cigarette smoking, and physical inactivity during leisure time. The most significant finding was that the level of physical inactivity among blacks was higher than that of Mexican-American and white women (Sunquist, Winkleby, & Pudaric, 2001).

Prevalence of smoking also varies with ethnicities, thereby causing disparities in health outcomes observed in different ethnic groups. For instance, the likelihood of exposure to second cigarette smoke is higher for white people compared to people of Hispanic background (Pamuk, 1998). This is in line with the odds of smoking for Hispanics, which are compared to those of whites (Pamuk, 1998). Such a disparity is of great relevant considering the importance of smoking as a leading cause of many preventable deaths and disabilities in the US. This is in addition to being a risk factor for lung cancer, heart disease, and many other chronic diseases.

Conclusion

Like many answers to scientific questions, the findings of this discussion provide a complex picture. This paper has discussed research relating to the nature of ethnic disparities in health behaviors in the US, evidence of ethnic variation in positive and negative influence of different health behaviors, and explanation for this ethnic variation.

The analysis, critique, and evaluation of this research evidence shows that the construct of ethnicity can shape health behavior either positively or negatively. Positive impact manifests itself through health behaviors that discourage members of a community from undertaking an activity. For instance, the evidence shows that white Americans are less likely to tolerate physical inactivity as a leisure undertaking compared to the American black population.

Physical inactivity is a major risk factor for cardiovascular disease; and the higher tendency to engage in this health behavior among blacks in comparison to whites has translated into higher death rates for the disease. There is a need for further research so that such correlations are explored with regard to other risk factors, such as smoking, poor diet, physical inactivity, lack of cancer screening practices, and high alcohol consumption. Moreover, such a discussion should be extended to cover other ethnic groups within the US for comparison purposes. If the discussion and evaluation showed a correlation similar to the one relating to the level of physical inactivity among whites and blacks, it would lend them credence to this finding.

The complex picture is largely created by the contradictory explanations that researchers provide for ethnic disparities in individuals’ health behaviors. Some researchers base attribute differences to historically significant events such as discrimination, which alter the socio-economic statuses of certain ethnic communities. Others attribute the ethnic disparities to inherent genetic factors. For other researchers, the health behaviors reflect differences in communities’ cultural values and norms. There is a need for consensus on this issue since it has an underlying influence on the trends and positions held regarding the way construct of ethnicity shapes health behavior either positively or negatively.

 

References

Braun, L. (2002) Race, Ethnicity, and Health: Can Genetics Explain Disparities? Perspectives in Biology and Medicine, 45(2), 159-174.

Duelberg, S. (1992) Preventive health behavior among black and white women in urban and rural areas, Social Science and Medicine, 34:191–198.

Geronimus, A. (1992) The weathering hypothesis and the health of African-American women and infants: Evidence and speculations, Ethnicity and Disease, 2(7), 207–221.

Goff, D. (1997) Greater incidence of hospitalized myocardial infarction among Mexican Americans than non-Hispanic whites: The Corpus Christi Heart Project 1988-1992, Circulation, 95(7), 433–1440.

Gutierrez-Ramirez, A. (1994) Latino health in the U.S.: A growing challenge, New York: Free Press.

Krieger, N. (2001) A glossary for social epidemiology, Journal of Epidemiology and Community Health, 55(12), 693–700.

National Research Council (1997) Racial and ethnic differences in the health of older Americans, Washington, DC: National Academy Press.

Pamuk, E. (1998) Socioeconomic status and health chartbook: Health, United States, Hyattsville, MD: National Center for Health Statistics.

Rogers, R. (1991) Health-related lifestyles among Mexican Americans, Puerto Ricans, and Cubans in the United States, New York: Greenwood Press.

U.S. Department of Health and Human Services (2001). Women and smoking: Report of the Surgeon General, Washington, DC: National Center for Chronic Disease Prevention and Health Promotion.

Weber, L. & Fore, E. (2007) Race, Ethnicity, and Health: An Intersectional Approach, Princeton: Princeton University Press.

Winkleby, M. (1999b) Ethnic variation in cardiovascular risk factors among children and young adults: Findings from the Third National Health and Nutrition Examination Survey, 1988-1994, Journal of the American Medical Association, 281(7), 1006–1013.

Winkleby, M. (2003), ‘Influence of individual and neighborhood socioeconomic status on mortality among Black, Mexican-American, and White women and men in the U.S.’ Journal of Epidemiology and Community Health, 57(6), 444–452.

Winkleby, M. (2010) Critical Perspectives on Racial and Ethnic Differences in Health in Late Life, New York: Pearson Books.

Zsembik, B. & Fennell, D. (2010) Ethnic variation in health and the determinants of health among Latinos, Social Science & Medicine, 61(1), 53-63.

 

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