Synopsis of Health Issues for Women of Color: A Cultural Diversity Perspective,

Edited by Diane L. Adams, M.D.

This work is a compilation of several essays, written primarily by women involved in healthcare and social justice issues. Aside from the chapters on diversity and ethics, each chapter considers a certain aspect of health issues for women of particular ethnicities, or environs in which women of color are overrepresented (e.g., prisons and homeless conditions). Despite the fact that each chapter is written by different authors, each chapter is consistent with each other in that each gives cultural background of that particular ethnicity, statistics on the most imperative problems facing that ethnic group, and suggests actions to remedy the situation. It is worth noting that each chapter stresses the lack of adequate research done for these women's health concerns, and the need for those working in the field of healthcare to gain a deeper cultural understanding of these groups in order to effectively serve the population.

The first two chapters are essays on cultural diversity in the United States, and provide definitions for terms used in reference to minority issues, such as quota system, social discrimination, and cultural diversity. These chapters also offer background as to why we are interested in the issues of minority groups, especially the subset of minority women. Facts concerning socioeconomic status of, and access to healthcare for women of color are among the pieces of information disclosed. Suggestions for reform and development of programs and policies for women of color, their representation, and their health concerns end this section. Some suggestions are implementation of cultural awareness training for health services and community leaders, as well as outreach efforts to and recruitment of minority women for employment and positions of influence in society.

The next six chapters cater to the health issues of Native American, Hispanic/Latino, Asian/Pacific Islander, African American, and Arab Middle Eastern women. The authors relay background information on certain diseases or phenomena that are more common among women of color than among white Anglo-Saxon women. Information is gathered in terms of statistics, such as incidences of certain types of cancer, tuberculosis, and types of mental illnesses among certain groups of women. Many of these statistics tackle commonly held stereotypes of color of women, such as the belief that Asians are the "healthy minority." For example, spousal abuse is not a typical image associated with Asian immigrants to the United States, yet Japanese and Chinese women have incredibly high rates of suicide, injury, and mental illness due to this occurrence. Understanding the various Asian cultural perceptions of family relations and mental illness can help a healthcare worker reach out to these victims, which would decrease the instances of harmful consequences with which healthcare workers would have to contend. Differences in health issues for American born and foreign born women are pointed out as well. Posttraumatic stress disorder is seen as a common effect of immigration to the Western atmosphere of the United States, especially for those who have come as refugees from countries such as Cambodia. American born women of color may have feelings of alienation from their parents as well as the Anglo-Saxon environment in which they live, causing stress, or a readiness to rebel, thereby becoming involved in unhealthy practices. Regardless of birthplace, simply being a different ethnicity may be cause for health concerns as well. Stress levels among African American women were found to increase accordingly with the darkness of their skin, showing the effect of racism on these women's health. It is these realities which may not be typically thought of by a physician or hospital which need to be specially addressed by culturally sensitive healthcare workers. The development of multilingual helplines, cultural awareness training, and nearby clinics are among the suggested lines of action to help remedy this problem.

The next five chapters of this book deal with prison conditions and homelessness among women of color and their children. Again, the authors tackle stereotypes surrounding these conditions, and stress the communicable diseases and mental illnesses which could be prevented or remedied by health authorities. The roles of shame, isolation, prostitution, drug use (or inadequate rehabilitation), and sexual and physical abuse are brought to attention so as to offer insight in treating mental illness, STD's, substance dependence, and injuries.

A chapter on ethical issues follows. Americans most unlikely to have adequate healthcare are poor women of color, and women in the United States are found to be have a worse health status than men. That most research is done on white males proves that research needs to be done with women, especially women of color. Issues such as informed consent are laden with stereotypes, such as women of color being less educated or less fit for research. Again, these stereotypes are attacked, and suggestions are made for research in certain areas.

The conclusion of the book emphasizes the need for health care reform for this "invisible" segment of the population, and the need for cultural awareness and increased research for women of color.

Audiences who would benefit most from this book include those in healthcare who wish to administer services more effectively to women of color, those involved in data collection for underrepresented groups in the country, and those acting in the interests of social justice for women of color through policy and program development and reform. The advantage of the compilation format is that each section is the particular author's expertise and unique perspective. Also, substantial lists of references for each chapter are present for those who want to do more research for each specific topic. Overall, this work contains comparisons of disease occurrence between women of color and white women, and cultural insights for particular ethnicities; this work does not divulge into biological details on transmission or treatment, but offers general suggestions for institutional reform. The authors are building awareness of particular diseases in groups around the country, and associating socioeconomic level, acculturation, and other factors are related to or indicative of health. This advances our thinking on disease and discrimination to issues of race, acculturation, and access to healthcare.

Adams, Diane L., ed. Health Issues for Women of Color: A Cultural Diversity Perspective.

California: SAGE Publications, Inc., 1995. 290 pp.