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The articles on health disparities among the Hispanic population of the United States in this issue of Hispanic Health Care International (HHCI) clearly illustrate not only the need to provide further evidence-based documentation of ethnocultural variation in health outcomes but an equally important mandate for health promotion and disease prevention to translate such findings into culturally competent curricula. The National Institute of Nursing Research (NINR) has outlined funding priorities for developing health outcomes models by the Hispanic nursing community to promote culturally sensitive and multiculturally competent evidence-based research for the elimination of health disparities (Phillips, 2003).
The articles in this issue of HHCI undertake the NINR challenge to target disparities with a focused nursing research agenda. Four articles examine lifestyle factors, like dietary practices (Benavides-Vaello) and physical activity (Nies, Vander Wal, Schim, Artinian, & Sherrick-Escamilla), and the attendant chronic conditions that may be a result of lifestyle risk factors among Hispanics, including gestational diabetes (Gonzalez et al.) and osteoporosis (Romero, Duarte-Gardea, Ortiz, Labrado, & Noe). An important article outlines the theoretical significance of sociocultural factors on stress and coping strategies among caregivers from different ethnic groups (Shurgot & Knight). The articles sift through the differential impact on individual level health outcomes of physiological, lifestyle, and ethnocultural factors, suggesting that if cultural competency were included as part of prevention programs, disparities could be substantially reduced.
All authors point to the importance of incorporating specific ethnic characteristics of the cultural and community context into the implementation of health education and lifestyle change programs that are directed at individuals from diverse groups. Shurgot and Knight differentiate ethnicity and cultural values as a group characteristic, "a shared sense of peoplehood" and "a group's way of life, including the values, beliefs, traditions, symbols, language, and social organization." Although a group characteristic, ethnocultural factors, however, are all measured at the individual level in these articles. Components of culturally competent interventions need to be further explored (Betancourt, Green, Carrillo, & Ananeh-Firempong, 2003).
A clearer understanding of the characteristics of multi-level differences in individual health, while retaining the ethnocultural context experienced by people, will, first, enable the identification of health differences and disparities between individuals and between social groups; second, identify specific structural conditions in the community that affect the health of...