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Cultural influences on care

As the U.S. becomes a multicultural environment, investigators are recognizing that physicians must adjust their treatment to take into account patients' cultural influences.

A recent study of diabetics performed at Harvard Medical School confirmed that minority patients may receive inappropriate care for reasons other than stark racial discrimination or inadequate access to care:  the same doctors treating multi-cultural patients may not discriminate enough.  Advice that works well when given to a white patient may not work when given to a patient from another culture:  for example, if rice or corn is an overwhelming staple, advice about "eating vegetables" must be more precise when given to that patient.   The study is reported in the Archives of Internal Medicine, and it examined the records of almost 7,000 diabetes patients. 

The researchers found that income or insurance status explained the significant difference identified between black and white patients' diabetes control, as measured by blood pressure, LDL cholesterol levels and hemoglobin AIC.  They concluded that since black patients' diabetes was more poorly controlled, even when the patients were served by the same population of doctors, the answer must lie in better educating physicians to discriminate among patients and to tailor treatments to a patient's dietary and environmental idiosyncracies.

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