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A photograph shows four people's hands holding each other's wrists.
Figure 5.1 A culturally diverse community finds its strengths in its differences. (credit: “School diversity many hands held together,” by “Wonder woman0731”/Flickr, CC BY 2.0)

Every person in the world belongs to a culture. Culture shapes one’s personal identity, influences social relationships, and contributes to the overall richness of human societies. Basic elements of culture include language, symbols, societal norms and customs, beliefs, values, and cognitive elements (such as learning to cope, managing difficult situations, and qualities taught to children). Culture plays a significant role in health and wellness, as it can affect what types of medicines and treatments to use, who is allowed to provide care, and beliefs about what causes illness and injury.

The United States has long had a reputation as a multicultural nation, and according to the United States Census Bureau (2020), it continues to grow even more racially and ethnically diverse every year (Jensen, 2022) (Figure 5.2). Nurses will interact with patients who belong to diverse cultures, both distinct from each other and distinct from the nurses’ own cultural background. It is crucial for nurses to understand and accommodate cultural differences, ensuring the delivery of the best possible care to all patients, regardless of their cultural background. This chapter discusses how to gain a better understanding of cultural differences among the patients who nurses serve as well as ethical and cultural practices in nursing and how to incorporate diversity and inclusion as best practice standards.

A series of bar graphs showing distribution differences between race and ethnicity differences from 2010 to 2018.  In people under 18 years old, the distribution of different ethnicities was almost identical between 2010 and 2018. In people aged 18 to 39, the amount of Hispanic people changed significantly between 2018 and 2018, but most other groups remained the same.  In people aged 40 to 64, the amount of White people was reduced and the amount of Hispanic and Black people increased between 2010 and 2018. And in people 65 years and older, almost all groups increased from 2010 to 2018.
Figure 5.2 tracks demographic data from year to year in the United States. This chart illustrates the increasing diversity of the nation across various age groups over time. (credit: “A More Diverse Nation” by US Census Bureau, Public Domain)

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