Diversity Considerations in Health Assessments

Posted: November 29th, 2022

Diversity Considerations in Health Assessments

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012). Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion. Diversity Considerations in Health Assessments  Students will: Analyze diversity considerations in health assessments Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment To prepare: Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments. Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you. Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information? Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. Case Assignment: TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.


The selected case study is about TJ, a 32-year-old lesbian who was pregnant. During the health assessment, the approach should be non-discriminatory and sensitive when interacting with the patient and during the health assessment. The culture of the patient should not be formative when drawing conclusions. The patient’s cultural inclination should be used to ensure the health assessment is constructive and avoid stereotyping the patient during probing (McDermott et al., 2018).

Identification of the gender preferences of the patient shouldn’t be utilized to identify her daily practices. Additionally, health history should be sensitively considered when designing questions to ask TJ. There are behavioral health risks among the lesbian population that can impact their health, even though there are no physiologic differences when compared to heterosexual women. The identified risk factors and practices allied to the lesbian population can be used to help healthcare providers to formulate focus questions and assess their risks (Felsenstein, 2018). Cultural and diversity differences should be integrated to determine the health needs of the patients. Diversity Considerations in Health Assessments

Potential Health Risks

Even though the pregnancy was planned and she has been getting the appropriate prenatal care, there is a possibility of unknown health risks likely to impact the maternal and infant well-being. Women identifying as lesbians normally encounter obstacles to healthcare regarding confidentiality, discriminatory attitudes, limited access to healthcare, and reduced health literacy about the possible health risks during pregnancy (Wang et al., 2019). Because of the obstacles the LGBT individuals may encounter, some practices and health histories might not be discussed. Evidence has shown that the LGBT population receives poorer healthcare and the population often faces discrimination from the healthcare providers which makes them avoid seeking medical attention. Therefore, healthcare providers should be considerate when attending the health needs and providing care to the LGBT population.

Therefore, it is important to understand the difficulties TJ may have in accessing care during pregnancy. Whereas people with different sexual orientations such as the LGBT population may have similar health concerns with the general population, the health issues are more prevalent in the LGBT population and the population also faces unique health challenges (Felsenstein, 2018). Therefore, identifying the health needs of TJ and being sensitive to her diverse background needs to be considered during the health assessment and when obtaining health history. Even though TJ has been receiving prenatal care, there may be issues likely to affect her pregnancy and health and have not been addressed during prenatal care. In TJ’s case, the family history of diabetes should be assessed since the condition is likely to impact both maternal and child health. Moreover, TJ’s practices and health understanding should be assessed to identify if there are more risks likely to affect the pregnancy. Diversity Considerations in Health Assessments

Targeted Questions

The questions for this patient will seek to address the individual medical needs while taking into account her diversity to gather patient-centered information. The questions include:

  1. How do you feel today?
  2. What are some recent changes during pregnancy that are of concern to you?
  3. Have you experienced morning sickness? How severe are the symptoms?
  4. Describe your daily diet?
  5. What is your marital status?
  6. Are you sexually active?
  7. Is there a health issue you have had in the past?


Felsenstein, D. R. (2018). Enhancing lesbian, gay, bisexual, and transgender cultural competence in a Midwestern primary care clinic setting. Journal for nurses in professional development, 34(3), 142.

McDermott, E., Hughes, E., & Rawlings, V. (2018). The social determinants of lesbian, gay, bisexual, and transgender youth suicidality in England: a mixed-methods study. Journal of Public Health, 40(3), e244-e251.

Wang, Y., Hu, Z., Peng, K., Xin, Y., Yang, Y., Drescher, J., & Chen, R. (2019). Discrimination against LGBT populations in China. The Lancet Public Health, 4(9), e440-e441. Diversity Considerations in Health Assessments


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