Health Inequities: Moving Beyond the Culture Lens in Nursing Education

Public health nurses interact with increasingly diverse populations. Education is essential to increase the capacity of public health nurses to improve population health. Despite an emphasis of cultural knowledge in nursing education, attention to other social health dimensions is less apparent. Nursing education tends to disregard and minimize issues of race, gender and class (Abrums & Leppa, 2001) and has depoliticized discussions of race and other social differences (Hassouneh, 2006). The emphasis of cultural competence at the exclusion of social forces risks further marginalization of diverse health care clients (Wear, 2003). The purpose of this research was to measure cultural competence and symbolic racism held by nursing students and explore if cultural competence in nursing education is associated with changes in racist beliefs among nursing students. This research examined the trajectory of cultural competence and racism among nursing students upon entry into nursing school and progression through a nursing education program. Using cross-sectional survey, levels of cultural competence and racism were ascertained among five cohorts of students at the same time. The sample was 100 nursing students. Descriptive statistics and regression analysis were used to analyze the data. The results revealed a gap in knowledge and praxis related to culture and race. Nursing students must have the opportunity to integrate their knowledge of causal factors associated with health disparities in a way that changes their behavior and care practices in the health care setting. These results facilitate recommendations for changes in nursing curriculum to promote equitable care for diverse populations.