1. Biological Variations in ethnic populations
NURS 3700
Tamara Mohr, BSN, RN

2. Before we begin… Any questions from last week?
Chapter 7 Giger & Davidhizar, outline printed out, characteristics

3. Objectives List biological variations in different populations
By the end of today, you should be able to:
List biological variations in different populations
Describe implications for nursing practice when caring for patients of different ethnicities and cultures
Illustrate how access to healthcare impacts overall health
Compare and contrast how genetic and biological differences may affect overall health

4. Let’s begin
Cultural differences can be easier to spot than biological variations – what are some examples that come to mind?
Examples: communication, spatial relationships, social organization (family, kinship, tribes), time orientation
Just as no two people are alike, no two cultural or racial groups are alike
Giger & Davidhizar (2007)

5. Biological variations
Examples of ethnic variations
Body structure
Bone density
Facial features
Skin color
ECG variations
Disease susceptibility
Nutritional preferences/deficiencies
Giger & Davidhizar (2009)
Adams-Homoda, Caldwell, Stotts & Drew (2003)

7. Nursing implications
What are some things that nurses should be aware of when caring for diverse patients?
Clinical standards and norms based on “white normed” standards(ex: Portland Fetal Growth Curves) (Geissler,1991)
Need to know different disease processes seen in different ethnicities and races
Sickle-cell
Tay-Sachs
Cystic Fibrosis(CF)
Osteoporosis
Phenylketonuria (PKU)

9. Nursing implications Disease susceptibility
Biological factors affecting different ethnicities
Disease susceptibility TB
Blood type
Diabetes
Hypertension
Drug interaction and metabolism
Different ethnicities do not always respond to meds in the same way
Skin color
May affect assessment
Check volar surface of arm, palms, soles of feet, mouth, conjunctiva, nail beds

10. Healthcare inequity
Equal access to healthcare?
There is growing concern that equal access does not guarantee equal quality of care
Many racial and ethnic minorities continue to experience lower quality of health services
Examples: less likely to receive dialysis, kidney transplants, analgesics to suppress pain with long-bone fractures
Giger & Davidhizar (2007)

11. Healthcare inequity Diabetes Minorities undermanaged
Equal access to healthcare?
Diabetes
Minorities undermanaged
Disparities arise from multiple causes
Access to high quality healthcare
Unhealthy food choices
Lack of opportunities for safe recreation
Cultural beliefs about food
Distrust of medical care providers
Nurses need to improve patient knowledge and increase motivation to make healthy lifestyle changes
Multifaceted approach needed
Giger & Davidhizar (2007)

12. Healthcare inequity Hypertension
Access to healthcare and it’s impact
Hypertension
Extremely prevalent in lower socioeconomic groups
Geography affects prevalence
Barriers to control of hypertension
Lack of awareness of disease consequences
Lack of access to patient education
Delayed diagnosis
Disadvantaged communities
Distrust of medical community

14. And the categories are…
Biological Variations
Name that disease

15. Biological variations $100
Dependent upon the amount of melanin one has
What is skin tone?

16. Biological variations $200
Differences can be seen in newborns; affects height, obesity; some ethnicities missing certain muscles
What is body structure?

17. Biological variations $300
Epicanthic folds, tooth size, small/large noses, attached or unattached earlobes
What are facial features?

18. Biological variations $400
Highest in Polynesians and African Americans, lowest in Asians and Caucasians
What is bone density?

19. Biological variations $500
Precordial voltages, elevated ST segments
What are ECG variations?

20. Name that disease $100
What is obesity?

21. Name that disease $200
What is diabetes?

22. Name that disease $300
What is hypertension?

23. Name that disease $400
What is sickle cell?

24. What is cystic fibrosis?
Name that disease $500
What is cystic fibrosis?

25. Please turn in your 1 minute papers before you leave
Thanks for your participation everyone and have a great day!

26. references
Adams-Homoda, M. G., Caldwell, M. A., Stotts, N. A., Drew, B. J. (2003). Factors to consider when analyzing 12-lead electrocardiograms for evidence of acute myocardial ischemia. American Journal of Critical Care, 12(1), Retrieved from
Geissler, E. M. (1991). Transcultural nursing and nursing diagnosis. Nursing and Healthcare, 12(4), Retrieved from
Giger & Davidhizar (2008). Transcultural Nursing: Assessment and Intervention (5th ed.). St. Louis, MO: Mosby Elsevier