Skip to main content
Erschienen in: Journal of Public Health 5/2007

01.10.2007 | Original Article

Diversity policies and practices - a new perspective for health care

verfasst von: Dagmar Vinz, Martina Dören

Erschienen in: Journal of Public Health | Ausgabe 5/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Globalization and migration intensify relations of interdependence between individuals all over the world and lead to complex forms of social and cultural diversity both within and across societies. The changing structure of family patterns and processes of individualization also contribute to growing diversity. Organizations and actors in health care will therefore also be challenged to achieve social inclusion of care seekers with different social and cultural backgrounds. Disparities in the health status of people from socially and culturally diverse backgrounds have been examined broadly, but the question is how diversity as an innovative concept will influence any agenda of research on human health and health care provision.

Objective

The purpose of this article is to theorize what a diversity framework could imply for health research and care system alike. Our thesis is that diversity as a reference point for research and practices will gain significance in Germany and Europe. We will present methodologies to understand diversity and “intersectionality” as paradigms to investigate the complexity and interdependence of health modifiers.

Methodologies

Diversity does not construct hierarchies of health modifiers and avoids focusing on groups without further differentiation. Health care programs will not only be challenged by the rising diversity among both patients and staff in the health care sector but also by supporting the integration of more disabled and chronically ill persons into the labor markets of ageing societies which cannot afford leaving groups behind as an unrecognized potential. Antidiscrimination legislation in Europe will possibly drive implementation of diversity policies in health care functions. Last but not least diversity management may become attractive as a strategy for improving the effectiveness of any structured health care program for prevention, rehabilitation and treatment alike through the implementation of a more consistent, multidimensional target group orientation.

Conclusion

Diversity as a conceptual framework applied to the health care field has yet to prove whether it may be a new tool possibly worthwhile to be developed to improve quality of care - but it has the potential to meat the challenges of health equity, defined in terms of resource allocations and access to health care determined by needs of multiple groups of patients.
Literatur
Zurück zum Zitat Andersson L, Öberg P (2004) Diversity, health and ageing, In: Daatland SO, Biggs S (eds) Ageing and Diversity. Multiple pathways and cultural migrations- Policy Press, Bristol, pp 45–60 Andersson L, Öberg P (2004) Diversity, health and ageing, In: Daatland SO, Biggs S (eds) Ageing and Diversity. Multiple pathways and cultural migrations- Policy Press, Bristol, pp 45–60
Zurück zum Zitat Braveman P (2006) Health disparities and health equity: concepts and management. Annu Rev Public Health 27:167–194PubMedCrossRef Braveman P (2006) Health disparities and health equity: concepts and management. Annu Rev Public Health 27:167–194PubMedCrossRef
Zurück zum Zitat Brown AF, Ettner SL, Piette J, Weinberger M, Gregg E, Shapiro MF, Karter AJ, Safford M, Waitzfelder B, Prata PA, Beckles GL (2004) Socioeconomic position and health among persons with diabetes mellitus: a conceptual framework and review of the literature. Epidemiol Rev 26:63–77PubMedCrossRef Brown AF, Ettner SL, Piette J, Weinberger M, Gregg E, Shapiro MF, Karter AJ, Safford M, Waitzfelder B, Prata PA, Beckles GL (2004) Socioeconomic position and health among persons with diabetes mellitus: a conceptual framework and review of the literature. Epidemiol Rev 26:63–77PubMedCrossRef
Zurück zum Zitat Brunner E (1997) Socioeconomic determinants of health: Stress and the biology of inequality. BMJ 314:1472–1476PubMed Brunner E (1997) Socioeconomic determinants of health: Stress and the biology of inequality. BMJ 314:1472–1476PubMed
Zurück zum Zitat Burchard EG, Ziv E, Coyle N, Gomez SL, Tang H, Karter AJ, Mountain JL, Perez-Stable EJ, Sheppard D, Risch N (2003) The importance of race and ethnic background in biomedical research and clinical practice. New Engl J Med 348:1170–1175PubMedCrossRef Burchard EG, Ziv E, Coyle N, Gomez SL, Tang H, Karter AJ, Mountain JL, Perez-Stable EJ, Sheppard D, Risch N (2003) The importance of race and ethnic background in biomedical research and clinical practice. New Engl J Med 348:1170–1175PubMedCrossRef
Zurück zum Zitat Clutterbuck D (2002) Establishing and sustaining a formal mentoring programme for working with diversified groups. In: Clutterbuck D, Ragins BR (eds) Mentoring for diversity: an international perspective. Elsevier, Oxford, pp 54–86 Clutterbuck D (2002) Establishing and sustaining a formal mentoring programme for working with diversified groups. In: Clutterbuck D, Ragins BR (eds) Mentoring for diversity: an international perspective. Elsevier, Oxford, pp 54–86
Zurück zum Zitat Collins FS, Mansoura MK (2001) The Human Genome Project: revealing the shared inheritance of all humankind. Cancer 91(Suppl):S221–S225 Collins FS, Mansoura MK (2001) The Human Genome Project: revealing the shared inheritance of all humankind. Cancer 91(Suppl):S221–S225
Zurück zum Zitat Cox THJ (2001) Creating the multicultural organization. Jossey-Bass, San Francisco Cox THJ (2001) Creating the multicultural organization. Jossey-Bass, San Francisco
Zurück zum Zitat Doyal L (2004) Sex and gender: five challenges for epidemiologists. Gesundheitswesen 66:153–157PubMedCrossRef Doyal L (2004) Sex and gender: five challenges for epidemiologists. Gesundheitswesen 66:153–157PubMedCrossRef
Zurück zum Zitat Dreachslin JL (1999) Diversity leadership and organizational transformation: Performance indicators for health services organizations. J Healthc Manag 44:427–439PubMed Dreachslin JL (1999) Diversity leadership and organizational transformation: Performance indicators for health services organizations. J Healthc Manag 44:427–439PubMed
Zurück zum Zitat Dressler WW, Oths KS, Gravlee CC (2005) Race and ethnicity in public health research: models to explain health disparities. Ann Rev Anthropol 34:231–252CrossRef Dressler WW, Oths KS, Gravlee CC (2005) Race and ethnicity in public health research: models to explain health disparities. Ann Rev Anthropol 34:231–252CrossRef
Zurück zum Zitat Engelbrech G (2003) Diversity und Chancengleichheit. Eine neue Herausforderung erfolgreicher Personalpolitik. In: Belinszki E, Hansen K, Müller U (eds) Diversity Management. Best practices im internationalen Feld, LIT Verlag, Münster, pp 62–103 Engelbrech G (2003) Diversity und Chancengleichheit. Eine neue Herausforderung erfolgreicher Personalpolitik. In: Belinszki E, Hansen K, Müller U (eds) Diversity Management. Best practices im internationalen Feld, LIT Verlag, Münster, pp 62–103
Zurück zum Zitat Foster MW, Sharp RR (2002) Race, ethnicity, and genomics: Social classifications as proxies of biological heterogeneity. Genome Res 12:844–850PubMedCrossRef Foster MW, Sharp RR (2002) Race, ethnicity, and genomics: Social classifications as proxies of biological heterogeneity. Genome Res 12:844–850PubMedCrossRef
Zurück zum Zitat Frank JP (1961) The people’s misery: mother of diseases. An address, delivered in 1790. Bull Hist Med 9:81–100 Frank JP (1961) The people’s misery: mother of diseases. An address, delivered in 1790. Bull Hist Med 9:81–100
Zurück zum Zitat Gardenswartz L, Rowe A (2003) From diverse teams at work: capitalizing on the power of diversity, 2nd edn. Society for Human Resource Management (SHRM), Alexandria, Virginia Gardenswartz L, Rowe A (2003) From diverse teams at work: capitalizing on the power of diversity, 2nd edn. Society for Human Resource Management (SHRM), Alexandria, Virginia
Zurück zum Zitat Gold R, Michael YL, Whitlock EP, Hubbell FA, Mason ED, Rodriguez BL, Safford MM, Sarto GE (2006) Race/ethnicity, socioeconomic status, and lifetime morbidity burden in the Women´s Health Initiative a cross-sectional analysis. J Women´s Health 15:1161–1173CrossRef Gold R, Michael YL, Whitlock EP, Hubbell FA, Mason ED, Rodriguez BL, Safford MM, Sarto GE (2006) Race/ethnicity, socioeconomic status, and lifetime morbidity burden in the Women´s Health Initiative a cross-sectional analysis. J Women´s Health 15:1161–1173CrossRef
Zurück zum Zitat Griggs JJ, Sorbero ME, Stark AT, Heininger SE, Dick AW (2003) Racial disparity in the dose and dose intensity of breast cancer adjuvant treatment. Breast Cancer Res Treat 81:21–31PubMedCrossRef Griggs JJ, Sorbero ME, Stark AT, Heininger SE, Dick AW (2003) Racial disparity in the dose and dose intensity of breast cancer adjuvant treatment. Breast Cancer Res Treat 81:21–31PubMedCrossRef
Zurück zum Zitat Hardmeier S, Vinz D (2007) Diversity und Intersektionalität - Eine kritische Würdigung der Originalität und Leistungsfähigkeit der zwei Ansätze für die Politikwissenschaft. In: femina politica. Frauen - Gender - Diversity. Perspektiven theoretischer Konzepte und ihrer politischen Umsetzung 1:23–33 Hardmeier S, Vinz D (2007) Diversity und Intersektionalität - Eine kritische Würdigung der Originalität und Leistungsfähigkeit der zwei Ansätze für die Politikwissenschaft. In: femina politica. Frauen - Gender - Diversity. Perspektiven theoretischer Konzepte und ihrer politischen Umsetzung 1:23–33
Zurück zum Zitat Hays-Thomas R (2003) Why Now? The contemporary focus on managing diversity. In: Stockdale MS, Crosby FJ (eds) The psychology and management of workplace diversity. Blackwell Publishers, Oxford, pp 3–30 Hays-Thomas R (2003) Why Now? The contemporary focus on managing diversity. In: Stockdale MS, Crosby FJ (eds) The psychology and management of workplace diversity. Blackwell Publishers, Oxford, pp 3–30
Zurück zum Zitat Hirschman J, Whitman S, Ansell D (2007) The black: white disparity in breast cancer mortality: The example of Chicago. Cancer Causes Control 18:323–333PubMedCrossRef Hirschman J, Whitman S, Ansell D (2007) The black: white disparity in breast cancer mortality: The example of Chicago. Cancer Causes Control 18:323–333PubMedCrossRef
Zurück zum Zitat Hurrelmann K, Kolip P (2002) Geschlecht, Gesundheit und Krankheit. Männer und Frauen im Vergleich. Hans Huber, Bern Hurrelmann K, Kolip P (2002) Geschlecht, Gesundheit und Krankheit. Männer und Frauen im Vergleich. Hans Huber, Bern
Zurück zum Zitat Isaacs SL, Schroeder SA (2004) Class - the ignored determinant of the nation’s health. New Engl J Med 351:1137–1142PubMedCrossRef Isaacs SL, Schroeder SA (2004) Class - the ignored determinant of the nation’s health. New Engl J Med 351:1137–1142PubMedCrossRef
Zurück zum Zitat Kawachi I, Daniels N, Robinson DE (2005) Health disparities by race and class: Why both matter. Health Affairs 24:343–352PubMedCrossRef Kawachi I, Daniels N, Robinson DE (2005) Health disparities by race and class: Why both matter. Health Affairs 24:343–352PubMedCrossRef
Zurück zum Zitat Knapp G-A (2005) “Intersectionality” - ein neues Paradigma feministischer Theorie? Zur transatlantischen Reise von Race, Class, Gender“. Feministische Studien 1:68–81 Knapp G-A (2005) “Intersectionality” - ein neues Paradigma feministischer Theorie? Zur transatlantischen Reise von Race, Class, Gender“. Feministische Studien 1:68–81
Zurück zum Zitat Krell G (2004) Managing diversity: Chancengleichheit als Wettbewerbsfaktor. In: Krell G (ed) Chancengleichheit durch Personalpolitik. Gleichstellung von Frauen und Männern in Unternehmen und Verwaltungen. Rechtliche Regelungen - Problemanalysen - Lösungen. Gabler, Wiesbaden, pp 41–54 Krell G (2004) Managing diversity: Chancengleichheit als Wettbewerbsfaktor. In: Krell G (ed) Chancengleichheit durch Personalpolitik. Gleichstellung von Frauen und Männern in Unternehmen und Verwaltungen. Rechtliche Regelungen - Problemanalysen - Lösungen. Gabler, Wiesbaden, pp 41–54
Zurück zum Zitat Krell G, Sieben B (2007) Diversity Management und Personalforschung, in: Krell G, Riedmüller B, Sieben B, Vinz D (eds) Diversity Studies. Grundlagen und disziplinäre Ansätze. Campus Verlag, Frankfurt a. M., (in press) Krell G, Sieben B (2007) Diversity Management und Personalforschung, in: Krell G, Riedmüller B, Sieben B, Vinz D (eds) Diversity Studies. Grundlagen und disziplinäre Ansätze. Campus Verlag, Frankfurt a. M., (in press)
Zurück zum Zitat Krell G, Riedmüller B, Sieben B, Vinz D (2007) Diversity Studies. Grundlagen und disziplinäre Ansätze. Campus Verlag, Frankfurt a. M., (in press) Krell G, Riedmüller B, Sieben B, Vinz D (2007) Diversity Studies. Grundlagen und disziplinäre Ansätze. Campus Verlag, Frankfurt a. M., (in press)
Zurück zum Zitat Krieger N (1994) Influence of Social Class, Race, and Gender on the Etiology of Hypertension among Women in the United States. In: Czajkowski SM, Hill DR, Clarkson TB, (eds) Women, Behavior, and Cardiovascular Disease: Proceedings of a Conference Sponsored by the National Heart, Lung, and Blood Institute. NIH Pub. No. 94-3309. Government Printing Office, Washington, DC, pp 191–206 Krieger N (1994) Influence of Social Class, Race, and Gender on the Etiology of Hypertension among Women in the United States. In: Czajkowski SM, Hill DR, Clarkson TB, (eds) Women, Behavior, and Cardiovascular Disease: Proceedings of a Conference Sponsored by the National Heart, Lung, and Blood Institute. NIH Pub. No. 94-3309. Government Printing Office, Washington, DC, pp 191–206
Zurück zum Zitat Krieger N (2003) Genders, sexes, and health: What are the connections - and why does it matter? Int J Epidemiol 32:652–657PubMedCrossRef Krieger N (2003) Genders, sexes, and health: What are the connections - and why does it matter? Int J Epidemiol 32:652–657PubMedCrossRef
Zurück zum Zitat Krieger N, Rowley DL, Hernan AA, Avery B, Phillips MT (1993) Racism, sexism, and social class: Implications for studies of health, disease, and well-being. Am J Prev Med 9(Suppl):S82–S122 Krieger N, Rowley DL, Hernan AA, Avery B, Phillips MT (1993) Racism, sexism, and social class: Implications for studies of health, disease, and well-being. Am J Prev Med 9(Suppl):S82–S122
Zurück zum Zitat Loden M, Rosener JB (1991) Workforce America: managing employee diversity as a vital resource. Irvin, Homewood Loden M, Rosener JB (1991) Workforce America: managing employee diversity as a vital resource. Irvin, Homewood
Zurück zum Zitat Marmot M, Siegrist J (2004). Social Science and Medicine Special Issue: Health inequalities and the psychosocial environment. 2004;issue 58 Marmot M, Siegrist J (2004). Social Science and Medicine Special Issue: Health inequalities and the psychosocial environment. 2004;issue 58
Zurück zum Zitat Pinn VW (2003) Sex and gender factors in medical studies: Implications for health and clinical practice. JAMA 289:397–400PubMedCrossRef Pinn VW (2003) Sex and gender factors in medical studies: Implications for health and clinical practice. JAMA 289:397–400PubMedCrossRef
Zurück zum Zitat Plummer DL (2003) Overview of the field of diversity management. In: Plummer DL (ed) Handbook of diversity management. University Press of America, Lanham, pp 1–49 Plummer DL (2003) Overview of the field of diversity management. In: Plummer DL (ed) Handbook of diversity management. University Press of America, Lanham, pp 1–49
Zurück zum Zitat Read JG, Gorman BK (2006) Gender inequalities in US adult health: The interplay of race and ethnicity. Soc Sci Med 62:1045–1065PubMedCrossRef Read JG, Gorman BK (2006) Gender inequalities in US adult health: The interplay of race and ethnicity. Soc Sci Med 62:1045–1065PubMedCrossRef
Zurück zum Zitat Rieder A, Lohff B (2004) Gender Medizin. Geschlechtsspezifische Aspekte für die klinische Praxis. Springer, Wien Rieder A, Lohff B (2004) Gender Medizin. Geschlechtsspezifische Aspekte für die klinische Praxis. Springer, Wien
Zurück zum Zitat Rieker PP, Bird CE (2005) Rethinking gender differences in health: why we need to integrate social and biological perspectives. J Gerontol Series B 60B(special Issue II):40–47 Rieker PP, Bird CE (2005) Rethinking gender differences in health: why we need to integrate social and biological perspectives. J Gerontol Series B 60B(special Issue II):40–47
Zurück zum Zitat Schiebinger L (2004) Nature's Body: Gender in the making of modern science. Rutgers University Press, New Brunswick Schiebinger L (2004) Nature's Body: Gender in the making of modern science. Rutgers University Press, New Brunswick
Zurück zum Zitat Schulz A, Mullings L (2006) Gender, race, class, & health. Intersectional approaches. Jossey-Bass, San Francisco Schulz A, Mullings L (2006) Gender, race, class, & health. Intersectional approaches. Jossey-Bass, San Francisco
Zurück zum Zitat Seeman TE, Crimmins E, Huang M-H, Singer B, Bucur A, Gruenewald T, Berkman LF, Reuben DB (2002) Cumulative biological risk and socio-economic differences in mortality : MacArthur Studies of Successful Ageing. Soc Sci Med 58:1985–1997CrossRef Seeman TE, Crimmins E, Huang M-H, Singer B, Bucur A, Gruenewald T, Berkman LF, Reuben DB (2002) Cumulative biological risk and socio-economic differences in mortality : MacArthur Studies of Successful Ageing. Soc Sci Med 58:1985–1997CrossRef
Zurück zum Zitat Sepehri P, Wagner D (2002) Diversity und Managing Diversity - Verständnisfragen, Zusammenhänge und theoretische Erkenntnisse. In: Peters S, Bensel N (eds) Frauen und Männer im Management - Diversity in Diskurs und Praxis, 2nd ed. Gabler, Wiesbaden, pp 121–142 Sepehri P, Wagner D (2002) Diversity und Managing Diversity - Verständnisfragen, Zusammenhänge und theoretische Erkenntnisse. In: Peters S, Bensel N (eds) Frauen und Männer im Management - Diversity in Diskurs und Praxis, 2nd ed. Gabler, Wiesbaden, pp 121–142
Zurück zum Zitat Singer B, Ryff CD (1999) Hierarchies of life histories and associated health risks. Ann N Y Acad Sci 896:96–115PubMedCrossRef Singer B, Ryff CD (1999) Hierarchies of life histories and associated health risks. Ann N Y Acad Sci 896:96–115PubMedCrossRef
Zurück zum Zitat Thompson N (1997) Anti-discriminatory practice. Palgrave Macmillan, London Thompson N (1997) Anti-discriminatory practice. Palgrave Macmillan, London
Zurück zum Zitat Vedder G (2006) Die historische Entwicklung von Diversity Management in den USA und in Deutschland. In: Krell G, Wächter H (eds) Diversity Management − Impulse aus der Personalforschung. Mering, München, pp 1–23 Vedder G (2006) Die historische Entwicklung von Diversity Management in den USA und in Deutschland. In: Krell G, Wächter H (eds) Diversity Management − Impulse aus der Personalforschung. Mering, München, pp 1–23
Zurück zum Zitat Yuval-Davis N (2006) Intersectionality and Feminist Politics. European Journal of Women‘s Studies 13:193–209CrossRef Yuval-Davis N (2006) Intersectionality and Feminist Politics. European Journal of Women‘s Studies 13:193–209CrossRef
Metadaten
Titel
Diversity policies and practices - a new perspective for health care
verfasst von
Dagmar Vinz
Martina Dören
Publikationsdatum
01.10.2007
Verlag
Springer-Verlag
Erschienen in
Journal of Public Health / Ausgabe 5/2007
Print ISSN: 2198-1833
Elektronische ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-007-0148-7

Weitere Artikel der Ausgabe 5/2007

Journal of Public Health 5/2007 Zur Ausgabe