Caucasian Patients
Essentials of Cultural Competence in Pharmacy
Practice: Chapter 6 Notes
Chapter Author: Dr. Wendy Brown
Learning Objectives
1. Understand Caucasian culture as the majority culture in the
United States.
2. Articulate key health concerns affecting Caucasian
individuals.
3. Recognize the high-risk behaviors present in Caucasian
culture.
Caucasian Race
 Defined by the Oxford English Dictionary as “a broad
division of humankind covering peoples form Europe, the
Middle East, South Asia and North Africa” and as “whiteskinned; of European origin.”
 White and Caucasian are used interchangeably.
 In the United States, Caucasians comprise the majority of the
population and have historically been bestowed privileges
because of this fact.
 Caucasian, as a race, is filled with great diversity impacted by
many religions, ethnicities, and sexual orientations.
Communication Styles
 The primary language used by this majority culture is
American English.
 There are within-group differences in non-verbal
communication, though some commonalities among
Caucasians exist (smiling, direct eye contact)
Family Roles
 The make-up of contemporary Caucasian families is varied.
 Earlier decades presented the ideal of the nuclear family,
though it is no longer the norm.
 Cohabitation, marriage, divorce, and remarriage have shaped
family roles.
 Most Caucasians marry. However, over half of all US
marriages end in divorce. The greatest risk factors for
separation or divorce include living in neighborhoods with
high levels of poverty, receiving welfare and/or
unemployment, and having a low level of income and/or
education.
Biocultural Ecology and Relevant
Disease States
 Cystic Fibrosis is the most significant genetically linked
disease embedded in the Caucasian culture.
 Currently 1 in 3300 Caucasians has cystic fibrosis
 1 in 29 Caucasians is a carrier
 Drug metabolism
 Caucasians are also known to have great variability in drug
metabolism (i.e. NAT gene and CYP 450)
High-Risk Behaviors
 Notably high incidence of alcohol, illicit drug use, and sexual
assault.
 Alcohol:
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13.4% lifetime abstainers
17.09% former drinkers
42.34% light drinkers
15.18% moderate drinkers
11.29% heavier drinkers
 Illicit Drugs
 4% of pregnant women reported using illicit substance within 1 month of
being surveyed
 7.2% reported currently using illicit drugs
 Sexual Assault
 17.9% of Caucasian women reported being raped at some time in their
lifetime.
Nutritional Trends
 There has been a historical shift from nutrient deficiencies to
overconsumption, decreased diet quality and poor food
choices for the majority of the Caucasian population.
 In 2004, a survey by the National Immunization Survey
showed that 71.5% of Caucasian children were ever
breastfed.
 Further, 53.9% of those ever breastfed continued
breastfeeding until at least 6 months.
Pregnancy/Childrearing Practices
 Caucasian women have a higher rate of multivitamin use
before becoming pregnant, typically have lower rate of
pregnancy-related complications, and are equal to other races
in prevalence of infant checkups and postpartum
contraceptive use.
 According to abortion surveillance data reported by the
Centers for Disease Control and Prevention, approximately
53% of women who obtained legal, induced abortions were
Caucasian compared with 36% black and 8% other.
Death Rituals
 The underlying theme of death practices and beliefs is
resolving loss.
 Most deceased bodies are embalmed, displayed in a chapel or
funeral home for a few days, and then buried or cremated.
 Funerals are held to honor the deceased and the death is
typically followed by a time of deep mourning and
expression of pain and sadness by loved ones or survivors.
Spirituality
 The general population of Caucasians believes in one God
and life after death.
 Many individuals have a religious affiliation and 77% think of
spirituality in a “personal and individual sense” rather than in
terms of “organized religion.”
 People with higher level of spirituality have a lower incidence
of mortality from cardiac-related illness, lower blood
pressure, less substance abuse, recover quicker from
depression, and are better able to cope with serious illness.
Health Care Practice
 In a 2000 census, 89.3% of Caucasians had some form of
health insurance.
 Among all adults, the likelihood of having health care
coverage correlated primarily with education level and
income.
 Caucasians report more pain than people of other races.
 The health care workforce, in general, lacks diversity. Thus,
Caucasians continue to be the dominant group of both
practitioners and patients.
Reflection Questions
1. How would you address the high incidence of alcohol, illicit
drug use, and sexual assault in treating Caucasian patients?
2. As a pharmacist, how will you work with Caucasian patients
to treat diseases more prevalent in Caucasians, such as cystic
fibrosis and poor drug metabolism?
3. How will you use the information contained in this chapter
to inform your practice?