Our world is diversifying and healthcare needs to respond

Our world is diversifying and will continue to do so. The growth of multicultural communities from sexual orientation, race, ethnicity, age, gender, etc., each with its own cultural traits and health profiles, present a complex challenge to health care providers and policy makers in providing equitable access. Access to healthcare, or mainly a lack of access, for marginalized populations, is one of the reasons for existing health disparities.

These realities are present in our eating disorders field on many levels. It was hypothesized that eating disorders exist in solely in heterosexual Caucasian cisgender adolescent girls. However, more recent studies are showing that marginalized populations groups are reaching parity with heterosexual Caucasian cisgender adolescent girls in body image and eating disturbances suggesting that one’s identity does not appear to protect against the broader sociocultural factors that foster body dissatisfaction and eating disturbances among adolescent females (Shaw,et.al., 2004; French, et.al. 1997.)
Not only is treatment access an issue but eating disorders screening is another complication to be addressed (Becker,et.al., 2003). Multicultural eating disorders studies demonstrate that contributing eating disorder factors for multicultural populations may be unique to their race/ethnicity/sexual orientation/gender/age/disability,etc. (Harris and Kuba, 1997; Harris ,Kuba & O’Toole, 2012) . Often these contributing factors involve cultural dynamics, racism, and oppression, assimilation to dominant culture standards and identity confusion (Harris and Kuba, 1997; Harris ,Kuba & O’Toole, 2012).

An even bigger question is are multicultural populations being diagnosed with eating disorders? Studies show that multicultural populations were significantly less likely than Caucasians to receive a recommendation or referral for further evaluation or care (Becker,A; et.al. (2003). Multicultural populations were also significantly less likely than Caucasians to have been asked by a doctor about eating disorder symptoms (Becker,A; et.al. 2003). These outcomes suggest a potential lack of reporting and diagnosis for multicultural populations that is a serious flaw in our health care system.

The levels of impairment reported by marginalized populations with eating disorders coupled with their low levels of treatment utilization have serious consequences (Marques, et.al., 2010; Alegria,et.al. ,2007). These populations with eating disorders often remain undetected and this needs to be addressed. The levels of impairment reported by those with eating disorders coupled with the low levels of service use suggest serious consequences for marginalized populations suffering from these disorders, which can no longer be overlooked or remain undetected (Alegria,et.al. (2007).

1. Alegria, M; Woo, M.; Zhun,C.; Torres, M.; Meng, X.; Striegel-Moore, R. (2007) “Prevalence and correlates of eating disorders in Latinos in the United States “ International Journal of Eating Disorders; Special Issue: International Journal of Eating Disorders Special Supplement on Diagnosis and Classification, 40,S3, pg. S15 ““S21.
2. Becker, A. et.al. (2003) Ethnicity and Differential Access to Care for Eating Disorder Symptoms “ International Journal of Eating Disorders33, 205-212.
3. 3French, S. et.al (1997) “Ethnic Differences in Psychosocial and Health Behavior Correlates of Dieting, Purging, and Binge Eating in a Population-Based sample of Adolescent Females “ International Journal of Eating Disorders, 22, pg. 315-322.
4. Harris, D. & Kuba, S. (1997) “Ethnocultural Identity and Eating Disorders in Women of Color “ Professional Psychology: Research and Practice, 28(4), pg. 341-347. 5. Shaw,H, Ramirez,L., Trost,A., Randall,P., Stice,E. (2004) “Body Image and Eating Disturbances Across Ethnic Groups: More Similarities than Differences “ Psychology of Addictive Behaviors, 18(1), pg. 12-18.