We are all members of a culture. How we interpret the reality around us, what we consider to be reasonable statements and behavior, and what we believe to be health and illness all stem from the culture we share with some people and not with others. Those whose cultural experiences differ from our own will also differ in their beliefs and interpretations of reality.

We are all rooted in an ethnic group as well, even if this group is simply the so-called "majority" of white, middle-class, protestant heritage. The degree to which we identify with an ethnic past will vary according to the strength with which family tradition has maintained that identity, and to the degree that the family chooses to assimilate into the larger society. The extent of an individual's or a family's identification with an ethnic heritage is as important as the specific features of that heritage.

American society is ethnically and culturally diverse, and community health nurses will find themselves practicing in communities that reflect this diversity. A particular family or a whole community may belong to an ethnic or cultural group very different from the nurse's own. Those community health nurses who are most sensitive to variations in clients' beliefs and behaviors will be most effective in promoting their wellness.

Community health nurses can achieve this sensitivity by examining their own culture in order to understand how it colors their world view and their interactions with individuals, families, and communities. Recognizing that clients are individuals as well as members of a larger culture, nurses will reject stereotypical views of clients' ethnic groups that can impede communication and diminish their effectiveness. Indeed, culture mediates all social encounters, including those between nurse and client, and its study can enhance the effectiveness of health care services.