Individuals needing health care come from many different cultural, ethnic, socio-economic and religious environments. All of these factors may impact their ability to access or partake in healthcare. As we can see from the article above, diversity plays a tremendous influence in First Nations parents' beliefs about immunizations and subsequent immunization uptake. This theme is common in many healthcare settings. .

             Hutchison & Quartaro (1993) support recognizing diversity and point out in their article "Training imperatives for volunteers caring for high-risk, vulnerable populations" that it is important for caregivers to "anticipate the caring needs of high risk populations" including culturally diverse populations (88). Nurses must be trained not only to recognize cultural or other influences that may impeded care, but also must work quickly to plan for appropriate care and provide an environment for patients where they feel supported and understood (Hutchison & Quartero, 1993). The authors also emphasize the importance of caregiver's role as an agent responsible for strengthening family ties where appropriate and intervening to provide for immediate survival needs, which may "vary according to locale, age, sex, sociocultural factors and availability of supportive resources" (89). .

             Pulido et. al (2001) also support the idea that immunization uptake may be a result of ethnic or cultural beliefs and socio-economic conditions. In their article "Vaccinating Asian Pacific Islander children against Hepatitis B" the researchers examine ethnic-specific barriers and social influences that prevent children from receiving adequate vaccinations. Their research suggests that factors influencing a child's coverage against Hepatitis B prior to entering school include the child's familial English speaking capability, living in different ethnic and different socio-economic groups. The researcher suggest that health care providers including nurses must act quickly to develop cultural-specific outreach programs in order to address the diverse needs of communities like that in the study.