Journal of General Internal Medicine

, Volume 27, Issue 6, pp 708–715 | Cite as

Religious Values and Healthcare Accommodations: Voices from the American Muslim Community

  • Aasim I. PadelaEmail author
  • Katie Gunter
  • Amal Killawi
  • Michele Heisler
Original Research



Minority populations receive a lower quality healthcare in part due to the inadequate assessment of, and cultural adaptations to meet, their culturally informed healthcare needs. The seven million American Muslims, while ethnically and racially diverse, share religiously informed healthcare values that influence their expectations of healthcare. There is limited empirical research on this community’s preferences for cultural modifications in healthcare delivery.


Identify healthcare accommodations requested by American Muslims.


Using community-based participatory research (CBPR) methods, we partnered with four community organizations in the Greater Detroit area to design and conduct thirteen focus groups at area mosques serving African American, Arab American, and South Asian American Muslims. Qualitative content analysis utilized a framework team-based approach.


Participants reported stigmatization within the healthcare system and voiced the need for culturally competent healthcare providers. In addition, they identified three key healthcare accommodations to address Muslim sensitivities: the provision of (1) gender-concordant care, (2) halal food and (3) a neutral prayer space. Gender concordance was requested based on Islamic conceptions of modesty and privacy. Halal food was deemed to be health-promoting and therefore integral to the healing process. Lastly, a neutral prayer space was requested to ensure security and privacy during worship.


This study informs efforts to deliver high-quality healthcare to American Muslims in several ways. We note three specific healthcare accommodations requested by this community and the religious values underlying these requests. Healthcare systems can further cultural sensitivity, engender trust, and improve the healthcare experiences of American Muslims by understanding and then attempting to accommodate these values as much as possible.


cultural modifications Islam minority health healthcare delivery 



We thank our respondents for sharing their insights with us, and our community partners for their invaluable recruitment assistance and support: Muzammil Ahmed MD, Hamada Hamid DO MPH from the Institute for Social Policy & Understanding, Adnan Hammad PhD from the Arab Community Center for Economic & Social Services, Mouhib Ayyas MD from the Islamic Shura Council of Michigan, and Ghalib Begg from the Council of Islamic Organizations of Michigan. We also thank Sonia Duffy RN and Michael D. Fetters MD MPH MA for assistance with study design, qualitative methods, and intellectual support. Lastly, a note of thanks to our troupe of research assistants, Heather Tidrick, Afrah Raza, Shoaib Rasheed, Ali Beydoun, Nadia Samaha, David Krass, Imen Alem, and Samia Arshad for their invaluable assistance.This project and the time-effort of AIP, AK, and KG was supported by the Robert Wood Johnson Foundation Clinical Scholars Program and additional project funding was provided by the Institute for Social Policy & Understanding.

Conflicts of Interest

None disclosed.


  1. 1.
    Smedley BD, Stith AY, Nelson AR. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC: National Academies Press; 2003.Google Scholar
  2. 2.
    Anonymous. Poor communications, cultural barriers impacting quality of health care for minorities. Qual Lett Healthc Lead. 2002;14(4):11–13.Google Scholar
  3. 3.
    Cross TL, Bazron BJ, Dennis KW, Isaacs MR. Toward a culturally competent system of care. Georgetown University Child Development Center. 1989.Google Scholar
  4. 4.
    United States Department of Health and Human Services, Office of Minority Health. What Is Cultural Competency? Available at: Accessed December 6, 2011.
  5. 5.
    Anderson LM, Scrimshaw SC, Fullilove MT, Fielding JE, Normand J. Culturally competent healthcare systems: a systematic review. Am J Prev Med. 2003;24(3 Suppl 1):68–79.PubMedCrossRefGoogle Scholar
  6. 6.
    Brach C, Fraser I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev. 2000;57(Suppl 1):181–217.PubMedGoogle Scholar
  7. 7.
    Miller T. Mapping the Global Muslim Population: A Report on the Size and Distribution of the World’s Muslim Population. Pew Research Center; 2010.Google Scholar
  8. 8.
    Ba-Yunus I. Muslims of Illinois, a demographic report. Chicago: East-West University; 1997.Google Scholar
  9. 9.
    Obama B. Remarks by the President on a New Beginning. Available at: Accessed December 6, 2011.
  10. 10.
    Allied Media Corp. Muslims American Demographic Facts. Available at: Accessed December 6, 2011.
  11. 11.
    Hassoun RJ. Arab Americans in Michigan. Lansing: Michigan State University Press; 2005.Google Scholar
  12. 12.
    Numan FH. The Muslim Population in the United States. American Muslim Council; 1992; Available at: Accessed December 6, 2011.
  13. 13.
    Arab American Institute Foundation. Michigan; 20011. Available at: Accessed December 6, 2011.
  14. 14.
    Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–8.PubMedGoogle Scholar
  15. 15.
    Wehbe-Alamah H. Bridging generic and professional care practices for Muslim patients through use of Leininger's culture care modes. Contemp Nurse. 2008;28(1–2):83–97.PubMedCrossRefGoogle Scholar
  16. 16.
    Smedley BD, Smith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Care. Washington, DC: The National Academies Press; 2002.Google Scholar
  17. 17.
    Israel BA. Methods in Community-Based Participatory Research for Health. 1st ed. San Francisco: Jossey-Bass; 2005.Google Scholar
  18. 18.
    Beine K, Fullerton J, Palinkas L, Anders B. Conceptions of prenatal care among Somali women in San Diego. J Nurse Midwifery. 1995;40(4):376–81.PubMedCrossRefGoogle Scholar
  19. 19.
    Simpson J, Carter K. Muslim women's experiences with health care providers in a rural area of the United States. J Transcult Nurs. 2008;19(1):16–23.PubMedCrossRefGoogle Scholar
  20. 20.
    Morioka-Douglas N, Sacks T, Yeo G. Issues in caring for Afghan American elders: insights from literature and a focus group. J Cross Cult Gerontol. 2004;19(1):27–40.PubMedCrossRefGoogle Scholar
  21. 21.
    Reitmanova S, Gustafson D. "They can't understand it": maternity health and care needs of immigrant Muslim women in St. John's, Newfoundland. Matern Child Health J. 2008;12(1):101–11.PubMedCrossRefGoogle Scholar
  22. 22.
    Matin M, LeBaron S. Attitudes toward cervical cancer screening among Muslim women: a pilot study. Women Health. 2004;39(3):63–77.PubMedCrossRefGoogle Scholar
  23. 23.
    Luna L. Care and cultural context of Lebanese Muslim immigrants: using Leininger's theory. J Transcult Nurs. 1994;5(2):12–20.PubMedCrossRefGoogle Scholar
  24. 24.
    DeShaw P. Use of the emergency department by Somali immigrants and refugees. Minn Med. 2006;89(8):42–5.PubMedGoogle Scholar
  25. 25.
    Zezima K. The Muslim patient will see you now, Doctor. New York Times. 2004 Sept 1;Sect. Health. Available at: Accessed December 6, 2011.
  26. 26.
    Modesty gowns for female patients. British Broadcasting Company. 2006 September 5;Sect. News. Available at: Accessed December 6, 2011.
  27. 27.
    Cainkar L. The Impact of 9/11 on Muslims and Arabs in the United States. In: Tirman J, ed. The maze of fear: security and migration after September 11. New York: The New Press; 2004.Google Scholar
  28. 28.
    Davidson J, Boyer ML, Casey D, Matzel SC, Walden D. Gap analysis of cultural and religious needs of hospitalized patients. Crit Care Nurs Q. 2008;31(2):119–26.PubMedGoogle Scholar
  29. 29.
    Amer MM, Hood RW. Special issue: part II. Islamic religiosity: measures and mental health. J Muslim Ment Health. 2008;3(1):1–5.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Aasim I. Padela
    • 1
    • 2
    Email author
  • Katie Gunter
    • 3
  • Amal Killawi
    • 3
  • Michele Heisler
    • 3
    • 4
  1. 1.Sections of General Internal Medicine & Emergency Medicine, Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Program on Medicine and ReligionUniversity of ChicagoChicagoUSA
  3. 3.Robert Wood Johnson Foundation Clinical Scholars ProgramUniversity of MichiganAnn ArborUSA
  4. 4.Veterans Affairs Center for Clinical Management ResearchVA Ann Arbor Healthcare SystemAnn ArborUSA

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