The U.S. is expanding culturally at an unprecedented rate. According to a study published by the American Association of Colleges of Nursing, 37% [more than a third] of the American population are individuals from racial and ethnic minorities.
It’s estimated that by the year 2043, they will no longer be the minority. Unfortunately, only 19% of RNs in the workforce are from racial or ethnic minority backgrounds and this disparity has presented a number of challenges in caring for a culturally diverse population.
The number of ethnically and culturally diverse groups is growing, and each has its own cultural traits. Additionally, some racial groups present unique health challenges specific to that group.
From triage to discharge, nurses spend an increasingly significant amount of time with their patients, making it critical for them to become culturally competent. Cultural competency in the health care sector supports positive patient outcomes and improves medical research accuracy.
Social determinants of health, such as working and living conditions and quality healthcare access, aren’t the same for everyone. Health inequities pose a serious challenge to the healthcare community, but healthcare providers have a powerful tool at their disposal: cultural competence. Cultural competence in health care addresses the disparities that people of racially and culturally diverse backgrounds often experience. It can ensure all patients get the care they need to live healthier lives.
What Is Cultural Competence in Health Care?
Cultural competence in health care means delivering effective, quality care to patients who have diverse beliefs, attitudes, values, and behaviors. This practice requires systems that can personalize health care according to cultural and linguistic differences. It also requires understanding the potential impact that cultural differences can have on healthcare delivery.
For example, race, socioeconomics, health literacy, and other factors can influence:
- How patients perceive symptoms and health conditions
- When and how patients seek care
- Patients’ expectations of care
- Patients’ preferences regarding procedures or treatments
- Patients’ willingness to follow doctor recommendations or treatment plans
- Who patients believe should participate in making healthcare decisions
While cultural competence in health care initially referred to meeting the needs of people from distinctive ethnic and racial groups, it now also refers to meeting the needs of people with disabilities, those from diverse socioeconomic backgrounds, and members of the LGBTQ community.
The Need for Cultural Competence in Health Care
Differences between healthcare providers and patients can affect communication. This can, in turn, impact both clinicians’ and patients’ decisions with regard to treatment. For example, a clinician may misinterpret a patient’s silence as a lack of interest in receiving care. As a result, the clinician may not order a diagnostic test, when in fact the patient’s response reflected their notion of respectful behavior.
When healthcare providers fail to recognize the differences between them and their patients, they may inadvertently deliver lower-quality care. Cultivating skills that improve cross-cultural communication can play an important role in delivering equitable care.
Additionally, building teams with healthcare professionals who reflect the diversity of the patient populations served can also improve cross-cultural communication. Diverse teams have a wider cultural knowledge base that they can share with one another. This makes them likely to respond with empathy to the unique cultural needs of patients.
Language accessibility is also key. Language barriers keep patients from accurately describing their symptoms and providers from explaining diagnoses. Language barriers can also create unsafe and inappropriate situations in other ways.
For instance, clinicians may rely on children to serve as interpreters, putting young people in the position of telling a parent they have cancer. As another example, clinicians may rely on abusive spouses to interpret for their battered partners. Both situations pose significant problems.
Combining Cultural Competence with Cultural Humility
Healthcare providers strive to develop a multicultural orientation to deliver culturally sensitive care and improve communication. However, even when healthcare professionals have a meaningful understanding of a culture, they still can’t predict the behaviors and attitudes of their patients simply based on their cultural backgrounds. That’s because people are unique, and their behavior and beliefs might not always reflect those of their cultures.
Given this, healthcare professionals must focus on building cultural competence and cultural humility. Cultural humility recognizes the limits of people’s knowledge of others. It also acknowledges that even people who have cultivated their cultural awareness can still have unintentional, unconscious biases about cultures other than their own.
Cultural humility involves an ongoing process of self-evaluation. Through exploration of and reflecting on their own beliefs and behaviors, healthcare professionals can improve their awareness of implicit biases and foster an approach to patients characterized by openness and curiosity about each new patient.
Goals of Cultural Competence in Health Care
Cultural competence aims to break down barriers that get in the way of patients’ receiving the care they need. It also strives to ensure improved understanding between patients and their providers.
The growing diversity in the U.S. population demands that the healthcare community expand its ability to address patient needs. Cultural competence offers a pathway and a framework to reach the goal of better health for all patients.
Culturally and linguistically appropriate services, or CLAS, respond to individual preferences and needs of each patient. They also help improve health outcomes and decrease health disparities.
According to the U.S. Department of Health and Human Services, National Culturally and Linguistically Appropriate Services Standards