Cultural Competency

by Anastasia Klipa

October 28, 2020

three people in a musuem setting looking at images of faces

Cultural competency is defined as the ability to understand, appreciate and interact with those whose cultures or belief systems differ from one's own. Within the U.S. healthcare system, cultural competency is intended to provide services that meet the cultural, social, and linguistic needs of patients. Improving and increasing cultural competency across the healthcare infrastructure holds notable significance, as there are many disparities that affect the needs of many different cultural groups in the United States.

Statistics from Georgetown University’s Health Policy Institute show that among older Americans, racial and ethnic minorities are disproportionately burdened by chronic illness. A higher proportion of Black and Latino people, when compared to white people, reported having at least one chronic ailment. Black, Asian American, Pacific Islander, Indigenous, Alaska Native, and Latinx groups also statistically have less access to professional healthcare resources than white people in America. Lower literacy rates and language barriers are also more likely to occur among BIPOC, due to cultural, linguistic, socio-economic and educational disparities, and can lead to negative patient experiences, such as confusion, miscommunication, and misutilization of medication. These disparities substantiate that cultural competency is essential to ensuring proper care to all patients. Healthcare professionals must learn and understand the negative impacts of inequalities within the healthcare system, so that patients who are disproportionately affected by these disparities can receive fair and proper care.

The American Hospital Association (AHA) finds that there is a correlation between effective educational or training programs for cultural competence and lasting awareness and understanding by hospital staff.

A case study conducted by the AHA at Advocate Lutheran General Hospital in Chicago, Illinois aimed to improve staff’s cultural awareness and form a better connection to the local communities served by the hospital. Results of the study showed that increased emphasis on cultural competency resulted in hospital staff’s ability to quickly identify patients who may require special care to accommodate their ethnic practices or beliefs. Lutheran General Hospital incorporated more education and training by adding a cultural competency component to new employee orientation and having the hospital CEO meet with staff to go over culturally competent initiatives. The hospital also established the South Asian Cardiovascular Center, the first cardiovascular center in the Midwest that focuses on educating, screening, preventing, and treating South Asian patients for their elevated risk of heart disease.

A similar case study conducted by AHA at Lutheran Medical Center in Brooklyn, New York found that as a result of the hospital’s efforts to increase cultural competency, patient satisfaction scores indicated high satisfaction with care administered by hospital staff. Lutheran Medical Center achieved this by creating a cultural competency department, engaging with community members through community liaisons and advisors, and by establishing a Chinese unit within its center, which addresses specific cultural issues faced by Chinese patients.

The AHA identified several action items that can be implemented across the healthcare system to increase cultural competency:

  • CollectREAL data: Race, Ethnicity and Language Preference
  • Identify and report disparities
  • Provide culturally and linguistically competent care
  • Develop culturally competent disease management programs
  • Increase diversity and minority workforce pipelines
  • Involve the community
  • Making cultural competency an institutional priority
  • Conduct self assessments to measure cultural competency
  • Engage with relevant resources that will increase cultural competency

The healthcare community needs to make concerted efforts to foster an environment that is inclusive and equitable towards all patients. By conducting training and education to healthcare professionals on topics that emphasize and increase cultural competency, a more understanding, inclusive and fair healthcare system can emerge.