No matter your age, you’ve most likely heard the United States referred to as the Melting Pot of the world. It’s a metaphor to describe the cultural integration and assimilation of immigrants into this country.
The diversity of the U.S. population continues to grow. That’s evidenced in the more than 350 languages people in America use to communicate.
With this diversity comes an increasing need for cultural competence — especially in the healthcare industry. Why? Because it’s crucial to ensure equitable healthcare quality for U.S. citizens from all ethnic backgrounds.
What is Cultural Competence?
According to the Agency for Healthcare Research and Quality (AHRQ), cultural competence in healthcare refers to the ability of healthcare organizations to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of healthcare delivery to meet patients’ social, cultural and linguistic needs. This concept considers that individuals from different cultures, races and ethnicities have disparate needs and preferences when it comes to receiving healthcare.
Unlike when the concept first was developed, cultural competence now also refers to meeting the needs of individuals with disabilities and those from diverse socioeconomic backgrounds. It emphasizes the way cultural factors have the potential to influence the way people define and evaluate situations, seek help for problems and respond to interventions. Another focus is how individuals present their problems, situations and information to others.
Key pillars of cultural competence include:
- Clear efforts to understand community needs
- A broad definition of culture
- Acknowledgement of language interpretation needs
- Continued learning among organizational leaders
- Cultural competency training for staff members and clinicians
- Cultural competency ingrained in organizational policies
When utilized correctly, cultural competence enables healthcare providers to address the disparities often experienced by patients of racially and culturally diverse backgrounds. It eliminates barriers prohibiting patients from accessing and receiving the healthcare they want and need. The result is a healthcare organization that recognizes the needs of such patients and develops new policies and procedures to overcome their care challenges.
Barriers to Healthcare Access and Communication
Of the more than 37 million adults in the U.S. who speak a language other than English, roughly 18 million or 48 percent report that they speak English less than “very well.” Language differences, including speech patterns or accents, are not the only obstacles to cultural competency, though. For example, barriers to communication consist of limited experience with healthcare concepts and procedures, specialized healthcare vocabulary and jargon, lack of understanding of insurance coverage and systemic hurdles.
These barriers to healthcare communication have the potential to result in serious consequences, from delayed care to higher morbidity and mortality from chronic diseases. Research consistently demonstrates healthcare disparities between minority and majority populations:
- Patients with limited English proficiency were more likely to be harmed than their English-proficient counterparts when they experienced adverse events, and that harm was more likely to be severe.
- African Americans and other ethnic minorities report less partnership with physicians, less participation in medical decisions and lower levels of satisfaction with care.
- Data shows that ethnic minorities and non-White patients face more social determinants of health (SDOH) than White patients.
- When healthcare organizations fail to provide culturally competent care, patients are at higher risk of having negative health consequences, receiving poor quality care or being dissatisfied with their care.
- When healthcare providers fail to recognize the differences between them and their patients, they may inadvertently deliver lower-quality care.
Consequences of a Lack of Cultural Competence
Patients faced with a lack of cultural competence are more reluctant to seek healthcare and are even less likely to engage with a provider. Similarly, they’re reportedly more reluctant to engage using digital healthcare tools, resources that enable clear and timely communication between providers and their patients and help to close any gaps in care.
This lack of patient engagement is problematic for numerous reasons. Patients have less of an understanding of health concerns, fewer opportunities for asking providers questions, higher thresholds for accessing medical records and a lack of confidence in choosing the best options for care.
Conversely, patient satisfaction and quality outcomes are improved when individuals become actively engaged in their own healthcare. And, engaged patients are three times less likely to have unmet medical needs and twice as likely to seek care in a timely manner when compared to those who aren’t active participants in their care.
Along with more patient participation and engagement, the improved understanding of cultural competence leads to increased patient safety, reduced care disparities and efficiencies and lower overall healthcare costs. Health benefits of a culturally competent healthcare organization consist of increased preventive care by patients, improved patient data collection and fewer missed medical visits and medical errors.
There are social benefits of cultural competency in healthcare, too. These include increased mutual respect and understanding between a patient and his or her healthcare provider, a higher level of patient trust, inclusion of community members and promotion of patient responsibilities for health.
A study published in the Journal of Sport Rehabilitation found that when healthcare providers acknowledged and honored cultural preferences, the following advantages occurred:
- Patients were more likely to share their full story.
- Patients tended to be more open with and trusting of the healthcare staff.
- Patients were more likely to follow the medical advice of their healthcare provider.
- Patients seemed to be more willing to comply with their treatment and engage with their provider.
Strategies for Increasing Cultural Competence in Healthcare
What exactly does it mean for a healthcare organization to be culturally competent? The Centers for Disease Control and Prevention’s National Prevention Information Network (NPIN) notes that it requires that organizations have a defined set of values and principles and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally. Culturally competent healthcare organizations also must have the capacity to value diversity, conduct self-assessment, manage the dynamics of difference, acquire and institutionalize cultural knowledge and adapt to diversity and the cultural contexts of the communities they serve.
There’s more, though. To be culturally competent, a healthcare organization must incorporate these values and principles in all aspects of policy-making, administration, practice and service delivery and systematically involve consumers, key stakeholders and communities.
Becoming a culturally competent healthcare organization does not require years of language learning by a physician. Healthcare practices instead can build their team with individuals who reflect the diversity of the patient populations they serve or employ the services of qualified foreign language and American Sign Language interpreters.
Another recommendation is to educate medical group staff about the importance of cultural competence and the specific cultural needs of patients with whom they typically interact. The American Hospital Association (AHA) explains that a successful educational program includes cultural assessment, multiple training methods, ongoing education and measurement and tracking.
Other common strategies for improving the patient-provider interaction through cultural competency include:
- Using community health workers
- Incorporating culture-specific attitudes and values into health promotion tools
- Including family and community members in healthcare decision-making
- Locating practices in geographic areas that are easily accessible to certain populations
- Expanding hours of operation
- Providing linguistic competency that extends beyond the clinical encounter to the appointment desk, advice lines, medical billing and other written materials
How HIPAA-Compliant Two-Way Text Messaging Can Help
Something as simple as frequent and clear communication with patients can make a huge difference for culturally competent providers. Plus, it aids physicians in building and maintaining long-term partnerships with patients.
A popular digital health resource because it gives providers and patients the ability to securely converse for appointment reminders, patient outreach, population health and more is secure, two-way text messaging. Messages can be customized for each patient, but provider staff also can send out the same message to a specific patient population. Contact the Providertech team today to find out how our HIPAA-compliant two-way text messaging solution can enable your healthcare practice to increase its cultural competency.