You know something’s not right with your health. You decide to visit your health care provider because you’re dizzy sometimes, your hands and feet are swelling, and you find yourself peeing often at night. But you don’t speak the language that the nurses or doctors are speaking. You’re struggling to tell them what’s wrong with the words that you know. They tell you the symptoms could be diabetes and ask you to go to the lab for tests. But the visit was frustrating and confusing, and kind of a hassle. You don’t feel like they’re respecting you or helping you, and you’d rather just figure out how to manage the symptoms yourself. Language is one of the barriers people can face in the health care system and is an example of how cultural competency can impact the relationship between health care providers and patients. Other barriers include cultural traditions, health literacy, religion and cultural assumptions. All can affect health outcomes of the patient.
What is cultural competency?
Cultural competency is the ability of providers and organizations to effectively deliver health care services that can meet the social, cultural and linguistic needs of patients. Cultural competency among health care providers is a growing need, as four out of 10 Americans will belong to a racial or ethnic minority group by 2030. This is important to understand, as racial and ethnic minorities have higher rates of morbidity and mortality from chronic diseases. Historically, the medical field has been predominantly white. A recent survey by the Association of American Medical Colleges found 56.2% of active physicians identified as white, 17.1% identified as Asian, 5.8% identified as Hispanic and 5% identified as Black or African American. This relative lack of diversity in the medical field is a factor when it comes to the significant role implicit bias plays in contributing to health care disparities. The assumptions and stereotypes on which we unconsciously rely can affect the thinking of health care providers and impact the kind of care delivered.
How can a lack of cultural competency impact patients?
Health care providers do their best to treat every patient with respect – but there are times when that doesn’t cover the gap in cultural norms. Using the language barrier as an example again, one in five Americans say communication with physicians is a problem in receiving health care – a figure that increases to 27% among Asian Americans and 33% among Hispanics. Research has shown that when there are language barriers between providers and patients, providers often compensate by ordering additional diagnostic tests – resulting in higher costs for the patient and health care system. A lack of cultural competency can also have the following impacts on patients:
- Lower patient satisfaction with care
- Poor comprehension and adherence
- Lower quality of care
- More interactions with the health care system
- Negative health consequences
- Less partnership with physicians in medical decisions
How can health care providers improve cultural competency?
Acknowledging the need to address cultural competency among health care providers is the first step. There are several strategies to consider:
- Consult traditional, culturally appropriate leaders
- Coordinate with community health workers
- Ensure all services from medical billing, appointment booking, handout information and registration/medical history paperwork are available in multiple languages
- Expand hours of operation
- Include family and community members in health care decision making
- Offer interpreter services
- Offer clinic locations in areas accessible for the population you are trying to reach
- Provide staff training to increase cultural awareness, knowledge and skills
- Seek out a diverse staff that’s representative of different cultures, communities and backgrounds
A health care system that is culturally competent can help eliminate racial and ethnic health disparities and can help improve health outcomes and quality of care. Throughout 2021, Blue Cross Blue Shield of Michigan journalists will be focused on implicit bias, one of the drivers of disparate outcomes in health care. We’ll be exploring where implicit bias comes from, how it affects the provider-patient relationship, its impacts on health outcomes and how Blue Cross is working to bring awareness to the issue. More from MIBluesPerspectives: