How Cultural Competence Can Improve Health Outcomes
Providing culturally competent health care could result in:
- more successful patient education, because culturally competent clinicians can target, tailor, and communicate health-related messages more effectively;
- an increase in patients seeking both preliminary health care and follow-up, by improving trust and understanding between clinician and patient;
- more appropriate testing and screening, because clinicians will have more knowledge about the genetic background, risk exposure, and common health-related behavior of various cultural groups;
- fewer diagnostic errors, as a result of compiling more comprehensive and more accurate medical histories;
- avoidance of drug complications, by becoming aware of home or folk remedies used by patients;
- greater adherence to medical advice, because clinicians establish a treatment plan that is most consistent with the patient's cultural beliefs and lifestyle; patients better understand how to follow the treatment plan;
- expanded choices and access to high-quality clinicians, because patients are no longer restricted to a small pool of clinicians who share their language and culture (Brach and Fraser 2000).
To eliminate racial and ethnic disparity, health care providers and organizations need to become more culturally and linguistically competent so that they can challenge and confront racism, sexism, classism, and other forms of prejudice and discrimination that occur in both clinical encounters and in society at large. Barriers to care fostered by both the health care system and by physicians themselves are often as important as patient and community barriers to care.
Through collaboration and achieving a better understanding and appreciation of our commonalities and differences, patients and physicians can become empowered to work together to help eliminate racial and ethnic disparities in health care (Betancourt and Like, 2000).
Robert C. Like, MD, MS, Director of the Center for Healthy Families and Cultural Diversity, Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, provides some cultural competence pointers for physicians. He suggests that health care providers:
- "check our own pulse" and become aware of personal attitudes, beliefs, biases, and behaviors that may influence (consciously or unconsciously) our care of patients and our interactions with professional colleagues and staff from diverse racial, ethnic, and sociocultural backgrounds;
- remember that every clinical encounter is crosscultural. He advises developing partnerships with our patients and maintaining "cultural humility" so we can learn about and better understand the historical, familial, community, occupational, and environmental contexts in which our patients live;
- understand that there is no one correct way to treat any racial and ethnic group. Given the great sociocultural diversity even within a racial or cultural group, we must have a framework of interventions that can be individualized and applied in a patient- and family-centered fashion;
- rely on evidence-based information about clinical and preventive care for the racial and cultural groups that we serve and tailor our interventions appropriately to our patients, their families, and their communities. Avoid cookbook approaches about working with patients from diverse sociocultural backgrounds that are based on stereotyping and overgeneralization;
- acknowledge that important intergenerational differences exist, and that diversity is often greater within groups than between them.
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