Building Cultural Competence in Health Care

The face of America is becoming increasingly diverse. By 2030, today’s minorities will make up more than half of the population. Indeed,Texas, New Mexico and California already have minority majorities. And the new 2010 Census analysis shows an unprecedented shift in the nation’s racial and ethnic makeup, one that is reshaping U.S. politics, schools, and workplaces. With the increasing diversity, healthcare professionals are more and more likely to encounter situations where culture plays an important role. Culture refers to integrated patterns of human behavior which include language, beliefs, values, norms, thoughts, and institutions of a group. Although it is impossible to ever fully comprehend the scope of each culture, healthcare professionals can, however, gain cultural competence in delivering culturally competent care. Simply, Cultural Competence, is the ability to interact effectively with people from different cultures. In healthcare, cultural competence further implies having the capacity to function effectively as an individual, agency or institution within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities. (Adopted from Cross, 1989). Cultural competency is an advocated strategy that helps close the disparities in healthcare. It is a tool that can be used to respond to the different health beliefs, practices, and linguistic needs of people in a respectful way that brings about positive health outcomes. Cultural competency is important because culture and language may influence:

Two major obstacles that keep people from interacting respectfully and effectively with others are stereotyping and ethnocentrism. Stereotyping is the erroneous assumption that a person possesses certain characteristics just because he or she is a member of a particular group. Ethnocentrism is the belief that ones’ culture is superior to all others. Both can lead to misunderstandings, conflict, discrimination and ultimately to poor health care delivery. Below are some helpful tips that individuals, agencies, and institutions can use to enhance their competency in providing equal access and quality health care.

Tips for Building Cultural Competence in Health Care

Triage: Knowledge

  1. Become aware of your personal culture. What are your personal beliefs, values, traditions, etc.? Where did they come from?
  2. Become aware of the factors in your life that have influenced you.
  3. Become aware of your patients/consumers culturally related practices, attitudes, values, and beliefs. Where did they come from? What is their experience?
  4. Expand your knowledge of the cultures that make up your consumer base in order to deliver access and quality health care services. Be aware of what is and is not acceptable within the cultures that you encounter.
  5. Recognize the “subcultures” that exist within a culture (a group of people who have developed interest or goals different from the primary culture, e.g., occupation, sexual orientation, religion, etc.).
  6. Recognize the different concepts involved in a cross-cultural setting.

Examine: Understanding

  1. Examine your biases, assumptions, attitudes, and prejudices towards other groups.
  2. Examine how your personal/organizational biases, assumptions, attitudes, and prejudices may create a barrier to delivering culturally competent care.
  3. Examine your behavior toward those different than you. Understand how your behavior impacts others.
  4. Examine your tolerance and/or acceptance of others’ beliefs and behaviors. Do you approach each person as a valued and unique individual?
  5. Examine the agencies/institutions system. Are they designed to meet diverse group’s linguistic and cultural needs?

Prescribe: Action

  1. Verbal Communication
    • Suspend your biases and prejudices while communicating with others.
    • Listen to understand, not to be understood.
    • Modify your manner of speaking to facilitate effective ocmmunication.
    • Communicate with a positive attitude while establishing common ground with cultures different from your own
  2. Be aware that different cultures have distinct perspectives on gestures, zones of territory/personal space, eye contact and physical contact.
  3. Take into account the social, political, ethnic, religious, educational and economic realities that shape the experiences and environments of your patients/consumers. Develop strategies that consider their preferences and needs which may vary from your own.
  4. Engage your team members in helping you to better understand and deal with cultural differences. Identify the differences that lead to misunderstandings, conflicts or get in the way of effective collaboration and contributions.
  5. What can you, your subordinates and/or work team do differently to create an inclusive and more collaborative health care setting? An initial step would be to acknowledge and foment shared commonalities.
  6. What can the organization (systemic, practices, etc.) do to promote an environment that is conducive to respect, empathy, and acceptance of diverse thoughts and practices?
  7. Cross-cultural marketing requires three key elements: Assessment/analysis/planning, Implementation and Evaluation:
    • Assessment/analysis and planning: Assess consumers to identify culture-specific information relative to products and/or services.
    • Implementation: Strategies, initiatives, processes, etc., must be congruent with cultural norms and values.
    • Evaluation: The consumer’s cultural perspective of success must be considered during this phase of maintenance.

In conclusion, demographic changes heighten the importance of recognizing and addressing diverse perspectives and needs. Cultural competence can facilitate the elimination of health and health care disparities and improve health care for all groups.

By Armida Mendez Russell

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