Cultural Competency is Critical to Health Reform
July 17, 2009
By Jason Leon
Foreign travel can be quite frustrating if you don’t know the language. Ordering food can resemble a game of charades, replete with wild hand gestures and grunting noises. Simply getting directions from a local can become an exercise in futility.
The frustration associated with an overseas trip is generally worth it, though.
Imagine if you had to face that same language barrier — and all the cultural understanding barriers — every time you went to your doctor’s office. It’d be difficult to communicate your health issues. Without an understanding of your life situation, health professionals would be limited in creating and communicating an effective treatment plan for you. In short, your care would be severely compromised.
Millions of minorities in America face this reality daily. The lack of cultural understanding between healthcare providers and minority populations is a critical public health concern. As lawmakers work to reform healthcare in the coming months, it’s important that they address this problem, which has long plagued America’s health system.
Although the issue of cultural competency among medical professionals receives scant media attention, for decades we have seen how cultural and language barriers have contributed to the disparities in healthcare quality experienced by minority populations.
These inequalities have been well-documented. Studies show that African American, Latino, Native American and Pacific Islander women are two to four times more likely to suffer from diabetes than white women. African Americans are 29 percent more likely to die from heart disease than whites. Their chances of dying from stroke are 40 percent higher.
Roughly 84,000 lives could be saved every year if the gaps in mortality between African Americans and whites were erased, according to former Surgeon General David Satcher.
While there are many critical factors at work here — from financial and geographic barriers to care, variations in disease prevalence and offered medical services — we know that differences in culture, language and non-verbal cues between patient and provider are also critically important.
The good news is that these disparities can be reduced through comprehensive healthcare reform.
Consider demographics. While African Americans, Latinos, and Native Americans comprise more than 25 percent of the population, these groups only represent nine percent of the nation’s nurses and just six percent of its physicians. According to the U.S. Census, by 2050 the African American population is expected to double, and the Hispanic and Asian American population will likely triple.
To correct for the current underrepresenta-tion of minorities in the healthcare industry, and to keep pace with these demographic changes, lawmakers could implement policies to attract minorities into the healthcare field as part of the comprehensive health reform bill. We need more minority medical researchers, public policy experts, physicians, nurses and other allied health professionals.
Today, many influential voices — including organized labor and the pharmaceutical industry through The Pharmaceutical Industry Labor- Management Association — have come to recognize the important role cultural competency plays in our health care system. This competency is absolutely essential for building confidence between patients and medical professionals, and for increasing the efficacy of community outreach programs.
Minority healthcare providers are more likely to be sensitive to the ethnic and cultural subtleties of their respective cultural group, and so are better equipped to respond to the unique needs of members of that group.
After all, the patient-caregiver relationship is built on mutual trust. And trust can only be gained through effective communication and genuine understanding. When trust and understanding increase between patient and caregiver, information is shared more freely, conditions are better understood and treatment options are explained more clearly.
Community-based early detection, prevention and disease management programs also stand to gain from an investment in greater cultural competency. These programs are designed to educate people about high prevalence diseases like diabetes and asthma, and about important environmental issues that can affect health.
Existing “trusted communicators”— such as clergy, teachers, community organizers, labor leaders, and elected officials — can lead and support comprehensive outreach programs. The more connected community members feel to their healthcare system, the more likely they are to absorb and act on the information it provides.
I believe that all Americans should support health reform. The recent announcement from the pharmaceutical industry to commit $80 billion to reduce the cost of brand name drugs under Medicare Part D shows leadership and a partnership with the White House and Congress. I am encouraged.
Improving the cultural competency of America’s healthcare professionals should be considered a necessary component of meaningful healthcare reform. With the current push to overhaul healthcare, the Obama Administration and Congress have a great chance to improve our system so that it serves all populations equally, regardless of race and ethnicity.
Jason Leon is the Executive Director of the Labor Council for Latin American Advancement.