|Websites for Professionals
Take control of your online presence
with your own professional website!
Why Cultural Competence
We have all heard stories, listen to news, or read studies that indicate the United States is metaphorically turning into a big melting pot. I propose this metaphor is an inaccurate description of our country now and most certainly in the future. I believe William Sonnenschein's description of who we are seems more relevant. We are much more like a garden salad. A garden salad is made up of many vegetables of different tastes and textures. (1) Said another way, we are many cultures with many differences. Hopefully, you can embrace this latter view as more fitting as I discuss reasons why cultural competence matters to healthcare organizations in the 21st century.
This article explores why cultural competence matters in health care. The article serves as a wake-up for boards, CEOs, and senior healthcare executives as they strategically align their organizations with 21st century challenges. Finally, the article highlights some useful resources for health care CEOs and senior leaders desiring to learn more on the topic. But first, some background information.
U. S. census reports indicate America's population is growing increasingly diverse. In 1900, only one in eight Americans was of a race other than white - today, that ratio is one in four. By 2050, the Hispanic and Asian populations will both triple, the black population will almost double, and the white population will barely hold its own (Salisbury and Byrd, 2006, p. 90)(2) . This diversity creates a rich cultural texture in America, but also brings challenges to the health care community with implications for every aspect of health care - the workforce, leadership, and most importantly, the communities served. The authors explain as the United States become more ethnically and racially diverse, there is a need for healthcare organizations that can reflect and respond to an increasingly heterogeneous community. Knowing how to serve people with different values, health beliefs and alternative perspectives about health and wellness is both a business and ethical imperative. A brief definition of cultural competence offers a practical starting point.
What is Cultural Competence?
The Department of Human & Health Services, Administration on Aging (2001) defines cultural competence as a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross cultural situations. (3) Cultural competency is achieved by translating and integrating knowledge about individuals and groups of people into specific practices and policies applied in appropriate cultural settings. When professionals are culturally competent, they establish positive helping relationships, engage the client, and improve the quality of services they provide which leads us to why cultural competence matters in health care.
Why Cultural Competence Matters
The following landmark reports and health care delivery related illustrations provide what I believe to be ample argument for developing cultural competence in health care. Consider the following:
In 2002, the Institute of Medicine (IOM) published a groundbreaking report, titled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, which illuminated one of the most critical health care challenges facing the United States. The IOM's findings that racial and ethnic minorities receive lower-quality health care than white people - even when insurance status, income, age, and severity of conditions are comparable - for the first time gave evidence-based credence to the assertion that the U.S. health care system is not color blind. The report offered comprehensive evidence to an uncomfortable reality-some people in the United States were more likely to die from cancer, heart disease, and diabetes simply because of their race or ethnicity, not just because they lack access to health care. (4) (p. 3)
From the reports and illustrations and many others not mentioned here, the rationale and leadership mandate is apparent: cultural competence in health care matters. It is an ethical, patient safety, and quality of care concern. Cultural competence is a health care business imperative.
The following resources provide CEOs and senior leaders a vigorous starting point for learning more on the topic of cultural competence in health care.
The Institute of Medicine (IOM) is one of the United States National Academies, and is a not-for-profit, non-governmental American organization chartered in 1970 as a part of the National Academy of Sciences; its purpose is to provide national advice on issues relating to biomedical science, medicine, and health. It works outside the framework of the government to provide independent guidance and analysis. An electronic version of Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare and other reports are available at http://www.iom.edu/.
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. The Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. The report, Racial and Ethnic Disparities in Access to and Quality of Health Care and other studies and reports are available at http://www.rwjf.org/.
The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. Studies, articles, and reports are available at http://www.commonwealthfund.org/.
The Office of Minority Health (OMH) was established in 1986 by the U.S. Department of Health and Human Services. It advises the Secretary and the Office of Public Health and Science on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders. OMH's mission is to improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities. The "National Standards for Culturally and Linguistically Appropriate Services in Health Care: Executive Summary" and other information are available at http://www.omhrc.gov/.
The Agency for Healthcare Research and Quality (AHRQ) is part of the United States Department of Health and Human Services which supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. It sponsors, conducts, and disseminates research to help people make more informed decisions and improve the quality of health care services. The 2006 National Healthcare Disparities Report and other reports are available at http://www.ahrq.gov/.
The Joint Commission offers two guides, "The Joint Commission 2007 Requirements Related to the Provisions of Culturally and Linguistically Appropriate Health Care" and "Office of Minority Health National Culturally and Linguistically Appropriate Services (CLAS) Standards Crosswalked to Joint Commission 2007 Standards for Hospitals, Ambulatory, Behavioral Health, Long Term Care, and Home Care" available at http://www.jointcommission.org/.
The imperative to become culturally competent is unconditional for healthcare organizations. Meeting the health care challenges brought on by demographic changes taking place in the 21st century precludes CEOs and senior healthcare executives from being passive bystanders in their communities but rather insists that they ethically employ all resources at their command to preserve and improve the communities served. Swedish (2007) concludes a culturally competent healthcare organization is better able to effectively and respectfully serve patients from a rich variety of cultures, with differing ideas, experiences and perspectives. (8) Leadership must be the catalyst for developing culturally competent healthcare organizations. I hope this article prompts you to learn more about cultural competence. If so, you have taken the first essential step.
Many more articles in Diversity & Cultural Competence in The CEO Refresher Archives