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Cultural Competency in Healthcare: Concerns & Improvements

Concerns About Cultural Competency

  1. There is a concern that prioritizing cultural competence might make it about the economic and market incentives rather than purely helping people.

  2. The ability to provide a respectful, empathic, and tolerant professional attitude might be particularly challenging in emergencies because healthcare providers are expected to work under extreme levels of stress, often in unfamiliar geographical and socio-cultural contexts.

  3. Culture can influence patients' values, beliefs, and health-related practices, making it difficult to provide proper care.

  4. Assessment bias where incorrect interpretations of patients' competence occurs and can lead to misdiagnosis amongst minority culture populations. 

  5. Occupational therapists have spoken of cultures where parents do not play with their kids, which can complicate service delivery as therapists feel conflicted about encouraging parents to use play in therapy.

  6. In disaster situations, increased vulnerability of ethnic minorities has been been attributed to multiple cultural, social, and financial factors, including the level of language proficiency, migration background, lower socioeconomic status, disparities in healthcare, reduced access to information, community isolation, and distrust in healthcare systems.

Chin, J. L. (2000). Culturally Competent Health Care. Public Health Reports, 115(1), 25.

Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R., & Potter, B. (2018). Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC Health Services Research, 18(1), 23. https://doi.org/10.1186/s12913-017-2811-1

Kula, Y., Cohen, O., Clempert, N., Grinstein-Cohen, O., & Slobodin, O. (2021). Educating nursing students for cultural competence in emergencies: a randomized controlled trial. BMC Nursing, 20(1), 1–12. https://doi.org/10.1186/s12912-021-00704-1

How to Improve Cultural Competency

  1. Provide educational materials in a different language.

  2. Provide online resources to educate physicians on cultural competence.

  3. Educate residents and students before they transition into attending roles.

  4. Incorporate diversity training and cultural competence exercises at meetings and conferences.

  5. Be responsive to all members of the population.

  6. Have a comprehensive management strategy to address culturally and linguistically appropriate services, including strategic goals, plans, policies, procedures, and designated staff responsible for implementation.

  7. Develop structures and procedures to address cross-cultural ethical and legal conflicts in health care delivery and complaints or grievances by patients and staff about unfair, culturally insensitive or discriminatory treatment, or difficulty in accessing services, or denial of services.

  8. Use a variety of methods to collect and utilize accurate demographic, cultural, epidemiological, and clinical outcome data for racial and ethnic groups in the service area, and become informed about the ethnic/cultural needs, resources, and assets of the surrounding community.

  9. Increased recruitment and hiring of professionals who are people of color and people of other-than-white cultural identities and experiences.

  10. Trainings/discussions from different cultures/ethnic backgrounds who are willing to meet with health care staff in order to learn about their cultures/norms and how health care providers would be most effective in helping those clients.

  11. Helping patients understand the health care system can include providing home visits, connecting them to resources, explaining how equipment is funded, and/or offering personalized support networks.

Chin, J. L. (2000). Culturally Competent Health Care. Public Health Reports, 115(1), 25.

Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R., & Potter, B. (2018). Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC Health Services Research, 18(1), 23. https://doi.org/10.1186/s12913-017-2811-1

Nair, L., & Adetayo, O. A. (2019). Cultural Competence and Ethnic Diversity in Healthcare. Plastic and Reconstructive Surgery - Global Open, 7(5), e2219. https://doi.org/10.1097/GOX.0000000000002219

Shepherd, S. M., Willis-Esqueda, C., Newton, D., Sivasubramaniam, D., & Paradies, Y. (2019). The challenge of cultural competence in the workplace: perspectives of healthcare providers. BMC Health Services Research, 19(1), 135. https://doi.org/10.1186/s12913-019-3959-7