Cultural Competency

Public and private sector organizations are involved in a number of activities that seek to reduce cultural and communication barriers to health care. These activities are often described as cultural competency and/or cross-cultural education. Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. 'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. 'Competence' implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities. (Adapted from Cross, 1989).

The Institute of Medicine's report "Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare" focused on clinical encounters and found evidence that stereotyping, biases, and uncertainty on the part of health care providers can contribute to unequal treatment. In fact, there is growing evidence of how important it is for us, as providers, to recognize the value of and respond appropriately to cultural differences. Cultural differences all too often result not only in deficiencies of care but also of health outcomes (Smedley et al. 2003).

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).