RespiteMatch.com Health Blog

As the diversity of cultures and languages increases in this country, healthcare systems are faced with the challenge of providing accessible and quality services that are responsive to the needs of our growing multicultural population. “Culturally competent health care” can improve health outcomes by making services available in the language spoken by patients and/or by recognizing and accommodating the cultural beliefs and practices of the community served. The need for culturally competent health care is great: according to the U.S. Department of Health and Human Services’ Office of Minority Health, “racial and ethnic minorities are less likely to have health insurance, may experience a lower quality of health care, and have higher rates of disease, disability and death.”
A systematic review of published studies in the healthcare literature, conducted on behalf of the Task Force on Community Preventive Services by a team of experts, found insufficient evidence to determine the effectiveness of selected interventions to increase the cultural competence of healthcare systems. This conclusion was based on a lack of comparative research on program effectiveness, particularly studies in which culturally competent interventions were compared with interventions uninformed by patient language or culture. A determination that there is “insufficient evidence to determine effectiveness” does NOT mean that the intervention does not work, but rather reveals gaps in the body of scientific literature where future prevention research is needed.
Background on Culturally Competent Healthcare Systems
Culturally competent healthcare systems provide an array of services for patients that accommodate differences in language and culture. Such services might include using interpreters or bilingual providers, cultural diversity training for staff, linguistically and culturally appropriate health education and other informational materials, ethnic-specific healthcare settings (e.g., a neighborhood outreach clinic to bring services to an immigrant group), and systems in place to recruit and retain a multicultural healthcare staff. Such approaches may improve health because:
• Clients can gain trust and confidence in accessing healthcare, thereby reducing differentials in use that result from perceived or actual discrimination.
• Healthcare providers can increase their ability to understand and treat a culturally diverse clientele with varying health beliefs and practices, thus improving accuracy of diagnoses and choice of effective interventions.
Findings from the Systematic Review
• The Task Force found an insufficient number of evaluation studies to allow conclusions about intervention effectiveness, reflecting a research gap in the evaluation of healthcare system interventions to improve the cultural competence of services.
• Researchers working in this area should develop comparative research to assess intervention effectiveness; identify meaningful health outcomes; focus on what works best, where, and for whom; and use methods that include measurements of the feasibility and cost-effectiveness of interventions.
Publications:
• American Journal of Preventive Medicine – Am J Prev Med 2003; 24(3S); 68-79. A report on evidence and findings.
The Guide to Community Preventive Services (Community Guide) provides recommendations on population-based interventions to promote health and to prevent disease, injury, disability, and premature death, appropriate for use by communities and healthcare systems. For more information about the Community Guide (including links to publications and a variety of resources) see www.thecommunityguide.org and for more information about the social environment & health review see www.thecommunityguide.org/social/.
This information is in the public domain. Copying and disseminating freely is encouraged. However, citation to source is appreciated.
Updated – April 4, 2003