Cultural Awareness and Competence in Healthcare

What is Culture?
Culture can be defined as the personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups. For healthcare providers, these elements influence beliefs and belief systems surrounding health, healing, wellness, illness, disease, and delivery of health services.¹ Cultural awareness is the ability to perceive our own cultural beliefs, values, and customs, and to understand how they shape our decisions and behavior. Cultural competence is being conscious of our own biases and how that may affect how we interact with others.

What is Culturally Competent Healthcare?
Culturally competent healthcare is the ability of practitioners to address the health issues of people from diverse backgrounds effectively by applying knowledge, empathy, and insight into the views on health that those backgrounds present. Culture can influence how patients perceive symptoms and health conditions, when and how patients seek care, patients’ expectations of care, patients’ preferences regarding procedures or treatments, patients’ willingness to follow recommendations or treatment plans, and who patients believe should participate in making healthcare decisions.²

Cultural competence leads to improved patient outcomes by improving communication. Clear communication allows healthcare providers to collect accurate information and encourages active dialogues in which patients and their physicians can ask questions, correct misunderstandings, and build trust. In addition to improving patient outcomes, cultural competence also leads to improved patient satisfaction.

How Can You Apply Cultural Competency at Your Practice?
According to the Centers for Disease Control and Prevention National Prevention Information Network cultural competence requires that organizations:

• Have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally.
• Have the capacity to value diversity, conduct self-assessment, manage the dynamics of difference, acquire, and institutionalize cultural knowledge, and adapt to diversity and cultural contexts of the communities they serve.
• Incorporate the above in all aspects of policy making, administration, practice, service delivery, and involve systematically consumers, key stakeholders, and communities.

Strategies for building cultural competence in your practice include:

• Collecting data about the race, ethnicity, and language preferences of your patient population to identify and meet specific community needs.
• Hiring staff that represent the community’s demographics.
• Forming relationships with community leaders and organizations that serve individuals from various cultures.
• Providing ongoing cultural competence training for all staff.
• Training staff to utilize interpreters to eliminate language barriers.

Want More on Cultural Awareness and Competence?
The U.S. Department of Health and Human Services (HHS) developed the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards). These standards provide a set of fifteen actions steps intended to advance health equity, improve quality, and help eliminate healthcare disparities by providing a blueprint to implement culturally and linguistically appropriate services. An Implementation Checklist for the National CLAS Standards can be found here.

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1. National Institutes of Health. Cultural Respect. https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/cultural-respect
2. Tulane University School of Public Health and Tropical Medicine. How to Improve Cultural Competence in Health Care. March 1, 2021. https://publichealth.tulane.edu/blog/cultural-competence-in-health-care
Cultural Competence In Health and Human Services | NPIN, https://npin.cdc.gov/pages/cultural-competence

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