Cultural competence is an issue that must be addressed in the medical community. Sources like Georgetown University, Michigan State Medical Society (MSMS), and the National Institutes of Health (NIH), all believe that increased diversity within the medical industry could greatly increase the quality and effectiveness of healthcare among minority groups and those who do not speak English.
Cultural competence is a standard of diversity that is defined by Georgetown University’s Health Policy Institute as “the ability of providers and organizations to understand and integrate these factors [race, ethnicity, nationality, language, gender, socioeconomic status, physical and mental ability, sexual orientation, and occupation] into the delivery and structure of the health care system.” Georgetown uses statistics like charts to observe the correlation between minority groups and incompetent healthcare. Chronic illnesses affect African Americans and Latinos more than they affect Caucasians, partly because of a lack of diversity in the healthcare system. Minority groups generally tend to have less access to healthcare and are more likely to be uninsured. This causes a cycle which hinders preventative measures, causing such chronic illnesses, but consequently does not provide the adequate care for these illnesses.
A language barrier also prevents high quality healthcare. The Michigan State Medical Society proposed a situation where a Middle Eastern female had a disease that required a hysterectomy. She spoke some English with a heavy accent, but a translation of her surgery consent form was declined. After the hysterectomy, she asked her doctors how soon she could become pregnant. Although the story may not be true, it reveals the heartbreaking truth of how much cultural and language barriers affect people’s lives and how urgent it is to improve it. Georgetown University reinforces this idea, saying that Spanish-speaking Latinos are less likely to visit a doctor, receive a mammogram, or receive an influenza vaccine than fluent English speakers. Less than 48 percent of non-English speakers reported that they usually had an interpreter present during a health care visit.
In addition to this, people with low literacy levels, most of which are elderly or ethnic minorities, are less likely to correctly interpret written instructions on prescriptions, health educational writings, insurance forms, and more. People with low literacy levels tend to need more medical intervention in their lives, leading to additional costs to their health care.
This brings the conversation to social determinants of health (SDH) like education, housing, and access to healthy foods. The NIH mentions that ethnic minorities tend to have worse SDH which decreases the quality of healthcare in many of their lives.
A journal by Lakshmi Nair, BS and Oluwaseun A. Adetayo, MD created as a part of the Plastic Reconstructive Surgery Global Open talks about how an underrepresented ethnic minority population causes a decline in the quality of medical care. People in ethnic minority groups accepted breast reconstructive surgery far less than Caucasian people did. Nair and Adetayo claim that 98% of senior managers in healthcare organizations are white. Women make up only 7% of department chiefs and chairs of plastic surgery. This lack of diversity evidently has an impact, as ethnic minority groups believe that they would have received better medical care if they were of another race far more often than white people do, according to Georgetown University. The journal states that efforts must be made to attract qualified women and minorities to the field. More steps need to be taken to improve cultural competence, such as training programs that go deeper than common health beliefs about certain groups, which perpetuate stereotyping of ethnic communities. Cultural competency on an individual level is made with experience, although a more diverse staff could help with quicker development. Interpreters should be offered more often, and cultural competency should become a larger priority among the mostly academic focus
On February 9, 2021, the Black Student Union at the Agnes Irwin School hosted Reverend Brain Dunlop at an all school assembly. He talked about Critical Race Theory (CRT) and how it affects every aspect of life, especially healthcare. Critical Race Theory is an ideology which states that the law and legal systems are inherently racist and that race is a social construct used by white people to advance themselves at the expense of people of color. It is perpetuated when white people desire to keep their historical advantage. He talked about how racism and CRT affects many aspects of life including the prison system, the justice system, standardized testing, and voting rights, but especially healthcare. An example of racism within healthcare is the treatment of people of color during the COVID-19 pandemic. Most ethnic minorities are over two times as likely to die from the coronavirus. Nevertheless, 70% of healthcare workers and 77% of the eldery being vaccinated are white. 70% of pharmacies exist in majority white areas. Black and brown communities are about two times less likely to have hospitals. These statistics prove how urgent it is to fight racism ingrained in these systems.
The reason that cultural competence is so important is because the quality of medical care could very much be a life or death situation. It is predicted that by 2050 minority groups will become almost half of the US population, creating an ever increasing demand for diversity in the medical system.
Sources:
https://hpi.georgetown.edu/cultural/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571328/
