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KEY CONCEPTS

KEY CONCEPTS

  • image Healthcare providers should strive toward cultural competency to improve care and access unique resources for patients and communities from diverse cultures and backgrounds.

  • image Changes in demographics in the United States, health disparities, and patient safety are among the reasons that cultural competency should be emphasized in healthcare.

  • image A variety of models recognize cultural competency as a process, not an achievement.

  • image Legal and regulatory issues surrounding cultural competency include understanding and interpreting accreditation standards for healthcare organizations and Title VI of the Civil Rights Act.

  • image Patients may enter the healthcare setting with a different explanation of their illnesses than found in the Western biomedical model (WBM).

  • image Cultural values and beliefs influence decisions and attitudes about healthcare, including race, ethnicity, age, gender, sexual orientation, and religious beliefs.

  • image Developing communication skills to interact with diverse population involves recognizing personal styles and cultural values of communication as well as barriers to patient understanding.

  • image Linguistic competency encompasses understanding the capacity of organizations and providers to communicate well with diverse populations such as patients with limited English proficiency (LEP), low literacy, or hearing impairments.

  • image Before practitioners can understand other cultures, they should understand personal and organizational values and beliefs.

  • image Skills for working with patients from diverse cultures include being able to listen to the patient’s perception of health, acknowledging differences, being respectful, and negotiating treatment options.

CULTURE, COMMUNITY, AND SOCIAL DETERMINANTS OF HEALTH

Culture defines us.1 Although our genetic makeup, which is largely nonmodifiable and affects our physical state of being, social determinants of health are also of great influence. Determinants of health describe the factors that affect the health of individuals. At the core of each person are their inherited traits as well as the choices that they make about their lifestyles (eg, diet, exercise, leisure activities). Their health is further marked by their exposure to healthy or risky behaviors based on the places where they live, work, worship, or go during the day and their built environment (eg, sidewalks, exposure to clean air, policies for healthy choices).2 Basically, our socioeconomic status, race and ethnicity, gender, age, and communities (environments), as part of our cultures, shape us.3

Consider the following brief descriptions of three individuals and the determinants of health that influence them. Patient 1 is a 42-year-old bilingual Vietnamese American, Buddhist woman living on the West Coast whose family immigrated to the United States 35 years ago. Her lifestyle choices include a vegetarian diet, gardening, and daily meditation. She lives in a suburban community with her husband and three children, drives a hybrid electric/gas car to her work as a school teacher, and purchases food from a local farmer’s market. She has health insurance and her city public policy includes no indoor smoking in public places and state policies include special low-emission requirements on vehicles. Weekend activities with the family include sports and dance for the kids along ...

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