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  • 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 strive to 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.


Preclass Engaged Learning Activity

Select any one of the patients from diverse backgrounds introduced at the beginning of the chapter. What are the factors that influence their health that are based on genetics? Individual and family choices? Community influences? Larger city and policy structures? Based on the information provided, what social identity and acculturation characteristics are involved? Look up information about healthcare beliefs and values based on how the patient self-identifies with religion and race or ethnicity. If approached by one of the patients, providers may argue that “we can’t solve everything in healthcare. I only have so much time during a visit.” How might you respond to those statements? What changes can be made at a provider level, clinic/hospital level, and at a larger system-wide level to improve care across cultures?


Culture defines us.1 Although our genetic makeup, that 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, ...

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