Cultural Competency in Healthcare Materials

IMPROVING CULTURAL COMPETENCY

IN THE HEALTHCARE SETTING

The following continuing medical education team members were involved in the initial planning, development, and review of this activity:

L. Austin Fredrickson, MD, FACP 

L. Austin Fredrickson is an Associate Professor of Internal Medicine at Northeast Ohio Medical University, where he serves as core faculty and teaches diagnostics, therapeutics, clinical skills, and health humanities. He is board-certified in general internal medicine and practices rural primary care. 

Steven Malen, PharmD, MBA

Steven Malen graduated with a dual degree in Doctor of Pharmacy (PharmD) and Master of Business Administration (MBA) from the University of Rhode Island. Throughout his career, he has worked as a clinical pharmacist across retail, specialty, and compounding sectors. He specialized in and taught topics ranging from vaccines to veterinary compounding.

Kristina (Tia) Neu, RN

Kristina (Tia) Neu is a licensed Registered Nurse and author currently developing in-service training for healthcare professionals. She is a National Board-Certified Health & Wellness and Lifestyle Medicine Coach. Her work experience includes work in several areas of the healthcare profession, including psychiatric nursing, medical nursing, motivational health coaching, chronic case management, dental hygiene, cardiac technician, and surgical technician.

Pamela Sardo, PharmD, BS

Pamela Sardo, PharmD, BS, is a freelance medical writer and licensed pharmacist. She is the founder and principal at Sardo Solutions in Texas. Pam received her BS from the University of Connecticut and her PharmD from the University of Rhode Island. Pam’s career spans many years in retail, clinics, hospitals, long-term care, Veterans Affairs, and managed health care responsibilities across a broad range of therapeutic classes and disease states.

Topic Overview

The United States is regarded as one of the most culturally diverse countries in the world. With diverse cultures also come challenges. This is particularly true for access to healthcare services across different segments of society. Health disparities can arise when explicit or implicit biases and prejudices are present in healthcare. One way to reduce health disparities is to cultivate cultural competence. Cultural competence is a clinician’s ability to recognize that a patient's cultural influences shape the patient’s life and social interactions, and to respond to and acknowledge them. Intersectionality is a framework for understanding how various social identities overlap, creating unique experiences of discrimination, privilege, and systemic inequality rather than simply adding up individual forms of bias.

Accreditation Statements

In support of improving patient care, RxCe.com LLC is jointly accredited by the Accreditation Council^TM for Continuing Medical Education (ACCME^®), the Accreditation Council for Pharmacy Education (ACPE^®), and the American Nurses Credentialing Center (ANCC^®), to provide continuing education for the healthcare team.

Joint Universal Activity Number: The Joint Accreditation Universal Activity Numbers assigned to this activity are as follows:

Pharmacists: JA4008424-0000-26-012-H99-P

Pharmacy Technicians: JA4008424-0000-26-012-H99-T

Credits: 2 contact hour(s) (0.2 CEU(s)) of continuing education credit.

Credit Types:

AAPA Category 1 Credit™️ - 2 Credits

AMA PRA Category 1 Credit™️ - 2 Credits

Pharmacy - 2 Credits

Type of Activity: Knowledge

Media: Computer-Based Training (i.e., online courses)

Estimated time to complete activity: 2 contact hour(s) (0.2 CEU(s)), including Course Test and course evaluation.

Release Date: January 29, 2026 Expiration Date: January 29, 2029

Target Audience: This educational activity is for Physicians, Physician Assistants, Pharmacists, and Pharmacy Technicians

How to Earn Credit: From January 29, 2026, through January 29, 2029, participants must:

Read the “learning objectives” and “author and planning team disclosures;”

Study the section entitled “Educational Activity;” and

Complete the Course Test and Evaluation form. The Course Test will be graded automatically. Following successful completion of the Course Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)

CME Credit: Credit for this course will be uploaded to CPE Monitor^® for pharmacists. Physicians may receive AMA PRA Category 1 Credit™️and use these credits toward Maintenance of Certification (MOC) requirements. Physician Assistants may earn AAPA Category 1 CME credit, reportable through PA Portfolio. All learners shall verify their individual licensing board’s specific requirements and eligibility criteria.

Learning Objectives: Upon completion of this educational activity, participants should be able to:

Define health disparities

Describe what is meant by cultural competency

Review patient characteristics such as race, gender, and sexual orientation, and describe how these groups can experience health disparities.

Review how race, gender, and sexual orientation may overlap and interact, thereby creating privilege, discrimination, or oppression that may not be visible when considered alone.

Identify tools to address discrimination and health disparities in the healthcare setting.

Disclosures

The following individuals were involved in planning, developing, and/or authoring this activity: L. Austin Fredrickson, MD, FACP; Kristina (Tia) Neu, RN; Steven Malen, PharmD, MBA; and Pamela Sardo, PharmD, BS. None of the individuals involved in developing this activity has a conflict of interest or financial relationships related to the subject matter. There are no financial relationships or commercial or financial support relevant to this activity to report or disclose by RxCe.com or any of the individuals involved in the development of this activity. 

© RxCe.com LLC 2026: All rights reserved. No reproduction of all or part of any content herein is allowed without the prior, written permission of RxCe.com LLC.

Educational Activity

Improving Cultural Competency in the Healthcare Setting

Introduction

Cultural competence in the healthcare setting can help reduce discrimination and healthcare disparities. Healthcare clinicians and staff can improve patient outcomes and satisfaction by raising their cultural competency in daily practice. Success in this endeavor requires an understanding of what cultural competency means and its relationship to health disparities. Once these concepts are understood, strategies can be developed to address discrimination and health disparities in healthcare settings and to enhance the cultural competence of healthcare clinicians and staff.

Diversity in the United States

The United States is regarded as one of the most culturally diverse countries in the world.¹ This is borne out by the recent US Census Bureau report that lists White American, Black or African American, Indian and Alaska Native, Asian American, Native Hawaiian, and Other Pacific Islander among the races residing in the US. In addition to racial groups, ethnic groups such as Americans of Hispanic origin contribute to cultural diversity.¹ Many of the world's religions are also represented in the US, and about one-fourth of Americans do not identify with any of them. There are also multiracial segments of the population, people of differing sexual orientations, genders, gender orientations, and socioeconomic statuses.² These ethnic, racial, and other differences form a unique, American character and tapestry that offers so much to the experience of living in the US or visiting.^1,2 Intersectionality has not been limited to the U.S. but has encompassed international travel, with academics, advocates, and policy makers redeploying it in institutional settings that attend to global dimensions of history and power, such as in Europe, where class may take precedence over race, or in the Caribbean, examining conjugal hierarchies shaped by colonial legacies.³

Cultural Diversity and Biases, Stereotypes, and Prejudices

With diverse cultures also come challenges. Language is one of the challenges.¹ English is the predominant language spoken in the United States; however, there are many other languages. Spanish is the second-most-spoken language in the United States.¹ While language diversity is a strength, it can also give rise to potential barriers to communication.

Another challenge arising from diversity is that people from different cultures or lifestyles may develop biases, stereotypes, and prejudices due to a lack of understanding or appreciation of those who are different from them.²

Cultural Diversity and Health Disparity

Health disparities can arise when explicit or implicit biases and prejudices are present in healthcare. Health disparity is defined as “a difference or inequality that occurs in health status or in the provision of and access to health care that is often linked with social, economic, and environmental disadvantage.”⁴ Said another way, with health disparity, a patient’s access to healthcare is linked to the patient’s race, ethnicity, gender, age, socioeconomic status, sexual orientation, disability status, or another characteristic that should not factor into the patient’s care.⁴ This is the opposite of “health equity,” which is present when all members of society have fair access to healthcare without regard to the characteristics enumerated above.⁵

The existence of inequitable disparities in the use or access to healthcare services is well documented and widely acknowledged.^4-6 In 2002, the Institute of Medicine (IOM) released a report that highlighted disparities in the delivery of healthcare services to racial and ethnic minority patients.^5,6 The IOM report found that “[b]ias, stereotyping, prejudice, and clinical uncertainty on the part of healthcare providers may contribute to racial and ethnic disparities in healthcare."⁶ Health disparity is a form of discrimination. Patients can be harmed when health disparities prevent them from accessing healthcare services. Health disparities may negatively impact the assessment, diagnosis, and management of health issues. Treatment recommendations may also be affected by conscious or unconscious bias, stereotyping, or prejudice in the clinical setting.

One way to reduce health disparities is to cultivate cultural competence.² Recent 2025 data show that overall cancer mortality rates remain higher in Black and American Indian/Alaska Native (AIAN) males (by 14% and 13%, respectively) and females (by 10% and 22%, respectively) compared to White individuals, highlighting persistent racial disparities. Additionally, deeply entrenched racial and geographical health disparities have increased over the last two decades, with life expectancy gaps widening and an estimated 150-175 million Americans experiencing health disparities.⁷ It is clear that health disparities negatively impact Blacks, indigenous people, and people of color.

Defining Cultural Competence

Culture may be understood as the human patterns, beliefs, and values shaped by a person’s racial, ethnic, religious, social, or institutional origins or affiliations. It can manifest through language, thoughts, communications, actions, and customs.²

Clinicians should understand that many cultures have distinct patterns, beliefs, and values.⁸ Healthcare clinicians can be more effective in their delivery of healthcare services if they are culturally competent. But what does it mean to be culturally competent?⁸ This question may be more complex than it seems. This is partly because the literature in this area lacks consistent definitions and terminology.⁸ Many terms are used interchangeably, but they can have different meanings, e.g., “cultural awareness, cultural respect, cultural safety, cultural understanding, and culturally appropriate healthcare.”⁸ In addition, cultural differences can be nuanced and complex. There may be variations across cultural and ethnic groups.⁸ This requires flexibility on the part of healthcare clinicians to be open to adapting to these variations.

Any definition provided here is a starting point, not the end of the issue. One definition of cultural competence is a clinician’s ability to recognize that a patient's cultural influences shape the patient’s life and social interactions, and to respond to and acknowledge them. When a clinician is in contact with a person, they should be open and respectful. This can foster trust in the clinician-patient relationship, leading to positive patient outcomes.² In healthcare, cultural competence means that a provider delivers effective healthcare across diverse cultures.⁹ This requires effective communication skills, and it may involve collaboration with a multidisciplinary team for broader input. Clinicians who are aware of a patient’s cultural background are more likely to achieve mutual understanding in clinician-patient encounters and to consider healthcare interventions appropriate to the patient’s culture.⁹

Groups that Experience Health Disparity

Patients should have access to healthcare, and they should not receive different care because of a personal characteristic irrelevant to their care. Patient populations have been denied equal access to healthcare based on ethnicity, race, HIV/AIDS and infectious disease status, language (limited English proficiency (LEP)), gender, sexual preference, gender identity, disabled status, socioeconomic status, and educational levels. All of these population groups are extremely important, but only a few can be covered here. The following examples illustrate how discrimination and health disparities are connected and why cultural competence is essential to reduce them.

Race and Ethnicity

Race and ethnicity are often grouped together. This is because these terms overlap in culture, values, and beliefs.^10,11 Some scholars argue that society needs to move beyond certain concepts of race and ethnicity and examine instead how these terms relate to socio-political processes, social class, gender, and social relationships.¹⁰ This discussion is beyond the scope of this course. Still, it highlights the complexity that may arise when a healthcare clinician explores culture, race, and ethnicity in the healthcare setting.

The key question here is how a lack of cultural competency affects patient outcomes. This is sometimes observed when a particular racial or ethnic group has a higher incidence of a specific disease. This may be an important factor to consider when diagnosing and treating a patient, but as Moskowitz, et al. (2012) suggest, these stereotypes may lead to unconscious diagnoses that unduly influence treatment plans.¹² For example, a physician or pharmacist as a member of a medication management team may read that hypertension is widely reported as being more prevalent among African Americans and Native Americans than among White Americans.¹² A male African American patient has been prescribed hypertension medications. These medications may be appropriate, but the clinician could conduct a deeper review of the patient’s hypertension medications to ensure they are not being prescribed as a matter of course based on the patient’s race or gender, and that a more thorough consultation or review was conducted.

This unconscious bias, described by Moskowitz, et al., is generally known as implicit bias.¹² Implicit bias involves biases and stereotypes that clinicians are unaware they have; however, these biases and stereotypes unconsciously direct their conduct and decision-making in clinical settings.¹²

HIV/AIDS and Infectious Disease Status

Studies consistently show that patients with HIV/AIDS and other infectious diseases (e.g., viral hepatitis, sexually transmitted diseases, tuberculosis) experience unequal access to care, and consequently, they have poorer health outcomes.¹³ This overlaps with other population groups since race, ethnicity, and gender may also influence health disparities.¹³ For example, compared with non-minorities, women and African Americans receiving treatment for HIV are less likely to receive antiretroviral therapy, protease inhibitors, and prophylaxis for pneumocystis pneumonia.¹³ These disparities have been reflected in AIDS mortality data for some time.¹³

Language: Limited English Proficiency (LEP)

As mentioned above, English is the primary language spoken and used in the US. Patients with limited English proficiency often have reduced access to healthcare.¹⁴ Nguyen, et al. (2022) reported how LEP created a barrier to proper postoperative care, including prescription medication refills.¹⁴ This is where a clinician may be culturally aware that a patient with LEP may need follow-up to ensure the patient understands the prescription instructions.

The U.S. Department of Health and Human Services (HHS) recognizes the intersection of culture and language (literacy).¹⁵ Health literacy measures a patient's ability to understand medical literature and communications from healthcare providers. As a consequence, the HHS has developed the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care. The standard states that “health care organizations must make available easily understood patient-related materials … in the languages of commonly encountered groups …”¹⁵ This means that material must meet the literacy levels of patients.

The National Standard not only requires that materials be culturally responsive but also tailored to patients' literacy levels. ^14,15 Culture and language are interrelated. Culture shapes attitudes and beliefs, and can influence a person’s health literacy.¹⁴

Health literacy remains a problem and will only become more pronounced as LEP populations grow.¹⁶ This provides an opportunity for clinicians to provide understandable materials when it comes to dispensing medications and providing refills.

LGBTQ+ and Gender Identity

Patients in the LGBTQ+ community confront bias and discrimination that contribute to healthcare disparities.¹⁷ In addition, providers may lack knowledge about LGBTQ+ individuals and may even convey personal discomfort to the patient.¹⁵ The same is true of transgender patients.¹⁸ Healthcare clinicians are not immune to these biases and prejudices.^17,18 At the same time, healthcare clinicians are uniquely positioned to reduce health disparities in these populations and engage in cultural competence.

The Impact of Intersectionality in Social Categories

Intersectionality, a term coined by Kimberlé Crenshaw, has become a powerful analytical tool that illuminates how various social categories such as race, gender, and class intersect and overlap, culminating in a complex system of privileges and oppressions.^3,19 When multiple marginalized social categories overlap, such as race, gender, disability, or class, individuals often experience compounded and qualitatively different forms of discrimination, not just more of the same.

For example:

A Black woman may face discrimination that cannot be fully understood by examining racism or sexism separately; the intersection of both creates distinct barriers in areas like employment, healthcare, and legal systems.

A Black disabled individual may encounter racism, ableism, and the ways those systems reinforce one another, such as reduced access to disability services due to racial bias or increased surveillance and mistreatment in public spaces.

Intersectionality emphasizes that social identities operate simultaneously, shaping lived experiences in ways that single-category analyses often overlook.¹⁹ Recognizing this helps institutions and policymakers better address inequities by accounting for how power systems interact, rather than treating forms of discrimination in isolation.

In her 1989 landmark essay, “Demarginalizing the Intersection of Race and Sex,” Kimberlé Crenshaw examines how the law has historically defined the contours of sex and race discrimination through prototypical representatives: white women in sex discrimination cases and African American men in race discrimination cases.¹⁹ As a result, Black women’s experiences are rendered invisible within both legal frameworks. Since the publication of “Demarginalizing” and later “Mapping the Margins,” scholars and activists have expanded the concept of intersectionality to address a wide range of social identities, power relations, legal and political systems, and discursive structures, both within the United States and globally.¹⁹

It is a prism for understanding how different aspects of a person’s identity can influence their experiences, including the expression and perception of sexual identity.¹⁹ This concept prompts a profound evaluation of how one’s sexual identity is not solely a manifestation of individual preferences or orientations but is profoundly impacted by the multifaceted network of intersecting social identities and affiliations.¹⁹

Firstly, cultural and racial backgrounds play a pivotal role in the formation and expression of sexual identity. Different cultures have unique norms, beliefs, and expectations regarding sexuality and gender. For some, there may be a pronounced stigma associated with being anything other than heterosexual, which can impede the exploration or expression of one’s sexual identity. In contrast, some cultures may be more inclusive, allowing for a more fluid and open expression of sexual identities.

Socio-economic status is also integral in intersectionality, determining access to resources, education, and spaces that can affirm or challenge one’s sexual identity. Economic privilege might afford someone access to safe spaces, mental health resources, and supportive communities, enabling them to navigate their sexual identity amidst a conducive environment. Conversely, economic hardship might limit access to such resources, exacerbating the difficulties associated with exploring and affirming one’s sexual identity.

Gender also significantly intersects with sexual identity. The societal expectations and stereotypes associated with masculinity and femininity can shape how one experiences their sexuality. For example, the societal trope of masculinity often comes loaded with expectations of heterosexuality, potentially making it challenging for men to express non-heterosexual identities openly.

Additionally, the legal and political environment of one’s location also shapes experiences of sexual identity. Laws and policies can either affirm or negate certain sexual identities, impacting societal attitudes and individual experiences. Progressive laws that protect LGBTQ+ rights, for instance, may foster environments where people feel safer exploring and expressing their sexual identities.

Therefore, intersectionality is a vital lens for understanding the complexities of sexual identity. By considering how various social identities and systems intersect, one gains a deeper understanding of the multifaceted influences shaping individuals’ experiences and expressions of their sexual identity. Thus, intersectionality facilitates a nuanced conversation that goes beyond singular identities, fostering a richer dialogue that captures the diversity of human experiences in the realm of sexual identity.

Assessing Cultural Competence

The first step in any effort to improve cultural competence is recognizing that healthcare professionals must address health disparities. The US Substance Abuse and Mental Health Services Administration provides free resources to assess cultural competency. It provides “counselor self-assessment tools, guidelines and assessment tools to implement and evaluate culturally responsive services within treatment programs and organizations, and forms addressing client satisfaction with and feedback about culturally responsive services.”²⁰ These tools are in the public domain, and they provide a good departure point for assessing cultural competency.²⁰ Other tools used for assessing students include the Clinical Cultural Competency Questionnaire.²¹

Practical self-assessment tools include resources from the Substance Abuse and Mental Health Services Administration (SAMHSA), such as counselor self-assessment tools and guidelines for evaluating culturally responsive services. Healthcare clinicians can use these to conduct ongoing self-reflection, identify implicit biases, and implement changes in practice to enhance patient interactions.²²

Barriers to Health Equity and How to Overcome Them

Barriers to effective healthcare delivery arise from poor clinician-patient communication. Healthcare clinicians and staff can leverage cultural humility in the clinician-patient relationship to improve communication. Healthcare clinicians and staff must clinically accommodate patient preferences and needs, which may require modifying practice processes and styles, as well as facility designs and decor.

Communicating with Patients

Language differences are the primary hindrance to healthcare clinicians and staff providing effective patient care. This will only become more pronounced as patient populations become more ethnically diverse.²³ Good communication skills when communicating with LEP patients are essential.²³ This should not be surprising, since effective communication with patients is not only needed to promote cultural competence but is also generally necessary for positive patient interactions and satisfaction.²⁴

Cultural Humility

Good communication skills are important, but what can a healthcare clinician do to improve them? One approach is to incorporate cultural humility into the clinician-patient relationship.⁵ Cultural humility describes a relationship with a patient that honors the patient’s beliefs, customs, and values.⁵ Healthcare clinicians may need to engage in regular self-reflection, combined with a willingness to learn from the patient.⁵ Cultural humility is not the same as cultural competence. Cultural humility “de-emphasizes cultural knowledge and competency and places greater emphasis on lifelong nurturing of self-evaluation and critique, promotion of interpersonal sensitivity and openness, addressing power imbalances, and advancement of an appreciation of intracultural variation and individuality to avoid stereotyping. Cultural humility encourages an interpersonal stance that is curious and other-oriented.”⁵ The wording here is important: Cultural humility “de-emphasizes cultural knowledge and competency,” but it does not eliminate them.⁵ It promotes cultural competence from a different focal point.

Accommodate Patient Needs and Preferences

Healthcare clinicians and staff must clinically accommodate patient preferences and needs.²⁵ This will invariably require modifying practice processes and styles.²⁵ This could involve using interpreters, the use of pictures, images, or computer-based information.^5,26 Healthcare clinicians and staff may need to develop processes to gather cultural information relevant to the patient’s care.²⁷ An example given by Misra-Hebert, et al. (2012) was a patient who believed his illness was caused by a “hex” his wife had placed on him.²⁶ This information could be extremely relevant since a patient who believes an illness was caused by a hex may believe that adherence to a treatment plan is futile. Engaging this patient respectfully could be the difference between the patient following the treatment plan and not.

A clinic or pharmacy could offer culturally specific treats or display cultural artwork and decor that reflect the diversity of its patient population, creating a welcoming, inclusive environment. This could rotate periodically.

Healthcare clinicians and staff must respect patients' modesty and consider cultural differences in communication styles. Shaking hands could be offensive to certain people. It is good practice to let the patient or coworker lead with communication styles and interactions.

Inclusive language that considers all gender identities should be used. A clinician should use the pronoun "they" instead of "he" or "she," and avoid making assumptions about a person's gender based on their appearance.²⁸ One example is a physician or pharmacist referring to someone using a pronoun that assumes they are a particular gender without verifying their gender. First names can be gender-neutral, and names that are foreign to English or a clinician’s culture could be vague when it comes to gender. That is why it is better to play it safe and not assume gender. A transgender patient may also become offended if their gender is misstated. Let the patient lead regarding pronoun usage.

Patients may have financial needs. A clinic or pharmacy should provide them with information on available financial assistance, including public insurance options such as Medicaid and the Children's Health Insurance Program (CHIP). Studies have found that financial assistance improves adherence by reducing the financial burden on patients.²⁹

Patients with disabilities may require additional services and resources. A clinic or pharmacy can make information available in a variety of formats, such as large print, braille, and audio, to accommodate people with vision or hearing impairments. Provide training for all staff on disability sensitivity and on providing appropriate care and support to patients with disabilities. Involve people with disabilities in the facility's design and planning to ensure it meets their needs and is welcoming to all.³⁰

Core Competencies for Healthcare Clinicians

Cultural awareness is the ability to recognize and understand how cultural differences affect communication and interactions with others. Healthcare staff need a basic understanding of cultural awareness to provide culturally competent care to patients from diverse backgrounds.

Core competencies that Healthcare clinicians and staff should consider when it comes to cultural awareness:

Recognize the impact of culture on health beliefs, behaviors, and communication: Healthcare staff should be aware that cultural differences can influence how patients perceive and approach their health and healthcare. To care for patients, we need to understand where they are coming from. Motivational interviewing is a patient-centered approach that helps individuals identify their own reasons for change, resolve ambivalence, and take an active role in improving their health. Understanding the patient's culture is an important factor in motivating patients to take control of their health. It is also important to note that cultures are not monolithic, so there can be significant variation within each ethnic community.^31,32

Understand and respect cultural differences: Healthcare staff should recognize patients' cultural backgrounds and avoid assumptions or stereotypes. This statement may seem contradictory, but it is not. There are differences across cultures; however, not everyone within each culture is identical. People may act out of cultural norms, but that does not mean everyone in that culture does the same thing. However, we must respect the general variation in patients' behaviors across cultures. Of course, this has limits if the behavior is offensive or rude. If clinical staff are offended or feel threatened by patients or other staff, this must be reported to management for review.

Communicate effectively with patients from diverse cultural backgrounds: Healthcare staff should be aware of potential communication barriers arising from cultural differences and take steps to overcome them. These barriers may be language-related; however, they may also stem from a lack of trust in healthcare. Some people come from countries where there is mistrust in healthcare, so they bring that mistrust with them. Healthcare clinicians and staff may have to work harder to create trust. As mentioned above, a clinician may use cultural humility to engender trust.

Seek out cultural competency training: Healthcare staff should be willing to seek out training and resources to improve their cultural competency and understand the unique needs of their patients.³³

Promote a culturally inclusive environment: Healthcare staff should work to foster a welcoming, inclusive environment for patients from diverse cultural backgrounds. This can involve ensuring informational materials are available in multiple languages, providing interpreters as needed, and being sensitive to cultural differences in body language and communication styles. Instead of “talking the talk” with cultural inclusion, you should “walk the walk.” Language barriers can impact health in significant ways, so setting up systems in the healthcare setting that allow communication with patients who speak different languages is reasonable, and these technologies are available and are not that expensive.³⁴

Address implicit bias: Have an awareness of the role implicit bias can play in communication, clinical judgments, and decision-making. Mitigate implicit bias in the clinical setting.³⁵

Cultural competency is a virtue that should be constantly sought by every person and organization. Everyone has implicit biases that affect how they communicate or interpret communication. This means that patients and coworkers will also have implicit biases that can contribute to miscommunication. In healthcare, miscommunication can be the difference between a patient adhering to a treatment plan and trusting their healthcare provider. Healthcare clinicians and staff have a unique opportunity to communicate with patients as they fill or refill prescriptions and help patients with over-the-counter products.

Summary

The United States is regarded as one of the most culturally diverse countries in the world. With diverse cultures also come challenges. Language is one of the challenges. Health disparities can arise from cultural diversity and from explicit or implicit biases and prejudices in healthcare. Health disparities are defined as differences or inequalities in the delivery or access to healthcare. It is often linked to social, economic, and environmental disadvantages.

Health disparities can harm patients when they are prevented from accessing healthcare services. Health disparities may negatively impact the assessment, diagnosis, and management of health issues. Treatment recommendations may also be affected by conscious or unconscious bias, stereotyping, or prejudice in the clinical setting.

Patient populations have been denied equal access to healthcare based on ethnicity, race, HIV/AIDS and infectious disease status, language (limited English proficiency (LEP)), gender, sexual preference, gender identity, disabled status, socioeconomic status, and educational levels.

Cultural barriers to effective healthcare delivery often arise from poor clinician-patient communication. Healthcare clinicians and staff can leverage cultural humility in the clinician-patient relationship to improve communication. Healthcare clinicians and staff must clinically accommodate patient preferences and needs, which may require modifying practice processes and styles, as well as facility designs and decor.

Cultural competency can mitigate health disparities. Cultural competence is the ability to recognize that a patient's cultural influences shape their life and social interactions. When a clinician is in contact with the person, the clinician can be open and respectful. This fosters trust in the clinician-patient relationship, leading to respectful exchanges and improved patient outcomes.

Course Test

The existence of inequitable disparities in the use or access to healthcare services

has limited evidentiary support.

is well documented and widely acknowledged.

leads to systemic health equality

is found in specific healthcare services and is not systemic.

Intersectionality highlights how race, gender, and sexuality interact, leading to

compounded and qualitatively different forms of discrimination.

class intersection.

cultural competence.

non-discrimination.

________________ is a clinician’s ability to recognize that a patient has cultural influences that shape the patient’s life and social interactions, followed by the clinician’s ability to respond to these influences and acknowledge them.

Health equity

Implicit bias

Cultural competence

Health disparity

The Institute of Medicine report found that bias, stereotyping, prejudice, and clinical uncertainty on the part of healthcare providers

may contribute to racial and ethnic disparities in healthcare.

was due to explicit racism by all clinicians.

made them unqualified to provide healthcare services.

did not lead to health disparities for minority populations.

Barriers to effective healthcare delivery arise from

explicit bias only, not unconscious bias.

a self-assessment for implicit bias.

poor clinician-patient communication.

health literacy guidelines.

___________________ measures whether a patient is able to understand medical literature and communications from the healthcare provider.

Health uncertainty

Health literacy

Implicit bias

Cultural safety

Cultural humility describes a relationship with a patient that

honors the patient’s beliefs.

honors the patient’s customs and values.

addresses power imbalances,

All of the above

In healthcare, cultural competence means that a provider delivers healthcare services

to one specific ethnic group.

effectively across diverse cultures.

after a self-assessment for implicit bias.

as part of a multidisciplinary health team.

The National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care require that health literature and materials

be provided only in English.

meet the literacy levels of patients.

be culturally neutral.

shape and change the patient’s cultural attitudes and beliefs.

Unconscious bias is generally known as

explicit bias.

cultural competence.

implicit bias.

health literacy.

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