Defining Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health Care

TLDR

Racial/ethnic health disparities in the U.S. are well documented, and the concept of cultural competence has emerged as a strategy to address them. The authors aim to define cultural competence, identify its key components, and propose a practical framework to reduce racial/ethnic disparities in health care. They conducted a literature review of academic, foundation, and government sources to identify sociocultural barriers at organizational, structural, and clinical levels.

Abstract

Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care.The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers.Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care.Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.