Cultural, racial, and income-level disparities in healthcare treatments are as evident as they are in any industry, and with healthcare literally being what keeps our well-being maximized, understanding what causes these disparities is the first step in ensuring the patient care gap starts to close. It is not an easy fix, and is a long, uphill climb rooted in lifetimes of inequality and societal differences, but an increase in cultural awareness allows for better understanding of the issues, and ultimately a more concrete path to providing equal, quality care for all patients, no matter their locale, income, or cultural demographics.
In addition to the locales and demographics mentioned above, cultural diversity also plays a part in what treatments are the most successful for a given group of people, as well as what medications and procedures may not be allowed due to religious beliefs. As defined by the NIH, “the concept of cultural respect… enables providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients.”
Cultural diversity issues touch on all parts of the healthcare spectrum. When it comes to staffing, a lack in a diverse staff can cause patients from varying cultural backgrounds to feel less comfortable. With that, hiring a diverse staff is step one in cultivating an inclusive culture at a given site of care.
When it comes to care itself, cultural competence varies widely from caregiver to caregiver. A nurse or doctor who understands and welcomes patients from diverse backgrounds, and even those from other countries who do not have an understanding of the complex U.S. healthcare system is a nurse or doctor with high cultural competence. In simple terms, everyone is different, but competence ensures those differences are taken into account when it comes to treatment, and unfortunately that is still an area of disconnect for some care providers.
Closing the Gap
Training on the issues that come with possessing a poor understanding of cultural diversity in healthcare and cultural competence in treatment decisions is the obvious first step in educating workforces, but educating on the larger issues of unintentional systemic racism and implicit bias are taking it an important step further.
After training on the “why,” some actions that can be taken to increase cultural awareness, and ultimately patient comfort, include staffing at least one individual per shift who can speak every language that a hospital’s reach may speak. Determining alternatives (and stocking them when they are drug-related) for members of any and all religious groups, and having those alternatives written down for everyone to use when appropriate, improves cultural diversity and the speed and accuracy of care.
On an even larger scale, improvements in legislature and regulations to ensure low-income areas, which are often very culturally diverse, receive the financial aid they need to be able to institute the appropriate trainings, hire the appropriate staff, and stock the appropriate alternative care items.
The Affordable Care Act, which is now a decade old, helped many Americans get insured, and ultimately able to get simple healthcare they could not have previously received. Additions to the Act have also involved requiring healthcare professionals, in most instances, to prepare for the chances the ACA would bring, and this meant preparation for new groups of patients. With a more culturally aware staff, this measure was very easy to meet.
Early and constant education is the only way to continue closing the gaps that exist between healthcare quality and availability, and the median income of a given hospital’s reach. Colleges are starting to offer courses in cultural competence and awareness, and continued education in the workplace, including new material, as cultural awareness changes and evolves just like healthcare practices and procedures.