Culturally competent health care can improve health outcomes and patient satisfaction

This is the fourth article in a series on health and health care disparities in Michigan. We’re looking at the various aspects of disparities and what Blue Cross Blue Shield of Michigan and its participating health care providers are doing to reduce or eliminate them.

The increasing diversity of the country underscores the need for health care providers, health care systems and policymakers to create and deliver culturally competent services.

According to the National Institutes of Health, 4 out of 10 Americans* will belong to a racial or ethnic minority group by 2030. This is especially important to keep in mind since racial and ethnic minorities have higher rates of morbidity and mortality from chronic diseases.

Yet, despite the increase in diversity in this country overall, the medical field has been predominantly white. A recent survey by the Association of American Medical Colleges found 56.2% of active physicians identified as white, 17.1% identified as Asian, 5.8% identified as Hispanic and 5% identified as Black or African American.

This relative lack of diverse representation in the medical field can play a key role in contributing to health care disparities. As we wrote in a previous article in this series, sometimes the assumptions and stereotypes on which we unconsciously rely — what we call unconscious or implicit bias — not only can influence the decisions and actions of health care providers but can affect the quality of care delivered.

Cultural competency defined

Cultural competency is the ability of providers and organizations to effectively deliver health care services that meet the social, cultural and linguistic needs of patients.

A culturally competent health care system can help improve health outcomes and quality of care, and contribute to a reduction in racial and ethnic health disparities and an improvement in overall health, according to an article* published by Georgetown University’s McCourt School of Public Policy.

The article stated that if providers, organizations and systems aren’t working together to provide culturally competent care, patients are at higher risk of having negative health consequences, receiving poor quality care or being dissatisfied with their care. For example:

• African Americans and other ethnic communities report less partnership with physicians, less participation in medical decisions and lower levels of satisfaction with care.
• The quality of patient-physician interactions is lower among non-white patients, particularly Latinos and Asian Americans.
• Lower quality patient-physician interactions are associated with lower overall satisfaction with health care.

Additionally, one in five Americans* say communication with physicians is a problem in receiving health care — a figure that increases to 27% among Asian Americans and 33% among Latinos. Research has shown that when there are language barriers between providers and patients, providers often compensate by ordering additional diagnostic tests. This can result in higher costs for the patient and health care system.

A lack of cultural competency can also have the following effects on patients:

• Lower patient satisfaction with care
• Poor comprehension and adherence to treatment plans
• Lower quality of care
• More interactions with the health care system
• Negative health consequences
• Less partnership with physicians in medical decisions

How to improve cultural competency

Acknowledging the need to address cultural competency among health care providers is a good first step, according to a blog on MI Blues Perspectives. Here are some other strategies to consider:

• Consult with traditional, culturally appropriate leaders as needed.
• Coordinate your efforts with community health workers.
• Ensure that services and materials — including medical billing, appointment bookings, flyers and registration forms — are available in more than one language.
• Offer interpreter services.
• Expand hours of operation.
• Include family and community members in health care decision-making.
• Offer clinic locations in areas accessible for the population you’re trying to reach
• Provide staff training to increase cultural awareness, knowledge and skills. (See article in the May – June issue of this newsletter for information on available training modules.)
• Seek out a diverse staff that’s representative of different cultures, communities and backgrounds.

The bottom line
A health care system that is culturally competent can help eliminate racial and ethnic health disparities and improve health outcomes and quality of care for all.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.