As our communities in North Carolina become more ethnically and racially diverse, health care systems and individual health care providers will need to develop skills that will allow them to more effectively address their patients varied perspectives, values and behaviors about health and well-being. Failure to understand and manage social and cultural differences may have significant impact on health outcomes for patients that do not share the same ethnic and racial cultural backgrounds of their health care providers.
Culture is defined as a way of life developed and shared by a group of people and passed down through generations. Culture is the result of integrated patterns of human behaviors that include thoughts, communication, actions, customs, beliefs, values and institutions of racial, ethnic, religious or social groups.
In the area of health service delivery several barriers to culturally competent care have been clearly identified and include:
- lack of diversity in health care’s leadership and workforce
- systems of care that are poorly designed to meet the needs of diverse patient populations
- poor communication between providers and patients of different racial, ethnic, or cultural backgrounds
The field of cultural competence has recently emerged as part of a strategy to reduce disparities in access to and quality of health care. Promoting cultural competency among health care professionals may help address barriers that have been created by long-standing distrust of the medical community by racial minorities and cultural stereotyping of minority patients by health care providers. Few would disagree that the first step toward health care providers developing cultural competence is self-awareness and the analysis of one’s own values, goals and stereotypes.
HWTF Solution (program description)
Since this is an emerging field, efforts to define and implement the principles of cultural competency are still ongoing, and a single set of criteria for establishing cultural competence has not been identified. Instead, there are many interpretations and models that can offer a conceptual framework.
In 2006 the Health and Wellness Trust Fund began funding the NC Academy of Family Physicians (NCAFP; www.ncafp.com/home/programs/disparity) to improve physician knowledge and understanding of health disparities and to educate its 2,600 members on how to provide culturally and linguistically appropriate services. The NC Academy of Family Physicians has developed and is implementing a comprehensive education curriculum, of which key portions are delivered at the organization’s winter, spring and annual meetings through keynote presentations and 2-3 hour workshops.
NCAFP is also utilizing the online cultural competency in health care curriculum developed by the National Office of Minority Health and administered through the Carolinas Center for Medical Excellence, and is recruiting primarily care practices and providers to take the 9-hour online curriculum entitled "A Family Physician’s Practical Guide to Culturally Competent Care"(www.thinkculturalhealth.org). NCAFP is also working to develop a 2-hour training module adapted for the 9-hour module currently available. NCAFP is also providing technical assistance to 6 family medicine practices in the Community Care of NC network to help them implement culturally competent practices and develop relationships and collaborate with local organizations that serve and represent minority populations in order to increase health literacy skills.