Today, people of color comprise more than one third of the U.S. population. By the year 2050, various ethnic groups and persons of color in the U.S. will total just over half (51.1 percent) of the population according to U.S. Census Bureau projections. Close to 90 percent of our total population growth will have come from high birth rates of persons of color and historic levels of immigration.
The census projection emphasizes what many have already realized: providing healthcare services to people who act, talk, relate, dress and eat different from what we have often considered the “mainstream” will become far more commonplace. Continued immigration into the U.S., along with increases in the population of various cultural groups, means that more patients with different cultural customs, beliefs and practices will enter into the healthcare delivery system. This brings with it a unique and complex set of challenges for providers.
While healthcare is a universal concept that exists in every cultural group, cultures vary in the ways they perceive health and illness and how care is given. Culture is predominant force in shaping an individual’s health and response to illness. For this reason, hospitals must not only provide excellent patient care, they must also be proficient in “cultural competency,” the understanding of different cultures, customs, and values.
Some hospital leaders understand the importance of being culturally competent and have responded by hiring more multilingual staff and interpreters, and providing diversity training to help staff members understand their patients’ different backgrounds. Some changes are even required by various regulatory and accrediting organizations including The Joint Commission and the U.S. Department of Health and Human Services Office of Minority Health, Culturally and Linguistically Appropriate Services (CLAS) standards. These are important steps. Yet, they are only the beginning of preparing for the reality of a multicultural and multilingual patient population and workforce.
In healthcare, the benefits can be much more significant, since in the industry, the business case accounts for more than return on investment. It translates to the “top line” of optimal patient care and the “bottom line” of business growth and sustainability. Healthcare organizations can potentially see the following in addressing diversity and cultural competency in their organizations:
- Better patient care
In healthcare, the bottom line is providing excellent care to patients. Although cost has to be considered, people are No. 1. Many reports have indicated that ethnic minority providers generally care for more minority patients than their non-minority counterparts. Also, ethnic minority patients are more likely to be compliant and comfortable with a provider who can speak their language and/or understands their culture.
- Reducing health disparities
Racial and ethnic minorities have higher rates of poor health outcomes than whites in the case of most diseases, even when controlling for various factors such as income, employment status, and insurance coverage. Cultural bias is one contributor to this, according to numerous studies. A diverse and culturally competent workforce can help reduce health disparities.
- Recruit and retain diverse professional talent
- Improve market share
Patients of color are the fastest growing population of healthcare consumers. Communities that include particular cultural groups tend to patronize and be most loyal to service providers that represent them, that understand and respond to them and appreciate their differences. As the population becomes more diverse, the providers that meet the needs of those diverse patients will become their providers of choice.
- Lower healthcare costs
Disease management has been implemented as part of many patient care plans to improve care and reduce costs. Diversity and cultural competence programs can reduce cost through communication with patients regarding their risks and increasing prevention and self-care. While this is the case for providers and employers, it is also such for all taxpayers and those paying insurance premiums. If usage increases for an employer as a result of untreated chronic conditions, the overall pool of payers pays more.
- Avoid legal issues
Failure to understand differences of culture or custom may lead to lawsuits. While this may or may not be warranted, the opportunities for a lawsuit increase with even the perception that care is not provided equally.
- Compliance with accrediting bodies
The HHS Office of Minority Health has implemented standards for culturally and linguistically appropriate services. The Joint Commission continues to explore ways to incorporate cultural and linguistic competence. While The Joint Commission evaluation is not meant to find fault, incorporating standards into the recommendations serve as a great opportunity for organizations to improve their cultural proficiency and, simultaneously, meet their business obligations.
- Expand the future work force pipeline
With the current work force shortage, the need for more people to choose the health professions (particularly nursing, allied health, and STEM fields) is overwhelming. Encouraging and promoting diversity sends a message to ethnic minority students in your community that the health professions are a place where they can make a difference, particularly by seeing professionals they can emulate.
- Good business sense
I’ve mentioned that understanding different patients’ cultures can have a positive impact on a hospital’s bottom line. Additionally, successful hospitals understand the need for a highly skilled and diverse workforce. Since the overall work force is also consistently diversifying and healthcare costs are skyrocketing, large employers will increasingly scrutinize their health plans and providers to ensure they have the caretakers and services that meet the needs of their employee population. Health plans also will want to make sure their hospital providers reflect their communities. The process is good for all involved, particularly the patient.
Many hospitals and healthcare providing organizations have already begun their journey toward understanding and integrating the importance of cultural competency – from both a business and patient-centered care and satisfaction standpoint. They have employed diversity coordinators, seek diversity training for executive and patient-care employees and are hiring more interpreters. Those hospitals that prepare for cultural diversity now are better equipped to provide excellent care and service. Employers will choose them as their provider. Insurers will enlist. And the community will support them. The healthcare providers who don’t respond to this growing need will be left behind.
Where are you
along the cultural competency continuum in your organization? Let us know at