Blog Post
Is Cultural Competence Training a Solution to Structural Racism in Health Care?

Is Cultural Competence Training a Solution to Structural Racism in Health Care?

Date: 
April 21, 2021

By Sunita Mutha, MD, FACP

One of my passions in my work here at Healthforce Center at UCSF is advancing culturally competent care for all patients. Having served on multiple panels and boards, including the Joint Commission’s Expert Advisory Panel to develop standards for culturally competent care, I believe this is one central solution to dismantling structural racism and achieving health equity.

To unpack this, we need to first acknowledge there are disparities and inequities in health. This recognition has been a long time coming, and now we have measured it in probably every way possible, we have clear proof. Given that concordance (in language, culture, etc.) between clinicians and patients can affect disparities, one solution is to increase the diversity of clinicians to better reflect the communities they serve.

Because we cannot achieve workforce diversity quickly enough, we will still have clinicians and patients coming together from different backgrounds for many years to come. Therefore we must train clinicians in how to meet patients' needs, whether it’s that they speak a language other than English, have a cultural belief that shapes how they understand care, or how they interact with healthcare settings.

Two points about the vaccine rollout speak to the challenges of bridging such gaps. First is the vaccine hesitancy that we’ve been seeing; in different communities this arises for different reasons. Hesitancy might develop from a variety, and even a combination, of doubts: contradictory information, past negative experiences with the health system, or questioning the science. Acknowledging people’s hesitancy is the first step in addressing their doubts.

The second concern with the rollout is access. We want to get the vaccine out quickly and efficiently, so one common strategy has been providing online access to appointments. But who does that leave out? It leaves out people who don’t have online access, who might be non-English speakers, who might be elderly or isolated. Upon reflection, it’s easy to predict who gets left out by this strategy. Ideally, this touchstone question would be integrated in all of our work at all times: “Who does this strategy advantage and who does it disadvantage?” Efficiency cannot always be the main driver of health care processes, particularly when it comes at a cost to equitable care. 

Recently I sat down to talk with Van Ton-Quinlivan, CEO of Futuro Health, for their podcast about the future of the health care workforce and education. We chatted at length about workforce diversity, the importance of one’s lived experience, and how training for cultural competence can help all clinicians bridge the gaps that they will inevitably encounter. I believe everyone can and should be trained, and that the positive results can be measured in the health outcomes of our patients. I invite you to listen to the discussion, which includes a number of real-world examples and approaches. 

Listen now to WorkforceRx episode 15, “Bridging Cultural Gaps to Provide Better Care."

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Healthforce Center at UCSF is available for consulting and training on cultural competence for clinicians. Please inquire for more information.

About Sunita

Sunita Mutha, MD, FACP, is the director of Healthforce Center at UCSF. For over a decade, she has been engaged in transformational leadership in health care with a special focus on emerging leaders and inter-professional training.