Bridging the Gap: The Role of Cultural Competence in Enhancing Healthcare for Minority Populations with a Focus on Women’s Health
Abstract
The growing variety of populations, driven by migration and globalization, creates difficulties in healthcare, especially for minority groups and women. Inequities in healthcare access, quality, and outcomes continue, frequently worsened by linguistic obstacles, cultural variances, and systemic injustices. Minority women, especially, encounter increased dangers in fields like reproductive health and chronic illnesses because of these differences. Cultural competence in healthcare is now seen as an essential framework to address these disparities. Cultural competence goes beyond just recognizing cultural differences to include actively incorporating cultural and linguistic factors into healthcare delivery when interacting with people from various backgrounds. This paper examines how cultural competence impacts healthcare disparities in women's health by studying the negative impacts of language barriers, current solutions, and challenges like the expense of interpreter services and limitations of technology. Additionally, it underscores the significance of enhancing cultural competence through training, policy interventions, and infrastructure investment. In the end, the article promotes the creation of a healthcare system that is culturally competent to decrease health disparities, enhance communication between patients and providers, and guarantee fair treatment for minority women.
References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of Language Barriers for Healthcare: A Systematic Review. Oman medical journal, 35(2), e122. https://doi.org/10.5001/omj.2020.40
Beilfuss, A., Zablock, K., Lowenstein, J., Goodsell, A., Rodriguez, J., & Varejão, I. (2023). The Importance of Interpreters in the Medical System. University of Michigan Undergraduate Research Journal, 16(0). https://doi.org/10.3998/umurj.3783 Bekendtgørelse (2018). Om tolkebistan efter sundhedsloven, BEK nr 855
Boylen, S., Cherian, S., Gill, F. J., Leslie, G. D., & Wilson, S. (2020). Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: A systematic review. JBI Evidence Synthesis, 18(7), 1360–1388. https://doi.org/10.11124/JBISRIR-D-19-00300
Brach, C., & Fraser, I. (2002). Reducing disparities through culturally competent health care: an analysis of the business case. Quality management in health care, 10(4), 15–28. https://doi.org/10.1097/00019514-200210040-00005
Cano-Ibáñez, N., Zolfaghari, Y., Amezcua-Prieto, C., & Khan, K. S. (2021). Physician–Patient Language Discordance and Poor Health Outcomes: A Systematic Scoping Review. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.629041
Chatterji, P., Joo, H., & Lahiri, K. (2012). Beware of being unaware: racial/ethnic disparities in chronic illness in the USA. Health economics, 21(9), 1040–1060. https://doi.org/10.1002/hec.2856
Chen, X., Acosta, S., & Barry, A. E. (2016). Evaluating the Accuracy of Google Translate for Diabetes Education Material. JMIR Diabetes, 1(1), e3. https://doi.org/10.2196/diabetes.5848
Chiarenza, A., Dauvrin, M., Chiesa, V., Baatout, S., & Verrept, H. (2019). Supporting access to healthcare for refugees and migrants in European countries under particular migratory pressure. BMChealth services research, 19(1), 513. https://doi.org/10.1186/s12913-019-4353-1
Day, K. J., & Song, N. (2017). Attitudes and concerns of doctors and nurses about using a translation application for in-hospital brief interactions with Korean patients. Journal of innovation in health informatics, 24(3), 916. https://doi.org/10.14236/jhi.v24i3.916
DESA, U. (2020). International migration 2020 highlights. UN DESA, Population Division. Retrieved from https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesapd2020internationalmigration_highlights.pdf .
Divi, C., Koss, R. G., Schmaltz, S. P., & Loeb, J. M. (2007). Language proficiency and adverse events in US hospitals: a pilot study. International journal for quality in health care : journal of the International Society for Quality in Health Care, 19(2), 60–67. https://doi.org/10.1093/intqhc/mzl069
Dungu, K. H. S., Kruse, A., Svane, S. M., Dybdal, D. T. H., Poulsen, M. W., Juul, A. W., Permin, A., & Poulsen, A. (2019). Language barriers and use of interpreters in two Danish paediatric emergency units. Danish medical journal, 66(8), A5558.
Flores, G. (2005). The Impact of Medical Interpreter Services on the Quality of Health Care: A Systematic Review. Medical Care Research and Review, 62(3), 255–299. https://doi.org/10.1177/1077558705275416
Floyd, A., & Sakellariou, D. (2017). Healthcare access for refugee women with limited literacy: layers of disadvantage. International journal for equity in health, 16(1), 195. https://doi.org/10.1186/s12939-017-0694-8
Heath, M., Hvass, A. M. F., & Wejse, C. M. (2023). Interpreter services and effect on healthcare- a systematic review of the impact of different types of interpreters on patient outcome. Journal of migration and health, 7, 100162. https://doi.org/10.1016/j.jmh.2023.100162
Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590–603. https://doi.org/10.1111/hsc.12556
Holden, K., McGregor, B., Thandi, P., Fresh, E., Sheats, K., Belton, A., Mattox, G., & Satcher, D. (2014). Toward culturally centered integrative care for addressing mental health disparities among ethnic minorities. Psychological services, 11(4), 357–368. https://doi.org/10.1037/a0038122
Horvat, L., Horey, D., Romios, P., & Kis-Rigo, J. (2014). Cultural competence education for health professionals. The Cochrane database of systematic reviews, 2014(5), CD009405. https://doi.org/10.1002/14651858.CD009405.pub2
Hwang, K., Williams, S., Zucchi, E., Chong, T. W. H., Mascitti-Meuter, M., LoGiudice, D., Goh, A. M. Y., Panayiotou, A., & Batchelor, F. (2022). Testing the use of translation apps to overcome everyday healthcare communication in Australian aged-care hospital wards-An exploratory study. Nursing open, 9(1), 578–585. https://doi.org/10.1002/nop2.1099
Idossa, L., Mau, L.-W., Ferguson, S. S., Denzen, E., Murphy, E., & Moore, H. (2019). Access to Linguistically Appropriate Information for Blood and Marrow Transplant Patients: Results from Transplant Center Staff Survey. Journal of Cancer Education, 34(5), 1031–1037. https://doi.org/10.1007/s13187-018-1407-8
Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Smedley, B. D., Stith, A. Y., & Nelson, A. R. (Eds.). (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academies Press (US).
Jacobs, B., Ryan, A. M., Henrichs, K. S., & Weiss, B. D. (2018). Medical Interpreters in Outpatient Practice. The Annals of Family Medicine, 16(1), 70–76. https://doi.org/10.1370/afm.2154
Kale, E., & Syed, H. R. (2010). Language barriers and the use of interpreters in the public health services. A questionnaire-based survey. Patient education and counseling, 81(2), 187–191. https://doi.org/10.1016/j.pec.2010.05.002
Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health services research, 42(2), 727–754. https://doi.org/10.1111/j.1475-6773.2006.00629.x
Kirmayer, L. J. (2012). Rethinking cultural competence. Transcultural psychiatry, 49(2), 149-164.
Kleinert, E., Müller, F., Kruse, S., Furaijat, G., & Simmenroth, A. (2021). Nutzbarkeit digitaler Anamnesehilfen für nicht-deutschsprachige Patienten in der allgemeinärztlichen Sprechstunde [Usability and Efficiency of a Digital Communication Assistance Tool to Obtain Medical History from Non-German-Speaking Patients]. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)), 83(7), 531–537. https://doi.org/10.1055/a-1144-2848
Kolhatkar, G., & Berkowitz, C. (2014). Cultural Considerations and Child Maltreatment. Pediatric Clinics of North America, 61(5), 1007–1022. https://doi.org/10.1016/j.pcl.2014.06.005
Kreienbrinck, A., Hanft-Robert, S., & Mösko, M. (2024). Usability of technological tools to overcome language barriers in health care: a scoping review protocol. BMJ open, 14(3), e079814. https://doi.org/10.1136/bmjopen-2023-079814
Kutalek R. (2012). Diversity competence in medicine: equity, culture and practice. Wiener klinische Wochenschrift, 124 Suppl 3, 3–9. https://doi.org/10.1007/s00508-012-0247-5
Like R. C. (2011). Educating clinicians about cultural competence and disparities in health and health care. The Journal of continuing education in the health professions, 31(3), 196–206. https://doi.org/10.1002/chp.20127
Lund Hansen, M. T., & Nielsen, S. S. (2013). Tolkebrug i det danske sundhedsvæsen [Interpretation in the Danish health-care system]. Ugeskrift for laeger, 175(10), 644–648.
Marbury, D. (2018, June 4). Tackle the Patient Cultural Divide With These Technologies. Managed Healthcare Executive.https://www.managedhealthcareexecutive.com/view/tackle-patient-cultural-divide-these-t echnologies
Markides, M. (2011). The Importance of Good Communication Between Patient and Health Professionals. Journal of Pediatric Hematology/Oncology, 33(Supplement 2), S123–S125. https://doi.org/10.1097/MPH.0b013e318230e1e5
Martin, A. C. (2019). The Use of Film, Literature, and Music in Becoming Culturally Competent in Understanding African Americans. In Child and Adolescent Psychiatry and the Media (pp. 109–116). Elsevier. https://doi.org/10.1016/B978-0-323-54854-0.00009-6
McCalman, J., Jongen, C., & Bainbridge, R. (2017). Organisational systems’ approaches to improving cultural competence in healthcare: A systematic scoping review of the literature. International Journal for Equity in Health, 16(1), 78. https://doi.org/10.1186/s12939-017-0571-5
Mckinsey & Co. (2020). Diversity wins: How inclusion matters. Mckinsey & Co. https://www.mckinsey.com/~/media/mckinsey/featured%20insights/diversity%20and%20 inclusion/diversity%20wins%20how%20inclusion%20matters/diversity-wins-how-inclus ion-matters-vf.pdf
Merriam-Webster. (n.d.). Language barrier. In Merriam-Webster.com dictionary. Retrieved August 27, 2024, from https://www.merriam-webster.com/dictionary/language%20barrier
Michaëlis, C., Krasnik, A., & Norredam, M. (2021). Introduction of user fee for language interpretation: effects on use of interpreters in Danish health care. European journal of public health, 31(4), 705–707. https://doi.org/10.1093/eurpub/ckaa254
Muller, R., & Konecny, L. T. (2023). Patient perceptions of the readability and helpfulness of bilingual clinical forms: A survey study. BMC Medical Education, 23(1), 607. https://doi.org/10.1186/s12909-023-04519-3
Nair, L., & Adetayo, O. A. (2019). Cultural Competence and Ethnic Diversity in Healthcare. Plastic and reconstructive surgery. Global open, 7(5), e2219. https://doi.org/10.1097/GOX.0000000000002219
Olani, A. B., Olani, A. B., Muleta, T. B., Rikitu, D. H., & Disassa, K. G. (2023). Impacts of language barriers on healthcare access and quality among Afaan Oromoo-speaking patients in Addis Ababa, Ethiopia. BMC Health Services Research, 23(1), 39. https://doi.org/10.1186/s12913-023-09036-z
Ozolins, U. (2011). Telephone interpreting: Understanding practice and identifying research needs. Translation & Interpreting: The International Journal of Translation and Interpreting Research, 3(2),33–47. https://search.informit.org/doi/10.3316/informit.055143204158024
Parag, N., Govender, R and Saadiya B. A. (2023). Promoting Cultural Inclusivity in Healthcare Artificial Intelligence: A Framework for Ensuring Diversity. Health Management, Policy and Innovation (www.HMPI.org), 8(3). https://hmpi.org/2023/12/10/promoting-cultural-inclusivity-in-healthcare-artificial-intelli gence-a-framework-for-ensuring-diversity/?pdf=4373
Patil, S., & Davies, P. (2014). Use of Google Translate in medical communication: Evaluation of accuracy. BMJ, 349. https://doi.org/10.1136/bmj.g7392
Peremore, K. (2024, February 20). Causes of language barriers in healthcare. https://www.paubox.com/blog/causes-of-language-barriers-in-healthcare
Rhee, T. G., Marottoli, R. A., Van Ness, P. H., & Levy, B. R. (2019). Impact of Perceived Racism on Healthcare Access Among Older Minority Adults. American journal of preventive medicine, 56(4), 580–585. https://doi.org/10.1016/j.amepre.2018.10.010
Sharma, K., Grant, D., Parikh, R., & Myckatyn, T. (2016). Race and Breast Cancer Reconstruction: Is There a Health Care Disparity?. Plastic and reconstructive surgery, 138(2), 354–361. https://doi.org/10.1097/PRS.0000000000002344
Squires A. (2017). Evidence-based approaches to breaking down language barriers. Nursing, 47(9), 34–40. https://doi.org/10.1097/01.NURSE.0000522002.60278.ca
Squires A. (2018). Strategies for overcoming language barriers in healthcare. Nursing management, 49(4), 20–27. https://doi.org/10.1097/01.NUMA.0000531166.24481.15
Stubbe D. E. (2020). Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. Focus (American Psychiatric Publishing), 18(1), 49–51. https://doi.org/10.1176/appi.focus.20190041
Taira, B. R., & Orue, A. (2019). Language assistance for limited English proficiency patients in a public ED: Determining the unmet need. BMC Health Services Research, 19(1), 56. https://doi.org/10.1186/s12913-018-3823-1
The Commonwealth Fund. (2023, June 30). Why Culturally Competent Care for Women of Color Matters. https://doi.org/10.26099/4spp-ja97
van Rooyen, D., Telford-Smith, C. D., & Strümpher, J. (2010). Nursing in Saudi Arabia: Reflections on the experiences of South African nurses. Health SA Gesondheid, 15(1).
Walkowska, A., Przymuszała, P., Marciniak-Stępak, P., Nowosadko, M., & Baum, E. (2023). Enhancing Cross-Cultural Competence of Medical and Healthcare Students with the Use of Simulated Patients-A Systematic Review. International journal of environmental research and public health, 20(3), 2505. https://doi.org/10.3390/ijerph20032505
Waters, E., Gibbs, L., Riggs, E., Priest, N., Renzaho, A., & Kulkens, M. (2017). Cultural Competence in Public Health. In International Encyclopedia of Public Health (pp. 181–186). Elsevier. https://doi.org/10.1016/B978-0-12-803678-5.00093-X
Williamson, G. (2024). Healthcare Access Disparities among Marginalized Communities. Global Perspectives in Health, Medicine, and Nursing, 3(1), 11–22. Retrieved from https://forthworthjournals.org/journals/index.php/GPHMN/article/view/98
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