Culturally Competent Care Means Better Outcomes For Patients

The COVID-19 pandemic has laid bare the tremendous health inequities coursing through America. While these disparities may be new to some, they are not new to the communities long affected by them. Medical care isn’t a one-size-fits-all undertaking. Inattention to differences in cultural backgrounds can cause real harm to a patient’s overall health. Patients tend to be healthier when their doctors and nurses take their ethnicity and race into account. That’s especially true when patient and providers share the same backgrounds, experiences, and language.

The data is so convincing along these lines that experts have a name for such symbiotic treatment: Cultural competency. A scholarly paper from George Washington University defines cultural competency as the ability of medical providers to offer care that meets the social, cultural, and linguistic needs of their patients.

Cultural competency originally was confined to meeting the needs of people from different ethnic and racial groups. Now, it also refers to consciously catering to people who have disabilities, come from diverse socioeconomic backgrounds, and are part of the LGBTQ community.

But in whatever way it’s defined, cultural competency is recognized as an important way to reduce disparities in medical care that have long been a problem among certain racial and ethnic groups. Forward-looking healthcare providers are also bringing care to minority neighborhoods – and hiring from those neighborhoods – with notable results.

It’s an unfortunate fact that some minority groups, such as Black and Hispanic Americans, receive inferior health care compared to the white population. The National Academies of Medicine found that people of color are less likely than their white counterparts to receive evidence-based kidney dialysis or transplants, cardiac care, or the best care for stroke, cancer, or AIDS. Prescribing patterns also differ, with white patients receiving access to better, newer medications than people of color.

“Black people simply are not receiving the same quality of health care that their white counterparts receive,” Khiara M. Bridges, a professor of law and anthropology at Boston University, wrote in the State of Healthcare in the United States.

Urban hospitals have been closing steadily and in 2018, Bloomberg News reported that out of roughly 6,000 public and private hospitals nationwide, 8 percent were at risk of closing "with another 10 percent considered ‘weak.’” Westlake Hospital in Chicago closed in 2018. Hahnemann University Hospital in Philadelphia closed in 2019.

Leaders in the field have tried mightily to find ways to fix the problem. And now there are promising avenues, which are simple and common sense. Providers are increasingly embracing their patients’ worldviews and meeting them where they live, literally.

Right now, in neighborhoods across America, a substantial number of private companies are moving clinics into underserved neighborhoods, including Cityblock and my own organization, Oak Street Health. Oak Street’s provider team is uncharacteristically diverse and reflects the communities it serves. Three-quarters of our healthcare providers are women, and a majority are non-white. Thirty-five percent of the Oak Street team identifies as Black or African American, 20 percent as Hispanic or Latino, 6 percent as Asian, and 29 percent as White. The U.S. healthcare workforce, by comparison, is 17 percent Black or African American, 14 percent Hispanic of Latino, 7 percent Asian, and 73 percent White.

The health outcomes we achieve are impressive. Our primary care clinics have cut patients’ hospitalizations and emergency department visits in half. Readmissions also are down significantly. Our patients also like the care they get. Nine out of ten give Oak Street a thumbs up in internal surveys.

As we work to meet our nation’s healthcare needs, it’s time to bring comprehensive, culturally competent, first-rate health care to the underserved. Doing so will result in better care and outcomes.

Dr. Maria Wilson is Central Division Executive Medical Director at Oak Street Health where she oversees clinical care in Indiana, Kentucky, Michigan, Ohio and Tennessee. Oak Street Health is a national network of primary care health centers for adults on Medicare.