Cultural competence in the provision of health care is a very important area of investigation and is receiving recognition at multiple levels. Minority groups constitute a significant and growing percentage of our population. However, there has been no commensurate increase in the number of minority physicians. There is a tremendous need for medical professional schools and health care organizations to implement formal cultural competence training for current and future health professionals. In this article, we present the findings of an extensive literature review that describes how several factors have brought the need for cultural competence to the forefront. These factors include a greater appreciation for the impact of culture on health, changes in U.S. demographics, increased awareness in health care disparities, and modifications in legislative and accreditation mandates.
The United States population is becoming increasingly culturally diverse. This trend is expected to continue, with the minority population projected to become the majority by the year 2056. 1 The definitions of culture as “the shared world-view, beliefs, and practices of a group of people”2 and of cultural competence as “the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of cultural distinctions”3 reflect the importance of providing cultural competence training for all health professionals. The interaction between patient and health professional embodies a form of multiculturalism in its merging of the disparate cultures of health professionals, medicine, institutions, and patients. Of secondary importance is that individual citizens and organizations are usually at different stages of acculturation and therefore behave differently even within their own cultures.
A major factor underscoring the need for cultural competence training is that although minority cultures are on the brink of becoming the majority of the population, there has not been a commensurate increase in the number of minority physicians. The enrollment of under-represented minority students in U.S. medical schools has in fact decreased. 4 Moreover, the current health professionals often trained in an environment that was not as culturally diverse, contributing to the growing “cultural gap” between physicians and patients. Another important argument for cultural competence training is the impact of culture on health beliefs and behaviors that may affect patient and provider satisfaction and disease outcomes. The cultural gap between physicians and patients may also contribute to the health disparities that currently exist. 5–7
Cultural competence addresses the role culture plays in shaping our attitudes, values, and beliefs. This highlights the fact that health professionals’ ability to effectively care for a diverse patient population plays a major role in delivering health care to our entire nation. Therefore, it behooves medical professional schools and health care organizations to train current and future health professionals in cultural competence.