Cultural competence and healthcare disparities: A critical analysis and ethical considerations

Abstract: The clinical encounter is complicated by dissimilarity between both patient and clinician with respect to ethnicity, positions of power, language, religion and other characteristics of personal identity. Research demonstrates an indisputable correlation between such interpersonal differences and patient/physician communication, accessibility of treatment, and quality of care.

Institutional programs and governmental organizations promoting “cultural competence” have emerged as means to address consequential health disparities and work towards more accessible, acceptable and effective healthcare for people of all cultural backgrounds and identities.

Cultural competence as a field of study highlights the need for increased awareness of culture, knowledge of customs and the related appropriateness of healthcare, and perhaps most importantly, cross-cultural communication skills. However, method(s) for obtaining the appropriate level of awareness, knowledge and skills are less clearly defined and thus cultural competency education and related policies remain in their infancy.

This presentation aims to facilitate further discussion of cultural competency frameworks and related healthcare policies. To contextualize the discussion, New Zealand will serve as model for analysis. The presentation will consist of four parts:

1) Introduction: foundations of cultural competency and health disparities

2) Exploration: cultural competency frameworks and emerging cultural profiles within New Zealand

3) Critical Assessment: clinical efficacy of emerging frameworks

4) Global Implications: suggestions for defining and implementing principles of cultural competence

Discussion and evaluation of cultural competence is critical to improving the cultural responsiveness, appropriateness and effectiveness of clinical services and ultimately reduce existing health disparities.