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Public Health Rep. 2003 Jul-Aug;118(4):293-302.

Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

Author information

  • 1Institute for Health Policy, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02114, USA. jbetancourt@partners.org

Abstract

OBJECTIVES:

Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care.

METHODS:

The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers.

RESULTS:

Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care.

CONCLUSIONS:

Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.

PMID:
12815076
[PubMed - indexed for MEDLINE]
PMCID:
PMC1497553
Free PMC Article
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