Studies show it can even help patients stick to their treatment regimens.
Cultural sensitivity and cultural responsiveness are big terms in many service industries. For businesses, CEOs can use cultural sensitivity to improve employee morale and relationships. In education, teachers can teach using culturally responsive curriculum. In health care, doctors and nurses can use cultural sensitivity to improve engagement from their patients.
When it comes to culturally sensitive health care, doctors cannot use a one-size-fits-all approach to treating their patients. That's especially true when it comes to providing lifestyle advice.
“If some particular population eats a certain way, … just telling them, 'Oh, you know, you need to eat a Mediterranean diet,' isn't gonna cut it, right?” asks Sanjai Sinha, MD, internist at Weill Cornell Medicine. “What if they don't have access to the food that's in a Mediterranean diet because they live in areas where there's not a lot of fresh groceries?”
Instead, a doctor may need to meet the patient where they are. This may include asking what some of their favorite meals are, where they shop, and how much time they have to prepare and eat meals. Then, they can discuss ways to improve the patient’s diet that are within reason.
Improving Health Outcomes
Cultural sensitivity isn’t just about being respectful: It’s effective. A 2011 study by researchers at the University of Florida surveyed low-income patients and how they viewed their doctors. The patients who perceived more cultural sensitivity from their doctors were more likely to adhere to their treatment recommendations.
It’s about “coming to a place where you can at least respect their culture, listen to what they have to say, and not just disengage and get frustrated,” says Dr. Sinha. “The fact that you've made that effort, most patients really are grateful for it, and they want to come back.”
“We need to understand our own biases,” says Dr. Sinha. “Do we give up more quickly? Do we say, 'Okay, you don't want this treatment, fine’?” These biases can all affect the outcomes of treatment for patients.
Biases and lack of cultural sensitivity are just two factors that may drive health disparities. Find out other barriers to health care that lead to health disparities, and learn more about ways health care is connecting vulnerable populations.
Dr. Sinha specializes in internal medicine at Weill Cornell Medicine in New York.
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I imagine that this wasn't something in medical school
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that you thought you'd be spending so much time thinking about
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and researching, healthcare disparities,
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but I'm wondering how it changed you as a physician
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and what you've learned by dealing with patients
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who have some of these challenges,
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to help them get healthy and live better lives.
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What I've been excited about is both researching
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and putting into practice some of the tools
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that people have studied to be more aware.
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So for instance, we talked about interpreters,
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but what about hiring more staff that look like our patients?
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What about hiring more people who can help these patients
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throughout all of their touches to the healthcare system?
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What about using health promotion tools
that are culturally sensitive?
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If some particular population eats a certain way,
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has a certain kind of pattern to their diet,
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because we know that diet has so much to do
with chronic conditions,
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just telling them, 'Oh, you know, you need to eat
a Mediterranean diet,'
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isn't gonna cut it, right?
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So what if they don't have access to the food
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that's in a Mediterranean diet because they live in areas
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where there's not a lot of fresh groceries?
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So what can we do to reduce the harm?
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Harm reduction's a great term here.
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And so coming to a place where you can at least respect
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their culture, listen to what they have to say,
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and not just disengage and get frustrated
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when they don't want to do what you say.
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It's hard work but it's very rewarding because most of the time,
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even if you agree to disagree, if you don't come
to that perfect decision,
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the fact that you've made that effort,
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most patients really are grateful for it,
and they want to come back,
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and so by having access to a doctor continuously over years,
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you know, you get to know each other well,
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and hopefully you can make the kinds of changes that they need
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to improve their chronic conditions.
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So where are we headed in the future to try
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and bridge the gap between healthcare disparities
that exist today?
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Well, I think, first and foremost,
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we have to keep these people insured. (laughs)
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We have to continue to advertise
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that Obamacare is still alive and kicking,
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and enroll people as much as possible
so they have an insurance plan.
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Without an insurance plan, people are not gonna engage at all.
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So that's one thing.
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Two, we need to create an environment
of cultural competence throughout.
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It's happening in institutions everywhere.
It's happening in education.
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We need to understand how to meet people
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where they're coming from, and we need to understand
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our own biases. I mean, there's systematic racism.
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We know this already.
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So what can we do throughout the United States
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but even in health care?
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Is there something about the way we view someone
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who is Black or Hispanic because of our lack of experience
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or ignorance of their values and preferences?
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Do we give up more quickly?
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Do we say, 'Okay, you don't want this treatment, fine.'
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They all need somewhere to go.
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If they go to a place that they think doesn't listen to them,
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doesn't respect them, doesn't empathize with them,
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they're gonna go elsewhere if they can.
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And if they can't go elsewhere, but they're not getting good care,
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then that's terrible, right?
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Most of us go into medicine because we want to help people,
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and we want to have that gratitude.
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We know that the system is a barrier,
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we know that we have to deal with a lot of bureaucracy,
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but on a micro level, what can we do to reduce
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some of those headaches for patients?
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- Cultural competence in health care: is it important for people with chronic conditions? Georgetown University. (Accessed on June 9, 2020)
- Tucker CM, Marsiske M, Rice KG, Jones JD, Herman KC. Patient-centered culturally sensitive health care: model testing and refinement. Health Psychol. 2011 May;30(3):342-50.