Without question healthcare practitioners are privileged to be part of one of the most worthwhile and rewarding professions. No doubt most of these professionals originally chose to enter the healthcare field in order to make a meaningful difference in individuals' lives. From relieving suffering and saving lives to improving patients' quality of life through research and medical advances, healthcare practitioners can experience tremendous job satisfaction. Our profession, however, is not without its challenges. This issue of Family & Community Health explores one contemporary issue facing all areas of the medical field-the expanding and increasingly important role of culture in healthcare.
America is more diverse than it has ever been.1 The recent debates and demonstrations surrounding immigration reform certainly highlight, among other issues, that fact. Citizens from more diverse backgrounds and in greater numbers than ever before are speaking more languages other than English at home.2 The United States Census Bureau projects that more ethnically diverse citizens speaking a language other than English at home will comprise an increasingly larger percentage of America's expanding population over the next 5 decades.3 The healthcare demands of such a diverse population have tremendous implications for the medical profession.
Mutha and Karliner suggest that the convergence of 2 major trends-increasing language and population diversity and "disparities in health care for racial and ethnic minorities and those with communication barriers"-pose serious challenges to the quality of care patients receive.4(p47)
Healthcare practitioners, regardless of area of practice or expertise, must prepare for and respond to these merging trends to more effectively care for an increasingly diverse population. The medical profession must provide culturally competent care by recognizing, understanding, and responding to "patients' varied perspectives, values, beliefs, and behaviors about health and well-being."5(p1)
Cultural competence is a relatively new phenomenon that emerged as a way to eliminate deficiencies in racial and ethnic healthcare, improve provider-patient communication, and meet the medical needs of an increasingly diverse population. Betancourt, Green, and Carrillo offer a definition of cultural competence that also serves as an appropriate challenge to healthcare practitioners:
Cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients' social, cultural, and linguistic needs. The ultimate goal is a health system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or [language] proficiency.5(p2)
While this is no small task, it is a goal to which all healthcare practitioners should be committed.
This issue of Family & Community Health features articles that explore a range of healthcare topics in a variety of settings. The authors provide practical recommendations for healthcare professionals and the role they must play in meeting the medical needs of diverse populations. I hope this issue will not only inform and enlighten but also enable you to pause to consider what role culture plays in your professional practice. Questions to consider include the following: What impact does my personal values, beliefs, and experiences have on the quality of medical care I provide? How can I instill culturally competent care into my own personal practice? What can I do to encourage culturally competent care throughout my organization? Reflecting on these and other questions can improve patient-provider communication and lead to more effective clinical encounters and greater patient satisfaction. I am confident that the quality and equity of healthcare for all patients will improve as we work together to infuse cultural competence in our clinical care and throughout the healthcare profession.
Jeanette Lancaster, PhD, RN, FAAN
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