New Guidelines Issued to Improve Cultural Competency

by Maya Rhodan
NNPA Washington Correspondent

WASHINGTON (NNPA) – The Department of Health and Human Services has updated its standards for cultural competency in health care, hoping to narrow the racial and ethnic health disparities common throughout the United States.

“This provides another opportunity to significantly improve health disparities,” Dr. Howard Koh, the agency’s Assistant Secretary for Health, said at a press conference on Wednesday. “Care needs to honor culture, it needs to be effective, understandable and respectful. Care needs to be delivered with ‘CLAS.’”

National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care – also known as CLAS Standards— serve as guidelines for facilitating “culturally and linguistically appropriate health services.”

The new standards were announced last week by HHS’s Office of Minority Health at a gathering of health care organizations the Kaiser Family Foundation office in Washington.

In 2000, under the Bush administration, the Office of Minority Health published the first set of standards, which were updated in 2010, to better cater the health care system to the nation’s increasingly diverse population.

The recently updated standards include 15 guidelines for effective cultural communication between patients and caregivers, including a “principal standard” that encourages hospitals to provide service that is “responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.”

Other standards include:
• Recruiting more culturally diverse leadership staff
• Offering language assistance at no cost to the patient
• Collecting and maintaining accurate demographic data
• Partnering with the community to design cultural and linguistic appropriate policies.

As the U.S. population becomes more diverse, with Whites becoming a minority in the U.S. by 2050, cultural competence in health care is being considered crucial to ending health disparities.

And those disparities are striking.

Black babies are 2.3 times more likely to die in infancy, Asians are 2.5 times more likely to develop liver cancer, Latinos are three times more likely to be uninsured and Black men are seven times more likely to be diagnosed with HIV than their White counterparts.

Currently, seven of the 15 most populated cities are majority minority yet African Americans, Latinos, Native Americans, and Asians continue to receive lower quality care than their White counterparts according to National Healthcare Disparities reports.

“Health is the most important thing we have regardless of our race, socioeconomic status,” said Dr. Nadine Gracia, director of the office of minority health at the Department of Health and Human Services. “Nothing more essential to opportunity than good health.”

In a 2002 report on Cultural Competence in Health Care presented by the Commonwealth Fund, a New York based foundation, states, “ As we become a more ethnically and racially diverse nation, health care systems and providers need to reflect on and respond to patients’ varied perspectives, values, beliefs, and behaviors about health and well-being. Failure to understand and manage sociocultural differences may have significant health consequences on minority groups in particular.”

A huge barrier between patients and health care providers occurs among non-English speakers. According to the National Health Disparity Report, Spanish-speakers are more likely to not have health insurance and are also more likely to report poor communication with nurses.

“Culture is language – it’s the way that we through signs, customs, beliefs, practices present ourselves to other people, understand other people,” said Leon Rodriguez, director of the office of civil rights at HHS. “Proper communication is not just a civil rights issue, it’s about delivering the best quality care—this is all about delivering good care, this all about good business.”

Although helpful, the standards are not mandatory; they are merely a set of guidelines put in place to assist the medical community better serve people of color.

Studies have shown that cultural competency training improves the patient-healthcare provider relationship. However only six states have legislation that requires or suggests cultural competence training: Maryland, Washington, Connecticut, New Mexico, California, and New Jersey.

Five states, including Illinois and Florida where 15 and 20 percent of the total populations are uninsured respectively, have vetoed or denied such legislation. Iowa, Colorado, and Oregon also followed suit.

The authors of the standards believe that if they can get hospitals and health care providers to adopt their standards, both the patients and the medical community will be better served.

“We hope over time this will be good for practice and good business,” Koh said. “If every organization can at least start by saying we embrace these values and get leadership to infuse these values throughout everyday work, we can begin to gather more data that show that this is not only good practice, but it’s good for business.”