America’s demographic landscape is undergoing a historic shift. Projections consistently show that the United States is headed toward a “majority minority” by the 2040s. This simply means that migrants and racial minorities will, combined, make up a larger portion of the population than non-Hispanic white people.
White Americans will still constitute the largest single demographic group, but for the first time in our nation’s history, they will account for less than 50% of the total population.
While certain political commentators might focus on alarming narratives about a changing “national identity,” healthcare professionals recognize a much more pressing and practical concern: cultural competency.
The critical question facing medical institutions is how to establish productive collaborations with patients and colleagues from increasingly diverse cultural backgrounds.
In this article, we will examine why cultural competency is essential in healthcare settings and what hospitals can do to foster it.
How Much Does Culture Matter?
That’s a good question. You can’t operate on someone’s holiday traditions after all. Medicine is supposed to be based on objective standards. So why does cultural competency matter?
There are a few compelling reasons. The most significant is that studies have consistently shown that minorities being treated by majority group doctors and nurses have worse outcomes than those who are not. The exact reason for this owes to a number of factors often described under the broad term of “unconscious bias.”
Certainly, unconscious bias does not mean that white doctors and nurses are racist. It does mean they relate to people a little differently when they aren’t familiar with their cultural expressions or mannerisms. Without getting too in the weeds, this form of “prejudice” is common across all groups and has its roots in the early stages of human development when “different” often meant dangerous.
What’s often happening is small miscommunications that can have big ramifications in healthcare. These subtle interactions can significantly impact treatment effectiveness and patient outcomes.
There are other issues as well. One critical factor? Patients may simply feel less comfortable trusting people they struggle to relate to. How can you feel confident in a doctor who seems to misunderstand you at a fundamental level?
Of course, a patient needn’t love their doctor to be healed by them. That said, it helps. The way a person feels about their treatment strategy can go a long way toward influencing how effective it is.
High Stakes
Cultural disconnections in healthcare can mean the difference between life and death. When providers miss symptoms or dismiss concerns due to communication barriers or bias, patients suffer.
Tennis champion Serena Williams nearly died after childbirth when medical staff initially dismissed her concerns about blood clots—a condition she knew she was prone to. Despite her wealth and fame, she had to fight to be heard. Her experience reflects broader patterns in maternal mortality statistics across racial groups. Cultural competency isn’t just about comfort—it directly impacts survival rates.
How to Facilitate Cultural Competency
Healthcare organizations can implement structured training programs focused on practical communication skills rather than abstract concepts. These programs work best when they include concrete examples of miscommunication and their consequences. Regular workshops with real case studies and role-playing exercises help staff recognize subtle cultural differences in expressing pain, describing symptoms, or understanding treatment instructions.
Hospitals should also create diverse clinical teams whenever possible and establish mentorship programs pairing staff from different backgrounds. Having resource materials available in multiple languages isn’t enough—staff need training on when and how to use interpreters effectively. The most successful programs track outcomes by demographic groups, measuring improvements in patient satisfaction and treatment adherence to refine their approaches over time.
Better Recruitment
Improved recruitment efforts are another piece of the pie, and can fix more than just miscommunication. It’s no secret that there are major healthcare shortages all over the country.
High school guidance counselors and college recruitment offices can both do a better job of pointing minorities toward healthcare careers. This can help fix several issues with one move. On the one hand, it will play a modest role in bridging the wealth gap across American communities.
It will also improve staffing and build cultural competency into healthcare teams through the most organic means possible.
Any Healthcare Job Can Benefit From Cultural Competency
You don’t need to learn another language or even learn a ton of new information to start improving cultural competency. Success can start in small ways by recognizing that you might be missing things in your communications with people from other cultural groups. That awareness can help you put more effort into those interactions. Advanced training is helpful, but in its absence, one makes do with what one can.
Who can benefit from this approach? Doctors. Nurses. Even pharmacists—possibly especially pharmacists. Those living in robust healthcare systems might easily forget that many people rely on pharmacists as their primary point of contact in the healthcare system. If you’re living in a rural community thirty-five miles from the nearest hospital, the pharmacy is where most of your healthcare encounters will take place. These communications are important, and they need to be done right.
Umm…is it even Legal to Be Talking About This?
That’s an interesting point. Anyone following even the smallest bit of American politics knows that many of the topics we’ve described in this article have become battlegrounds in today’s culture wars. Is this approach merely repackaged DEI? Well, it depends on who is asking.
Here’s what is true—Diversity, Equity, and Inclusion initiatives at their very best have never been about prioritizing competency over equality. Good diversity initiatives ask: why can’t we have both? Hospitals will need to develop policies and procedures to help them assist all segments of the population. Long-term outcome gaps between racial groups more than prove this necessity.
Healthcare institutions can call these efforts whatever is politically fashionable, just so long as they direct their initiatives in ways that reflect the nuanced complexity of modern society and effectively address documented disparities in care outcomes.
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