Healthcare disparities are more common than you might think in the United States. Health inequities usually disproportionately impact immigrants, people of lower economic status, LGBTIQ+ groups and people of color.
According to The National Interview Health Survey, more than 14% of Native Americans and roughly 20% of Black and Hispanic adults reported fair or poor health status. Although reasons vary, interpersonal biases, social health determinants and systemic racism are among the factors contributing to stark disparities in health outcomes within marginalized communities.
What makes this worse is that healthcare inequities can lead to diminished health outcomes, social injustice and significant economic consequences. As per the National Institutes of Health, the financial burden of health disparities within the nation remains alarmingly high.
Data shows health inequities based on race and ethnicity are associated with more than $90bn in excess annual healthcare expenses and cost the economy more than $40bn in lost productivity annually. With healthcare inequities becoming a nagging issue in the nation, the case for recalibrating processes to ensure healthcare equity and diversity is now left in the social worker’s hands. Below, we discuss several ways social workers address healthcare equity and diversity to achieve culturally competent care.
Advocating for culturally sensitive care
Creating an environment of openness and respect for all individuals is no longer an option in today’s healthcare. When healthcare providers make an effort to understand their patient’s societal and cultural beliefs, practices and communities, they can provide a space where everyone can feel safe. As per the Health Policy Institute, culturally sensitive care can improve health outcomes and quality of care while contributing to the elimination of ethnic and racial health disparities.
It is also worth noting that culturally sensitive care requires more than a statement of quality practice. Culturally sensitive care also requires advocacy and activism, and this is where social workers can help. Contrary to popular belief, providing culturally sensitive care involves challenging institutional and structural oppression and the accompanying emotions of privilege and internalized oppression.
Social workers advocate for culturally sensitive care by actively engaging with diverse communities, examining forms of oppression, domination and discrimination, respecting cultural differences and personalizing interventions to meet the unique needs of individuals from various backgrounds. This includes understanding and incorporating cultural values, perspectives and traditions into their practice to promote inclusivity and equity in their interactions. Depending on patient requirements, some strategies social workers employ to advocate for culturally sensitive care include:
Embracing cultural humility
Social workers approach clients with cultural humility, recognizing that each one has a unique societal background. This involves openness, a willingness to learn from clients about their cultural experiences and a commitment to self-reflection. By embracing cultural humility, social workers can understand clients better and make positive changes within their respective communities. This also allows them to address implicit biases within healthcare systems to promote fair and objective treatment for every individual.
Social workers must understand their biases and work to mitigate them to deliver culturally sensitive care. They may need to engage in ongoing self-reflection to recognize their biases and how they may impact their client interactions. By recognizing these biases, social workers can align their assessment methods with the cultural norms and values of the clients they serve.
Conducting community engagement activities
Social workers conduct community engagement activities to understand the specific strengths and challenges of different cultural groups. This allows them to advocate for the development of targeted and culturally appropriate interventions.
Community engagement activities also allow social workers to act as cultural brokers that help bridge the gap between the client’s cultural background and the service system. This allows clients to navigate complex systems and ensure their cultural nuances are understood and respected.
Promoting cultural competence policies
Issues are the central point of policy formulation, so the initial stage of developing the policy involves research and identifying the issues to be dealt with. During this process, healthcare leaders and policymakers need social workers to identify the issues that prevent a specific community from receiving culturally sensitive care.
Social workers work at the grassroots level and interact with marginalized communities and the most vulnerable. These social workers are ideally positioned to communicate these issues to policymakers and healthcare leaders to develop laws and policies to address them. With this ongoing communication, social workers can ensure existing issues and demands preventing the delivery of culturally sensitive care are addressed by the concerned authorities.
Using the strategies mentioned above, social workers can create a comprehensive approach to advocating for culturally sensitive care and foster better outcomes for individuals from diverse backgrounds. This also helps build trust between healthcare professionals and patients, ultimately resulting in a more supportive environment where patients feel understood, heard and respected. This empowers social workers and healthcare professionals to address global health challenges, support international collaboration and foster more equitable medical care for everyone.
Bridging language barriers
Language difference is among the most significant barriers to achieving culturally competent care. As per The Pew Research Center, nearly 50% of immigrants do not speak English proficiently. The data adds that individuals across the nation speak more than 300 different languages. While this diversity is impressive, it can often impede effective communication between healthcare providers and patients.
According to the National Library of Medicine, roughly a quarter of interpretations from family members and untrained personnel are incorrectly translated. When intake medical staff cannot understand the patient’s issues, they miss out on sensitive data that should be provided and clearly understood for further diagnosis. It also makes it more challenging for healthcare providers to personalize their approach, which could potentially compromise care quality and patient outcomes.
Regardless of the situation, patients with a language barrier are more likely to receive more intravenous fluids, larger workups and longer emergency department stays. As social workers undergo training from leading academic institutions to understand and respect cultural differences, they can navigate diverse communication styles and preferences.
Achieving culturally competent care requires continuous commitment and learning and, if this sounds like a worthwhile career, click here to learn more about how students of Florida State University’s Online Master of Social Work program work towards understanding a patient’s local culture and language to meet individual needs and achieve culturally competent care. This program helps students stay informed of emerging research on human behaviors and social environments, the needs of evolving communities and best practices to adapt their approaches accordingly.
Social workers undergo rigorous training to develop awareness, knowledge and skills related to diverse cultures. This allows them to understand and ensure they approach clients with an open mind and cultural humility. It also ensures social workers can provide care that is respectful and responsive to their clients’ diverse cultural backgrounds. Overcoming cultural barriers to client dialog helps avoid stereotypes and generalizations while recognizing and appreciating each patient’s unique condition.
Integrating anti-racism principles into healthcare practices
Racial discrimination affects healthcare in many ways. Recent data reveals US Black people are nearly four times more likely to die from diseases such as COVID-19 than White people. Similarly, the risk of death within the Latino population is nearly twice that of the White population. One way for social workers to promote healthcare equity amid diversity and achieve culturally competent care is to integrate anti-racism principles into healthcare practices.
This allows social workers to address the root causes of health inequities associated with racism while helping healthcare professionals increase cultural competence and improve their ability to understand and meet the unique needs of a diverse patient population. When healthcare workers are more culturally competent, they can shift the focus towards a patient-centered approach that values the individual’s experiences and perspectives. This also helps identify and eliminate unconscious biases and discriminatory practices within healthcare settings.
Social workers frequently integrate anti-racism principles into healthcare practices through community engagement activities, anti-racism workshops, collecting disaggregated data and addressing microaggressions. Alternatively, they can also incorporate trauma-informed care strategies that highlight and address the impact of racial trauma on a patient’s mental and physical wellbeing. By actively working to eliminate systemic racism, social workers can improve public health outcomes and address cultural differences effectively.
Social workers can also participate in anti-racist research and evaluation within healthcare to assess the impact of racism on healthcare outcomes, determine effective interventions for reducing racial disparities and examine the efficacy of anti-racist practices within health settings. This allows them to collaborate with healthcare providers to develop culturally responsive interventions that incorporate specific healing practices, natural healthcare healing modalities and community-based resources.
Addressing social determinants of health within marginalized populations
On the surface, this might not seem obvious, but non-clinical factors such as environment, transportation, education access, employment, housing and food insecurity can impact an individual’s health. Estimates reveal these factors, known as the social determinants of health (SDOH), have twice the impact on health outcomes as quality healthcare has. Addressing these non-clinical factors requires a holistic approach to create supportive environments and reduce health disparities.
What makes SDOH issues more challenging is that they often appear outside clinic and hospital walls. This means that healthcare workers are not typically in a position to help. Fortunately, social workers can because of their ability to navigate multiple dimensions that influence health, such as community, policy, family and healthcare settings. In their everyday work, social workers break barriers by facilitating communication between healthcare providers and community partners to offer critical social support for a patient’s disease management.
Depending on the circumstances, social workers can implement a person-in-environment approach to communicate and meet with individuals in non-traditional settings. This creates access for the most marginalized segments of the population and for those who otherwise cannot receive appropriate and equitable care. This approach also examines an individual’s behavior, psychological state, relationships, local environment and family system to address particular disparities and inequities that would otherwise be ignored. Several strategies social workers use to address SDOH within marginalized populations include:
Assessment and personalized planning: Social workers perform comprehensive individual and community evaluations to identify unique SDOH and subsequently create personalized plans that address specific needs and issues. Depending on the circumstances, social workers can advocate for the incorporation of cultural evaluations into intake processes and care planning to ensure that societal factors are considered in care delivery.
Crisis intervention: Social workers address SDOH-related crises such as homelessness or domestic violence by providing immediate support and connecting individuals to necessary services. By delivering crisis intervention, social workers can prevent situations from worsening and connect individuals with relevant resources and services.
Health education and promotion: Social workers conduct health promotion activities to educate individuals about healthy behaviors, preventive care and the importance of addressing SDOH to achieve overall wellbeing.
Community development: Social workers work collaboratively with communities to establish and implement programs that address SDOH, such as community gardens, affordable housing initiatives and after-school programs.
Case management: Social workers provide continuous client support and coordination by helping individuals navigate complex systems and access various services that can enhance their overall wellbeing. Through comprehensive case management, clients can receive personalized assistance and identify their strengths and challenges effectively to lead healthy lives.
Individual and family counseling: Social workers provide individual and family counseling services to tackle mental health concerns, build coping skills and support overall client wellbeing. This can help individuals and families navigate the challenges associated with SDOH and achieve healthcare equity amid adversity.
By addressing these determinants, social workers can create equitable opportunities for better health. This reduces health inequities among marginalized communities, promotes social justice and improves society’s overall health. As mentioned, marginalized populations often face systemic barriers that adversely impact their ability to lead healthy lives. When social workers focus on these SDOHs, they acknowledge that health extends beyond medical care and is deeply connected with environmental, economic and social factors. This helps to foster a more inclusive and resilient society and allows for holistic healing.
Achieving health equity
Promoting healthcare diversity and equity is an ongoing process. Social workers must work towards staying informed about emerging research, community needs and best practices to deliver culturally competent care and address social determinants of health.