Journal Health Affairs publishes special issue devoted to racial/ethnic disparities — several articles link between cultural and linguistic competence to quality of care

Literature Update 5, Janurary 2005

The March/April issue of the journal Health Affairs is devoted to racial/ethnic disparities, and assesses progress made since the Institute of Medicine released its landmark report, Unequal Treatment. Released March 9th at the National Press Club, papers in the journal identify gaps in health and health care that still exist, and they offer a blueprint for eliminating disparities.

Among the many issues covered in this special issue was the link between cultural and linguistic competence to quality of care. In one article by Brach et al. entitled "Crossing the Language Chasm" (3), a review of the literature highlights that the quality of communication between patients and clinicians can have a major impact on health outcomes, and limited English proficiency can interfere with effective communication. The article points out that more than ten million U.S. residents speak English poorly or not at all, constituting a language chasm in the health care system. In addition to reviewing the evidence on the link between linguistic competence and health care quality, it draws on the experiences of fourteen health plans that have been at the forefront of linguistic competence efforts, to identify lessons for plans, purchasers, policymakers, and researchers on ways to improve the availability and quality of interpreter services.

Another study by Betancourt et al. entitled "Cultural competence and health care disparities: key perspectives and trends" (4) highlights that cultural competence has gained attention as a potential strategy to improve quality and eliminate racial/ethnic disparities in health care. In 2002 the researchers conducted interviews with experts in cultural competence from managed care, government, and academe to identify their perspectives on the field. In the study, they present their findings and identify recent trends in cultural competence focusing on health care policy, practice, and education. Their analysis reveals that many health care stakeholders are developing initiatives in cultural competence, yet the motivations for advancing cultural competence and approaches taken vary depending on mission, goals, and sphere of influence.