Developing a Self-Assessment Toolfor Culturally - Office of Minority ...

assess their own beliefs and have knowledge of general ethnic, regional, and religiousbeliefs and practices before discussing health care issues with patients.Linguistically appropriate health care services—i.e., the provision of translatedwritten materials and oral interpretation services—are vital for a patient’s understanding,compliance, and positive health outcomes. Perhaps the most critical component of qualityhealth care is the patient’s ability to understand and be understood. Key consequences oflanguage barriers in the health care setting include: 1) inadequate communication fromthe patient to the provider, making it difficult to relay a complete medical history or toaccurately report symptoms; and 2) inadequate communication from the provider to thepatient, which interferes with accurately informing (or educating) the patient about theillness and treatment (Woloshin et al. 1995).Also, studies suggest that accurate communication between patient and providerdecreases unnecessary diagnostic testing and increases proper diagnosis, patientcompliance, and the retention and use of appropriate services (National Committee forQuality Assurance NCQA 1995). Within this context, researchers raise several points inarguing the need for CLAS. When utilizing the health care system, non-English speakingindividuals encounter communication challenges that hinder access to care and effectivetreatment (Putsch 1985). In addition to language, researchers note that cultural issues arerelevant throughout the health care delivery system. Although some studies havesuggested reduced access to medical care may be due to language barriers or lowsocioeconomic status (Brach and Fraser 2000; Gany and Thiel de Bocanegra 1996; TheHenry J. Kaiser Family Foundation 1999), in other studies, the same disparities have beenobserved in racial and ethnic minorities of any socioeconomic status (Brach and Fraser2000; Smedley et al. 2002).Culture influences the way patients perceive illness (Landrine and Klonoff 1994;Landrine et al. 1994), seek care (Geissler 1991), and participate in and respond totreatment (McCormick 1993; Pilowsky 1993). Receipt of equal care may also be inhibitedby biases and stereotypes (HRSA 2000; The Henry J. Kaiser Family Foundation 1999;Smedley et al. 2002).2.1.4 CLAS Address Disparities in Health CareEvidence suggests that interaction of genetic differences, environmental factors, andhealth behaviors propagates health care disparities. These elements include biases ofhealth care workers toward racial and ethnic minorities, lack of prevention messagestailored to specific populations, lack of physician awareness of higher risk factors for someillnesses in particular populations (HRSA 2000), lack of physician knowledge oftraditional remedies and folk practices, and diagnostic errors due to miscommunication(Brach and Fraser 2000).COSMOS Corporation, December 2003 2-4