Cultural Competency & Social Determinants of Health in Patient Care

Historically in the U.S. healthcare system, patients from racial and ethnic backgrounds are often ignored, dismissed, and denied care. Studies have shown that across clinical pathology, Black and Indigenous people of color receive worse healthcare and healthcare outcomes. 1  Black New Yorkers consistently have the shortest life expectancy among racial or ethnic groups 2 , while also facing the highest burden for hypertension. 3  These healthcare disparities exist at every step of the process, and not having this diversity reflected within the healthcare field means that the humanity of marginalized communities has to be argued.  Patients themselves are becoming increasingly aware of the health disparities present because they know that culturally competent care can be the difference between care and cure or life and death. The bottom line is that cultural competency within medical education systems saves lives. 

Cultural competency is seen as foundational to tackling health disparities. Still, when they begin to intersect with other social determinants of health, the typical linear approach does not prove to be the most effective. Current approaches to building a culturally competent healthcare workforce include leveraging medical interpreters, integrating community health workers as well as social workers, and institutionalizing structural policies aimed at rectifying or eradicating healthcare disparities. 4

These approaches to care aim to have professionals at each point in a patient's care who are committed to understanding the communities in which patients live and how their cultural or racial/ethnic background may impact how they navigate healthcare spaces. When certain aspects of a patient's being are dismissed or misunderstood, this can inadvertently impact the care they receive. Institutionally, there have been efforts to actively recruit and retain minority staff within the healthcare workforce in order to reflect the diverse demographics of the communities they serve. 5

Another crucial way institutions have become committed to providing culturally competent care is by tracking various racial demographics and having research specifically focusing on the healthcare disparities these communities might be vulnerable to. 6 In recent years, there have been drawbacks to diversity, equity, and inclusion in the healthcare sector. This has caused researchers to draw back on efforts that once had a racially focused lens to keep their funding.  With this emerges a key question: How are healthcare professionals able to rectify crises that affect one population over another when they are not able to direct specific spending, research, or interventions to that population? In these pressing moments, healthcare professionals need to remain committed to addressing healthcare crises affecting specific populations and take a microlevel approach. This means practicing humility and taking nothing for granted. For example, language is a universal human phenomenon, but that does not mean all languages are universally understood. 

Language barriers often exacerbate other barriers that reduce access to healthcare. Language barriers within the healthcare sector lead to miscommunication between the medical professional and the patient, which only reduces the quality of care. 7 In turn, this negatively impacts the quality of healthcare delivery and patient safety.  It is not hard to imagine how a patient who does not speak the local language of the area they reside in will be disadvantaged in terms of accessing healthcare services. For example, they may not be fully knowledgeable about the resources available to them, and they would be less able to advocate for themselves. This communication gap can delay diagnosis since crucial symptoms that would have otherwise been explained or noted may be missed. When diagnosis is delayed, a patient may need to be readmitted, which puts an extra strain on their pockets. Additionally, having little to no proficiency in the language you are expected to receive care in can be highly dangerous. Studies have shown that language barriers also lead to errors within medication since patients are not able to understand the prescription dosages and can cause patients to suffer from adverse drug reactions. 8 It is also important not to assume that every hospital will have translation services readily available. Only a fraction of U.S. hospital patient portals offer multilingual access beyond English and Spanish, which drastically limits linguistically marginalized groups. 9

Increasing language access ensures that every individual receives the high-quality treatment they deserve. Research conducted by Healthy People 2030 has shown that limited language and low literacy skills are directly associated with worsened chronic condition management. 10. Education empowers individuals with the knowledge needed to make informed, proactive decisions about their well-being. Education often serves as a bridging gap between understanding health risks and making well-informed decisions that will benefit your overall health. 

To make health equity a reality, healthcare has to change at its core. Instead of treating everyone the same, providers need training that embraces different backgrounds, life experiences, and cultures. This shifts care from a "one-size-fits-all" approach to one that truly centers on the patient, helping to break down old barriers, rebuild trust, and make sure everyone gets the care they deserve.

Works cited 

1: Macias-Konstantopoulos, W. L., Collins, K. A., Diaz, R., Duber, H. C., Edwards, C. D., Hsu, A. P., Ranney, M. L., Riviello, R. J., Wettstein, Z. S., & Sachs, C. J. (2023). Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity. The western journal of emergency medicine, 24(5), 906–918. https://doi.org/10.5811/westjem.58408

2: Health Department Annual Statistics Show Increased Life Expectancy, but Racial Inequities Remain - NYC Health. (2023). In Nyc.gov. https://www.nyc.gov/site/doh/about/press/pr2025/2023-statistics-show-increased-life-expectancy-for-new-yorkers.page

3: Lackland D. T. (2014). Racial differences in hypertension: implications for high blood pressure management. The American journal of the medical sciences, 348(2), 135–138. https://doi.org/10.1097/MAJ.0000000000000308

4: Lee, Y., Sung, S., & Fan, X. (2025). Cultural competency education for healthcare professionals: an umbrella review. BMC medical education, 25(1), 1445. https://doi.org/10.1186/s12909-025-08008-7

5: Awan, O. (2025). Trump Administration’s Attack On DEI Threatens Health For Everyone. In Forbes. https://www.forbes.com/sites/omerawan/2025/03/23/trump-administrations-attack-on-dei-threatens-health-for-everyone/

6: Health Policy Institute. (2022). Cultural Competence in Health Care: Is it Important for People with Chronic Conditions? In Health Policy Institute. GeorgeTown University. https://hpi.georgetown.edu/cultural/

7: Wong, M., Siddiqui, S., Nnamdi, G., Nguyen, B., Harutyunyan, N., & Dermenchyan, A. (2025). Addressing Language Barriers in U.S. Healthcare: The Role of CLAS Standards, Telehealth, and Policy in Supporting Limited English Proficiency Populations. Health Sciences Review, 100249. https://doi.org/10.1016/j.hsr.2025.100249

8: Branch, J., Hiner, D., & Jackson, V. (2021). The impact of communication on medication errors. Patient Safety Network. https://psnet.ahrq.gov/web-mm/impact-communication-medication-errors

9: Blum, K. (2025). Only 11% of patient portals are accessible in multiple languages. In Association of Health Care Journalists. https://healthjournalism.org/blog/2025/12/only-11-of-patient-portals-are-accessible-in-multiple-languages/

10:Healthy People 2030. (n.d.). Language and Literacy - Healthy People 2030 | odphp.health.gov. In Health.gov. Retrieved July 21, 2026, from https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/language-and-literacy