YOUNGSTOWN Ohio –Cultural Competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.
According to Georgetown University, a culturally competent health care system can help improve health outcomes and quality of care.
There is a strong emphasis on cultural competence in Ohio for medical professionals due to the lack of care for minorities which has been shown in the outcomes of health issues across the globe and in Ohio. The racial disparities among patients in Ohio are catastrophic.
Current 15thDistrict Ohio State Senator Charleta Tavares previously served as the Executive Director of the Multiethnic Advocates for Cultural Competence, whose mission was to enhance the quality of care in Ohio’s health care system.
Tavares noted that in Senate Bill 332, which primarily focuses on infant mortality, they [legislators] researched what other states were doing to reduce their number of infant deaths as whole and did the same except they did not include cultural competency.
This triggered Tavares to present Senate Bill 16 which would educate medical professionals how to successfully care for minority patients teach the goals and needs of the patient at hand.
Unfortunately, presenting the bill was only half of the battle. Getting medical associations and professionals on board with it has been the problem to this day.
“I wanted it required, but I know it’s not going to happen. I’ve heard some professionals that don’t believe they’re biased and already culturally competent. None of us are, it’s a continuum,” she said.
When the bill was introduced, the Ohio State Medical Association, which represents physicians in Ohio did not approve of making it a requirement to have all medical professionals take a cultural competence course.
Tavares said, “we’re still trying to get it through because we know that it is a critical component in order to serve our patients most appropriately.”
According to The Commonwealth Fund, the lack of diversity in the healthcare workplace and leadership is one of the leading obstacles to cultural competence, contributing to racial and ethnic disparities of care.
According to the Association of American Medical Colleges, over 38 states in the United States have over 60% of white physicians employed into the healthcare workplace.
In Alabama where the infant mortality rate was listed at 9.1% in 2016, their medical field is 74.9% white with a very diverse population. Similar to Ohio’s 2020 infant mortality plan, Alabama also has an infant mortality goal of 6.0 by the same year.
While Alabama and Ohio seem to have a similar end goal, their objectives are not quite the same.
Ohio is targeting mothers while they’re pregnant and ensuring the medical workplace is falling through on the same note making it a safe environment for all parties involved. Ohio also is making sure that programs for minority women that are pregnant are available due to the alarming rate in which black infants are dying. This includes mothers-to-be, physicians, home visitors, etc.
Alabama is focused primarily on the actions that the mother is doing during her pregnancy. For instance, four out of eight of Alabama’s objectives are listed as, according to the Alabama Public Health are:
- Increase the use of progesterone to women with a history of prior preterm birth.
- Reduce tobacco use among women of child-bearing age.
- Encourage women to wait at least 18 months between giving birth and becoming pregnant again.
- Continue safe sleep education efforts.
There’s not much proposing of requirements on the medical side or implements of systems that have home visits such as Ohio.
In Ohio, the 2018-19 state budget dedicates roughly $50 million to improving birth outcomes and reducing racial and ethnic disparities. Much of state funding is dedicated to contest infant mortality in high-risk areas. Nine cities in Ohio accounted 59 percent of all infant deaths and 86 percent of African-American infant deaths making this a very important matter.
Many minorities do not believe that health care professionals have their best interest therefor there is a lack of urgency when turning to these professionals for issues.
For example, according to the National Cancer Institute, black women have a 20 percent higher cancer death rate than white women. These diseases are developed earlier in life and black people overall have a shorter life expectancy than their white counterparts with the same illness.
NCI believes these disparities could stem from lack of medical coverage and barriers to early detection.
This lack of trust between minorities and health care systems could also possibly stem from the historical evidence of medical professionals and the government exploiting and experimenting on minority people in the name of science such as the Tuskegee Syphilis Study.
In this study, 600 black men were administered syphilis without their consent and knowledge, and denied treatment.
Other experiment examples like this are American doctors knowingly giving Philippine citizens the bubonic plague in 1902 and Dr. Eugene L. Saegner at the University of Cincinnati irradiating black men and women for 11 years through overexposure to radiation with no painkillers.
A cultural competent workplace could establish a great connection between the community and health professionals beyond just the social realm.