Racial Disparities in Health Care and Cultural Competency

Posted: 23 Jan 2004

See all articles by Lisa Chiyemi Ikemoto

Lisa Chiyemi Ikemoto

University of California, Davis - School of Law

Abstract

A close look at health care's institutional practices reveals a near monoculture that is predominantly English-only, ethnocentric, and racist. That institutional culture interferes with the way health care is delivered to racial and ethnic minorities, and thus, contributes to racial disparities in health care. Nearly every aspect of health care's culture contains a portal for bias that, in turn, can affect access, patient status, and quality of care. Those portals include the use of discretion in helping patients navigate institutional bureaucracy, the way that institutional authority reinscribes race, gender, and wealth hierarchies within the provider-patient relationship, the embrace of efficient practices such as racial profiling in diagnoses, the failure to provide language assistance for patients whose primary language is not English, and the use of nativist assumptions in communicating with patients.

Cultural competency efforts have the potential to improve the way that health care is delivered, particularly to persons of color and others not included in health care's institutional culture. Perhaps not surprisingly, recent efforts to use law to implement cultural competency in health care have provoked vehement debate about the role of law in the most basic aspects of patient care. The political discourse formed by the debate between cultural competency's advocates and objectors has so far resulted in a narrow vision of change in health care delivery. Existing law and proposed standards resulting from this discourse similarly express limited goals for cultural competence and narrowing racial disparities in health care. This Article argues that a bigger vision and a more ambitious legal agenda are necessary to avoid shrinking the promise of cultural competence to reduce racial disparities in health care.

Suggested Citation

Ikemoto, Lisa Chiyemi, Racial Disparities in Health Care and Cultural Competency. Available at SSRN: https://ssrn.com/abstract=492223

Lisa Chiyemi Ikemoto (Contact Author)

University of California, Davis - School of Law ( email )

Martin Luther King, Jr. Hall
Davis, CA CA 95616-5201
United States

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