Care Transformation Center Blog

Take a two-step approach to reducing health disparities

by Matt Gayer

Cultural competency—the ability to work effectively in cross-cultural situations—isn't a new concept in health care; in fact, it's been widely discussed for more than a decade. However, many health care organizations are still determining how to ensure culturally competent care.

Now is the time to start taking steps

Culturally competent care is more important now than ever before for three main reasons. First, the demographic landscape of American patients is changing. This is partly due to shifts in national and regional demographic trends: racial minorities compose an increasing percentage of the United States population. Second, this is also a byproduct of health care reform, which has increased access to health care services for low-income and young adult patients. And third, the shift toward population health is elevating the importance of culturally competent care.

Providing medical care that is culturally appropriate has been shown to improve patient outcomes and satisfaction. In a system increasingly focused on outcomes and patient engagement, cultural competency is no longer optional.

Broadly speaking, there should be two main phases in the transformation of your organization's care toward cultural competence:

Phase 1: Learn about your community

The first step is finding out what’s really going on—and what your community really needs. Many health care organizations take this first step by conducting a survey of their patient population. The process of designing and administering a community needs assessment will be different for every health care organization and community, but every assessment should seek to answer three main questions:

What is your community like?
This involves understanding demographics, primary languages spoken, and public infrastructure (e.g., sidewalks; parks; libraries) in your community. This will help highlight prominent issues and available resources.

What does your community care about?
This involves understanding your population's attitudes toward health, family, medicine, and building community, among other factors. This portion of the assessment will help prioritize what culturally competent strategies your organization should pursue.

What skills do your providers and staff already have, and how can they develop?
It's critical to assess how prepared your staff are to deliver excellent care to patients whose experiences, backgrounds, and priorities might differ from theirs. Understanding your staff's existing skills, opportunities for development, and attitudes toward culturally competent care will help you prioritize and plan interventions. As you assess your organization's people, you'll also need to consider the infrastructure of your organization to determine how it is promoting—or limiting—culturally competent care.

To review, any community needs assessment should center on the following three questions:

Community Needs Assessment Questions

Phase 2: Change how you work

Of course, the community needs assessment is just the beginning. Once you've learned more about your community, you can enter the second phase of instilling cultural competence in your organization. The second phase should focus on training care providers to understand and meet the needs of your patient population, along with launching new processes, programs, or services. This is the actual work of culturally competent care. Offering a culturally relevant care experience for patients requires provider buy-in, strategically deployed resources, and ongoing evaluation.

Over the next few months, we'll dive into the tactics and strategies related to both of these phases: first, finding out what's going on in your community, and second, how to take action to become a more culturally competent organization.

In the meantime, reach out to us at with any questions or suggested topics that you'd like to see us cover.

Get more Advisory Board resources on health disparities

Our Health Disparities Initiative offers many more tools for understanding health disparities, building cultural competency at your organization, and developing community partnerships.