Black History Month 2024: Focusing on cultural humility to reduce disparities

The Buzz This Week

Each February in the United States is dedicated to honoring Black history, experience, and culture in observance of Black History Month. While we celebrate the achievements and contributions of Black Americans, we also reflect on the injustices faced, including disparities in healthcare.

The official theme for Black History Month this year, from the Association for the Study of African American Life and History (ASALH), is African Americans and the Arts. ASALH notes, “African American artists have used art to preserve history and community memory as well as for empowerment.” Black Americans have played an integral role in numerous artistic and cultural movements throughout history. This month is an opportunity to recognize and appreciate Black history’s cultural impact.

In healthcare, unfortunately, Black culture has not always been recognized or celebrated. A recent survey demonstrated many Black patients feel they need to alter aspects of their culture to receive appropriate care from providers. In 2022, California Health Care Foundation and Evitarus conducted a study of more than 3,000 Black Californians and found 35% tailored their behavior and speech to put a provider at ease, 35% of those enrolled in Medi-Cal avoided receiving care, and 32% thought about how they dressed before visiting their provider.

The Office of Minority Health has demonstrated its commitment for Black History Month 2024 through the slogan, “Advancing Better Health Through Better Understanding.” Patients provided with culturally and linguistically appropriate information receive better outcomes.

Why It Matters

“Cultural humility,” at times referred to as “cultural competence,” is a critical aspect of preventing and addressing health disparities. The National Prevention Information Network (NPIN), a project within the Centers for Disease Control and Prevention (CDC) notes that “Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.”

A successful provider-patient relationship relies on communication and mutual trust. Patient language, cultural norms, and beliefs are vital to optimal treatment, diagnostics, and experience. Patients who feel respected and engaged have a higher likelihood of medical adherence, follow-up and referral appointment attendance, and patient satisfaction.

There are numerous ways providers can focus on cultural humility:

Incorporate cultural humility into organizational policy. Organizations can show commitment to change by incorporating cultural humility expectations into policy, which governs behavior and sets rules, responsibilities, process, and timelines. Organizational policy can apply to employees, management, clinicians, and suppliers.
Involve and understand the community served. Understand the demographics of the community, engage with community leaders, and determine how cultural practices may be incorporated to demonstrate reverence to various cultural and demographic perspectives. “Nothing about us, without us” is the sentiment that many communities and healthcare organizations have adopted to foster a sense of belonging.
Create a learning environment. Provide ongoing training for all employees. Create a culture that encourages staff to share successes, ask questions, challenge the status quo, and express constructive criticism that nudges the organization to perform better.
Collect data. REAL (race, ethnicity, accessibility, language), SOGI (sexual orientation and gender identity), and social needs data are important to establish understanding of population demographics and serve as a baseline for unearthing disparities in clinical care and outcomes. The Joint Commission and the Centers for Medicare and Medicaid Services now require collection of REAL and social needs data. SOGI data collection is on the horizon.

Black History Month is an opportunity to honor and celebrate Black contributions, including those to culture and the arts. It also serves as a reminder to focus on culturally humble and relevant care all year round, to ensure Black patients receive equitable care and respect as patients of other races and cultural backgrounds.