Conversations in Cultural Competency

A Call to Action for Healthcare Providers

During June of 2020, Quality Interactions held a weekly live webcast series of conversations on how to provide culturally-competent healthcare amid the Covid-19 pandemic and social unrest due to racial injustice. Led by Dr. Joseph Betancourt, and moderated by Michele Courton Brown, these candid discussions drew on Dr. Betancourt's experience leading the pandemic response at Massachusetts General Hospital and his longtime leadership in the fight against racial and ethnic healthcare disparities.

Statement on Racial Injustice from Quality Interactions

Our country is in a pivotal moment. Against the backdrop of a pandemic that has disproportionately impacted communities of color at staggering rates, tens of thousands of Americans in all fifty states are protesting to demand an end to racial injustice and police brutality. We can no longer turn away from the reality of racism and racial inequality in America. 

Racial health disparities have been magnified dramatically by the COVID-19 crisis. In the Boston area, where Quality Interactions is based, we see that the hardest-hit communities are ones of color, where social distancing is a luxury not available to most residents. The epidemic is disproportionately affecting our most vulnerable populations, while also widening the gaps in preexisting health disparities. One of the most shocking amplifications of this is in maternal healthcare.

Top media outlets, including NPR and CNN, have turned to Quality Interactions Co-Founder, Dr. Joseph Betancourt, to better report on the critical issue of health disparities and the COVID-19 pandemic. 

Even in the absence of adequate race and ethnicity data, a clear picture of disparities in COVID-19's impact has nonetheless emerged: Black and Latino communities are the hardest hit. This is not due to features of the virus itself, but is an indicator of social conditions—including population density and socioeconomic status—which put black and Latino individuals at higher risk for contracting and perishing from the respiratory illness.

Dr. Betancourt is on the front lines of the epidemic at Massachusetts General Hospital, where he serves as Vice President and Chief Equity and Inclusion Officer, as well as a primary care physician. As a leading expert in health equity, Dr. Betancourt has been named to the City of Boston COVID-19 Health Inequities Task Force, alongside Quality Interactions CEO, Michele Courton Brown.

This summary of Dr. Betancourt's recent interviews provides a primer on how COVID-19 has created a perfect storm for communities of color and offers direction for how municipalities and institutions should apply immediate efforts to stem the tide.

Cross-cultural communication during a health crisis

The COVID-19 pandemic is disproportionately affecting the most vulnerable among us. This includes the elderly and those with underlying health conditions. It also includes communities of color, immigrant communities, low-income workers, and the prison population.

As more data emerges that show how social inequities are fueling the pandemic in the United States, it is clear that cultural competency and bias awareness in healthcare is more important than ever.

The healthcare system in many states is overwhelmed by cases of COVID-19 and struggling to secure the resources it needs to safely and effectively treat patients. It may seem like too much to ask for physicians and caregivers to be mindful of cross-cultural communication issues and unconscious bias in such hectic conditions.

But this is precisely the time when skills in cultural competency are most needed. The Three Tenets of Cross-Cultural Communication presented below are a helpful touchstone for all of us to keep in mind as we move forward in our professional interactions—whether they be in the most critical care settings or in other roles no doubt touched by our current reality. They may seem like simple recommendations, but there are concrete ways clinicians can actively exhibit them for maximum effect. They are empathy, curiosity, and respect.

A model for value-based healthcare

As healthcare moves toward a value-based system that rewards positive outcomes over procedures, social determinants of health (SDOH) are a central part of the effort to improve overall health and reduce health disparities.

Quality Interactions’ pioneering cultural competency education is ACAP’s choice to reduce unconscious bias and improve customer experience for member organizations.

We are pleased to announce that Quality Interactions was selected as a Preferred Vendor by the Association for Community Affiliated Plans (ACAP). 

ACAP is a national trade association representing not-for-profit Safety Net Health Plans. ACAP’s goal is to support and strengthen Safety Net Health Plans as they work with communities and providers to improve the health of vulnerable populations. ACAP members represent over 50 percent of individuals enrolled in Medicaid-based programs. The Preferred Vendor Program connects ACAP members with vendors who are optimized to meet their unique needs. 

How culture affects mental health

Culture impacts every mental health patient—and every mental health practitioner. Culture is a key factor that we all bring to every interaction, and it can be especially influential in times of emotional distress. Culture, including beliefs, values, norms, and behaviors, affects how we experience and interpret the world, including the meaning we impart to mental illness. In a clinical setting, cultural meanings of mental illness can account for whether and how a patient:

Massachusetts General Hospital improved patient experience—learn how you can too

Massachusetts General Hospital (MGH) is one of the nation's top medical institutions and a leader in the practice and research of medicine. It was established a community hospital charged with serving the medical needs of Boston's diverse population. Over 200 years later, people travel from all over the world to seek medical care at MGH, and serving diversity is still central to its mission.

Expanding the social history

Religion and spirituality are key cross-cultural issues that can impact the way patients react to disease and illness. They also affect the way patients approach medical management. Learn how healthcare providers can expand social history questioning to include religious and spiritual considerations. View and share the infographic.