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Creating a Culturally Competent Health Care System

For more than a decade, cultural competency has been an emerging issue in health care delivery. California, as it often does in health care trends, has been leading the way.

An Agency for Healthcare Research and Quality report, “Cultural Competence California Style,” outlined efforts that helped set the national stage for innovative practices to improve health care for diverse populations in 2006.

Now the stage is changing.

The U.S. Census Bureau announced last month that for the first time, white infants no longer comprised a majority of births. Hispanic, black, Asian and other non-white infants accounted for 50.4% of U.S. births in the 12-month period that ended last July.

In California, which has been a “majority minority” state since the late 1990s, communities of color account for about 60% of the population.

With the Affordable Care Act adding as many as 30 million newly insured Americans to the system — up to three million in California — the need for health care providers who understand language and cultural differences will be greater than ever.

The number of people in the U.S. who don’t speak English as their native language has grown 140% over the past three decades, according to the Census Bureau. While it may not continue at that pace, the number of Americans for whom English is a second language is expected to continue growing.

California, with one of the most diverse populations in the country, has large — and growing — populations whose first language is Spanish, Chinese, Tagalog, Korean, Vietnamese or another of the 100 languages spoken in the state. Officials estimate about 40% of Californians speak a language other than English at home.

We asked stakeholders how legislators, policymakers, educators and business leaders can best prepare California’s health care system for an increasingly diverse population.

We got responses from: