Author: By Capt. Robert Tosatto, R.Ph., M.P.H., M.B.A., director, HHS Office of the Assistant Secretary for Health, Division of the Civilian Volunteer Medical Reserve Corps
For decades our nation’s healthcare community has been working to address health disparities by improving health services and access to health care in routine times and during disasters for the neediest members of our nation. It’s a journey that begins with training, recruitment and engagement and ends with health security and resilient communities.
People with the least in our society are often impacted the most by disasters. Frequently, when compared to those with more in our society, those with the least aren’t as healthy to begin with and their health conditions decline when housing, health care and social services are disrupted or unavailable after disasters. Minority members of our communities often are impacted disproportionately.
By reducing vulnerabilities and increasing access to health care, we can improve our entire community’s resilience before and reduce risks after disaster. Solving the problem sounds simple enough – understand who is impacted by disasters in a geographic area and improve their health outcomes. In reality, the problem and solutions are quite complex.
One way to improve health outcomes is to develop cultural competency within the health care workforce. Cultural competency is a combination of behaviors, attitudes and policies that enable effective work in cross cultural situations. By increasing cultural competency, health care professionals can plan for the services that will be needed after disasters and will be prepared to help the most vulnerable in our communities respond and recover from disasters.
Cultural competency begins with training. HHS agencies are working with health professional schools, such as schools of medicine, nursing, pharmacy, and public health, to focus curriculum on the needs of at-risk populations. Because of these efforts, most schools now offer or are developing classes on health disparities.
Culture competency is strengthened with the growing number of minorities who join the health security workforce. At HHS, we’re working with external partners, such as HOSA-Future Health Professionals, to encourage minority students to pursue health careers. Of the over 150,000 HOSA members, about 50 percent are minorities. HOSA promotes health careers among high school and college students and identifies ways students can get engaged in health in general, as well as with public health emergencies.
For healthcare professionals already in the workforce, do a bit of self-reflection on your own cultural competence. Understand that the provider and the patient each bring their individual learned patterns of language and culture to the health care experience which must be transcended to achieve equal access and quality health care. Look to professional organizations and other sources for training in cultural competence.
Watch, too, for coalitions being formed around developing core competencies and not just related to disaster response. Get involved. Create a coalition. Ensure that continuing education is competency based, so cultural competence can be woven into the professional competencies being taught.
As you pursue continuing education or provide training for others, look at cultural competency. Then take the next step: work with the variety of people within your community to understand their health needs and take those needs into account in planning for day-to-day health care services and in planning to ensure those services can withstand disaster, especially for the most vulnerable among us. After all, cultural competency goes beyond training; it’s about engaging the most vulnerable for a more resilient community.
Developing a culturally competent healthcare workforce helps improve community resilience, and ultimately, health security. In fact, developing the healthcare workforce is an element of the 2009 National Health Security Strategy, a national (not a federal) strategy. ASPR is currently revising the strategy, and is looking for feedback from diverse stakeholders on improving health security. Check out the draft 2015-2018 National Health Security Strategy and share your ideas on ways to improve health security and cultural competency in the healthcare workforce.
