Disparities by Race/Ethnicity and Immigration Status in Perceived Importance of and Access to Culturally Competent Health Care in the United States

J Racial Ethn Health Disparities. 2024 Jun;11(3):1829-1841. doi: 10.1007/s40615-023-01655-w. Epub 2023 Jun 14.

Abstract

While cultural competence has been proposed as an important framework for enhancing health care equity, how members of different racial/ethnic groups consider the importance of cultural competence and their access to culturally competent health care are insufficiently understood. Despite continuously increasing immigrants into the US, it is unclear how immigration status intersects with race/ethnicity to shape individuals' perception of and access to culturally competent care in the US health care system. To fill this research gap, this study examined how the intersection of race/ethnicity and immigration status is associated with people's perception of and access to culturally competent health care and among immigrants, whether their length of stay matters, using data from the 2017 National Health Interview Survey. The results show that while racial and ethnic minority members reported greater importance of culturally competent care than non-Hispanic whites, Asian, black and other-race immigrants reported even greater importance than their US-born counterparts. Additionally, although racial/ethnic minorities reported greater limited access to culturally competent care than their white peers, this gap in access was observed primarily among US-born racial/ethnic minorities. Shorter length of residence (fewer than 15 years) was associated with greater perceived importance than residence of at least 15 years among immigrants, but access to culturally competent care did not differ by length of residence. The findings speak to racial/ethnic minorities' greater desire for culturally competent care and their unmet needs.

Keywords: Cultural competence; Immigrants; National Health Interview Survey; Race/ethnicity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian
  • Black or African American
  • Cultural Competency
  • Culturally Competent Care
  • Emigrants and Immigrants* / psychology
  • Emigrants and Immigrants* / statistics & numerical data
  • Ethnic and Racial Minorities / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Healthcare Disparities* / ethnology
  • Humans
  • Male
  • Middle Aged
  • United States
  • White
  • Young Adult