Being able to access safe and appropriate medical care is incredibly important for individuals to improve their quality of life as well as their mental and physical wellbeing. An important aspect of appropriate care that is often overlooked or dismissed is ensuring that it is culturally competent. Culturally competent care can be thought of as recognizing the unique experiences of individuals, their religious beliefs, cultural values, and preferences in order to care for them in a way that meets their social, cultural and linguistic needs. In a country where Western values and traditions are seen as the norm, Western ways of thinking can translate into the medical field as well, resulting in bias and prejudice against non Western thinking and approaches.
The situation in Canada
Research has shown that many marginalized individuals and communities do not feel like they are able to obtain culturally competent care in Canada and many health care professionals do not know how to administer it properly (McConkey, 2017; Steele et al., 2017). This can lead to members of marginalized communities to have negative experiences engaging with healthcare providers and, consequently, to avoid seeking care (Edge & Newbold, 2013). Additionally, there are many reports of a relationship of medical mistrust that exists between marginalized communities and medical professionals (McConkey, 2017). Medical mistrust refers to attitudes that individuals develop including feeling like their care providers do not have their best interests in mind, do not listen to them, invalidate their experiences, or force unwanted forms of treatment onto them (Edge & Newbold, 2013; McConkey, 2017; Steele et al., 2017). This can be an intergenerational process, influencing children of marginalized parent to develop negative attitudes towards Canada’s healthcare system before they even have significant levels of engagement with it.
As a result of the negative experiences, avoidance of care, and long-term medical mistrust, many marginalized individuals and communities have poor health outcomes as well as mental and physical wellbeing.
Some individuals may argue that culturally competent care does not need to be an important component of Canada’s healthcare system. These ideas are often largely influenced by the prioritization of Western values when it comes to science and medicine. The idea that conditions can be treated and/or cured is all that matters regardless of how they are treated or cured. But this perspective ignores the psychological impacts of negative experiences with the healthcare system and subsequent poor mental and physical health outcomes.
What can culturally competent care look like?
We can ask ourselves what culturally competent care should look like within the Canadian healthcare system. What types of care need to be accessible for different communities? What experiences may have impacted individuals’ engagement with the healthcare system in a negative way? How can these experiences be addressed? Who is providing care? What types of training have they received? Culturally competent care can manifest itself in the form of increasing diversity amongst healthcare providers, making traditional forms of medicine easily accessible to community members, and personalizing care for different individuals.
Increasing the diversity amongst healthcare providers from marginalized communities allowed individuals who are also from these communities to feel there is someone who may be able to relate to them and their experiences. It also broadens the wealth of knowledge about cultural traditions and values when it comes to healthcare within medical institutions.
Knowing how to care for individuals from marginalized communities in a culturally competent way is not enough when it comes to developing a culturally competent healthcare system if these types of care are inaccessible. Improving access to traditional forms of medicine and care is the next step to ensuring that all Canadian citizens are experience safe and appropriate care. This does not just include increasing the amount of healthcare professionals who can provide such care, but also making it financially accessible. For example, many forms of traditional Indigenous medical care are not covered by private insurance companies or included in employment benefits. So, even if there is care available it is often too expensive to be accessible for many individuals.
Personalizing care is integral to implementing intersectionality when it comes to the health of Canadian citizens. Intersectionality means taking into account all aspects of an individuals’ identity when describing their experiences or analyzing the social problems that may affect them. For example, when speaking about racialized women in Canada, we must consider that both their race and their gender impact their experiences when engaging with our social institutions, including our healthcare system. Therefore, in order to be able to truly achieve culturally competent care in Canada, we must use an intersectional lens.
Leading the way
An organization that is setting an incredible example of culturally competent care is Canadian Virtual Hospice and their Living my Culture program. With a focus on end-of-life care, this organization takes into account the cultural traditions and values of its patients in order to give them peace of mind and comfort during one of the most vulnerable times of their lives. With options for Indigenous, Chinese, and Somali communities amongst others, they recognize differences in experience that influence the care one needs. Organizations like this prove that culturally competent care is both possible and effective. While we hope that this perspective will become increasingly integrated into mainstream healthcare over time, we will continue to champion organizations such as Canadian Virtual Hospice who are doing the work right now.
Reference Material and Future Reading:
British Columbia. (2020). In Plain Sight: Addressing Indigenous-specific Racism and
Discrimination in B.C. Health Care. Retrieved from
Edge, S. & Newbold, B. (2013). Discrimination and the Health of Immigrant and Refugees:
Exploring Canada’s Evidence Base and Directions for Future Research in Newcomer
Receiving Countries. Journal of Immigrant Minority Health, 15, 141-148.
Health Policy Institute. (n.d.). Cultural Competence in Health Care: Is it important for people
with chronic conditions? Retrieved from https://hpi.georgetown.edu/cultural/
LivingMyCulture.ca. (2021). Culture. Retrieved from https://livingmyculture.ca/culture/
McConkey, S. (2017). Indigenous access barriers to health care services in London Ontario.
University of Western Ontario Medical Journal, 82(2), 6-9.
Siddiqi, A., Shahidi, F. V., Ramraj, C. & Williams, D. R. (2017). Associations between race,
discrimination and risk for chronic disease in a population-based sample from Canada.
Social Science & Medicine, 194, 135-141.
Steele, L. S., Daley, A., Curling, D., Gibson, M. F., Green, D. C., Williams, C. C., Ross, L. E. (2017).
LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by
Sexual Minority Women and Trans-Identified People. Journal of Women’s Health, 26(2),
116-127.