Health Disparities, Systemic Racism, and Failures of Cultural Competence.

Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Instead, it has adopted a culture-based agenda through the framework of cultural competence to address dis...

Descripción completa

Detalles Bibliográficos
Publicado en:American Journal of Bioethics Vol. 21; no. 9; pp. 4 - 11
Autores principales: Berger, Jeffrey T., Miller, Dana Ribeiro
Formato: Journal Article
Publicado: Taylor & Francis Ltd Sep2021
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Instead, it has adopted a culture-based agenda through the framework of cultural competence to address disparities despite a paucity of supporting data. Cultural competence is ethnocentric in orientation and its content sustains biases that are long-standing in health care. Moreover, Cultural competence is based on a number of flawed assumptions and is not structured around a set of clearly stated ethical values. In this paper, we will demonstrate ways in which Cultural competence reflects embedded ethnocentrism, perpetuates entrenched biases, and fails to recognize the depth and breadth of systemic racism as these relate to the stated goal of Cultural competence—the mitigation of health disparities. In addition, we offer a reframed approach to health disparities in medical education.