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Cultural Competence in Health Care
A Systems Approach
Janice L. Dreachslin (Author), M. Jean Gilbert (Author), Beverly L. Malone (Author)
9781394351213, Wiley
Paperback / softback, published 24 April 2026
480 pages
23.1 x 18.5 x 3 cm, 0.68 kg
Build organizational and clinical skills to deliver equitable care to diverse populations The second edition of Cultural Competence in Health Care: A Systems Approach presents the growing evidence base for a systems approach to cultural competence and strategic diversity management in health care and explains how health care professionals and organizations can use that knowledge to ensure that every patient receives high-quality, safe, and cost-effective personalized health care. The impact of race and ethnicity, gender and gender identity, sexual orientation, age, language, socioeconomic status, and religion on health and health care are discussed. Despite the current challenges, private sector organizations that accredit health care providers, health plans, and educational programs in medicine, nursing, and allied health continue to affirm the need for cultural competence through their accreditation criteria. Voluntary health care professional associations continue to provide membership with support, encouragement, and resources for the delivery of culturally and linguistically competent health care. And health care providers strive every day to deliver personalized care and work diligently to improve their patients' health by delivering health care in a manner that is respectful of each patient's needs and preferences. Written by the same three nationally known scholars and experts as the first edition, the second edition presents principles and practices that can be realistically incorporated into the ongoing work of any health care provider or organization. Each chapter contains learning objectives, summary, key terms, and review questions and activities designed to allow the reader to explore, analyze, and apply concepts and practices identified throughout the text.
Figures and Tables xii About the Authors xiv Preface xvii Acknowledgments xxii About the Companion Website xxiv Part One THE DIVERSITY IMPERATIVE 1 Chapter 1 Systems Approach to Cultural Competence 3 Dimensions of Diversity 7 Health Care Diversity Challenges 20 Health Care Disparities in the United States 22 Changing the US Health Care System 23 Systems Approach in the Health Care Delivery Organization 27 The Importance of Leadership 29 Summary 30 Key Terms 30 Review Questions and Activities 31 References 32 Chapter 2 Systematic Attention to Health Care Disparities 37 What Are Health Care Disparities? 38 Racial and Ethnic Disparities in Health Status 39 Disparities Across Other Diversity Dimensions: Gender, Gender Identity, Sexual Orientation, the Elderly 53 Stakeholder Attention to Health Care Disparities 62 Systematic Strategies for Reducing Health Care Disparities 66 Summary 70 Key Terms 70 Review Questions and Activities 71 References 71 Chapter 3 Workforce Demographics 78 Trends in the US Labor Force 79 Diversity and the Health Professions 83 Drivers of Disparities in the Health Professions 86 Recommended Organizational- Level Actions 91 Workforce Diversity Challenges 93 Summary 97 Key Terms 98 Review Questions and Activities 98 References 99 Part Two The Development of Cultural Competence 103 Chapter 4 Foundations for Cultural Competence in Health Care 105 What Is Cultural Competence in Health Care? 106 Long Journey Toward Cultural Competence 117 Cultural Competence and the Health Care Provider Organization 124 Cultural Competence and the Multicultural Health Care Workforce 130 Summary 134 Key Terms 135 Review Questions and Activities 135 References 136 Chapter 5 Hallmarks of Cultural Competence in Health Care Professionals 138 Personal Journey of Cultural Competence 140 Framework for Role Development 148 Journey of Self- Discovery 152 Summary 161 Key Terms 162 Review Questions and Activities 162 References 164 Chapter 6 Training for Knowledge and Skills in Culturally Competent Care for Diverse Populations 165 Eight Principles for Knowledge and Skills Training 167 Cultural Competence Knowledge and Skills for Administrators and Directors 171 Cultural Competence Training for Health Care Professionals in Direct Patient Care 177 Cultural Competence Training for Support Staff 201 The Role of Assessment in Cultural Competence Training 203 Receptivity to Knowledge and Skills Training 206 Summary 208 Key Terms 208 Review Questions and Activities 209 References 210 Part Three Cultural Competence and Health Care Delivery 215 Chapter 7 Cultural Competence in Health Care Encounters 217 Models from Transcultural Nursing 221 Giger– Davidhizar Transcultural Assessment Model (GDTAM) 234 Being Culturally Responsive 246 Summary 248 Key Terms 249 Review Questions and Activities 249 References 250 Chapter 8 Language Access Services and Crosscultural Communication 254 Language Use in the United States 256 Language Differences in Health Care Encounters 258 Attitudes Toward Limited- English Speakers 263 Changing Responses to Language Barriers in Health Care 266 An Expanding Profession: The Medical Interpreter 277 Translation in Written Health Care Communication 283 Communication Is More Than Words 286 Summary 289 Key Terms 290 Review Questions and Activities 290 References 291 Chapter 9 Group Identity Development and Health Care Delivery 297 Research Highlights 299 Minority Status Group Identity Development 303 Majority Status Group Identity Development 311 Using the Models 323 Summary 325 Key Terms 326 Review Questions and Activities 327 References 328 Part Four Cultural Competence and the Health Care Organization 331 Chapter 10 The Centrality of Organizational Behavior 333 The Science of Organizational Behavior 335 Organizations as Contexts for Behavior 336 OB Research Highlights 338 Can Culturally Competent Health Care Professionals “Go It Alone”? 350 Summary 356 Key Terms 357 Review Questions and Activities 357 References 358 Chapter 11 The Business Case and Best Demonstrated Practices 362 Evolution of the Business Case 364 The Business Case for Cultural Competence in Health Care 364 Workforce, HRM, and the Business Case 375 Best Demonstrated Practices 378 Assessment and the Systems Approach 391 Benchmarking 393 Role of Metrics in the Systems Approach 394 Summary 399 Key Terms 400 Review Questions and Activities 401 References 402 Chapter 12 The Future of Diversity and Cultural Competence in Health Care 406 Trends That Support Widespread Adoption of the Systems Approach 407 The Sustainability Movement and the Systems Approach 417 Change Management and Force- Field Analysis: Tools to Envision and Shape the Future 418 Summary 424 Key Terms 424 Review Questions and Activities 425 References 425 Glossary 429 Index 437
Subject Areas: Medicine: general issues [MB]
