Improving health equity through the practice of cultural humility
Cultural humility is an approach to expanding one’s appreciation for differing cultures and the life experiences of individuals identifying with those cultures. These experiences intersect with socioeconomic class, education, sexual orientation, race and ability. In health care settings, cultural humility means actively listening to gain an understanding of how each patient’s unique background and life experiences impact their health care goals and how they wish to engage with the health care system and staff. A culturally humble approach to health care is a step forward in addressing the persistent and longstanding health inequities experienced by historically underrepresented groups. Delivering health care that “meets the social, cultural and linguistic needs of patients” can lead to improved health outcomes and reduce racial and ethnic health disparities.1
UnitedHealthcare works to embed the practice of cultural humility into the health care ecosystem through workforce development, community collaborations and training opportunities. Continually growing our cultural intelligence is directly linked to our ability to understand and respond to the everchanging needs of our members and to meet our goals for improving health equity.
How practicing cultural humility improves health equity
There are individuals who through their culturally defined community or intergenerational experiences hesitate to use health care. Proceeding in the way we always have will not help to resolve the mistrust created by those who came before us. As managed care and other health care organizations increasingly focus on health equity, the approach they take matters. The practice of cultural humility compels us to make intentional changes in how we show up for those we serve. It requires us to take time to understand a member’s lived experience so that we can effect change between the individual and the health care delivery system.
Creating a nonjudgmental, safe space for members to share allows health care providers to develop a treatment plan that’s much more personalized and specific. For example, we’ve created assessments that ask how a member identifies, but we also have intentional scripting for our care managers that says, “Tell us how that experience/identity impacts your engagement, perception and use of the health care system.” These intentional pauses help staff to practice showing up and inviting important conversations that might otherwise get missed.
Cultural humility differs from cultural competency, which is training that was developed in the health care profession to increase knowledge of differing cultural practices and beliefs. When employed alone, cultural competency practices have shown limited effectiveness in combating health inequities.2 Cultural humility differs in that it focuses on engagement with patients to better understand their lived experience and to support their active engagement in their own health care. The goal is to level the power dynamic, elevating a patient’s power in every interaction within the health care system without making any assumptions about an individual when they seek care.
Recognizing each member’s unique life experience
UnitedHealthcare is invested in learning from and supporting its diverse workforce and patient base. Staff with similar lived experiences to patients can connect more humbly and genuinely to learn how that experience and background shapes a patient’s perceptions and engagement with the health care system. This allows health care workers and patients to work alongside one another, setting and achieving goals that are important to the patient and that address their whole-person health care needs.
To further our practice of cultural humility, we cultivate trusted partners throughout the country. These organizations are local, understand the community context and have continual engagement with populations that can be hard to reach due in part to a lack of trust in the health care system.
UnitedHealthcare is committed to the practice of cultural humility and to delivering care that focuses on removing power differentials. Instead, we place emphasis on building relationships and understanding each patient’s full life experience.
