If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart. – Nelson Mandela
My colleague, Natasha Takyi-Micah kicked off the blog series for National Minority Health Month detailing its history, and present-day relevance to eradicating health disparities for all ethnic minority groups. Let’s explore the importance of culturally and linguistically appropriate services.
What are culturally and linguistically appropriate services?
Culturally and linguistically appropriate services (CLAS) are services mindful of an individual’s communication needs and cultural background. CLAS helps providers consider preferred languages, communication needs, health literacy levels, and cultural perspectives on health. The framework guiding the implementation and administration of CLAS is upheld by National CLAS standards. These standards are meant to facilitate health equity measures.
Provide effective, equitable, understandable, and respectful quality care services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.
The National CLAS Standards were developed by the Office of Minority Health in 2013, meant to advance health equity, eliminate health disparities, and improve quality of treatment. These efforts are guided by a principal standard to “Provide effective, equitable, understandable, and respectful quality care services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.” The standards fit into three themes, which focuses on:
- Governance, leadership, and workforce
- Communication and language assistance
- Engagement, continuous improvement, and accountability
Why are culturally and linguistically appropriate services important?
The Civil Rights Act of 1964 stated that discrimination based on race, color, religion, sex, or national origin is unconstitutional. This protection is extended to Limited English Proficiency (LEP). Despite this guarantee under constitutional protection, individuals experiencing LEP are challenged with a range of adversity in areas of healthcare coverage, accessing health information, and communication barriers, with regular gaps during interactions with healthcare providers. CLAS helps individuals overcome these adversities by considering the intercultural differences between patients and health care providers. CLAS also helps reduce stigma that could deter individuals from seeking necessary treatment. Diversity in America is rising, and this increase in diversity must be met with programs and services that are culturally and linguistically appropriate.
What is Ohio already doing to champion cultural and linguistic competence?
Several programs, services, and organizations are working to champion culturally and linguistically diverse populations. Vocalize Columbus is an organization that works to support LEP individuals by connecting volunteer interpreters with free clinics. The intention is to address the language barrier between caregivers and patients, and to reduce any other health disparities that impact LEP individuals.The Ohio Department of Mental Health and Addiction (OHMAS), has resources on behavioral health engagement and stigma reduction focused on developing effective communication strategies to address behavioral health needs.In 2021, the Cuyahoga County Department of Job and Family Services and The Ohio Department of Job and Family Services (ODJFS) published a LEP Plan to show that customers of the Cuyahoga Department of Job and Family Services are provided meaningful access to benefits, services, and programmatic information despite experiencing LEP. Updated bi-yearly, the plan allows time to address changes in methods of the plan and relevant updates to the LEP population. According to the document, languages that are expected to be met by employees of Cuyahoga County Job and Family Services are Arabic, Ukrainian, Nepali, Chinese, Spanish, Russian, and American Sign Language.The Dayton and Montgomery County’s public health website details primary goals focusing on CLAS objectives, including:
- Ensuring that Public Health employees receive competency-based training in relation to culturally and linguistically appropriate services.
- Quarterly reporting of progress through a dashboard accessed by the Executive Team.
- Evaluating the status of the Public Health agency in meeting CLAS standards, and relaying information obtained to the Executive Team and Diversity and Inclusion Committee, and identifying CLAS strategies. The Executive Team will institute priorities and assign these priorities to personnel that will implement the CLAS strategies.
Ongoing efforts to increase cultural competence in healthcare must persist.
Conclusion
CLAS programs and initiatives are important in the application of services to minority populations. Much still needs to be done to fully realize administrative policy and direct engagement with communities that have distinct cultural and linguistic identities. Ongoing efforts to increase cultural competence in healthcare must persist by bridging the divide between communities, providers, and policy makers to center health equity measures.As National Minority Health Month continues, Community Solutions will explore issues affecting minority populations. These issues must be understood in their own unique context, accounting for cultural differences, entirely separate from dominant society. Be sure to subscribe to 5Things to read more amazing work from my colleagues and to learn more about these communities, what is impacting them, and what can be done to improve health outcomes.
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