Using Cultural Humility to Combat Disparities

Humility

Dr. Doom and Gloom annoyed my grandpa. Hell, she annoyed me. When I think about it now, I think that she caused my grandpa a lot of anxiety. He put on a brave face because that was how he was groomed. He was a man. Men don’t show fear. He was fearful.  Dr. Doom and Gloom was what he “affectionately” called his doctor because she was always, as he put it, “so negative.” My Grandpa was diagnosed with Hodgkin’s Lymphoma. His doctor was concerned with his smoking habit and like any good doctor, she let him know it. It wasn’t that she was letting him know, it was the way she said it.

He had smoked everyday since he was 12 years old. Obviously, my grandfather was addicted to nicotine. Every visit, she would immediately ask him if he gave up the cigarettes. He would reply, “Not yet Doc.” She would proceed to tell him that he was going to die and it was only a matter of time if he didn’t give up the cigarettes. His prognosis was poor but her approach didn’t ease his mind. She didn’t know my grandpa as a human being. She just knew what it said in his chart. This isn’t uncommon.  She met with several patients a day. Like a lot of doctors, she was over worked, tired, and stressed and she just didn’t have the time to get to know him, his fears, his hopes or his concerns. She failed to understand that this man was hesitant to go to a doctor because of a clear mistrust of the system. He lived through a time of the Tuskegee experiments, which heightened the suspicion. She didn’t understand that he had been smoking everyday since he was 12 years old and he couldn’t just quit. He probably needed resources in order to do so. He needed understanding and comfort. He needed a doctor who would remain optimistic even though he was facing uncertainty. He needed a doctor who practiced cultural humility.

Cultural humility is a beautiful thing. I get excited speaking to others about it. The concept will blow your mind.  It normalizes the idea of “not knowing.” Cultural humility is not a difficult concept, we all could engage in it. Cultural humility is an approach that was developed initially for doctors. The approach acknowledges that no one can know completely another’s experience. It is impossible to try to know everything about another’s culture. It would be a waste of time. If one tries to master another’s culture it could lead to stereotyping, which isn’t productive.  Cultural humility is about knowing yourself, knowing your own biases, weaknesses and stereotypes. If you are able to understand those things, you can understand others. Easy, right?  Just blows your mind, huh? As a doctor or a public health practitioner or a social worker, you are not the expert. You shouldn’t act like the expert therefore you look silly even trying. Your job is to learn. You are the learner. Reflecting upon yourself is what is going to get you to be able to serve your patient or client better.   The patient or the client could teach you about their worldview, if they face oppression daily, their hopes, their fears or any discrimination that they have faced or continue to face.

Cultural humility, in health, will help you grow as health professional, practitioner and a human being. Health inequities remain but there are people who disagree. There are people in this country that believe that a lot of racial progress has taken place for people of color. To some extent, they are right.  Yes, our schools have been desegregated, we can sit at counters to eat our lunches, our President is a Black man but we still have a distance to go in order to assess full and equal civil liberties.  There are people who still have a difficult time accessing quality health care in this country. Cultural humility is a tool for self-reflection. If people would realize the power imbalance, acknowledge their own privilege and focus on each patient or client as an expert of their own discrimination, that can lay the foundation of trust and respect. Practicing cultural humility enhances the quality of interaction and care.

Cultural humility is the foundation for reducing through culturally sensitive and unbiased quality care.  Combating health disparities and achieving health equity needs to be an important goal for health professionals all over this country.   Cultural humility has the potential to enlighten health care workers and to decrease biased personal and institutional practices to improve health outcomes for an increasingly diverse, marginalized and underserved patient population.  Let’s use cultural humility to fight health disparities, prevent and treat diseases and save lives.  My grandparents, James and Juliette deserved it.  Many others do too.

Invest in health.

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2 thoughts on “Using Cultural Humility to Combat Disparities

  1. I love this and thank you for sharing your story. It is so true. Medical Providers are not practicing cultural humility and they are not taught it in medical school. I think this drastically impacts the level of care they provide to people of color, especially African/Black Americans.

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    1. Absolutely. Public health practitioners are taught this as well. Unfortunately, health disparities continue to exist and I believe that one of the reasons they do is because the cultural humility link is missing. It is an important piece of providing quality and equitable care.

      Like

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