Cultural Differences Affect Clinical Outcomes
Cultural diversity can have a real impact on clinical outcomes. Ignoring culture can lead to negative health consequences in many ways:
- Patients may choose not to access needed services for fear of being misunderstood or disrespected;
- Providers may miss opportunities for screening because they are not familiar with the prevalence of conditions among certain minority groups (Lavizzo-Mourey and Mackenzie 1996; Lawson 1996; Moffic and Kinzie 1996);
- Providers may fail to take into account differing responses to medication (Lavizzo-Mourey and Mackenzie 1996; Lawson 1996; Moffic and Kinzie 1996);
- Providers may lack knowledge about traditional remedies, leading to harmful drug interactions (Lavizzo-Mourey and Mackenzie 1996; Lawson 1996; Moffic and Kinzie 1996);
- Providers may make diagnostic errors resulting from miscommunication (Lavizzo-Mourey and Mackenzie 1996; Lawson 1996; Moffic and Kinzie 1996);
- Patients may not adhere to medical advice because they do not understand or do not trust the provider;
- Providers may order fewer or more diagnostic tests for patients of different cultural backgrounds because they may not understand or believe the patient's description of symptoms.
Cultural bias has an important effect on clinical decision-making
Schulman et al. found that cultural bias had an important effect on clinical decision-making among physicians. In their study, "The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization," they found that physicians referred hypothetical white male, black male, and white female patients (videotaped actors who presented with the same symptoms of cardiac disease) for cardiac catheterization at the same rates (90.6%) but were significantly less likely to recommend catheterization procedures for black female (78.8%) patients exhibiting the same symptoms (Schulman 1999; Schwartz 1999).
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