CULTURAL COMPETENCE IN HEALTH CARE: EMERGING FRAMEWORKS AND PRACTICAL APPROACHES Joseph R. Betancourt Massachusetts General Hospital–Harvard Medical School Alexander R. Green and J. Emilio Carrillo New York-Presbyterian Hospital–Weill Medical College of Cornell University FIELD REPORT October 2002

Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff. Copies of this report are available from The Commonwealth Fund by calling our toll-free publications line at 1-888-777-2744 and ordering publication number 576. The report can also be found on the Fund’s website at www.cmwf.org.

CONTENTS About the Authors.......................................................................................................... iv Acknowledgments .......................................................................................................... iv Executive Summary......................................................................................................... v Introduction .................................................................................................................... 1 Findings........................................................................................................................... 3 Defining Cultural Competence .................................................................................. 3 Barriers to Culturally Competent Care....................................................................... 3 Benefits of Cultural Competence ............................................................................... 6 Models of Culturally Competent Care ............................................................................. 7 Academia