Cultural Competency and Social Determinants in Health

This article discusses the role of cultural liaison within the NSW health service, the relationship between social determinants and health outcomes, five key constructs of cultural competency within the NSW, relationship of healthcare policy to cultural safety, barriers and facilitators to culturally safe and competent professional practice, and cultural competence and social determinants in health.

Running head: HEALTH SCIENCE
Health Science
Name of the student
University name
Author’s note

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Table of Contents
Role of cultural liaison within the NSW health service.............................................................2
Relationship between social determinants and health outcomes...............................................2
Enact five key constructs of cultural competency within the NSW...........................................3
Relationship of healthcare policy to cultural safety...................................................................4
Barriers and facilitators to culturally safe and competent professional practice.......................5
Cultural competence and social determinants in health.............................................................6
References..................................................................................................................................7

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Role of cultural liaison within the NSW health service
In my role as health service manager I often have to work across multicultural and
multilingual setups where I have to interact with people coming from different countries
across different races. In my role as a healthcare service manager I need to emphasis upon
cultural competency where I need to ensure that all the patient visiting the hospital unit are
provided with equal support and care services. The language and cultural differences often
makes it a problem. However, my professional enables me to travel across different
geographical locations and boundaries intermixing with people of different culture. This also
allows me the scope of learning different languages. This further allows me to identify their
individual cultural faiths and beliefs, which is crucial for being culturally sensitive.
Therefore, working across diverse cultures would help me absorb the aspects of
cultural liaison well. It covers two basic aspects such as – cultural humility and linguistic
competency. It also takes into consideration confidentiality and safety concerns while the
delivery of treatment and care within a hospital setup. As mentioned by McNab, Paterson,
Fernyhough & Hughes (2016), cultural liaison helps in the provision of holistic care
approaches. It helps in bridging of the communication gaps which allows for the
establishment of a global healthcare.
Relationship between social determinants and health outcomes
There are a number of factors which plays a crucial role in determining the health
outcomes. Some o these are social determinants, human rights and cultural competence. In
this respect, the social determinants of health mean the economy and living conditions of the
people. As mentioned by Weller, Boyd & Cumin (2014), poor socio-economic conditions
often serves a hindrance in the path of availing appropriate healthcare services. As argued by

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Garg, Toy, Tripodis, Silverstein & Freeman (2015), the people living within the rural areas
often improper or poor healthcare services as much of the health professionals do not want to
move towards the interior. The cultural competence helps effective implementation of the
human rights as it helps one develop sensitivity to others social and cultural beliefs.
Therefore, learning about some of these aspects would help me in removing the health
and support care services biases. It would help me promote the healthcare needs of the poor
and the marginalized people. In order to ensure that equitable distribution of support and care
services are provided I could personalised visit the rural and the marginalized area with a
healthcare team where free health checkups and vaccinations could be provided as a basic
healthcare objective. Some of these have been supported through NSW healthy living
programmes which aim towards promoting cultural competency in healthcare by improving
community health through healthy eating active living programs.
Enact five key constructs of cultural competency within the NSW
The five key constructs of cultural competency are as follows – cultural desire,
cultural awareness, cultural Knowledge, cultural skill and cultural encounters. The cultural
desire is the motivation of individual and organizations to engage in the process of being
culturally competent. As mentioned by Sallis, Owen & Fisher (2015), cultural desire helps
one to be open to others and accept difference or similarities. This will me be in being more
patient in my interaction with others. The cultural awareness on the other hand helps in
removing the biases possessed by one towards different cultures. The cultural knowledge will
help in understanding the world views which help me in implementing a culturally sensitive
practice. The cultural skills will help me in the collection of client data pertaining to the
patient health history. It helps one in performing cultural sensitive assessment. Therefore, I
could use these skills within my actual clinical setup where I have to encounter patients from

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across different races and cultures. An effective cultural encounter would help me in breaking
the stereotype while addressing the patients and engage with them in a friendly manner.
Some of these aspects are very important with respect to health service management as it
helps in the establishment of a culturally competent practice.
Relationship of healthcare policy to cultural safety
The cultural safety could be associated with a number of nursing and health service
principles, which forms the basis for health management as well. Some of these are critical
thinking and analysis, practise of therapeutic relationships, maintaining the capability for
practice, comprehensive conduct of health assessments, development of a plan for patient
centred practise, provision of responsive quality services, and evaluation of outcomes (Pauly,
McCall, Browne, Parker & Mollison, 2015).
The policies places sufficient importance upon the therapeutic relationships which
forms the backbone of healthcare practices as it helps in bridging the gap between different
race and cultures (Waring, Allen, Braithwaite & Sandall, 2016). The provision of responsive
support and care services also help in reducing the heath inequalities faced by the
marginalised and the poor people (Weller, Boyd & Cumin, 2014). The policies also places
sufficient importance upon the evaluation methods and practices. These help in monitoring
the progress ion health within the present society. In my opinion, one of the most important
parameters in implanting a safe cultural practice is through effective therapeutic
communication approaches. These when applied within my clinical setup would help me in
the settlement of disputes. Additionally, it will help in providing a person centred care by
supporting policies such as informed decision making where the support users will be
informed by the health service management before making any crucial changes within their
plan of care.

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Barriers and facilitators to culturally safe and competent professional practice
According to Hart and Mareno (2014), healthcare professionals are challenged under
the healthcare environment in order to provide culturally competent care to a diverse group of
population. In order to provide culturally competent care, the healthcare staffs are required to
deliver person and family centred care via acknowledging the culturally difference among the
families of different patient’s group while incorporating patients and their family members in
the decision making process. However, the healthcare professionals experience certain
barriers towards comprehensive implementation of the culturally competent care (Hart &
Mareno, 2014). The main barriers include diversity among the patient population, lack of
adequate resources to deliver culturally competent care along with biasness and prejudices
towards sudden cultural values and beliefs (Hart & Mareno, 2014). The main barriers of
patient in obtaining the culturally competent care include linguistic barriers. The Australian
aboriginals come from a linguistically diverse background in comparison to the healthcare
providers and this creates a barrier towards enjoying optimal culturally competent care
(Komaric, Bedford & van Driel, 2012). The main facilitators of the culturally competent care
model include proper cultural awareness among the healthcare practitioners and other health
care staffs. This help in the establishment of efforts along with the provision for proper
therapy based on the psychological and physiological requirement of the patient. Moreover,
cultural awareness among the service providers also helps in proper understanding about the
health-related goals of the patient. In case of patient also, the main facilitator of the culturally
competent care is the cultural awareness (Grandpierre et al., 2018). Proper cultural awareness
among the patient population helps in improved communication among the patient and the
caregivers. This helps in proper understanding of the patient’s complications and drafting the
care plan accordingly (Grandpierre et al., 2018).

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Cultural competence and social determinants in health
As health service management professional, I think proper understanding about the
concept of the cultural competence helps in the proper management of the social determinant
of health among the aboriginals and Torres Strait Islanders residing in Australia. For example
for understanding of the cultural competence, helps in the proper understanding the main
barrier towards the socio-economic status among the Australian aboriginals and the Torres
Strait Islanders. Poor socio-economic background is the main social determinants of health. I
think the main barriers towards the poor socio-economic status of aboriginal population is
their lack of proper exposure towards education, health awareness, poor society background
and lack of employment. This lack of proper education and health awareness make them
more susceptible towards developing fatal diseases. Moreover, poor social-economic status
lead to the generation of behavioural risk factors, which further increases the chance of
disease development (Australian Institute of Health and Welfare, 2016). As professional
health service management professional, I would promote awareness in the domain of
maintaining healthy behavioural habits in order to promote quality health and well being. In
the grounds of human rights, I feel that the proper awareness of cultural competency among
the health service management professionals help in considering the individuals a unique
patient with unique needs. This will help in the reduction of the prejudices and other barriers
towards implementing proper care plan (Australian Institute of Health and Welfare, 2016).

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References
Australian Institute of Health and Welfare. (2016). Social determinants of Indigenous health.
Access date: 26th May 2018. Retrieved from:
https://www.aihw.gov.au/getmedia/d115fe0f-9452-4475-b31e-bf6e7d099693/ah16-4-
2-social-determinants-indigenous-health.pdf.aspx
Garg, A., Toy, S., Tripodis, Y., Silverstein, M., & Freeman, E. (2015). Addressing social
determinants of health at well child care visits: a cluster RCT. Pediatrics, 135(2),
e296-e304. Retrieved from :
http://pediatrics.aappublications.org/content/135/2/e296.short
Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R., & Potter, B. (2018).
Barriers and facilitators to cultural competence in rehabilitation services: a scoping
review. BMC health services research, 18(1), 23. doi: 10.1186/s12913-017-2811-1
Hart, P. L., & Mareno, N. (2014). Cultural challenges and barriers through the voices of
nurses. Journal of clinical nursing, 23(15-16), 2223-2233. doi: 10.1111/jocn.12500
Holland, K. (2017). Cultural awareness in nursing and health care: an introductory text.
CRC Press. Retrieved from : https://books.google.co.in/books?
hl=en&lr=&id=MwMvDwAAQBAJ&oi=fnd&pg=PT10&dq=Holland,+K.+(2017).
+Cultural+awareness+in+nursing+and+health+care:+an+introductory+text.
+CRC+Press.&ots=KDII4eOMyb&sig=hHzFWTBxPVvqmpYkJxz7thrwpaU&redir_
esc=y#v=onepage&q&f=false
Komaric, N., Bedford, S., & van Driel, M. L. (2012). Two sides of the coin: patient and
provider perceptions of health care delivery to patients from culturally and

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linguistically diverse backgrounds. BMC health services research, 12(1), 322.
https://doi.org/10.1186/1472-6963-12-322
McNab, J., Paterson, J., Fernyhough, J., & Hughes, R. (2016). Role of the GP liaison nurse in
a community health program to improve integration and coordination of services for
the chronically ill. Australian journal of primary health, 22(2), 123-127. Retrieved
from : http://www.publish.csiro.au/py/PY14089
Pauly, B. B., McCall, J., Browne, A. J., Parker, J., & Mollison, A. (2015). Toward cultural
safety: nurse and patient perceptions of illicit substance use in a hospitalized
setting. Advances in nursing science, 38(2), 121-135. doi:
10.1097/ANS.0000000000000070
Sallis, J. F., Owen, N., & Fisher, E. (2015). Ecological models of health behavior. Health
behavior: Theory, research, and practice, 5, 43-64. Retrieved from :
https://books.google.co.in/books?
hl=en&lr=&id=0j4LCgAAQBAJ&oi=fnd&pg=PA43&dq=Sallis,+J.+F.,+Owen,+N.,
+%26+Fisher,+E.+(2015).+Ecological+models+of+health+behavior.
+Health+behavior:+Theory,+research,+and+practice,+5,+43-
64.&ots=w20tdnqAll&sig=XaJNlb-xRXY9-
N4dOLGUB0C7OCM&redir_esc=y#v=onepage&q&f=false
Waring, J., Allen, D., Braithwaite, J., & Sandall, J. (2016). Healthcare quality and safety: a
review of policy, practice and research. Sociology of health & illness, 38(2), 198-215.
Retrieved from : https://doi.org/10.1111/1467-9566.12391
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming
barriers to effective teamwork in healthcare. Postgraduate medical journal,

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postgradmedj-2012. Retrieved from :
http://pmj.bmj.com/content/early/2014/01/07/postgradmedj-2012-131168.short

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