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Health Equity: Culturally Specific Healthcare Settings


What the CPSTF Found

About The Systematic Review

A search for evidence did not find any eligible reviews (search period 1965 - 2001).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to promoting health equity.

Summary of Results

No studies qualified for this systematic review.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • How does changing the structure and process of healthcare delivery affect meaningful health outcomes? What works best, where, and for whom?
  • Do interventions improve satisfaction with care, reduce ethnic differentials in utilization and treatment, and improve health status?
  • What are intervention effects on knowledge, attitudes, use of services, receipt of treatments, and changes in health outcomes?
  • What are the unintended consequences of, and potential barriers to these interventions?
  • What are the additional effects of language on existing provider–client communication patterns?
  • Do ethnic-specific health messages generate negative stereotypes?
  • Do the client benefits of engaging in culturally competent healthcare systems carry over to other social institutions (e.g., education, employment)?

In 1964, the Civil Rights Act, Title VI, mandated provisions for the language needs of clients. Healthcare organizations cite cost as an important factor that limits their ability to provide trained interpreters. Very little research has been done on the effectiveness and cost-effectiveness of providing linguistically competent healthcare services in the United States or on ways to reduce the costs of providing such services.

  • Do trained interpreters compare favorably with family or ad hoc staff interpreters in improving outcomes of satisfaction, appropriate utilization, and health status?
  • What are the relative contributions of improvements in linguistic competence and cultural sensitivity skills to reducing miscommunication and the resulting medical errors?
  • Are linguistically and culturally appropriate health education materials more effective than standard materials in improving health outcomes?

Healthcare providers and provider organizations are concerned about the burden placed on resources by implementing interventions to improve the cultural competence of healthcare systems, particularly in the absence of proven effectiveness.

  • What role should communities play in collaborating with area healthcare organizations to communicate the needs of ethnically diverse populations? At what levels (e.g., management, provider, staff) in a healthcare organization does investment in linguistic and cultural competencies create the greatest improvement in health or other outcomes?
  • Which cultural competencies within a healthcare system increase client satisfaction and improve health outcomes?

Study Characteristics

No studies qualified for this systematic review.