Cultural and linguistic competence in healthcare: the case of Alabama general hospitals.

As the nation's foreign-born population continues to increase, the importance of understanding cultural, ethnic, and religious differences to combat racial/ethnic disparities in access to and utilization of healthcare services intensifies. In Alabama, specifically, the shifting migration patterns and the growth of the foreign-born population have altered the state's demographics, introducing new cultures and languages to this traditionally biracial state. Because Alabama general hospitals are not immune to the widespread cost, access, and quality paradox that plagues every healthcare organization, they too must consider the value of cultural and linguistic competence in providing high-quality, cost-effective care. This exploratory study examined the awareness of and preparedness for the diversifying patient population of general medical and surgical hospitals in Alabama. Questionnaires were mailed to the chief executive officers of 101 general medical and surgical hospitals. A sample of 53 respondents provided data on the measures and resources that the hospitals currently use to meet cultural and linguistic competence standards. Our findings indicate that, although these hospitals are taking the initial steps to prepare for the diversifying patient population, a great deal needs to be accomplished before they are able to meet the National Standards for Culturally and Linguistically Appropriate Services in Health Care established by the U.S. Department of Health and Human Services's Office of Minority Health.