Structural Competency in Healthcare

By: Bianca Walker

Both structural and  cultural  competency  have  an  overwhelming  effect  on  cardiovascular health and disease research. The textbook definition of structural competency can be described as  the  ability  of  health  care  providers  to  appreciate  how  health  problems,  diseases,  attitudes toward  a  patient  or  population,  and  health  systems  are influenced  by  social  determinants  of health. For example, in these past few months, research has shown how COVID has affected more African Americans than any other ethnic group. But when looking at these results, it is essential to look at the underlying causes of why African Americans are susceptible to this virus similar to how they are more susceptible to cardiovascular failure. It is the combination of other underlying health  conditions  and  social  determinants  of  health  that  make COVID so  deadly  for  African Americans. Additionally, many health care providers need to take time to understand how the lack of health care,  transportation,  funding,  and  other inequalities all have a role in their patient’s overall health. Taking the time out to  look  at  them  not  just  someone  who  will  make  them  money,  but  a  real  person who has struggles that affect their everyday life can have a significant difference in their patient’s care.

In my research for  my  summer  media  project,  I  noticed  a  pattern  of  African  American women  being  more  susceptible  to  Preeclampsia  (hypertension  during  pregnancy)  than  other ethnic groups. Like many other diseases especially cardiovascular disease, this can be due to their underlying health problems before pregnancy or simply because of their zip code. In a perfect system,  these  social  factors  would  not  determine  the  care  that  one  would  be  provided,  but unfortunately in reality, they do. For my project, my group will be conveying the various actions that women can take  before they  are  pregnant  to  reduce  their  likelihood  of  developing  this  form  of hypertension.  These include  encouraging  to  go  to  the  doctor  for  a  check-up  if  possible  before pregnancy and choosing their doctor wisely to ensure they have the best care. Unfortunately, it is a reality that many of the deaths that come from African American pregnancies are due to the lack of  healthcare  they  receive  while  at  the  hospital,  especially during early postpartum.  This is  a  direct result from the lack of structural competency within health care providers and the health care system continues without accountability. An article from the JAMA Network states that the U.S. healthcare system needs a new structurally competency report and a new set of board examinations. Creating doctors who already have a background and understanding in recognizing the many inequitable factors that goes into a patient’s health can improve the quality of the system overall. A cultural shift in the mindsets of healthcare providers is one of the many steps that need to be taken to ensure that everyone receives the equitable healthcare.

https://jamanetwork.com/journals/jama/fullarticle/2767027

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