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Cultural Competence: an Answer Required to Overcome Barriers to Health Care Access for Minoritized Populations

ABSTRACT

The recognition of cultural characteristics of social groups, as well as their different needs and conceptions of the health-disease process is, according to Starfield, one of the important attributes derived from primary care: cultural competence. Through this attribute it is possible to develop strong bonds with the people and families who are the target of health care, resulting in greater satisfaction, more accurate diagnoses and greater adherence to treatment. Even in a country like Brazil, which still offers a free universal health system, minoritized populations whether by ethnicity, gender identity, sexual orientation or socioeconomic status face barriers to access these services and report poorer health indicators. Both the health professional and the user can belong to several cultural groups simultaneously, according to their gender, age, ethnicity, regionality, religion, sexual orientation, profession, role in the family, social class, as well as other characteristics and manifest in culturally distinct ways in different situations. It is important for the family physician to recognize the set of fundamental assumptions and values which influence their behavior and their interpretation of what is said by the other. Due to this complexity, these aspects should be considered in the discussion of the health-disease process and the construction of a shared care plan. This essay aims to discuss the development of cultural competence as a response to barriers health care access for minorities in the context of family and community medicine. An exploratory review of the literature was carried out, which also identified learning objectives and teaching strategies that can be incorporated into family and community medicine residency programs, aiming to collaborate with the systematization of teaching of this competence, respecting regional specificities. It also points out the need for institutional changes so that there is encouragement and appreciation of the practice of cultural competence, with the provision of time and infrastructure for the development of this competence by primary care professionals.

Family Practice; Cultural Competence; Curriculum

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