The difference Between a Cultural Broker and a Community Health Worker

The difference Between a Cultural Broker and a Community Health Worker

The difference is that cultural brokers are individuals who do not need a formal certification.  A cultural broker can be a doctor, a nurse, front desk staff, patient’s relative, clergy, in some cases which is not preferable, children.  Have said that it is important to understand that a cultural broker depending at what level they are needed, they will need extensive training in understanding and building skills as a cultural broker in order to work with a specific ethnic groups of individuals. 

A community health worker needs a certification or a more formal training in order to perform this task here is the link to the Texas Department of State health Services www.dshs.state.tx.us/mch/chw.shtm, here you can see the application.  It contains information on the core sections of the training curriculum.

However, both a cultural broker and a community health work have many things in common such as training specific in communication, advocacy, bilingual skills, provide culturally and linguistic appropriate health education, serve as mediators, and others.

A cultural broker focuses more on how he/she can bridge the gap of communication between patient and the health care system (health care providers) through knowledge and understanding of cultures by serving as a mediator of agent of change.  There is a lot of intensive training on cultural and linguistic competency for non-natural support systems such as family.  Here is the link to the National Center for Cultural competence which provides a case of cultural brokering between Western health care professionals and healer or shaman Hmong http://www.culturalbroker.info/appendix_A/3_appendixA.html.

One point I want to make is that cultural brokering is becoming not exclusive to HCO but also human and social community-based organizations trying to reach their consumers.

Here are a few definitions of a cultural broker and a community health worker:

The goal of the Cultural Broker Project is in keeping with the NCCC’s overall mission to “increase the capacity of health care and mental health programs to design, implement and evaluate culturally and linguistically competent service delivery systems.” Cultural and linguistic competence have emerged as fundamental approaches to the goal of eliminating racial and ethnic disparities in health. A major principle of cultural competence involves working in conjunction with natural, informal supports and helping networks within diverse communities (Cross et al., 1989).

A Promotor(a) or Community Health Worker is a person who provides cultural mediation between their communities and health and human service systems. They are a bi-lingual/cultural liaison between patients and healthcare providers through activities that include assisting in case conferences, providing linguistically and culturally appropriate health education, informal counseling, and social support; advocates for individual and community needs; assures people get the services they need; builds individual and community capacity; and provides referral and follow-up services (Colorado 

Institute of Public Policy, 2007).

Cultural Brokers (CB) are navigators and bridge the cultural gap between communities and the formal healthcare system. CB, like Community Health Workers, are drawn from the community they serve though their backgrounds are highly variable. Some CBs are immigrant children who live in two cultures daily. Some are leaders of advocacy organizations. Training may be extensive or non-existent. The need for CBs is only increasing as the U.S. population is diversifying and health disparities persist. A Cultural Broker fulfills a variety of roles. They serve as

·     Liaisons between (1) the family/community’s health values, beliefs and practices and (2) the healthcare system.

·     Cultural guides who understand the strengths and needs of a community but also know about the structures and functions of the healthcare setting.

·     Mediators who help establish and maintain trust with communities and build relationships between the patient and medical provider.

·     Advocates for change of the healthcare system by virtue of the work they do for communities and with the medical community (National Health Service Corps, 2004).

References

1.     Cultural Responsiveness: Social-Emotional Health of Young Children, Birth – 5 Years of Age: Research, Policy and Financing

Link: www.denverearlychildhood.org/.../D%205%20DECC%20Report%20Chapter%202%2011.18.09.pdf

2.     National Center for Cultural Competence: Bridging the Cultural Divide in Health Care Settings

Link: http://www.culturalbroker.info/appendix_A/3_appendixA.html

For more information contact Helen Dao, MHA at Helen@daoconsultingservices.com