One of the most significant changes affecting health care in the United States is the increasing racial and ethnic diversity of the population.

Opening Doors: Reducing Sociocultural Barriers to Health Care was a national program of the Robert Wood Johnson Foundation (RWJF) that aimed to sharpen the focus on the implications of culture, language, race, and ethnicity on access to health care.

Key Results
Opening Doors supported 23 projects in rural and urban areas in 11 states.

The funded projects fell into two categories:

• Service projects to reduce sociocultural barriers. The program funded several replicable models that exemplified cost-effective strategies to reduce sociocultural barriers to care.
• Research projects to identify the sociocultural barriers to health care and strategies to reduce them.

The accomplishments of the Opening Doors program and its projects include:

• Affecting direct services in rural and urban settings in 11 states across the country by:
  • Using community outreach workers.
  • Providing interpreter services.
  • Changing policies and practices that created barriers.
• Training health staff through:
  • Developing cross-cultural curricula for medical students.
  • Providing community-based training opportunities for residents.
  • Offering cultural competency training for agency staff and board members.
• Improving use patterns, such as:
  • Reducing unnecessary emergency room visits in a rural immigrant community.
  • Increasing patient enrollment in an urban, hospital-based HMO where interpreters and outreach workers were available for immigrants.
• Developing policy recommendations regarding:
  • Cultural competency in managed care.
  • HMO compliance with state standards for access to reproductive health care.
  • Cultural and linguistic competency in interpreter services.

Funding
The program was authorized by the RWJF Board of Trustees in January 1992 for $4 million. It was co-sponsored by the Henry J. Kaiser Family Foundation.

About This Report
This report was produced by the national program office and edited by the Grant Results Reporting Unit.