Studying State Legislation of Cultural and Linguistic Competence

An emergent body of evidence and consensus among many in the health and mental health care community concludes that cultural competence and linguistic competence are key approaches in efforts to reduce health disparities and improve quality of care. Some states have either introduced or enacted legislation requiring cultural and/or linguistic competence for health care professionals as a policy imperative to address disparities.

Researchers at the National Center for Cultural Competence at Georgetown University analyzed efforts by 14 states to integrate cultural and/or linguistic competence into curricula, continuing education and licensure requirements for health and mental health care professionals.

Key Findings

  • Legislative champions who were knowledgeable about health disparities and cultural competence—and who possessed the skills to address attitudinal barriers and build needed coalitions and collaborations—were more successful in shepherding legislation to enactment.

  • States that introduced or passed legislation:

    • Had more laws on the books with mandates related to health
    • Were more likely to have Democratic than Republican legislatures and governors
    • Were more likely to have legislators who worked at least two-thirds time
  • Barriers to passage of legislation included:

    • A sole legislator sponsoring bills without the support of consumer advocates, health care stakeholders, and fellow legislators
    • Bias and lack of awareness of health disparities among some legislators who associated the need for cultural and linguistic competence with undocumented immigration
    • State medical societies, institutions of higher education, and professional associations that viewed the legislation as an intrusion on professional authority