Abstract

Although workers’ compensation mandates ensure healthcare access for injured workers for a compensable accidental injury claim, identified healthcare disparities include lower treatment costs, lower disability ratings, and less compensated time off work for African American claimants than for White claimants. Cultural competence has gained focus in the United States as a means to eliminate healthcare disparities and improve healthcare outcomes. To date, no direct link has been established between providing culturally competent healthcare and reducing or eliminating healthcare disparities or improving healthcare outcomes. The purpose of this study was to discuss moving beyond cultural competence theory and exploring the impact of culturally competent interventions on intermediary and ultimate healthcare outcomes. The study used the theoretical framework for the Functional Capacity Evaluation (FCE) and Work Hardening Program (WHP) presented by Matheson (1995, 1997, 2003) and the conceptual framework for cultural competence presented by Campinha-Bacote (2002, 2003) with a sample of 19 injured African American workers in the state of Maryland. The objective was to explore and to identify injured workers’ perceptions of service provider cultural competence during participation in the Work Hardening Program, as well as to explore any influences on the outcome of return to work (RTW) and to discuss cultural competence as defined by injured African American workers. The study also explored cultural competence from the perspective of racial concordance theory. Healthcare leadership could use the increased knowledge gained from the current study about healthcare disparities and culturally competent healthcare to assist injured workers in returning to work while also considering the overall costs to the workers’ compensation system. Additionally, gaining injured workers’ perspective on cultural competence could facilitate efforts by healthcare organizations to develop tools for assessing cultural competence, and subsequently to provide necessary training or policy and procedure modification to incorporate institutional cultural competence.