What Is the Role of Cultural Brokers in Health Care
Delivery?
 The Concept
of Cultural Brokers: A Historical Overview
The concept
of cultural brokering is an ancient one that can be traced
to the earliest recorded encounters between cultures. The term
cultural broker was first coined by anthropologists who observed
that certain individuals acted as middlemen, negotiators, or
brokers between colonial governments and the societies they
ruled. Different definitions of cultural brokering have evolved
over time. One definition states that cultural brokering is
the act of bridging, linking, or mediating between groups or
persons of different cultural backgrounds for the purpose of
reducing conflict or producing change (Jezewski, 1990). A cultural
broker is defined as a go-between, one who advocates on behalf
of another individual or group (Jezewski & Sotnik, 2001)
Rationales
for Cultural Brokering in Health Care
The concept
of cultural brokering has evolved and permeated many aspects of
the U.S. society, including health care. A review of literature
reveals that during the 1960s, researchers began to use the concept
of cultural brokers within the context of health care delivery
to diverse communities. Wenger (1995) defined cultural brokering
as a health care intervention through which the professional increasingly
uses cultural and health science knowledge and skills to negotiate
with the client and the health care system for an effective, beneficial
health care plan. Numerous rationales exist for the use of cultural
brokers in the delivery of health care. They include, but are not
limited to:
- emergent
and projected demographic trends documented in the 2000 Census
in which the diversity in the United States is more complex
than ever measured;
- diverse
belief systems related to health, healing, and wellness;
- cultural
variations in the perception of illness and disease and their
causes;
- cultural
influences on help-seeking behaviors and attitudes toward
health care providers; and
- the use
of indigenous and traditional health practices among many
cultural groups.
In addition,
formal education may not have provided many health care practitioners
with the knowledge and skills needed to address effectively
cultural differences in their practice. Last, the need for
cultural and linguistic competence in health care delivery
systems is emerging as a fundamental approach in the goal to
eliminate racial and ethnic disparities in health. The concept
of cultural brokering is integral to such a system of care.
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