National Center for Cultural Competence

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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