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The Voice of the Black Community


Medicine, health and patient connectivity
Cultural competency a modern necessity
Published Saturday, January 26, 2019 9:27 am
by Ashley Mahoney | The Charlotte Post

Cultural competency is as important in the doctor-patient relationship as physician skill.

Do you see yourself in the medical community? For many African Americans, the answer is no.

Whether it’s proximity, financial constraints, or other factors, it can be difficult to relate to someone who comes from a different background, let alone a different culture.

Dr. Sandy Charles of Novant Health’s Heart and Vascular Institute has experienced both sides of the spectrum as a native of Brooklyn, New York. Charles, who earned her medical degree from Columbia University and attended Princeton University for undergrad, is a cardiologist in a field that is 12 percent female in the United States. Even fewer are black women.

At an early age, she noticed medical disparities in her community.

“My own family members were reluctant to seek medical care because they thought that their doctors, because they did not look like them, or come from their background that they did not feel like they could adequately care for them,” Charles said. “I saw the negative consequences of that.”

Cardiovascular disease is the leading cause of death in America, but significantly impacts the African American community. It encompasses heart attacks, strokes and events, and kills more people than cancer. Charles experienced this first-hand when her grandmother, Marie Charles, died from a stroke.

“She is of Caribbean descent,” Charles said. “In New York there were very few black doctors. A lot were white or Jewish or Russian. It was very much, ‘hi, how are you doing? Your blood pressure is high. You need to take this medication. You need to stop eating this, and have a nice day.’”

While a doctor may not do anything clinically wrong, a lack of cultural understanding and interaction with patients can lead to disparities in care.

“With the history of racism in medicine, especially in America with the Tuskegee Experiment, there can be distrust,” Charles said.  

What was coined as the “Tuskegee Study of Untreated Syphilis in the Negro Male” began in 1932 as a collaboration between the Tuskegee Institute and the Public Health Service. Six hundred black men – 399 with the disease and 201 without – were told they were being treated for bad blood. The experiment was conducted without their informed consent and lasted until 1972.

Without cultural context, communicating with a patient, let alone treating an individual can become problematic.

“Maybe thinking that “[the doctor] doesn’t really identify with me, or maybe they don’t know my experience, or culturally this is all we eat in our diet, so if you are telling me not to eat this, what am I going to eat?’” Charles asked. “It’s just having that cultural awareness and making people just feel comfortable. I have people who will search me out just because I am a woman. It’s not that my male colleagues aren’t great, they just feel more comfortable. That is something that patients are entitled to, and that is something we have to work on.”

Look for more stories like this in February, American Heart Month.


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