Bringing structural competency to the forefront of dental education

Abstract

Cultural competency as introduced to the healthcare industry had the intention to alleviate and familiarize all healthcare providers with individuals of other cultures and backgrounds than "self". It attempted to fill in the gaps and prepare providers to relate better with their patients and provide cross-cultural care. Although it gave the impression of helping to decrease biases and stigma, it resulted in stronger biases, stereotypes of different ethnic groups, and racial profiling. It never acknowledged the systemic barriers that are so ingrained in our society that determine who gets access to care, and who gets the best outcomes in our healthcare system. Starting with the premise of our Surgeon General Reports, we reviewed the Social Determinants of Health and the relationship to structural barriers. This manuscript describes the numerous barriers that affect the access to care, and outcomes of the most marginalized population in the US. Numerous of which are so prevalent amongst all of us that they "feel normal" that there is a degree of structural blindness. We share the experience and frameworks to assess the structural vulnerability of our patients and introduce the different aspects of the curriculum and research that are currently in place to address and bring structural competency to the forefront of dental education at WesternU College of Dental Medicine in Pomona CA.

Keywords: cultural competency; social determinants of health; structural competency; structural violence; structural vulnerability.