Perception of culturally competent care among a national sample of skin cancer patients

Given limited information about patient experiences with cultural competency within dermatology, we sought to characterize the perception of culturally competent care among skin cancer patients in the United States. We used the 2017 National Health Interview Survey (NHIS) to identify a sample of patients with skin cancer and analyzed responses to the following questions: "How important is it for providers to understand or share your culture?" and "How often are you able to see health care providers that understand or share your culture?" For each question, we calculated the overall prevalence along with adjusted odds ratios for each sociodemographic group. Overall, 31% (95% CI 27-35%) of skin cancer patients responded that it was very or somewhat important for providers to share/understand culture. Patients with income below 200% of the federal poverty level (aOR 1.52; 95% CI 1.02-2.25), foreign-born patients (aOR 3.33; 95% CI 1.25-8.88), and patients with the highest educational attainment of a high school diploma (aOR 1.50; 95% CI 1.08-2.09) all had increased odds of placing importance on sharing/understanding culture. Furthermore, 80% (95% CI 75-85%) of skin cancer patients responded that they were able to see providers that shared/understood their culture all or most of the time, and therefore 20% of patients had access to culturally competent care only some or none of the time. Our study revealed that many (31%) skin cancer patients highly value culturally competent care, with lower-income, foreign-born patients, and patients with the highest educational attainment of a high school diploma, placing greater importance on culturally competent care. However, as many (20%) skin cancer patients have limited access to culturally competent care, future research should focus on analyzing and improving care for patient groups affected by cultural barriers.