What Are Cultural Brokers?
This book excerpt is from the Introduction of my upcoming book, A Case of Culture, available for purchase in January 2022. Learn more about the book here.
The United States is a country of ever-increasing diversity. According to the 2000 US Census Bureau, there were around seventy million people from nineteen non-European ethnic and cultural groups living in the US. With each of these groups comes a unique set of cultural beliefs about health and illness. Some swear by using antibiotics for every condition, while others won’t even touch a medication unless it is all-natural. Some believe that illness is due to an imbalance of good and bad energies, while others believe that illness is caused by evil-eye or dark spirits. Some prefer that family members or elders take care of the individual’s health-related matters, while others forbid disclosing anything about one’s personal health to even the closest of family.
As you can imagine, it is close to impossible for people from every one of these diverse cultural groups to find a physician that knows and understands the cultural beliefs they hold about health and illness. Similarly, it is close to impossible that a physician is competent and knowledgeable about the cultural beliefs of every single patient they see.
At the end of the day, what patients want is to be listened to and understood by their physicians. Likewise, what physicians want is to help empower their patients toward taking ownership of their health in the way that best fits their needs and goals. But when there exists a discrepancy in language and literacy, distrust of the medical system, unfamiliarity with Western medical practices, differences in health beliefs, varying emotional states of mind, and many other barriers to communication, it can be extremely difficult for the patient to open up with their doctor. To top it off, our physicians work in a healthcare system that burns them out, that prioritizes quantity over quality, that gives them ten to fifteen minutes per patient max (Linzer, 2015). With all of this on the plate, the patient’s hope of being understood threatens to become just that…a lost hope.
A very special group of people ensures that patients can receive the culturally concordant care they need: cultural brokers. According to the Jezewski model, cultural brokering is defined as “the act of bridging, linking, or mediating between groups or persons of different cultural backgrounds for the purpose of reducing conflict or producing change.” The practice of cultural brokering is actually quite ancient, dating back thousands of years to the first recorded encounters between groups of different cultures. From encounters between ancient Macedonians and Persians in the third century BCE, to those between Anglo-Europeans and Native Americans in the eighteenth century, cultural brokers were crucial to bridging divides across these cultures in order to enact change and mediate conflict.
The term “broker” is used in many industries and contexts to refer to the middleman who facilitates the flow of information between two parties. For example, brokers are an important part of the financial and real estate industries because their knowledge of both buyers and sellers allows them to serve as an effective means of communication. The buyer may not understand all the jargon and technical terms that a seller uses, or perhaps the buyer is unable to make a financial negotiation because he lacks the necessary knowledge. In such cases, the broker steps in to help the buyer make sense of the various industry rules and regulations, explaining them in layman’s terms. By helping ease communication and build trust between the buyer and seller, the broker helps to establish a meaningful relationship between the two parties.
In a similar vein, cultural brokers in the healthcare field facilitate between the culture of the (often) foreign-born patient, the culture of the host country where the patient seeks care, and the culture of the healthcare system itself. Sometimes the patient may not agree with what the doctor suggests because it is at odds with their cultural beliefs. Other times, the patient may be overwhelmed by the many moving parts of a foreign healthcare system and needs help with navigating it. In such situations, the cultural broker steps in to ease these interactions between patient and provider, mitigating any misunderstandings that may arise in the process. This process of cultural brokering in the healthcare system can be carried out by anyone who has an understanding of both cultures. This might be an interpreter, a priest, a patient advocate, a family member, and sometimes even the doctor themselves.
In this article series, I share excerpts and stories from my book, A Case of Culture. If you would like to learn more about cultural brokers and what they do, you can find the rest of the story in the Introduction of my book, releasing January 2022 on Amazon, Barnes and Noble, and other retailers. If you enjoyed this book excerpt, please consider subscribing to this newsletter and sharing it with your network. To learn more about the book, visit my website. If you would like to connect, you can reach me here via email at firstname.lastname@example.org or connect with me @snigdhanandiauthor on Instagram and Facebook.