The racial and ethnic composition of the United States' population has changed significantly during the past two decades. Displaced by war, famine, political unrest and economic necessity, Latin Americans, Asians, Middle Easterners, Eastern Europeans and Africans have immigrated to this country in unprecedented numbers, bringing with them their unique and distinctive cultural legacies. Defined as the thoughts, actions, customs and beliefs of a racial, ethnic, religious or social group, culture unifies members of the same group and distinguishes those from differing groups. Cultural manifestations can range from subtle to explicit. The greater the differences are between two cultures, the more challenging it becomes to understand the underlying mechanisms of culturally determined practices.

Satisfactory physician-patient relationships require the provision of culturally competent care. In order to serve effectively and appropriately an increasingly diverse patient population, health care providers from all disciplines should become sensitive to the many and varied cultural factors that influence health. The more physicians learn about a patient's health beliefs and practices, the more likely it is that culturally appropriate health care will be delivered, positive health outcomes will result, and patient satisfaction will improve.

To help obstetrician-gynecologists realize this goal, the Committee on Health Care for Underserved Women has developed a chapter (access limited to members) on this topic and is involved with numerous national initiatives to increase cultural competency among health care providers. For example, ACOG is a member of the National Advisory Committee for the National Alliance for Hispanic Health's Caring for Hispanics: Culturally Competent Systems of Care initiative. This is a year-long project, funded by the Department of Health and Human Services, Office of Minority Health, to provide technical assistance to select health systems and organizations in their efforts to incorporate cultural competency into their education programs.

Additionally, ACOG is involved with the Department of Health and Human Services, Office of Minority Health's efforts to determine the state-of-the art for improving provider-patient communication and in assessing the capacity of improved communication to increase the effectiveness of health care for racial and ethnic minorities. Through our involvement with these and other initiatives, ACOG aims to increase cultural sensitivity among its members and improve the health status of all women.