Community-based and culturally tailored health interventions have significantly improved health outcomes for BIPOC communities, particularly in areas like maternal health and chronic disease management. 

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Community health workers (CHWs) who share lived experiences, language, and culture with the populations they serve, help bridge gaps in care by delivering culturally relevant health education, navigation support, and self-management of chronic diseases. Culturally congruent doulas, for example, provide emotional and physical support during pregnancy, leading to lower rates of preterm birth, healthier birth weights, and higher breastfeeding initiation. Beyond maternal health, community spaces like churches, mosques, and cultural centers serve as trusted hubs for chronic disease prevention, offering health education alongside fitness and nutrition programs. 

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These interventions are effective because they are rooted in the specific needs, values, and experiences of the communities they serve—they address the medical issues alongside the systemic barriers that have long contributed to health inequities. 

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Case studies of culturally focused interventions

• The Community Outreach and Patient Empowerment (COPE) program has successfully improved diabetes management across Navajo Nation by integrating culturally tailored outreach through community health representatives. Findings have shown that the intervention has been particularly effective in reaching and benefiting the most vulnerable populations, demonstrating its strength as a culturally responsive and community-driven health initiative.

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• Project Dulce in San Diego, CA has proven to be an effective culturally tailored intervention for diabetes management in medically underserved, diverse communities. By combining nurse-led case management with peer-led self-empowerment training, the program significantly improved key clinical outcomes, including reductions in HbA1c, blood pressure, and cholesterol levels. 

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• The iCON 2020 Chinese Health Forum successfully improved self-efficacy in chronic disease management among Vancouver’s Chinese community through culturally tailored health education and community engagement. Participants found the forum’s accessible and engaging approach effective, highlighting its potential as a model for similar culturally specific health initiatives in multicultural populations.

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• Achieving Blood Pressure Control Together (ACT) study developed and tested a multifaceted, patient-centered intervention to improve hypertension self-management among African Americans living in urban areas. By engaging patients, families, and community resources, the ACT study aimed to enhance blood pressure control through culturally relevant, sustainable strategies that leverage social support and non-pharmacological interventions.

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• Project IMPACT in New York City demonstrated the effectiveness of culturally tailored, community-based strategies in addressing hypertension disparities in South Asian patients—a group with disproportionately high rates of cardiovascular disease. Project IMPACT successfully improved blood pressure control among patients through a community health worker-led health coaching intervention within primary care settings. 

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• The Roots Community Birth Center in North Minneapolis, Minnesota is a community-based organization for birthing people and families affected by structural racism, intergenerational underinvestment, and other forms of discrimination. The neighborhood that Roots serves experiences disproportionately adverse maternal and newborn outcomes. However, Roots’ 2020 outcomes included: a 0 percent low birth weight rate, 99 percent breastfeeding rate at six months (compared to 58 percent nationally), and a 17 percent hospital transfer rate, with 97 percent of transfers being for non-emergency issues.

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Gaps in provider cultural competence

A number of factors, including implicit bias and lack of provider cultural competence training, contributes to racial health disparities, including the Black maternal health crisis, sickle cell disease (SCD) neglect, and coronary artery disease (CAD) disparities. While community-based interventions play a crucial role in improving health outcomes, they can’t fully address the systemic inequities that drive health disparities. 

The onus often falls on community-based health organizations to fill in the gaps, yet these programs often operate with limited resources, making it difficult to sustain long-term impact without broader policy and institutional support. 

Additionally, while they can effectively build trust and engagement at the local level, they can’t dismantle structural barriers such as discriminatory health care policies, inadequate insurance coverage, or social determinants like poverty and housing instability. 

Scaling cultural competence in clinical settings

Expanding the impact of community-based interventions requires embedding cultural competence into health care education, provider training, and institutional practices.

Violet is joining this effort with a standard measure for cultural competence—Violet Benchmarks. By assessing providers' ability to deliver culturally competent care to BIPOC, LGBQ, TGNC communities, and more, Violet helps health care organizations and plans build and verify culturally responsive provider networks that meet the needs of diverse patients. 

When clinicians better understand patient identities and experiences beyond their own, it leads to greater trust and a more collaborative care environment. By integrating these tools into medical education and ongoing professional development, health care systems can ensure cultural competence becomes a standard practice, rather than an exception. 

The ripple effect of culturally competent care

When health care organizations integrate the cultural values, traditions, and languages of the populations they serve, patients feel seen and respected.  This results in better appointment attendance, closer adherence to prescribed medication plans, and overall more active participation. 

Beyond individual outcomes, the long-term effects of culturally competent care contribute to closing health equity gaps on a broader scale. By prioritizing culturally competent care, health care organizations not only enhance the well-being of historically marginalized communities, but also create a more effective, and sustainable model of care for all.

What’s next?

Without systemic changes—such as expanding health care access, diversifying the medical workforce, and implementing policies that address racial and economic inequities—community-based efforts risk being band-aid solutions rather than transformative, lasting interventions. To achieve true health equity, community programs must be integrated with larger systemic reforms that address the root causes of disparities.

In order to drive lasting change, the same trust and inclusion that make community-based health interventions so effective must also be embedded within health care organizations and health plans. By integrating cultural competence into medical education, provider training, and institutional policies, health care systems can better deliver more equitable, patient-centered care.

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