Implicit bias, lack of cultural competency, structural racism, and intentional historical discriminatory policies have affected equal access to healthcare for many groups of people in the United States. Until recently, many people were not aware of the attitudes and prejudices that have created these barriers and disparities.

The COVID pandemic brought healthcare inequities into sharp focus. Illness and death hit minority communities, nursing homes, rural communities, and Indigenous communities with terrible ferocity. Among frontline workers, women, minorities, and people of color were disproportionately affected.

As the population of the U.S. has become more diverse, the need for culturally competent training has become an imperative. From a practical standpoint, reducing implicit bias and improving cultural competence will have a positive effect on outcomes and costs. Eliminating health disparities will save billions of dollars by reducing healthcare costs, improving productivity, and saving lives.

Research has shown that addressing implicit bias and improving cultural competency is possible. Understanding the effects of colonial medicine, slavery, and Jim Crow provides a basis for examining structural issues that have been slow to change.

Despite this growing interest in reducing implicit bias and improving health equity, many racial and ethnic minority groups continue to experience disproportionate rates of infectious and chronic diseases and their associated risk factors (Jibrel, 2021). These entrenched negative influences on health in some communities have compounded over generations (Towe et al., 2021). Achieving health equity will eliminate gaps in healthcare access, quality of care, and, most importantly, the social and environmental determinants of health (MDHHS, 2019).