Medical leaders are moving toward an approach to address healthcare disparities called trauma-informed care, in contrast to cultural competency, an older approach. "There's little evidence showing that cultural competency initiatives have improved outcomes," said Uchenna Anani, M.D., a neonatologist at Monroe Carell Jr. Children's Hospital at Vanderbilt.

"A cultural competency approach only looks at the surface, recognizing a known disparity."

In a recent article, Anani contrasts trauma-informed care and cultural competency, using a hypothetical case about breastfeeding involving a young Black mother and her premature infant in the NICU. "If someone had asked, she could have explained that she lacks the flexibility to pump at work," Anani said, opening the possibility of peer support for breastfeeding.