Recognising barriers, assumptions, and bias

Barriers in cross-cultural care are both practical and interpersonal. They include language, trust, health literacy, privacy and modesty, digital exclusion, money and transport, family roles, and past experiences of being ignored or stereotyped in healthcare.

Common barriers in pharmacy practice

• Language differences: the person may not fully understand spoken English, written information, or pharmacy terms.
• Health literacy: someone may speak English well but still find health information, dosage instructions, or service pathways confusing.
• Assumptions and bias: staff may unconsciously make decisions based on accent, appearance, religion, age, or ethnicity.
• Privacy and dignity concerns: some conversations may feel unsafe or embarrassing at a busy counter.
• Practical access issues: work patterns, caring roles, transport, fasting, gender preferences, or distrust of services may all affect care.

Bias can be subtle

Bias is not always deliberate. It can show in who is interrupted, who is spoken over, who is given simplified explanations, whose questions are dismissed, or whose preferences are ignored.

Recognising bias is not about blame. It means pausing, reflecting, and adjusting when assumptions may be shaping care.

Assumptions can feel efficient in a busy pharmacy but often cause misunderstanding. Check actual needs, speak respectfully, and keep the patient at the centre of the interaction.