Second, care that is not culturally competent may further increase the gap in racial and health disparities between minority and majority populations. Failure to effectively respond to the health care needs and preferences of culturally and linguistically diverse individuals may: (1) increase barriers to equitable access to care, (2) inhibit effective communication between the client and the nurse, and (3) create obstacles in gathering assessment data, thus limiting the development and implementation of effective treatment plans. In the current climate of economic constraints, the health care industry is focused • on cost-effectiveness, which means balancing cost and quality (Agency for Healthcare Research & Quality, 2009b).