Ronny A. Bell, PhD, MS
Professor of Epidemiology and Prevention
Director, Maya Angelou Center for Health Equity
Wake Forest University School of Medicine
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Family/friends
Where you grew up
Where you live
Religious beliefs
Education
Entertainment
Employment
Travel experiences
Tastes in Foods and Beverages
Race/Ethnicity
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“An integrated pattern of human knowledge,
belief, and behavior that depends upon the
capacity for symbolic thought and social
learning”
“The set of shared attitudes, values, goals,
and practices that characterizes an
institution, organization or group”
Source: Wikipedia
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Having a defined set of values and
principles, and demonstrated
behaviors, attitudes, policies, and
structures that allow for effective work
cross-culturally.
National Center for Cultural Competence, 1998
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Having the capacity to:
◦ (1) value diversity,
◦ (2) conduct self-assessment,
◦ (3) manage the dynamics of difference,
◦ (4) acquire and institutionalize cultural
knowledge, and
◦ (5) adapt to diversity and the cultural
contexts of communities they serve.
National Center for Cultural Competence, 1998
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Incorporate the above components in
all aspects of policy-making,
administration, practice and service
delivery, systematically involve
consumers, families and communities.
National Center for Cultural Competence, 1998
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“The ability of systems to provide care
to patients with diverse values, beliefs
and behaviors, including tailoring
delivery to meet patients’ social,
cultural, and linguistic needs.”
(Betancourt, 2002)
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“Having the capacity to function
effectively as an individual and an
organization within the context of the
cultural beliefs, behaviors and needs
presented by consumers and their
communities.” (Office of Minority
Health, 2001)
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At a systems, organizational or program
level, cultural competence requires a
comprehensive and coordinated plan
that includes interventions on levels of:
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policy making;
infra-structure building;
program administration and evaluation;
the delivery of services and enabling supports; and
the individual.
Denboba, MCHB, 1993
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At the individual level, cultural
competence means an examination of
one’s own attitude and values, and the
acquisition of the values, knowledge,
skills and attributes that will allow an
individual to work appropriately in
cross cultural situations.
Denboba, MCHB, 1993
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Cultural competence mandates that
organizations, programs and individuals must
have the ability to:
◦ value diversity and similarities among all peoples;
◦ understand and effectively respond to cultural
differences;
◦ engage in cultural self-assessment at the individual
and organizational levels;
◦ make adaptations to the delivery of services and
enabling supports; and
◦ institutionalize cultural knowledge.
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Asking the right questions
Asking the right questions the right way
Answering the right questions the right way
Institute of Medicine
Unequal Treatment Report
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Excess rates of diabetes, hypertension and stroke
among African Americans and Latinos relative to
whites will cost the health care system $23.9
billion dollars in 2009.
Medicare alone will spend an extra $15.6 billion,
and private insurers will spend an extra $5.1
billion.
Over the next decade, the total cost is
approximately $337 billion.
Left unchecked, these annual costs will more
than double by 2050 as the representation of
Latinos and African Americans among the elderly
increases.
Waidman, The Urban Institute, http://www.urban.org/publications/411962.html
Racial and Ethnic Health
Disparities in North Carolina
REPORT CARD
2006
Office of Minority Health and Health Disparities
And
State Center for Health Statistics
North Carolina Department of Health and Human Services
State Center for Health Statistics
State Center for Health Statistics
State Center for Health Statistics
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Understanding the unique patterns of
initiation and use of tobacco
Understanding the cultural and economic
value attached to tobacco
Recognizing the symbols/images that convey
messages important for tobacco prevention
Utilizing the forms of communication that are
important to communities
www.aaip.org, www.diabetes.org
www.lumbeetribe.com
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African American
◦ 7 African American owned newspapers in NC
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American Indian
◦ 6 Tribes
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Latino
◦ 1 Latino Media Enterprise
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Cultural competency is a critical but often
elusive component of delivering health care
and conducting health related research
Effort should be made enhance the cultural
competency of individuals and systems that
provide health care and conduct health
research
Providing cultural competency makes
business sense, but, more importantly, it’s
THE RIGHT THING TO DO!