Cultural
Competency
Lara Miramontes
HSCI 825: Advocacy & Communication
April 11, 2013
Overview
• History and Terminology
• What is Culture?
• Cultural Competency 101
• Relevance to Public Health
• Questions?
History and Terminology
• Cultural competency
 Intercultural / cross-cultural competency
 Cultural sensitivity
 Cultural humility (USA: Tervalon, Murray-García)
 Cultural safety (New Zealand, Canada)
 Intercultural / cross-cultural communication
• Basis in patient-centered medicine (1970s-1980s)
• Developed from immigrants to all cultural groups;
encompasses privilege, prejudice, social determinants;
interpersonal, community and systemic implications
• Now embedded in many disciplines and embraced by
business, nonprofit, government, healthcare sectors
What Defines Your Culture?
What Defines Your Culture?
What Defines Your Culture?
What is Culture?
• “Culture is the learned and shared knowledge that
specific groups use to generate their behavior and
interpret their experience of the world.”
• “Most cultural groups tend to believe that how
they see the world is correct, and how they
believe and behave is what is most natural to
human beings; that is, ‘human nature.’ However,
in learning about culture, we need to understand
that to have culture is human nature, but no
specific culture is human nature!”
(National Center for Cultural Competence. [N.D.])
What is Culture?
Cultural Competency 101
• “Having the knowledge that cultural differences as well as
similarities exist, without assigning values such as better,
worse, right or wrong to those… differences.” (Devore &
Schlesinger, 1996)
• A mindset that leads to lifelong learning with:
 Respect for differences
 Eagerness to learn
 Willingness to accept that there are many different ways of
viewing the world
• It is not knowing everything about every culture!
Cultural Competency 101
• Awareness of culturally imbued biases, beliefs
• Knowledge of culturally relevant language, facts
• Skills for culturally appropriate interventions
(Sue et al., 1982)
• Attitude that moves beyond the intellectual to
compel continuous reexamination, assessment
(Martin & Vaughn, 2007)
Relevance to Public Health
• Diversity and equity stressed by CPHA, CIHR; culture
embedded in core public health competencies
• Qualitative reflexivity sought even in quantitative
studies
• Cultural competency is an emerging, expansive field!
Growing relevance and lots of opportunity
• Within 20 years, 80% of Canada’s population growth
owed to new immigrants (Martel & Chagnon, 2013)
Relevance to Public Health
What can public health practitioners do?
• Basic understanding of cultural background is helpful, but
not the only necessary step
 Good intentions, but can lead to stereotyping
 Can bypass importance of understanding the individual
• Acknowledge cultural differences; understand your own
(personal, institutional) culture (including biases and
racism); engage in self-assessment; acquire cultural
knowledge & skills; view behavior within cultural context
Questions?
References
 Blough, M., Burgoyne, K., and Tran, T. Cultural Competency Training:
Bridging the Cultural Divide. Developed by and accessed with
permission via Americana Community Center, Louisville KY. For more
information: www.americanacc.org. Contact: (502) 366-7813,
maria@americanacc.org or kristin@americanacc.org.
 Canadian Public Health Association. (N.D.). Cultural Competency.
Accessed via http://www.cpha.ca/en/activities/safeschools/culture.aspx on April 8, 2013.
 Center for Victims of Torture. (N.D.). Healing the Heart (informational
pamphlet). For more information: http://www.cvt.org/.
 Devore, W., and E. G. Schlesinger. 1996. Ethnic-sensitive social work
practice (4th edition). Boston: Allyn & Bacon.
References Cont’d
 Martel, L. and Chagnon, J. (2013 January 8). Population growth in
Canada: From 1851 to 2061. Prepared for Statistics Canada. Accessed
via http://www12.statcan.gc.ca/census-recensement/2011/as-sa/98310-x/98-310-x2011003_1-eng.cfm on February 14, 2013.
 Martin, M., & Vaughn, B.E. (2007). Cultural competence: The nuts &
bolts of diversity & inclusion. Strategic Diversity & Inclusion
Management: pp. 31-38. San Francisco: Diversity Training University
International Publications Division.
 National Association of Social Workers. (2001). NASW Standards for
Cultural Competence in Social Work Practice. Accessed via
http://www.naswdc.org/practice/standards/NAswculturalstandards.p
df on April 8, 2013.
 National Center for Cultural Competence. (N.D.). Accessed via
http://nccc.georgetown.edu/ on April 8, 2013.
References Cont’d
 Saha, S., Beach, M.C., and Cooper, L.A. (2008 November).
Patient Centeredness, Cultural Competence and Healthcare
Quality. Journal of National Medical Association, 100(11): pp.
1275–1285.
 Simon Fraser University. (N.D.). Core Public Health
Competencies. Accessed via
http://www.fhs.sfu.ca/docs/Core%20Public%20Health%20Comp
etencies.pdf on April 8, 2013.
 Sue, D. W., Bernier, J. E., Durran, A., Feinberg, L., Pedersen, P.,
Smith, C. J., et al. (1982). Cross-cultural counseling
competencies. The Counseling Psychologist, 19(2): pp. 45–52.
References Cont’d
 Tervalon, M., and Murray-García, J. (1998 May). Cultural
humility versus cultural competence: A critical distinction
in defining physician training outcomes in multicultural
education. Journal of Health Care for the Poor and
Underserved, 9(2): pp. 117-125.
 Williams, R. (1999). Cultural safety — what does it mean
for our work practice? Australian and New Zealand Journal
of Public Health, 23: pp. 213–214.
Image Sources
•
Slide 5-6: http://melbaylon.wordpress.com/2012/01/10/musingson-nationality/;
http://treecitytimes.blogspot.ca/2012/07/absurdity-ofpolitically-correct-gender.html;
http://www.counselor.org/gender.html;
http://humanitiesresearch.ca/research-clusters/disabilityresearch-cluster/;
http://www.gegca.com/en/index.php?option=com_content&vie
w=article&id=143:professional-team&catid=43;
http://www.edrawsoft.com/clipart-religion.php;
http://www.clker.com/clipart-9736.html
•
Slide 12: Credit: Dana Duncan, accessible through
https://www.facebook.com/AmericanaCommunityCenter