Individual and Organizational Cultural Competency
Individual and Organizational Cultural Competency
Cultural competency in the context of health education, is the integration of knowledge, behaviors, and policies within a public health system, that support cross-cultural interactions and delivery of tailored services at the individual, community, organizational, and institutional levels. For a health education professional, this includes the commitment to self-assessment, recognizing the need for ongoing education, and a values-driven approach to improving the health of diverse populations (Georgetown University Center for Child and Human Development, n.d.).
The overarching goals established by Healthy People 2020 recognize the value of good health, free from preventable disease and disability, with an emphasis on improved quality of life for all people (U.S. Department of Health and Human Services [HHS], 2011). To truly serve all populations, cultural competency must be a foundational goal in health education programs and professional development, to provide equal opportunities for improving health across all cultural boundaries. Shifting demographics require consistent efforts to identify culturally competent health educators to deliver tailored programming that meets the needs of the targeted population (Perez & Luquis, 2014). Understanding the unique set of attitudes and beliefs associated with race, ethnicity, gender, disabilities, and sexual orientation, allows health educators to reach diverse groups of individuals to reduce health disparities and improve quality of life. Individuals and organizations have specific roles in improving the level of cultural competency and quality of services for a diverse population.
Individual Cultural Competency
Improving competency as an individual requires a baseline level of knowledge regarding historic and current cultural conditions and attitudes, including respect for demographic and psychographic differences. There are several key characteristics that individuals must possess to demonstrate cultural competency. The U.S. Department of Health and Human Services indicates an appreciate for diversity and the ability to appropriately respond to various cultural differences are necessary attributes of effective health professionals (HHS, 1997). Individuals who are able to self-assess will identify gaps in knowledge, ambiguous thoughts, or challenges that may occur due to a lack of cultural information. These findings will assist individuals in creating solutions that improve the services and programs for the targeted population (HHS, 1997).
In addition to the characteristics identified for cultural competency, several exercises may improve general population knowledge and acceptance of a multi-cultural environment. At the community level, integration offers an opportunity to share traditions and cultural practices within the context of the larger community. When individuals are accepting of community members, the shared experiences will provide commonalities for future interactions. Communities that serve all of their populations demonstrate an understanding of fair and equitable support. Individuals from the dominant population have an opportunity to reach out to minority groups as a means of reducing barriers, learning new customs and beliefs, and increasing confidence and civic harmony. Creating events that draw groups together for positive purposes will allow communication to develop before potentially harmful or negative interactions occur. As an example, understanding the stages of adjustment for immigrants will allow other community groups to respond accordingly, providing support for acculturation in a community setting (Perez & Luquis, 2014).
Organizational Cultural Competency
The American Association for Health Education provides a foundational cultural competency position statement, clearly demonstrating a commitment to developing skills in health professionals that enhance health literacy and the interactions that occur in diverse populations and settings (American Association for Health Education, 2006). They advocate “to achieve cultural competency by understanding the meaning of culture, its complexity within each group, and its effect on health decisions and practices” (American Association for Health Education, 2006, para. 1). Health educators may embrace the framework provided by the organization, as it emphasizes the value of professional development and continuing education at all career stages. Cultural competency exists on a continuum, as the population is in constant change, requiring ongoing learning and adaptation when developing, implementing, and evaluating health education programs.
The National Alliance on Mental Health (NAMI) is an organization with a strong commitment to cultural competency in mental health care. A 1999 mental health report by the Surgeon General acknowledged the disparities in mental health treatments, particularly for consumers of color (National Alliance on Mental Illness, n.d.). It recognized that a lack of cultural competency contributed to a lack of services, concerned that people of color “may not seek services in the formal system, cannot access treatment, drop out of care, are misdiagnosed, or seek care only when their illness is at an advanced stage” (NAMI, n.d., para. 4). A follow up report in 2003 emphasized the importance of cultural competency in the mental health system, recognizing that the current state had not kept pace with a shifting population, including the growth of minority groups, often failing to provide appropriate treatment (NAMI, n.d.) The resulting recommended reforms provide guidance at the organizational and state level, where many mental health service decisions occur. The reforms include education and adaptation, ensuring providers address diverse populations with key mandates including the following:
- All agencies receiving federal assistance must commit to providing quality and equal treatment.
- The consumer’s culture must be integrated into the treatment.
- Mental health systems must adapt to people of color.
- Cultural competency education must be incorporated into clinical training and continuing education.
- Government and private providers must perform a cultural self-assessment and competence standards.
- Culture-specific research must be funded.
- Financial programs must be created to increase the number of minority mental health professionals (NAMI, n.d.).
These progressive reform measures set forth by NAMI, provide a foundation for mental health professionals and organizations within the mental health system, defining clear actions to improve mental health outcomes for all populations, with particular emphasis on people of color, due to the identified disparities preventing equal treatment opportunities. They are strongly aligned with the American Association for Health Education’s cultural competency position statement in that they concur that disparities and inequities exist for minority groups, and that the responsibility for ensuring equality resides with the health professionals who serve the diverse groups of individuals within the public healthcare system. Both organizations seek to reduce the barriers that prevent optimal treatment and services, by ensuring cultural competency measures are taken in professional development and program planning (American Association for Health Education, 2006). Although the American Association for Health Education casts a wider net over all health education services, NAMI’s commitment to mental health equality applies the concepts to the organizations and policies of governmental and private providers (NAMI, n.d.). Ultimately, both organizations support the Healthy People 2020 goals by ensuring a greater quality of life for all populations with advances in cultural competency.
American Association for Health Education. (2006). A position statement of the American Association for Health Education, April 2006. Retrieved from https:// mycourses9.atsu.edu/bbcswebdav/pid-420207-dt-content-rid-8207692_1/courses/ 14-15FAB1-CGHS-DHED8000-1-CGHS/Appendix%20A.pdf
Georgetown University Center for Child and Human Development. National Center for Cultural Competence. (n.d.). Definitions of cultural competency. Retrieved from http:// www.nccccurricula.info/culturalcompetence.html
National Alliance on Mental Illness. (n.d.). Cultural Competence in mental health care. Retrieved from http://www.nami.org/Content/NavigationMenu/Find_Support/ Multicultural_Support/NAMI_Espanol1/Cultural_Competence.htm
National Institute of Mental Health. (1999). Mental Health: A report of the Surgeon General. Retrieved from http://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/NNBBHS
Perez, M. A. & Luquis, R. R. (2014). Cultural competence in health education and health promotion (2nd ed.). San Francisco, CA: Jossey-Bass.
U.S. Department of Health and Human Services. (2011). About Healthy People. Retrieved from http://www.healthypeople.gov/2020/about/
U.S. Department of Health and Human Services, Health Services and Resources Administration. (1997). MCHB/DSCSHCN Guidance for Competitive Applications, Maternal and Child Health Improvement Projects for Children with Special Health Care Needs. Retrieved from http://mchb.hrsa.gov/programs/needsassessment/titlevfederalguide.pdf