Frequently Used Terms

Cultural competence / cultural competency

The ability of a service provider or educator to address the needs of their recipient populations in a way that acknowledges and is sensitive to their cultural differences. This includes finding ways to:

1. Communicate in a manner that is culturally and linguistically appropriate. http://healthliteracy.worlded.org/docs/culture/intro_glossary.html
2. The ability to understand, interact, and work well with people of different cultures. In medicine, one goal of cultural competency is to help make sure that the quality of the healthcare is equal among different cultural groups. http://www.nci.nih.gov/Templates/db_alpha.aspx?CdrID=635466
3. Cultural Competency is a process of developing proficiency in effectively responding in a cross-cultural context. It is the process by which individuals, agencies, and systems integrate and transform awareness of assumptions, values, biases, and knowledge about themselves and others to respond respectfully and effectively across diverse cultures, language, socioeconomic status, race, ethnic background, religion, gender, sexual orientation, and ability. Cultural competence recognizes, affirms, fosters, and values the strengths of individuals, families, and communities and protects and preserves the worth and dignity of each." http://www.scaoda.state.wi.us/docs/main/CulturalCompetencyDefinition.pdf

Cultural humility

(Tervalon, M., & Murray-Garcia, J. 1998. 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):117-125.):

• "Incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and non-paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations."

Culture

Culture refers to: http://www.roshan-institute.org/templates/System/details.asp?id=39783&PID=474552

• Language: the oldest human institution and the most sophisticated medium of expression.
• Arts & Sciences: the most advanced and refined forms of human expression.
• Thought: the ways in which people perceive, interpret, and understand the world around them.
• Spirituality: the value system transmitted through generations for the inner well-being of human beings, expressed through language and actions.
• Social activity: the shared pursuits within a cultural community, demonstrated in a variety of festivities and life-celebrating events.
• Interaction : the social aspects of human contact, including the give-and-take of socialization, negotiation, protocol, and conventions
• The shared characteristics of a group of people, which may include patterns of behavior, beliefs, customs, traditions, artistic expression, and language. http://healthliteracy.worlded.org/docs/culture/intro_glossary.html
• Culture consists of "learned systems of meaning, communicated by means of natural language and other symbol systems, having representational, directive, and affective functions, and capable of creating cultural entities and particular senses of reality".Roy G. D'Andrade Ph.D. http://puffin.creighton.edu/bucko/courses/syllabi/culture.html
• Culture is "an extrasomatic (non-genetic, non-bodily), temporal continuum of things and events dependent upon symbolingCulture consists of tools, implements, utensils, clothing, ornaments, customs, institutions, beliefs, rituals, games, works of art, language, etc. (Leslie White Ph.D.). http://puffin.creighton.edu/bucko/courses/syllabi/culture.html

Ethnicity

• Relating to a particular group that is defined by factors that may include race, religion, nationality, ancestry, or culture.http://healthliteracy.worlded.org/docs/culture/intro_glossary.html
• Ethnicity is social identification based on the presumption of shared history and a common cultural inheritance

• The social, cultural, religious, linguistic and other affiliations often characterized by cultural features such as dress, language, religion, and social organization http://www.understandingrace.org/

Healthcare disparity

Refers to differences in the preventive, diagnostic, and treatment services offered to people with similar health conditions

Healthcare equity

Providing care that does not vary in quality by personal characteristics such as ethnicity, gender, geographic location and socioeconomic status

Minority

• Years ago, persons in racial or ethnic groups outside of non-Hispanic Caucasian were referred to as minorities. Numbers aside, the term provided the description of a group with significantly less control or power over their lives than that held by members of the dominant or majority group. As the US population increases in diversity, groups traditionally referred to as "minorities" have become the "emerging majority" in some US communities. However, these groups often remain underserved and collectively make up the greater part of low income persons in the US . Based on Richard T. Schaefer , Racial and Ethnic Groups 5 - 10 (1993) http://books.nap.edu/openbook.php?record_id=9599&page=243
• A minority group is defined on the basis of a relatively permanent and unchanging status and on the basis of being different-often visibly-from the majority group http://science.jrank.org/pages/7873/Minority.html
• A group that experiences a narrowing of opportunities (success, education, wealth, etc) that is disproportionately low compared to their numbers in the society; as well as having significantly less control or power over their lives than members of a dominant or a majority group. http://academic.udayton.edu/race/01race/minor01.htm

• Populations that are racially or ethnically different from the majority http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1070046

Race

A social construction created by western Europeans following exploration across the world to account for differences among people and justify colonization, conquest, enslavement, and social hierarchy among humans www.understandingrace.org

Race and ethnicity (definitions of)

Definitions of race & ethnicity from the Office of Management and Budget, which are used on the United States Census and other federal documents and policies:

• American Indian and Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment.
• Asian - A person having origins in any of the original peoples of the Far East , Southeast Asia , or the Indian subcontinent including, for example, Cambodia , China , India , Japan , Korea , Malaysia , Pakistan , the Philippine Islands, Thailand , and Vietnam . It includes 'Asian Indian', 'Chinese', 'Filipino', 'Korean', 'Japanese', 'Vietnamese', and 'Other Asian.'
• Black or African American - A person having origins in any of the Black racial groups of Africa . It includes people who indicate their race as 'Black, African American, or Negro', or provide written entries such as African American, Afro American, Kenyan, Nigerian, or Haitian.
• Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."
• Native Hawaiian and Other Pacific Islander - A person having origins in any of the original peoples of Hawaii , Guam , Samoa , or other Pacific Islands . It includes people who indicate their race as 'Native Hawaiian', 'Guamanian or Chamorro', 'Samoan', and 'Other Pacific Islander.

• White - A person having origins in any of the original peoples of Europe , the Middle East , or North Africa . It includes people who indicate their race as 'White' or report entries such as Irish, German, Italian, Near Easterner, Arab, or Polish

Stages of the cultural competence continuum

Reference: NIH. (2014). Exhibit 1-2 The Continuum of Cultural Competence. In National Center for Biotechnology Information . Retrieved February 20, 2018, 

• Cultural destructiveness - attitudes, policies, structures, and practices within a system or organization that are destructive to a cultural group.
• Cultural incapacity - lack of capacity of systems and organizations to respond effectively to the needs, interests, and preferences of culturally and linguistically diverse groups. Example: institutional bias, discriminatory hiring and promoting practices, disproportionate allocation of resources, lower expectations for some cultural, ethnic, or racial groups.
• Cultural blindness - expressed philosophy of viewing and treating all people as the same. Example: policies that encourage assimilation, ignoring cultural strengths, little value placed on cultural competence training, few structures dedicated to acquiring cultural knowledge.
• Cultural pre-competence - level of awareness within systems or organizations of their strengths and areas for growth to respond effectively to culturally and linguistically diverse populations. Example: expressing a value for quality services for culturally diverse population, commitment to civil rights, hiring practices that support a diverse workforce.
• Cultural competence - systems and organizations demonstrate an acceptance and respect for cultural differences. Example: create a mission statement that values cultural and linguistic competence, specific policies that integrate cultural and linguistic competence into each core function, adapt evidence-based practices that are culturally and linguistically competent, develop capacity to collect and analyze data using variables that have meaningful impact on culturally and linguistically diverse groups, etc.
• Cultural proficiency - systems and organizations hold culture in high esteem, and use this as a foundation to guide all of their endeavors. Example: continue to add to the knowledge base within the field of cultural and linguistic competence by conducting research and developing treatments/interventions/education/etc., employ faculty/staff/consultants with expertise in cultural and linguistic competence in health and mental health, publish and disseminate evidence-based practices, support and mentor other organizations as they progress along the cultural competence continuum, establish and maintain partnerships with diverse constituency groups to eliminate racial and ethnic disparities in health and mental health.