Page 110 - Cultural Competence in Health Education

88 Cultural Competence in Health Education and Health Promotion

INTRODUCTION
Education for health happens in many contexts. It happens formally when it is pre-
sented by health educators in classes in schools, communities, and universities and by
health care professionals in hospitals or health clinics. But it also happens less for-
mally in families, in cultural communities, and in religious institutions and other set-
tings, presented by those who educate to promote a holistic view that sees caring for
the body, mind, soul, and spirit as an important way to promote health. The word
health actually comes from the root term hal, which means “ to be whole ” (Sanford,
1977). Thus one could easily argue that education for health is about education for
wholeness. Such a definition is in keeping with the World Health Organization ’ s (1948)

definition, which describes health as “ a state of complete physical, mental and social

wellbeing and not merely the absence of disease or infirmity. ” Further and more
recently, the World Health Organization (WHO) (1998) noted that “ quality of life ”
relates to how individuals perceive their lives in relation to their cultural context and
value systems and is also related to their physical health, social relationships, spiritual-
ity, and salient environmental factors.
The purpose of this chapter is to discuss a spiritually grounded and culturally
responsive approach to education for health, in light of both the literature and the
authors ’ experience. Because the health education literature on spirituality is sparse, it
is hoped that this chapter, through its sharing of experiences in health and education
related practice, will inspire the reader to develop the concept of spirituality within
health education. We, the authors of this chapter, are educators for health in the broad

sense of that term. We recognize that health education is a defi ned field in which nei-
ther of us practices. One of us (Ann Swartz) is an educator for health in the expected
sense in that she teaches practicing registered nurses (RNs) as they work to complete
their bachelor of science degrees. The other (Elizabeth “ Libby ” Tisdell) is not a health
care professional but teaches in a doctoral program in adult education with part - time
adult students who themselves work as educators of adults in many contexts, includ-
ing health education settings. One class she teaches is titled “ Spirituality and Culture
in the Health and Education Professions ” and is based on her research into spirituality,
culture, and health in adult education. Both of us attempt to be spiritually grounded,
culturally responsive educators, working for the health of both individuals and society
as a whole.
According to our shared perspective, body, mind, soul, and spirit are one in the
individual who is inextricably linked to her or his context, the rest of society, the envi-
ronment, and the sacred. Health is that which fosters the interconnection and expres-
sion of all these aspects of self. Because society is broad and individuals are unique,

they must be allowed to define health for themselves. Sometimes that defi nition is
related to the absence of disease, sometimes it is a more culturally determined con-
struct. Often it is directly tied to spirit.
This chapter will outline the understanding we have arrived at of what it means to
educate for health, and it will discuss how we carry this understanding into practice.

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