Page 150 - Cultural Competence in Health Education

128 Cultural Competence in Health Education and Health Promotion

communication methods — oral, written, and corporal — to educate their target population.
It is equally important for them to consider the health and religious beliefs of their clients
in order to plan interventions that are culturally appropriate.

Language and Communication
The primary spoken language of the target population is one of the first things to take

into consideration because it is the most important means of communication; hence it
plays a prominent role in the relationship that individuals establish with the profession-
als who are trying to maintain or restore their health. “ Studies have shown that without
language assistance services, such as medical interpreting and translation of written
health information materials, the quality of health care for limited English profi cient
consumers suffers ” (Bau, 2003, p. 1). Arguably, this is true not only for medical care but
also for health education and promotion services, because in order for the clients to get the
best out of those services they need to understand the information they are receiving.
Communication between client and provider is also important in achieving compliance
with any behavior modification program that may be required of the client.

Language differences are the most important obstacle that health professionals
face, given the cultural diversity of the U.S. population. An illustration of the dimen-
sion of language diversity can be found in an assessment conducted in 2001 by the
Instituto Nacional Indigena (National Indigenous Institute), the Mexican entity in
charge of developing policies and programs targeting Mexico ’ s indigenous popula-
tion. It found that in addition to Spanish, over sixty indigenous languages are spoken
by the native groups in Mexico. Members of many of these groups have migrated to
the United States: Mixtecs, Zapotecs, Triquis, Chatinos, Chinantecos, Purepechas,
Nahuatls, and Mayas are just the most prominent among the groups whose members
have settled in California and other areas of the United States. It is also important for
health educators to know that most of the languages spoken by these indigenous Mexican
immigrants — along with the languages spoken by immigrants from other regions, such
as the Hmong from Thailand — exist in a variety of dialects (for example, Low and
High Mixtec, Zapotec del Valle, Zapotec de la Sierra, and Zapotec del Istmo), which

makes communication even more difficult. Determining the specific dialect that a pop-
ulation speaks is crucial when the needs assessment, the intervention, or the evaluation
tool requires having oral communication with the target population.
Language is also an important means of communication in its written form; how-
ever, not all languages have a written version. Furthermore, the existence of a written
language does not guarantee a certain level of literacy among the population that
speaks that language. Therefore, health educators must assess not only whether the
language of the target population has a written version but also, if it does, whether
the intended population knows how to read and write that language. Continuing
with the examples of the indigenous groups from Mexico, it is important to understand
that most of their indigenous languages are predominantly oral (as, for example,
Chatino and Triqui are). Scholars began the work of developing written versions of

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