Page 170 - Cultural Competence in Health Education

148 Cultural Competence in Health Education and Health Promotion

INTRODUCTION
Every ethnic group has its specific cultural and communication patterns. This chapter

discusses communication patterns among racial, ethnic, and other groups and the role
that language plays in delivering health education programs to these population
groups. The discussion focuses on historical perspectives on communication across
cultures, communicating across cultures about health and disease, communication
and persona and community health, communication and marketing techniques for
various cultures, and communication patterns, barriers, and empowerment.

COMMUNICATION AND CULTURE
Culture is a complex concept that can be defined in many ways. It involves people ’ s

knowledge, beliefs, art, morals, laws, customs, and any other capabilities and habits
that guide groups of people in their natural and immediate environments. All these
capabilities can be summarized in terms of people ’ s behavioral patterns, ideas, values,
attitudes, and material objects. Culture is learned and shared. The process of acquiring
culture throughout an individual ’ s or a group ’ s developmental life stages is called
enculturation.
Culture is “ a system of interrelated values enough to influence and condition per-

ception, judgment, communication, and behavior in a given society ” (Mazrui, 1986,
p. 239). Culture is rooted in institutions such as families and schools and also in com-
munication industries. In our daily lives, we are always making decisions about such
matters as what foods to eat, what clothes to wear, how to greet others, what idiom of
language to use when communicating with others, what behaviors to exhibit in a
group, and how to perceive the world around us. Such decision - making processes are
informed by our heritage and life experiences and these lead us to develop our own
cultural identity.
Everyone comes from a culture, and individuals want to be associated with a cul-
ture. Cultural identity is made up of the specific and often unique ways that people think

and act within the norms of their group. It encompasses a wide range of cultural infl u-
ences on people ’ s behaviors, beliefs, attitudes, and values. It is transmitted from genera-
tion to generation. Therefore cultural identity is based primarily on a shared historical,
linguistic, and psychological lineage. People with a common culture live in accord with
a shared set of socially transmitted perceptions about the nature of the physical, social,
and spiritual world, particularly as it relates to achieving life goals (Basch, 1990).
It is paramount that planners and evaluators of health education programs and ser-
vices carefully examine the differences and the similarities in groups ’ cultural percep-
tions, so that they can understand health beliefs, practices, knowledge, and attitudes
more fully and hence address them appropriately within each group ’ s particular context.
Furthermore, they need to examine culture with a critical and open spirit. Culture is
passed down from generation to generation. People have come before us and people will
come after us. Therefore all individual moral and intellectual choices are superimposed

7/1/08 2:55:21 PM
c08.indd 148 7/1/08 2:55:21 PM
c08.indd 148