Page 214 - Cultural Competence in Health Education

192 Cultural Competence in Health Education and Health Promotion

FOUR AREAS OF CULTURAL COMPETENCE
Cultural competence has been defined as “ the ability of an individual to understand and

respect values, attitudes, beliefs, and mores that differ across cultures, and to consider
and respond appropriately to these differences in planning, implementing, and evaluat-
ing health education and promotion programs and interventions ” (Joint Committee on
Health Education and Promotion Terminology, 2000, p. 7). Some authors in the fi eld
group cultural competence with cultural profi ciency, which is the highest capacity for
interacting with members of diverse groups and delivering quality health education
programs. Cultural competence or proficiency does not require the health educator to

adopt others ’ racial or ethnic cultural practices nor does it require him or her to become
an expert in every possible cultural group; it does require that the health educator con-
tinually develop his or her abilities in four areas — awareness, knowledge, experience,
and skills — and be willing to make a commitment to a lifelong process of change.

RECOMMENDATIONS FOR WORKING WITH DIVERSE GROUPS
It should be obvious, given the discussion up to this point, that cultural competence is
not an end by itself, but rather a lifelong process requiring a commitment to ongoing
examination of one ’ s cultural blinders, one ’ s own biases, and one ’ s desire to interact
with others who are not like oneself. Cultural competence needs to constantly evolve
in order to have meaning and a real - life application for health educators. Cultural com-
petence also requires that we make a commitment to learn about our own group and
avoid making assumptions about each other.
The following general recommendations, based on the professional literature and
the author ’ s personal experience, are designed to give health educators practical sug-
gestions for dealing with different cultural groups.

■ Differentiate among culture, race, and ethnicity. As we have seen throughout this
text, the terms culture, race, and ethnicity, although used as synonyms for conve-
nience, are not. Erroneous classifications may lead us to make erroneous assump-

tions about people; for instance, we might think a person to be of a given race
given her skin color, but her cultural identity or ethnicity may not correspond with
that color.
■ Avoid stereotypes. Many publications, including this book, highlight some cul-
tural health values documented in the professional literature. It is, however, impor-
tant to realize that not every member of a particular group will ascribe to those
generally accepted standards. Keep in mind, for example, that not everyone over
the age of 65 uses a walker, and many people over 65 enjoy a satisfying social life
that includes dancing and sexual activity.

■ Ascertain acculturation levels. Acculturation has been defined as the degree to
which an immigrant adopts the culture and behaviors of the host country. Income,
education, and language preference are all proxies for acculturation but do not

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