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232 Cultural Competence in Health Education and Health Promotion

INTRODUCTION
As described in the first chapter of this book, the U.S. population is becoming more racially

and ethnically diverse. In addition, demographic estimates suggest that U.S. racial and eth-
nic populations, such as the populations of African Americans, Hispanics, Asians, Pacifi c
Islanders, and others, will continue to grow in the next few decades. Consequently, it is
estimated that by 2050 the percentage of non - Hispanic whites will be only half of the total
U.S. population (U.S. Census Bureau, 2004). As proposed throughout this book, and espe-
cially Chapter One , this increasing racial and ethnic diversification of the U.S. population

is making it essential to incorporate the concept of cultural and linguistic competence into
every aspect of the planning, implementation, and evaluation processes of health education
and promotion programs (Luquis & P é rez, 2005, 2006; Luquis, P é rez, & Young, 2006;
Mar í n et al., 1994; P é rez, Gonzalez, & Pinzon - P é rez, 2006). Moreover, leading public

health organizations, including the Institute of Medicine (2004) and the Office of Minority
Health (2000), have advocated for a workforce capable of delivering culturally competent
and linguistically appropriate services to an ever more diverse U.S. population.
What do these changes have to do with health educators? The field of health edu-

cation is predicated on the belief that providing health information and skills through
planned learning experiences will enable the individuals, groups, and communities
receiving that education to make informed choices that will assist them in making
quality health decisions and attaining their optimal health status. Similarly, health pro-
motion is based on the belief that providing a combination of educational, political,
environmental, regulatory, and organizational mechanisms can support actions and
conditions of living conducive to the health of individuals, groups, and communities.
However, these foundational beliefs often fail to address the reality that given the cur-
rent diversity of the population in the United States, health education and promotion
interventions found to be effective in one racial or ethnic group might not be equally
effective with another group. Thus, in order to be effective, health education and pre-
vention strategies must address each group ’ s unique culture, experiences, language,
age, gender, and sexual orientation and be culturally and linguistically appropriate.
The purpose of this chapter is to provide some final thoughts on the importance of

cultural and linguistic competence and to discuss how to integrate these concepts into
health education and health promotion programs. This chapter will also discuss some
strategies for promoting cultural and linguistic competence that can assist health educa-
tion specialists in working with individuals or communities effectively and addressing
their health needs successfully. Finally, this chapter will discuss standards to promote
cultural and linguistic competence in health education.

UNDERSTANDING THE NEED FOR CULTURAL
AND LINGUISTIC COMPETENCE

The professional literature discussed in the previous chapters reveals that nonwhites in
the United States are less likely than their non - Hispanic white counterparts to have
access to health insurance and to take advantage of preventive services, and are also

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