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234 Cultural Competence in Health Education and Health Promotion

Similarly, the National Center for Cultural Competence (NCCC) (Cohen & Goode,
1999, revised by Goode & Dunne, 2003) has suggested a variety of reasons why cul-
tural and linguistic competence are required at the health provider and patient level.
For example, people ’ s beliefs about health and their perceptions of disease and ill-
nesses vary by their cultural groups. Individuals ’ cultural groups also infl uence their
help - seeking behaviors and their attitudes toward health care providers, and play a role
in their use of traditional and complementary healing practices. Exhibit 13.1 displays
six of the salient reasons identified by the NCCC that highlight the critical importance

of cultural and linguistic competence in health care.
The recommendations listed in Exhibit 13.1 for incorporating cultural and linguis-
tic competence into health care practice apply to health educators just as much as they
do health care providers. Our work is an essential ally of health care services, and if

EXHIBIT 13.1. Six Reasons Why We Need Cultural and Linguistic
Competence in Health Care and Health Education.

1. To respond to current and projected demographic changes in the United States. As

stated previously in this chapter and throughout this book, signifi cant population
increases are occurring among racially, ethnically, and culturally and linguistically diverse
groups in the United States. Health care organizations and programs must implement
systemic change in order to meet the health needs of this diverse population.

2. To eliminate long - standing disparities in the health status of people of diverse racial,
ethnic, and cultural backgrounds. Although there has been progress in the overall
health of the nation, African Americans, Hispanics, Native Americans, Asians, and
Pacifi c Islanders still have poorer health in many areas than the U.S. population as a
whole does. In response to these disparities the federal government has aggressively
targeted and committed resources to six areas: cancer, cardiovascular disease, infant
mortality, diabetes, HIV/AIDS, and child and adult immunizations (see CDC, n.d.).

3. To improve the quality of services and health outcomes. The delivery of accessible,
effective, cost - effi cient, and high - quality primary health care calls for health care prac-
titioners who have a deep understanding of the sociocultural backgrounds of their
patients and their patients ’ families and who are also aware of the environments in
which their patients live. Culturally and linguistically competent health services facili-
tate encounters with more favorable outcomes, enhance the potential for a more
rewarding interpersonal experience, and increase the satisfaction of the individual
receiving health care and disease prevention services.

4. To meet legislative, regulatory, and accreditation mandates. Title VI of the Civil Rights
Act of 1964 mandates that “ no person in the U.S. shall, on ground of race, color, or

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