Page 73 - Cultural Competence in Health Education

Cultural Competence and Health Education 51

with a wide sample, one that includes variety in age and gender and also the rich and
the poor, educated and uneducated, strong and weak, and healthy and sick. Follow-
ing this principle guides health educators to a balanced view of the culture under study.
The third principle is for health educators to add to their factual knowledge base real - life
experiences shared with the cultural group. The fourth principle is for health educators
to address, through informal and formal assessments, their own biases and the biases of
persons around them. This last principle is especially difficult to follow for it requires

health educators to accept responsibility for moving out of their comfort zones.
These four principles make it obvious that developing cultural competence requires
personal growth. It may be uncomfortable, even painful, to undertake the close, criti-
cal, and honest inspection needed to evaluate one ’ s own sense of decency, morality,
fairness, and justice. Thus, personal growth is the outcome of one ’ s willingness to
challenge one ’ s own social conditioning and cultural incompetence.

Principles for Discipline - Specific Cultural Competence

The field of health education and the professional organizations associated with this
fi eld are also guided by set of principles that are helpful in making the health profes-
sional culturally competent. Several discipline - specific principles are briefl y explored

here. Perhaps paramount among the many principles in this field is that the adoption of
healthy behaviors is voluntary (Green et al., 1980). The impact of lifestyle exceeds all
other health determinants. Healthy and unhealthy behaviors are decided upon primar-
ily by the individual. Coercion is not the desired means of changing behavior, nor is it
effective in getting people to adopt what should be voluntary healthy behaviors. In
addition to motivating the adoption of health - promoting behaviors, culturally compe-
tent health educators show sensitivity and responsiveness in identifying and support-
ing healthy behaviors that are culturally related.
A second principle that the profession follows is that health and social practices
are usually the manifestations of cultural beliefs and individual life experiences
(Braithwaite & Taylor, 1992). Implicit in this principle is that behavioral change can
occur only within the context of a person ’ s culture and life experiences. For some
minority groups, pedagogically tying past history into current sociopolitical issues is
essential in motivating behavioral change (Marbley, Bonner, McKisick, Henfield, &

Watts, 2007). For example, all cultures do not agree that today ’ s obesity problem is
escalating. Whereas in one cultural group the height - weight charts may be the rule to
follow, in another culture a little extra weight may mean “ eating fi ne. ”
A third principle that the health education profession follows is tied to the medical
model that is built on the premise that the causes and cures of diseases are scientifi -
cally founded. Conversely, certain cultural groups may be guided by beliefs passed
down through generations that support the existence of a higher being or spirit that

will grant them good health. A group with cultural practices that reflect harmony with
the environment may fi nd its practices challenged by the use of medicines prescribed
by the medical profession. Thus cultural awareness and sensitivity become essential in
accepting, establishing, and promoting compliance to medical treatment.

7/1/08 2:51:02 PM
c03.indd 51
c03.indd 51 7/1/08 2:51:02 PM