Cultural Competence in Health-Care

Insurgent Multiculturalism

Movement beyond cultural competence and multiculturalism tolerance to the influence of power and the foundations of inequities that allow some groups but not others to acquire and keep resources.

Enculturation

"A process by which developing individuals acquire (either by generalized learning in a particular cultural milieu, or as a result of specific instruction and training) the host of cultural and psychological qualities that are necessary to function as a member of one's group."

Ethic

"A set of principles of right conduct; a theory or system of moral values."

Sociocultural Barriers

"A social or cultural quality, characteristic, or experience of a racial/ethnic group or individual that led to differential treatment and varying quality of care."

Culture Competence

"Ability of individuals and systems to respond respectfully and effectively to people of all cultures, classes, races, ethnic backgrounds, and religions in a manner that recognizes, affirms, and values the cultural differences and similarities and the worth of individuals, families, and communities and protects and preserves the dignity of each." A set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations.

Culturally Competent Health-Care System

"Acknowledges and incorporates, at all levels, the importance of culture, health care system assessment of cross-cultural relationships, vigilance towards the dynamics that result from cultural differences,expansion of cultural knowledge, and adaptation of services to meet culturally unique needs."

Caring

"Attitudes, judgments, and actions that show support and professional skill."

Heterosexism

"Belief that heterosexuality is the only 'natural' sexuality and that it is inherently healthier or superior to other types of sexuality."

Diversity

"Collective mixture of any combination of individuals who are different in some ways and similar in others. This mixture includes both the primary dimensions of diversity (i.e., age, ethnicity, gender, mental/physical characteristics, race, and sexual orientation) as well as secondary dimensions (i.e., communication, education, family status, military experience, organizational role and level, religion, first language, geographic location, income, work experience, and work style)."

Discrimination

"Differential actions toward others according to their race."

Biomedical views

"Diseases as natural mechanistic errors, correctable with interchangeable or repairable parts or by manipulating chemical pathways that are the cause of distress."

Generalization

"Draws on experiences and commonalities of groups or cultures while allowing room for the individual experience."

Subculture

"Group that deviates in certain areas from the dominant culture in values, beliefs, norms, moral codes, and ways of living with some distinctive or unique features of its own but usually closely related to the dominant culture."

Ethnicity

"Groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background."

Stereotypes

"Imposing preconceived assumptions or observations about behaviors, beliefs, and actions to individuals without evaluating unique values and experiences."

Culture

"Integrated pattern of human behaviors that includes thoughts, communications, languages, practices, beliefs, values, customs, courtesies, rituals, manners of interacting and roles,relationships and expected behaviors of a racial, ethnic, religious or social group; and the abilityto transmit the above to succeeding generations." "Culture shapes how we explain and value the world and provides us with the lens through which we find meaning." "Process in which views and practices are dynamically affected by social transformations, social conflicts, power relationships, and migrations."

Institutional Culture

"Learned, shared, and transmitted values, symbols, beliefs, norms, and lifeway practices within a short-term or long-term health care setting or organization that guides the thinking, decision making, and actions of residents and staff in serving others."

Illness

"Meaning of disease to the individual or her/his social group; etiology can be natural, supernatural, or metaphysica."

Disease

"Objective, measurable, pathophysiology that creates illness."

Ethnohistory

"Past facts, events, instances, experiences of individuals, groups, cultures, and institutions that are primarily people-centered (ethno) and used to explain and interpret human lifeways of particular cultures over short or long periods of time."

Race

"Possessing traits that are transmissible by descent and sufficient to characterize it as a distinct human type."

Ageism

"Prejudice or discrimination against or in favor of an age group."

Health Disparity

"Racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention ... [but related to] the operation of health care systems and the legal and regulatory climate ...[and] discrimination: ... biases, prejudices, stereotypes, and uncertainty in clinical communication and decision-making." "Potentially avoidable differences in health (or in health risk that policy can influence) between groups of people who are more and less advantaged socially; these differences systematically place socially disadvantaged groups at further disadvantage on health."

Health

"State of well-being that is culturally defined, valued, and practiced which reflects the ability of individuals (groups) to perform their daily role activities in culturally expressed, beneficial, and patterned ways."

Assimilation

"The process by which cultural distinctions between ethnic groups are minimized or eliminated."

Acculturation

"The product of culture learning that occurs as a result of contact between the members of two or more culturally distinct groups."

Morality

"The quality of being in accord with standards of right or good conduct. A system of ideas of right and wrong conduct, e.g., religious morality."

Prejudice

"Unjustified negative attitude based on a person's group membership."

Sexual Minority

A person with an orientation toward people of the same gender in sexual behavior, affection or attraction and/or a person who self-identifies as gay, lesbian, or bisexual.

Homophobia

An irrational hatred and fear of lesbian and gay people that is produced by biases against a non heterosexual orientation.

Transgender

An umbrella term that is used for people whose gender identity or experience runs contrary to norms. This can include transsexual, cross-gender living, intersexed individuals, and others.

Gender Minority

An umbrella term that is used for people whose gender identity or experience runs contrary to norms. This can include transsexual, cross-gender living, intersexed individuals, and others.

Cultural proficiency

Cultural competency with a research and dissemination component.

Institutional Racism

Differential access to the goods, services, and opportunities of society by race"; differences in material conditions and power.

Personally Mediated Racism

Intentional or unintentional prejudice or discrimination, acts of racism omission and commission; lack of respect, suspicion, devaluation, scapegoating, and dehumanization.

Disparity

Racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention.

Ethnocentrism

View that one's"own cultural orientation is the 'correct' view of reality."