Indiana University Bloomington

Indiana Prevention Resource Center (IPRC)

Cultural Competency: Essential to All Prevention Efforts

Cultural competency is a value that involves skills and practices. It is at once a goal and an ethical obligation. Like honesty, it is basic and essential. Like customer service, it is a process that offers room for improvement, requires continuous attention and study, and has minimum standards for performance. Like breathing is to living, sustainability and cultural competency are to prevention. Without them prevention fails. The higher our level of cultural competency, the healthier our prevention efforts and the more potential we have for success. While not the only necessary component, without cultural competency all our efforts are at high risk. Resulting failures will include inequitable distribution of services, ineffective services, inappropriate services, and denial of services to people we are responsible to serve. Just as we often take our breathing for granted and can neglect our cardiovascular health, so, too, the importance of cultural competency and its maintenance and development can be overlooked.

Disparities across cultural groups (e.g., by gender, age, race, ethnicity, socioeconomic status) in access to health care and in the way health care is delivered exist (Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, 2002; Surgeon General’s Report, 2000) and are a matter of great concern for our nation. In addition to the problem of lack of resources, these disparities may also be associated with lack of awareness, knowledge, skills and/or the desire or political will required to achieve greater equity. Besides seeking additional resources, there is much that we can do with the resources we already have.

The Center for Substance Abuse Prevention has highlighted the critical importance of cultural competency to prevention work by placing it, along with sustainability, at the center of the Strategic Prevention Framework. Cultural competency is an essential component of every step in the Strategic Prevention Framework and all of our prevention efforts. CSAP defines cultural competency as “A set of behaviors, attitudes, policies that come together in a system or agency that enable effective interaction in a cross-cultural framework (on-going process).” CSAP defines culture as “shared values, norms, traditions, customs, arts, history, folklore, institutions of a group of people.”

Cultural competence has much to do with communication, which, in turn, has to do with cultural expression. As we know, communication can be difficult and break down even between individuals who share the most intimate familiarity and knowledge of one another. Perhaps the largest challenges associated with cultural competence are associated with communication. Communication includes spoken and written language and non-verbal body language. Expressive culture includes artistic expression such as music, dance and art. Body language includes customs of eye contact, gestures, and comfort zones for distance.

We all belong to multiple culture groups by virtue of, for example, our age, gender, hobbies, occupation, ethnic and national origin. Reflecting upon our own cultural identity is a good starting point for raising awareness about commonalities and differences. Understanding the cultural influences on our lives will help us to relate to others. Persons belonging to the first few generations of an immigrant family, will be especially aware of this, as many stressors occur during transition to their new environment, including challenges to personal cultural identity and intergenerational differences. Prevention professionals need to understand the risk and protective factors associated with the process of acculturation to best serve this population.

The work of cultural competency is a never ending process, requiring the pursuit of knowledge, awareness, communication and other skills, evaluation, and sustained desire to maintain and improve upon the quality of services being offered, so that every member of the community has equal access and receives the services they need, delivered in a culturally appropriate manner.

By Barbara Seitz de Martinez,   3/3/2010