Cultural Competence

What is a culture of health?

Building a culture of health means working together to improve health for all in America. It means prioritizing well-being in every aspect of our lives. In a culture of health, Americans understand that we’re all in this together — no one is excluded. Everyone has access to the care they need and a fair and just opportunity to make healthier choices. In a culture of health, communities flourish and individuals thrive.

Culturally and linguistically appropriate services (CLAS) are a way to improve the quality of services provided to all individuals, which will ultimately help reduce health disparities and achieve health equity. CLAS is about respect and responsiveness: Respect the whole individual and respond to the individual’s health needs and preferences.

Health inequities are well-documented in our nation. Providing CLAS is one strategy to help eliminate health inequities. By tailoring services to an individual's cultural and language preferences, health professionals can help achieve positive health outcomes for diverse populations.

The provision of health services that are respectful of and responsive to the health beliefs, practices, and needs of diverse patients can help close the gap in health outcomes. The pursuit of health equity must remain at the forefront of our efforts; we must always remember that dignity and quality of care are the rights of all and not the privileges of a few.

As a public health practitioner, provider, or community member, regardless of your belief system, one should always respect the patient's or customer’s views and ideals.

What are beliefs?

Belief is the attitude that something is the case or true; in addition, belief is a state or habit of mind in which trust or confidence is placed in some person or thing. Religion, culture, beliefs, and ethnic customs can influence how patients understand health concepts, how they care for their health, and how they make decisions related to their health. Without proper training, clinicians may deliver medical advice without understanding how health beliefs and cultural practices influence the way that advice is received. By asking about patients’ religions, cultures, and ethnic customs, clinicians can better engage patients to devise treatment plans together that are consistent with the patients’ values.

Examples of how religion, culture, and ethnic customs can influence patients and their families:  

• Health beliefs: Some cultures believe that speaking of a potential negative health outcome can actually bring it about. For example, some individuals believe in the active “energies” or “karma” surrounding what is vocalized. Professing that you may have a poor outcome will result in it due to the energy that has been released into the atmosphere.
• Health customs: In some cultures, family members play a large role in healthcare decision-making. For example, a patient’s parents may “make the call” on a specific treatment, regardless of whether the spouse agrees on the decision. Legally, this action is approved in some states via an official surrogacy agreement.
• Ethnic customs: Differing roles of women and men in society may determine who makes decisions about accepting and following through with medical treatments.
• Religious beliefs: Religious faith and spiritual beliefs may affect healthcare-seeking behavior and people’s willingness to accept specific treatments or behavioral changes. For example, some individuals of specific religious faiths will not agree to receive a blood transfusion, regardless of their chances of survival.
• Dietary customs: Disease-related dietary advice will be difficult to follow if it does not conform to the foods or cooking methods used by the patient.
• Interpersonal customs: Eye contact or physical touch will be expected in some cultures, and inappropriate or offensive in others.

Helpful Resources

• EthnoMed offers information about cultural beliefs, medical issues, and other related issues relevant to the healthcare of recent immigrants.