Cultural Competence: More than Just Diversity & Inclusion
The urgency for incorporating cultural competence into all aspects of our society is as important as ever, so how can you advance cultural competence in your organization?
A recap: While living through a pandemic with a virus that disproportionately impacts Black, Indigenous, and People of Color (BIPOC), the police killing of George Floyd – and too many before him –sparked the largest protests ever recorded across the U.S. Some have expressed concern about the protests causing increased spikes in Covid-19 cases, without considering that higher Covid-19 infections in BIPOC and police killings are directly related. Protesters across the country will tell you that the pervasiveness of racism in all aspects of life poses just as big a public health threat as Covid-19. Fully aware of the risks of engaging in protest during a pandemic, protesters have determined the stakes are too high and are demanding sweeping transformations for a more equitable, safe, and just world for all of us. Because of these twin crises, many structural policies are in need of new examination, while at the same time organizations will need to institutionalize cultural competency to truly combat the racism embedded in our society.
Flashback: In 1989, Dr. Terry Cross and collaborators aimed to define and provide guidelines to bring about a culturally competent system of care to improve service delivery, especially to children of color with severe mental health issues. From there, cultural competence has evolved to mean a framework for viewing our work through a culturally sensitive and unbiased lens, a process that evolves over time as individuals and organizations increase their levels of awareness, knowledge, and skills through continued self-assessment and cultural awareness, and adapt their work according to increased knowledge.
Our understanding of how to enact cultural competence has also grown to include the idea that cultural competence exists on a continuum, from cultural destructiveness which causes intentional harm to individuals within a specific culture, to cultural proficiency which strives for deliberate inclusiveness and responsiveness to the cultural needs of the staff and people served by an organization.
In context: In the healthcare sector, cultural destructiveness (causing intentional harm), cultural incapacity (maintaining bias against certain groups), and cultural blindness (maintaining that the mainstream culture’s approach is universally relevant) have resulted in worse health outcomes for BIPOC, especially those with chronic conditions. This can look like a provider treating BIPOC patients disrespectfully, not providing care in a language an individual can understand, and even denying patients care, as we have seen with a large number of BIPOC being denied Covid-19 tests early in the pandemic. Although cultural competence is often brought up within the healthcare sector, it is important that cultural competency be incorporated into all types of work, including the nonprofit sector which often provides service delivery, advocacy, and health services.
Why does this matter to nonprofits?: At best, a lack of cultural competence disenfranchises people which means you’re losing out on potential service delivery or clients. At worst, a lack of cultural competence causes tangible harm to individuals and groups. Cultural destructiveness has resulted in dangerous studies like the Public Health Services Syphilis Study (or the Tuskegee Study) which intentionally misled Black men consenting to be research subjects wherein they were observed with untreated syphilis rather than provided treatments to improve the disease. Even though a treatment for syphilis was identified in 1945, the study continued until 1972 when journalists condemned the research as explicitly racist (and culturally destructive). Meanwhile in 2020, the denial of Covid-19 testing early on for certain groups of people can be described as cultural incapacity. This lack of testing often resulted in delayed care, increased spread of the virus within the BIPOC community, and worse health outcomes. Outside of the healthcare setting, similar examples can be seen in the way police issue citations at a higher rate to BIPOC than white people for the same offenses.
With this framework in mind alongside our current circumstances, the urgency for incorporating cultural competence into all aspects of our society becomes a literal life and death issue that many organizations have to address throughout their work, so how can you start to create a culturally competent environment in your nonprofit?
A culturally competent organization integrates knowledge about individuals and groups of people into specific standards, practices, and attitudes to increase the quality of services provided and ultimately yield better outcomes by reducing disparities.
Organizations cannot be culturally competent without employing culturally competent individuals, and individuals cannot thrive in their journey toward becoming culturally competent without an organization that fosters continued self-assessment, cultural learning, and growth.
Principles of cultural competence include: valuing diversity, having the capacity for self-assessment, being conscious of the inherent dynamics when different cultures interact, institutionalizing cultural knowledge, and developing adaptations to service delivery that reflect an understanding of cultural diversity and new cultural knowledge.
Some examples of cultural competence in practice:
Leadership & Staffing: A culturally competent organization hires BIPOC and women into leadership positions.
Who Gets a Voice: A culturally competent organization incorporates members of the community being served into all aspects of the organization’s work and decision making.
Language: In a culturally competent organization written translation, simultaneous interpretation, and visual cues all reflect the various cultures and languages of the individuals served.
Research: A culturally competent organization incorporates members of the community being served into the design of research tools and protocols and identifies and utilizes culturally sensitive and relevant language in research questions.
Workplace Practices: A culturally competent organization incorporates sensitivity and awareness of different religious cultural holidays, customs, food preferences, etc. into work settings. Explicitly prohibits the use of stereotypes, prejudicial comments, and racial and sexual slurs or jokes. Does not allow speakers from any one group to dominate meetings or discussions.
The examples above provide a glimpse into what it means to be a culturally competent organization. It requires work at both the organizational and individual level, with continued self-assessment and adaptation as new knowledge is learned. It is an iterative process, and will be rewarding for you, your staff, and the people you serve. The benefits of a culturally competent organization are immense – from better service delivery, to better health and well being outcomes for your clients, and increased trust and value in the communities you serve.
When thinking about cultural competence, we often think of one of the great thinkers of our time, Angela Davis, who has called out diversity as a corporate strategy. Rather than put together a diversity and inclusion statement and consider your work done, we challenge you and your organization to identify where you are along the cultural competence continuum and begin your journey toward cultural competence by putting actions to address areas where you are lacking in your strategic plan for the year. Then share and ask your audiences to hold you accountable.