Cultural Competency

 By Moon Chen, Jr., PhD, MPH, Chair, Division of Health Behavior and Health Promotion 

College of Medicine and Public Health, Ohio State University 

Closing the Gap, The U.S. and U.K. Collaborate on Minority Health • March 1998 

Cultural competence has three components: purpose, attitude, 

and skills. The purpose of cultural competence is to achieve 

improved health outcomes. Attitude is the willingness to 

adapt oneself to others’ needs. And skills are those competencies or 

behaviors that exemplify correctness of technique in interactions between the professional and the patient. 

Minority health professionals are individuals most likely to be 

the impetus to empower their own communities for health improvement. Hence, increasing the number of trained minority health professionals is one strategy that must be pursued. They are the ones most 

like the racial and ethnic communities who need to be targeted because of their disparate health status. 

In analyzing the empowerment of ethnic minorities in human 

service organizations, L.M. Gutierrez discusses appreciating and understanding diversity of minority clients, rather than just considering 

their human service needs. She outlined the following steps for ethnic 

sensitive services: 1) Developing access to services such as hiring bilingual and bicultural staff members; 2) Tailoring interventions through 

learning another culture; 3) Modifying services such as integrating 

traditional medicine with Western medicine; 4) Initiating an appropriate organization development model and a specialized program 

model such as initiating a Native Hawaiian health care system. Another model by Arthur Himmelman discusses empowerment in a 

continuum of collaboration strategies. He indicates that this continuum is differentiated by the degree to which time, trust, and turf 

can be overcome. 

Networking, the first stage, is defined as exchanging information 

for mutual benefit. While networking reflects initial trust, commitments of time and turf are limited. The next stage is coordinating, and 

results in exchanging information and altering activities to achieve a 

common purpose. Mutual investments of time, trust, and turf sharing are increased. Cooperating is the third stage, and requires greater 

organizational commitments than either networking or coordinating. 

The final stage is collaborating. 

Dr. Pui-Ling Li, a U.K. workshop presenter, illustrated how she 

had empowered the Chinese community in London. First, she compiled demographic data on the Chinese population in the U.K. From 

an analyses of that data, she discovered that the largest group was age 

20-44 and that nearly 30 percent of that group is born in the U.K. 

She also discovered that nearly all older people born outside of the 

U.K. don’t speak English and that 25 percent of the older group had 

an education beyond the primary school level. 

The majority of Chinese people in the U.K. work in the food 

catering trade. Dr. Li documented that access to health care meant 

taking into account work schedules of 12 or more hours per week each 

day. She founded the London Chinese Health Resource Center in 

London’s Chinatown as a means of empowering the Chinese community to meet its needs. The center not only provides linguistically and 

culturally competent health services, but also English lessons. The 

center has become an identifiable organization and creates a focus for 

coordinating Chinese health care. It is rooted in community and is 

forming an infrastructure to influence district and national levels of 

health policy. 

Both the U.S. and the U.K. are nations of immigrants and are 

increasingly becoming more demographically diverse. Based upon 

the 1990 Census, the only original inhabitants of the U.S., American 

Indians and Alaska Natives, made up approximately one percent of 

the population. It is clear that at the individual and social levels in 

both the U.S. and the U.K., overcoming linguistic and cultural barriers is fundamental. As the population becomes increasingly diverse, 

these issue of empowerment will become even more complex.

Office of Minority Health Resource Center U.S. Department of Health and Human Services