community assessments, developing community outreach or stakeholder involvement, planning community programs, distribution of human resources, and system change. Similar practice skills and criteria pertain to community research and evaluation because they affect selection of topics, design of research, development and selection of measures, data analyses, and interpretation of findings.
The goal in cultural competence education is to increase public health professionals’ cultural awareness, knowledge of self and others, communication skills, attitudes, and behaviors. Part of this process is confronting stereotypes, because many students entering public health have minimal experience with ethnic minorities. This is accomplished by a systematic exposure to a knowledge base that, combined with practice methods, provides an additional dimension to public health education. The knowledge base includes specificity about inter-ethnic and intra-ethnic health indices, sociocultural aspects of health and help seeking, assessment techniques adapted to community cultural diversity, improving communication of health prevention and promotion, and medical care information, cultural translation and mobilization strategies for communities and their institutions, and methodologies to improve the delivery of public health interventions and to evaluate their effectiveness (Lee, 1988; Gold, 1992; Mo, 1992; Alcalay et al., 1993; Vega and VanOss-Marin, 1997; House and Williams, 2000; Kaplan et al., 2000; Schulz et al., 2001).
The need for cross-cultural sensitivity becomes apparent when placed in a global context. Other societies, such as Chinese, South Indian, and African societies have rich traditions in the medical arts that are centuries old and based on an epistemology that is distinct from western thought and action. Cross-cultural sensitivity is no less important for public health within the United States. There are now in excess of 80 million people in the United States in the four groups customarily categorized as “minorities”: African Americans, Hispanics, American Indians, and Asians and Pacific Islanders (U.S. Census, 2001). There are many other people, perhaps less visible, whose cultural background or sexual orientation places them outside the cultural mainstream.
Definitive reviews have appeared from authoritative sources highlighting disparities in health status, barriers to services, and lower quality of medical care received by minorities. The Office of Minority Health (U.S. DHHS, 2002b) issued a report, Teaching Cultural Competence in Health Care, where current concepts, policies and practices were reviewed. This report identifies several recommended cultural competence guidelines and standards issued by professional groups such as the American Psychological Association (APA), the American Medical Association (AMA), the National Association of Social Workers (NASW), the American Public Health Association (APHA), and minority medical associations. The Institute of Medicine (IOM) (2002) released a report that carefully describes