Cultural Competency

People who are considered about unequal treatment and disparate outcomes for people who are not of the dominant culture and ethnicity in our society -- what we usually call minorities -- worry about a lot of problems, including insurance coverage and discrimination. But a very hot issue is called cultural competency -- the idea that taking care of people who don't come from the dominant anglophone European settler culture here in the U.S.A requires some specific knowledge or set of skills.

Most of the literature about this subject, at least until recently, focused on "folk illnesses" and "folk healing." The idea was, these exotic people are hard to take care of because they all believe in the voodoo guy instead of you, the expert scientific doctor. Provider institutions figured the way to get culturally competent was to hire somebody to do Cultural Competency Training, which has become a very big business. So they'd have somebody come and tell the doctors and nurses that Puerto Ricans believe in mal de ojo, so you have to touch the kids on the head and say "Dios te bendiga." Or Mexicans believe in folk illnesses like empacho and they all go to curanderos. African-Americans, of course, go to root workers and get themselves a mojo hand.

Sadly, no. This is like saying that if you want to take care of Californians, you have to know that they believe in the healing power of crystals. All nations and cultures have various traditions, home remedies, beliefs and superstitions that aren't taught in medical school, and some people go for some of them and others don't. But except for a few immigrants from very remote places, immigrants and non-immigrant minorities in the U.S. are familiar with allopathic (that's the right word for so-called "Western" or "mainstream" medicine) medicine, know what doctors do, and don't get that mixed up with whatever else they may do about their health. As a matter of fact, the most common non-allopathic medical practice in the U.S., and throughout Latin America and much of Africa and Asia, happens to be Christian faith healing. But somehow that doesn't get included in the list of "folk beliefs."

Cultural competency is not principally, or even very much, about medical anthropology. It is about communication, which goes at least two ways. The next post will begin to address this most important idea.