Significant criticisms of cultural competency have been raised. This guide also provides resources related to structural competency and cultural humility, as well as racism and bias in medicine.
"Attitudes and behaviors, which are characteristic of a group or community." (HRSA, 2019)
"A set of similar behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations." (HRSA, 2019)
See: Masters C, Robinson D, Faulkner S, Patterson E, McIlraith T, Ansari A. Addressing Biases in Patient Care with The 5Rs of Cultural Humility, a Clinician Coaching Tool. J Gen Intern Med. 2019 Apr;34(4):627-630. doi: 10.1007/s11606-018-4814-y. Epub 2019 Jan 8. PMID: 30623383; PMCID: PMC6445906..
See: Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition (Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P., 2019). The article presents a number of definitions for different terms, as collected from a literature review, and recommends a definition for cultural safety.
See January 2020 article from County Health Rankings for background reading
"occurs when providers respond to the inherent uncertainty of the diagnostic and treatment processes by interpreting the data and information relevant to a minority patient differently from the way they do with white patients"... involves "misusing and misapplying factually accurate information to reach an inaccurate conclusion concerning the specific patient."
See pages 98-99 in Matthew (2015).
Matthew, D. (2015). Just medicine : a cure for racial inequality in American health care. New York University Press.
Available online through Himmelfarb.
"the trained ability to discern how a host of issues defined clinically as symptoms, attitudes, or diseases (e.g., depression, hypertension, obesity, smoking, medication “non-compliance,” trauma, psychosis) also represent the downstream implications of a number of upstream decisions about such matters as health care and food delivery systems, zoning laws, urban and rural infrastructures, medicalization, or even about the very definitions of illness and health" (Metzl & Hansen 2014)
See also: Spring 2014 article, With Understanding Comes Empowerment, from New Physician and Sep 2014 article, Structural Competency Meets Structural Racism: Race, Politics, and the Structure of Medical Knowledge, from AMA Journal of Medical Ethics.