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The Promise of Cultural Competence and Higher Education for our Health

I have made this point consistently in previous posts and will make it again: our health is our wealth and therefore an exceedingly important problem to solve. Higher education is uniquely poised to play a role in this. Yet, practical health curriculum is the exception rather than the rule.

Looked at from a diverse perspective, the health problem is even bigger. Wide disparities in health outcomes continue to persist between various cultural groups. And, it seems, despite these disparities, there has been a shift away from approaches that consider and take into account cultural differences. Cultural competence as it relates to health appears to focus mainly on identifying barriers to health care such as bias, communication (linguistic, literacy) and access (social, administrative). Tanya

As it relates to health, I believe culture can play a much more prescriptive role in understanding opportunities to improve health outcomes and overall well-being within particular population groups. My view of cultural competence in health not only eliminates barriers but also leverages the actual resources that a given culture’s traditions and behaviors provide. My book GET A GGRiPP: The Health and Wellness Movement Rooted in Black Cultural Traditions, is itself rooted in the premise that examination of a particular culture’s traditions and behaviors can uncover innovative ideas for how members of that culture can achieve their optimal state of wellness.

I mentioned the apparent shift away from acknowledgment of individual cultures in the context of health and health improvement. I have seen it at various levels and in multiple sectors; in 2011, as the Lead for the “African-American Campaign” I found myself making the case to the California Public Health Department to keep public health campaigns targeted at individual cultures rather than moving to a single, aggregated “minority” campaign. Prior to that, as the Lead for the African-American Support Network for my fellow corporate consultants, despite the obvious statistics, we constantly had to defend the need for such a support organization. Lastly, I have watched the consistent struggle at my alma mater (even since my days as a student 25 years ago) for support for cultural/ethnic theme houses and dorms.

At multiple levels and in various sectors, we “tolerate” but don’t embrace cultural difference. Perhaps it is the oft-cited “fear of the unknown.” Perhaps it is a lack of the maturity and self-esteem required to see distinct cultures, not in competition or comparison, but for culture’s uniquely beautiful aspects. Perhaps it is the assumption that to honor individual cultures somehow creates division.

Whatever the reason, there needs to, can and should be a healthy appreciation and respect for the richness of cultures and the differences that make each unique. The bottom line is, as AT&T CEO Randall Stephenson said in 2016, “tolerance [of difference] is for cowards.” The acknowledgement of individual cultures gives us the basis for critical conversations and needed mutual understanding.  From an education perspective, the sheer number of learning opportunities inherent in cultural differences provide enormous value. From a health perspective, it offers opportunities for specific culturally-relevant recommendations for good health.

In that vein, I would love to see cultural competence enable the development and dissemination of more prescriptive approaches for improving health and well-being. The promise of cultural competence for health embraces the full “cultural context” to include specific recommendations rooted in biological, social and historical perspectives on good health and optimal well-being for those of a certain cultural heritage.

This is again where higher education is uniquely poised to play a role. The development of culturally relevant approaches to health requires research to understand of the what and how of which cultural behaviors are most supportive but also why they have become behavioral norms. In other words, we need to understand what culture dictates in terms of behaviors but also the underlying core set of values that supports and maintains these behaviors in the culture.  Cultural competence would then be the development of recommendations and approaches that are both effective and sustainable, i.e. competent in improving health for diverse cultures and populations. Understanding the motivation for and adherence to behavioral norms that affect health enables the design of successful culturally-rooted prescriptions for good health.

What does that look like?  I am happy to say that I have discovered examples of organizations and individuals that support this approach. First, I discovered the Oldways organization when I was researching information on traditional African foods and methods of food preparation. Their mission is “inspire good health through food traditions.” Through research and collaboration, as an alternative to the USDA pyramid models for food grouping and consumption, they have developed various “heritage pyramids,” as healthier, tradition-based alternatives. Their “A Taste of African Heritage” curriculum (for which they offer a training and certification that I have completed) based on their African Heritage pyramid is a perfect example of the type of prescriptive, culturally relevant approaches (to food) that is needed. (A similar program is in process based on their Latin American Heritage pyramid.)

Second, as part of my collaboration with the Student Health Services at Clark Atlanta University, I was introduced to Dr. Stephanie Y. Evans, professor and chair, Department of African-American Studies, Africana Women’s Studies and History at Clark Atlanta University. Dr. Evans developed curriculum for at least three courses and seminars to date focusing on specific recommendations for Black women’s health and wellness, based in social and historical contexts. I have been excited to work with her: 1) in developing guest presentations using this same contextual lens on various topics including the relationship between traditional foods and new food trends (Old Food, New Food); stress and food against the lens of Black women’s current experiences with stress; and my prescriptive GET A GGRiPP model for culturally-rooted behaviors to encourage; and 2) by guest authoring salad memoirs for her celebratory anthology of culturally-informed soup recipes called OASIS (Oldways Africana Soup In Stories), coincidentally a collaboration between Dr. Evans and the Oldways African Heritage and Health leadership team.

The opportunity to improve health through the lens of individual cultures’ traditions and behaviors is as yet undervalued. Cultural traditions and behaviors offer an as-yet untapped resource for specific prescriptions to lessen disparities in health outcomes among their respective diverse populations. I look forward to a time when we unabashedly embrace our cultural differences as resources for health, deepen our understanding of these differences and leverage this understanding to develop and disseminate more prescriptive, culturally-relevant recommendations for improved health and well-being. This is the promise of cultural competence and health.

Tanya Leake is a certified health coach, group fitness and dance instructor, wellness educator, presenter and author of GET A GGRiPP: The Health and Wellness Movement Rooted in Black Cultural Traditions. Her column appears in Diverse every month.

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