Introduction to Cultural
Competence and Attributes
Culturally competent, or congruent, care emphasizes the need to
provide care based on an individual’s cultural beliefs, practices,
and values. Care must be culturally sensitive and culturally
appropriate to meet the healthcare needs of each client,
family, and community.
Cultural beliefs and values are learned from birth in a variety of
ways and settings. As a healthcare professional, you must
continually strive to work effectively within the cultural context
of a client. The goal of culturally
,competent care is to provide culturally specific care that is safe
and beneficial to the well-being of the client.
In this lesson, you will learn how culture influences health and
illness and explain the approaches used to deliver culturally
competent care.
Changing Demographics
As demographics in the United States continue to shift,
challenges arise for healthcare professionals. According to the
2020 U.S. Census, approximately 40% of the population belongs
to a racial or ethnic minority group (CDC, 2021). This percentage
represents:
• 13% African American persons
• 18.5% Hispanic or Latino persons
• 1.3% American Indian and Alaskan Native persons
• 6% Asian persons (U.S. Census Bureau, 2021)
By 2050, these percentages are expected to reach 15%, 22%,
and 8% respectively. In 2010, the percentage of non-Hispanic
white Americans is expected to decline from 60% to 50% in 2050
(CDC, n.d.).
Though some health indicators, such as life expectancy and
infant mortality, have improved for many Americans, some
minority groups experience a disproportionate burden of
preventable disease, death, and disability compared with non-
minorities (CDC, 2021).
Cultural Attributes
Have you ever seen a foreign magazine or movie? Aside from the
language, did you notice any other cultural attributes (i.e.,
differences) between what you see around you and what you
saw in the pictures or film?
,Because the picture, magazine, or film represented another
culture, you may have seen people in clothing you have not seen
before with customs and practices that you have not
experienced. If you have ever visited another country, the
cultural differences may have been experienced in a more
personal way, because you were the one who was different from
those around you.
What Are Cultural Attributes?
Cultural attributes are characteristics that define a culture. By
understanding cultural attributes, healthcare professionals can
further develop cultural competence.
Some generalizations can be made about ethnic groups that will
help you understand differences that might be encountered
during client interactions. However, as you explore the ethnic
groups on this page, be aware that although certain beliefs,
values, and experiences may be shared by an ethnic group,
widespread diversity also exists within the group. Stereotyping is
an assumed belief regarding a particular group that we must be
very careful to avoid.
African Americans
Countries of Origin: largely descendants of Africans brought
forcibly to America as slaves
, Communication: national languages often retained by
immigrants; the primary language is English for those born in
America; highly verbal and nonverbal
Space: close personal space; comfortable with touch
Social Organization: large, extended families; many female-
headed households; traditionally strong religious orientation,
mostly Protestant; community social organizations; there are
cultural differences between African American natives and
recent immigrants
Time: present-time-oriented
Environmental Control: traditional healthcare delivery system;
some individuals prefer to use folk practitioners or home
remedies
Biological Variations: health concerns include cardiovascular
disease, hypertension, sickle cell disease, diabetes mellitus, and
lactose intolerance
American Indians and Alaska Natives
Countries of Origin: North America, Alaska, Aleutian Islands
Communication: 200 tribal languages recognized; comfortable
with silence
Space: large, extended space important; uncomfortable with touch
Social Organization: families: nuclear and extended; children
taught the importance of tradition; social organizations: tribe
and family most important
Time: present-time-oriented
Environmental Control: religion and health practices intertwined;
a non- traditional healer (shaman) uses folk practices to heal; a
shaman may work with a modern healthcare practitioner
Biological Variations: health concerns include alcoholism,
tuberculosis, accidents, diabetes mellitus, and heart disease
Competence and Attributes
Culturally competent, or congruent, care emphasizes the need to
provide care based on an individual’s cultural beliefs, practices,
and values. Care must be culturally sensitive and culturally
appropriate to meet the healthcare needs of each client,
family, and community.
Cultural beliefs and values are learned from birth in a variety of
ways and settings. As a healthcare professional, you must
continually strive to work effectively within the cultural context
of a client. The goal of culturally
,competent care is to provide culturally specific care that is safe
and beneficial to the well-being of the client.
In this lesson, you will learn how culture influences health and
illness and explain the approaches used to deliver culturally
competent care.
Changing Demographics
As demographics in the United States continue to shift,
challenges arise for healthcare professionals. According to the
2020 U.S. Census, approximately 40% of the population belongs
to a racial or ethnic minority group (CDC, 2021). This percentage
represents:
• 13% African American persons
• 18.5% Hispanic or Latino persons
• 1.3% American Indian and Alaskan Native persons
• 6% Asian persons (U.S. Census Bureau, 2021)
By 2050, these percentages are expected to reach 15%, 22%,
and 8% respectively. In 2010, the percentage of non-Hispanic
white Americans is expected to decline from 60% to 50% in 2050
(CDC, n.d.).
Though some health indicators, such as life expectancy and
infant mortality, have improved for many Americans, some
minority groups experience a disproportionate burden of
preventable disease, death, and disability compared with non-
minorities (CDC, 2021).
Cultural Attributes
Have you ever seen a foreign magazine or movie? Aside from the
language, did you notice any other cultural attributes (i.e.,
differences) between what you see around you and what you
saw in the pictures or film?
,Because the picture, magazine, or film represented another
culture, you may have seen people in clothing you have not seen
before with customs and practices that you have not
experienced. If you have ever visited another country, the
cultural differences may have been experienced in a more
personal way, because you were the one who was different from
those around you.
What Are Cultural Attributes?
Cultural attributes are characteristics that define a culture. By
understanding cultural attributes, healthcare professionals can
further develop cultural competence.
Some generalizations can be made about ethnic groups that will
help you understand differences that might be encountered
during client interactions. However, as you explore the ethnic
groups on this page, be aware that although certain beliefs,
values, and experiences may be shared by an ethnic group,
widespread diversity also exists within the group. Stereotyping is
an assumed belief regarding a particular group that we must be
very careful to avoid.
African Americans
Countries of Origin: largely descendants of Africans brought
forcibly to America as slaves
, Communication: national languages often retained by
immigrants; the primary language is English for those born in
America; highly verbal and nonverbal
Space: close personal space; comfortable with touch
Social Organization: large, extended families; many female-
headed households; traditionally strong religious orientation,
mostly Protestant; community social organizations; there are
cultural differences between African American natives and
recent immigrants
Time: present-time-oriented
Environmental Control: traditional healthcare delivery system;
some individuals prefer to use folk practitioners or home
remedies
Biological Variations: health concerns include cardiovascular
disease, hypertension, sickle cell disease, diabetes mellitus, and
lactose intolerance
American Indians and Alaska Natives
Countries of Origin: North America, Alaska, Aleutian Islands
Communication: 200 tribal languages recognized; comfortable
with silence
Space: large, extended space important; uncomfortable with touch
Social Organization: families: nuclear and extended; children
taught the importance of tradition; social organizations: tribe
and family most important
Time: present-time-oriented
Environmental Control: religion and health practices intertwined;
a non- traditional healer (shaman) uses folk practices to heal; a
shaman may work with a modern healthcare practitioner
Biological Variations: health concerns include alcoholism,
tuberculosis, accidents, diabetes mellitus, and heart disease
