Purpose The purpose of this paper is to explore and extend understanding of the concept of cultural competence in relation to whiteness, particularly the implications of this link in the context of heightened concerns about safety and risk connected with the responsibilisation of health and social care. Design/methodology/approach The paper is a critical review of academic literature about cultural competence in health and social care, focussing on Scotland. The discussion develops understandings of cultural competence in light of important writing about whiteness and draws on recent related research, for example, about racial patterning in relation to disciplinary proceedings. Findings Cultural competence is an example of the neoliberal fusion of the ideals of quality and equality. It is a technology of whiteness which may reinforce racial disadvantage especially in the current environment of responsibilisation. Cultural competence is associated with individual responsibility tropes which undermine state-funded welfare provision and re-inscribe traditional inequalities. Practical implications The findings reinforce the importance of a focus on the social determinants of health and challenge “audit” approaches to competence of all kinds, favouring instead the promotion of creativity from the margins. Originality/value This paper brings together several areas of literature, which have perhaps previously not overlapped, to identify under-recognised implications of cultural competence in the sector, thus linking the critical discussion to decolonisation and good practice in new ways.
This paper uses analysis of interview transcripts and notes from participant observation to explore white reactions to the introduction of diversity management in a large public sector workplace in Glasgow. The paper analyses white talk about racial equality in a social context where the shaming, exclusion and demonization of disadvantaged groups including migrants, asylum seekers and the poor have ensured that issues of entitlement and race are highly charged. It is suggested that in such contexts diversity management is being wielded as a new kind of civility by middle-class people invested in the objectification of poor whites. This represents a form of class conflict over belonging within the body of whiteness that risks reinforcing rather than redressing racial resentments.
Young people with chronic conditions often face more difficulties negotiating the tasks of adolescence than their healthy peers. National, population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months. However, 10-13% of teenagers report having a chronic condition that substantially limits their daily life or requires extended periods of care and supervision. The burden of chronic conditions in adolescence is increasing as larger numbers of chronically ill children survive beyond the age of 10. Over 85% of children with congenital or chronic conditions now survive into adolescence, and conditions once seen only in young children are now seen beyond childhood and adolescence. In addition, the prevalence of certain chronic illnesses in adolescence, such as diabetes (types 1 and 2) and asthma, has increased, as has survival from cancer. Impact of chronic conditions on adolescence Chronic conditions in adolescence can affect physical, cognitive, social, and emotional spheres of development for adolescents, with repercussions for siblings and parents too. Physical effects Common sequelae of chronic illness and its treatment include short stature and pubertal delay. Undernutrition is common in many chronic conditions, and obesity can result from conditions that limit physical activity. Visible signs of illness or its treatment mark young people out as different at a time when such differences are important to young people and their peers. Body image issues related to height, weight, pubertal stage, and scarring can contribute to reduced self esteem and negative self image, problems that may persist into adult life.
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