Cultural Competence: Substance or Lip Service?

Abstract

ultural competence has become a buzzword in recent years. The backdrop is that the U.S. population is becoming increasingly diverse both culturally and ethnically. In addition, cultural competence is associated with patient outcomes and reducing of health disparities (Doorenbos, Schim, Benkert, & Borse, 2005). Consequently, the federal government and regulatory agencies began to require cultural competence of health care personnel. One case in point is the issuance of the 14 standards regarding culturally and linguistically appropriate services by the U.S. Department of Health and Human Services Office of Minority Health (2000). Another example is the Joint Commission on Accreditation of Healthcare Organizations (1994), which has incorporated cultural competence as an integral part of accreditation standards. The cultural competence movement has also affected nursing education and its funding. For instance, the Health Resources and Services Administration (HRSA) requires that its funded nursing education programs must address cultural competence. As a result, there was a dramatic increase of training programs and publications on cultural competence in recent years. Shen (2004) asserted that publications on cultural competence and cultural competence models increased from virtually none for either in 1989 to 148 and 14, respectively, in 2003. However, based on personal HRSA grant review experience and conversations with HRSA staff, there are few grant applications on cultural competence although