Cultural Humility: A Key Element to Advancing Racial and Health Equity

Over the past few years, it has become common to hear terms such as “woke” or “culturally competent” to describe an individual, organization, or community regarding awareness of social justice or political issues. These terms can imply “arriving” at an answer or having achieved some level of knowledge on topics like racial justice, equity, disability, gender and more. Some take pride in being described as “woke,” while others consider it an insult.

Thinking more about both terms can yield insight. Let’s start with “woke.”

Many who use the word today—including those who take it on themselves, or who use it as a pejorative for progressives—may be surprised to know that “woke” originated with Black nationalism in the early 20th century. According to this Washington Post opinion piece by Bijan C. Bayne, Black leaders have been calling on Black people to wake up for decades, and for the first users of the word, it meant recognizing racial subjugation committed by whites. Leaders such as Marcus Garvey, Malcom X and Rev. Martin Luther King, Jr. encouraged Black Americans to “free their mind” and “remain awake.” In 1938, blues singer Huddie Ledbetter sang that Black people “best stay woke, keep their eyes open.” And more recently, in Spike Lee’s 1988 movie “School Daze” the final lines have actor Laurence Fishburne screaming “Wake up!”

Based on its original meaning and use, white people can’t, by literal definition, be woke. And in addition to using the term incorrectly, it’s an appropriation. The term “woke,” like many others, should be returned to the community that originated it, resigned from social media hashtags and common parlance, and relegated to Black leaders and the communities they serve.

The other term, “cultural competence,” has also been around for decades, and has evolved to the point that there is no universal definition. It is used across government policy and programs, private sector organizations and academic settings. One definition from Georgetown University from 1989 has provided a foundation for other adaptations:

Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations.

Five essential elements contribute to a system’s, institution’s, or agency’s ability to become more culturally competent, which include:

  1. Valuing diversity
  2. Having the capacity for cultural self-assessment
  3. Being conscious of the dynamics inherent when cultures interact
  4. Having institutionalized culture knowledge
  5. Having developed adaptations to service delivery reflecting an understanding of cultural diversity

By this definition, cultural competence applies mostly to systems or institutions to which individuals belong—not, necessarily, to a single individual. Groups and communities of people are more likely to collectively be culturally competent because of the experience, knowledge and diverse perspectives they bring to the group. For one person to hold all five tenants of cultural competence, while not impossible, is likely far beyond what individuals assume they’re saying when claiming the title.

The big takeaway? Both terms imply that being “woke” or “culturally competent” is a point at which one can arrive. That belief can lead people to assume that the work is done. If someone believes they are both woke and culturally competent, they might assume they know all that they need to in order to effectively navigate culturally diverse settings. And while it may be true that one group of people or one person may hold extensive knowledge of one or some cultures, it is unlikely that they have no room for growth.

Could we do better? Could we improve how we describe our ability to interact with other humans from terms that are appropriated and inaccurate? Terms that are over-zealous or out of context?

One term that is gaining traction lately is “cultural humility.” It follows the same idea as “cultural competence,” but it’s truly accessible to individuals and leaves room for growth.

Cultural Humility as a Path Forward

According to Shopify.com, there are 2.91 billion monthly active users on Facebook. Almost 3 billion people regularly hop online to check out what their “friends” are doing and how they’re feeling, as well as to share their own opinions, photos, and generally positive updates about their house, job, outfit, pet and fitness routine.

These posts involve a deliberate choice about what we want others to know about our lives – and many have become experts at promoting only the most desirable and interesting aspects of life.

But in a world of constant self-promotion, humility makes space for new possibilities. While cultural competence and “wokeness” showcase the knowledge we have, cultural humility reveals our dire need for deeper understanding. Rather than closing us off to others, cultural humility can open up the possibility that everyone needs a little more information to understand the world better, deepen empathy and advance equity.

Within health care, cultural humility opens the door to other understandings of wellness—to the idea that dandelions are medicine rather than a scourge on our reputation. It could open us to the wisdom that patients possess, rather than focusing on the medical knowledge they lack.

A Step Toward Equity

The starting point for this journey is simple: listen. The old maxim that “everyone just wants to be heard” is as true today as ever. And according to the Facebook example above, nearly 3 billion people are regularly online, trying to be heard. Amid all the talking, are we taking the time to hear the stories people are telling?

The second step requires a little – but not much – more work: believe. Believe the stories people tell about their lives. In this recently produced documentary series on cultural humility, you can hear stories from community members across Minnesota – stories about wellness, childhood, farming, art, food and trauma. And all of it combines to develop a deeper connection to and understanding of the communities that surround us. This understanding develops something stronger than “competence” or “wokeness.” It rehumanizes the people who have been consciously or subconsciously ignored, and reminds us that everyone deserves the opportunity for health, education, justice, and peace. These are small steps toward advancing racial and health equity, but by taking them together, we all move forward. If we admit – with humility and regardless of political identity – that we have more to learn from the lived experiences of our neighbors, we might find that the answers to some of our most complex social issues are standing right in front of us.

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