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Beyond Diversity to Cultural Competency

by Rodney L. Brown, M.H.S.

At the close of the 20th century, diversity became a watchword in both public and private institutions. Almost as second nature, we now recognize diversity in race, gender, age, sexual orientation, parental status, religious beliefs, and so on. In this century, organizations face a more compelling challenge: How to move beyond diversity awareness and achieve cultural competency in the workplace.

The need for cultural competency is real and growing. The profile of the American population is increasingly racially, ethnically, culturally and linguistically diverse. The 2000 census revealed that 17.4 million workers (12.4% of the civilian labor force) were foreign-born. More than 20% of the U.S. population is of "foreign-stock," defined as foreign-born or having at least one foreign-born parent. And the number of persons who speak a language other than English at home exceeds 30 million.*

Cultural competency is also needed to addresses subtle ways and morays that contribute to the American melting pot and to destructive biases. Consider these examples: a man who speaks with a Southern drawl; an immigrant who speaks English with an accent, and a woman whose voice is high-pitched and childlike. Is the Southerner mentally "slow" because he speaks slowly? Is the immigrant uneducated? Is the woman incompetent? Many people who respond 'yes' to these scenarios may not even realize they are engaging in biased thinking.

Diversity vs. cultural competency. For organizational leaders, the first step toward cultural competency is to distinguish it from traditional diversity. Diversity has become shorthand for a wide range of dimensions of human and social differences. Most organizations embrace, or at least salute, the wisdom of recognizing groups that may have been overlooked, disenfranchised or discriminated against. Diversity initiatives run the gamut from building awareness and tolerance to proactively engaging representatives from diverse groups for various outcomes.

Cultural Competency takes the concept of diversity deeper. Cultural affinity can supersede race, ethnicity and class. Cultural references frame an individual's worldview, values, beliefs, attitudes and behaviors. A culturally competent organization recognizes that both subtle and obvious cultural perspectives influence the way all people think, interact and make choices.

Diversity seldom recognizes or deals with issues like linguistic profiling, use of time; attitudes toward personal space; interaction with authorities and the law; and non-verbal communications. A cultural competency approach does.

Traditional diversity misses the mark. Even when an organization has achieved "diversity" as measured by racial, gender or other dimensions, lack of cultural competency can produce a host of problems, such as inter-personal conflicts, high staff turnover, substandard customer service and even lawsuits. In health care delivery, cultural breakdowns in staff-to-staff and staff-to-patient communication has even proved fatal.

In fact, the health care industry has been mandated to comply with federal standards for Culturally and Linguistically Appropriate Services (CLAS). Compliance with CLAS will push health care organizations to the forefront of the cultural challenge, but approaches based on traditional diversity initiatives are likely to fall short.

Traditional "diversity" programs and policies tend to scratch the surface with goals or activities aimed at

• Understanding minorities, e.g., from a historical perspective
• Ensuring that communications are produced in multiple languages and feature images of recognizably diverse people
• Reaching a target number or percentage of women, minorities, handicapped, etc.
• Putting "ethnic minorities" in visible positions
• Gathering people together for ethnic-themed events. Food, clothing and music get showcased, but very little exchange of values, attitudes and beliefs occur.

Many diversity initiatives short-circuit or fail because they do not provide people the tools they need to develop (1) self-awareness about their values, motives, and personal beliefs and (2) interpersonal skills to change day-to-day behaviors.

Cultural Competency Requires "Competency". Cultural competency requires people to overcome fear and discomfort and become fluent in four areas:

1. Knowledge - Factual information that supplants stereotypes and generalizations about people from diverse backgrounds and cultures. The more accurate information we have about others, the more likely it is we will develop appropriate opinions, feelings, and behaviors.
2. Understanding - Awareness and comprehension of how and why people may see the same situation differently because of their cultural viewpoint differs from our own. The highest level of understanding is empathy, the ability to make connections with others on an emotional level and put ourselves in other people's shoes.
3. Acceptance - Tolerance and respect that allows others the same freedom of behavior and style that we expect for ourselves. Ultimate respect sees value in having people contribute from the perspective of their background and culture. When our views of other people are not blemished or tarnished by negative cultural or racial characterizations, respect creates change through trust. In some cultures,
4. Behavior - Ability to interact effectively with others different from ourselves. Ultimately, cultural competence is expressed through words and actions, one person to another.

Benefits of cultural competency. In many organizations, culture clashes lie at the heart of daily inter-personal conflicts. While illegal discriminatory behaviors may be waning, direct or unwitting collusion persists to reinforce stereotypical attitudes, prevailing behaviors, and norms. Cultural ignorance can hamper workforce productivity, stifle creativity and innovation, and derail business ventures.

As the American workforce and consumer markets grow more diverse, organizational and business challenges can only be addressed by developing cultural competency. By moving beyond diversity to a cultural perspective, organizations can enhance the way they create and provide services, successfully recruit and retain productive workers, and realize results both on the bottom line and in day-to-day human activity.

More Information on Cultural Competency in Health Care

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Rodney L. Brown holds a Master of Human Services degree from Lincoln University and a Diploma in Educational Policy and Leadership from New York University. Mr. Brown is President of Brown, Brown & Associates, Inc. BBA is at the forefront of assisting organizations that want to realize the benefits of a culturally competent workforce.

* SOURCE: Schmidley, A. Dianne, U.S. Census bureau, Current Population Reports, Series P23-206, Profile of the Foreign-Born Population in the United States: 2000. U.S. Government Printing Office, Washington, DC, 2001.