Cultural humility

Cultural humility refers to the concept of maintaining openness to other people's cultures and self-identities. It involves setting aside biases and stereotypes to understand how another person's culture and background affects that person as an individual. It is usually a factor in interactions among people of different races or ethnic backgrounds but can apply to exchanges among those of different religions, age groups, geographic regions, and so on. While cultural humility can be a factor in any form of interpersonal communication, it often is a greater concern for those involved in medicine, psychiatry, and social work.

Background

The "cultural" part of cultural humility refers to the beliefs, attitudes, behaviors, customs, and practices of a society, group, person, or period. It includes aspects such as racial and ethnic background, religious beliefs, language and communication norms in a community or family, educational experience, and geographically driven behaviors. For example, for North Americans who live in cold climates, winter holidays often are associated with snow. For Australians, however, the same holiday season might be associated with time at the beach. This is because geography results in different weather in these areas at that time of year.

Although the "humility" part of cultural humility may suggest meekness or an attitude of humbleness, in this context it refers to the idea that a person is open to self-examination and has a willingness to take steps to overcome limitations or shortcomings. Cultural humility specifically refers to the idea of remaining open and avoiding biases and stereotypes when interacting with others. A bias is a predetermined attitude for or against someone. A stereotype is assuming something about an individual based on the group to which he or she belongs.

The concept of cultural humility originated in the 1990s in California. In 1991, an Black taxi driver named Rodney King was involved in a police chase. Videotaped footage of his subsequent apprehension showed police striking King repeatedly, but the four officers involved were acquitted of criminal charges (several were later convicted of federal civil rights violations). This led to five days of rioting in Los Angeles and tense racial relations throughout the community.

Pediatrician Melanie Tervalon was part of a team of people who conducted educational sessions to help ease racially driven tensions among the staff at a children's hospital in the area. After several sessions, Tervalon developed the concept of cultural humility as a way of going beyond learning about another's culture to understand how that culture affects individuals. In 1998, Tervalon and another pediatrician, Jann Murray-Garcia, wrote a journal article titled "Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education." The article helped popularize the adoption of cultural humility and cultural competence in the medical community.

Overview

Cultural humility is not the same as cultural competence. Cultural competence is knowledge of the practices, beliefs, attitudes, and customs of a group of people. In medicine, this involves knowing any differences in the way people's race, ethnicity, religion, dietary practices, and so on may affect their health and how they might respond to different treatments. Cultural competence focuses on generalizations based on the group to which a person belongs. Cultural humility involves a more individualized approach to understanding how aspects of a person's cultural background have shaped and formed that individual.

A person employing cultural humility learns about the ways groups of people differ but does not rely on that knowledge alone when dealing with people. For example, a nurse who is about to gather information from a new patient may have dealt with other patients from the same culture who were very accommodating to his or her requests, but this new patient is reluctant and unresponsive. A nurse applying cultural humility will not assume that because this patient is different that he or she is being difficult but will instead try to understand why the patient is uncooperative. The nurse will recognize that the idea that the patient is uncooperative is coming from his or her own stereotype that all members of that cultural group are accommodating and that the patient's behavior may be caused by something other than intentional uncooperativeness.

Cultural humility involves attempting to resolve negative stereotypes or biases that the other person holds that are interfering with communication or hampering the relationship. For instance, a physician who is treating a patient of a different ethnic background will be aware that the patient may harbor suspicions or other negative attitudes toward the physician. The physician exhibiting cultural humility will ask questions, administer treatments, and give instructions in ways that will convey respect for the patient and the patient's needs and feelings. The physician also will communicate in a way that makes it clear that the patient is seen as an individual. For example, the doctor will avoid making assumptions about what the patient eats simply based on cultural background.

Another key aspect of cultural humility is addressing imbalances in power that exist in interactions or relationships. Tervalon and Murray-Garcia noted that it was important to recognize and respect the value of each individual. This is especially true in relationships in which the roles are different and may be perceived as unequal, such as the relationships between physicians or psychiatrists and patients or social workers and their clients. The physician, psychiatrist, or social worker may have expertise in his or her subject matter, but the patient or client has all the expertise on his or her own life and circumstances. When cultural humility is employed, both sides learn and benefit from each other.

Recognizing and respecting that expertise is a key to successful relationships between individuals with cultural differences, according to Tervalon and Murray-Garcia. They emphasized the importance of making cultural humility a systemic part of organizations in which intercultural relationships are common. Experts say that the application of cultural humility will become increasingly important as the world becomes more diverse and multicultural.

Bibliography

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Hohman, Melinda. Cultural Humility: A Lifelong Practice. Fairfax County, 10 Sept. 2013, www.fairfaxcounty.gov/healthymindsfairfax/sites/healthymindsfairfax/files/assets/documents/pdf/ho1%20-%20cultural%20humility.pdf. Accessed 9 Aug. 2024.

"Jann Murray-García, M.D., M.P.H." Betty Irene Moore School of Nursing, UC Davis, health.ucdavis.edu/nursing/ourteam/faculty/Murray-Garcia‗bio.html. Accessed 9 Aug. 2024.

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Sastry, Anjuli, and Karen Grigsby Bates. "When LA Erupted in Anger: A Look Back at the Rodney King Riots." NPR, 26 Apr. 2017, www.npr.org/2017/04/26/524744989/when-la-erupted-in-anger-a-look-back-at-the-rodney-king-riots. Accessed 9 Aug. 2024.

Tervalon, Melanie, and Jann Murray-Garcia. "Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education." Journal of Health Care for the Poor and Underserved, vol. 9, no. 2, 1998, pp 117–25. Melanie Tervalon, melanietervalon.com/wp-content/uploads/2013/08/CulturalHumility‗Tervalon-and-Murray-Garcia-Article.pdf. Accessed 9 Aug. 2024.

Waters, Amanda, and Lisa Asbill. "Reflections on Cultural Humility." American Psychological Association, Aug. 2013. Mount Royal University, www.mtroyal.ca/AboutMountRoyal/TeachingLearning/CSLearning/‗pdfs/adc‗csl‗pdf‗exculhumcap.pdf. Accessed 9 Aug. 2024.

Yeager, Katherine A., and Susan Bauer-Wu. "Cultural Humility: Essential Foundation for Clinical Researchers." Applied Nursing Research, vol. 26, no. 4, Nov. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3834043/#‗‗ffn‗sectitle. Accessed 9 Aug. 2024.