Addressing the socio-cultural complexity in cultural competence: Applying public health critical race praxis (PHCR) and cultural humility

Cultural competence is conceptualized as one of the keys to addressing health disparities and building health equity in public health and health care. However, a growing body of literature underscores the relationship between structural factors and health inequities. To better address disparities tied to race and racism, public health practitioners and researchers must expand traditional conceptualizations of cultural competence. Frameworks that focus on individual acquisition of a finite body of knowledge, skills and attitudes are not adequate to the task of understanding and critiquing the underlying social, political, and economic processes of power, privilege, and institutional racism that create, support, and maintain existing health disparities. In this session we will discuss the potential of two frameworks to extend and enrich the concept of cultural competence — (1) Public Health Critical Race praxis, an activist theoretical framework to conceptualize and address the racial inequities that lead to health disparities (Ford and Airhihenbuwa, 2010), and (2) cultural humility (Tervalon and Murray-Garcia, 1998), an application of sustained self-reflection and self-critique that allows for reflective inquiry of one's social location in systems of privilege and oppression. We will outline how key principals in these frameworks can work together to produce a robust public health practice and research agenda that better address the impact of structural inequities on health disparities.