Core competencies for Indigenous public health: A strategy to improve cultural safety practices

Although efforts to mitigate Indigenous health disparities and improve the quality of Indigenous health services are widespread, the degree to which these interventions are culturally appropriate varies. Indigenous cultural safety in health care is a concept that acknowledges historic tensions between Western and Indigenous cultures and teaches practitioners to respectfully integrate the culture and health beliefs of an Indigenous individual/community into health interventions. A group of Aboriginal scholars from Australia, Canada, New Zealand and the United States propose a set of international core competencies for Indigenous public health be developed to promote the widespread practice of Indigenous cultural safety. To determine the feasibility of this proposal, public health education programs, Indigenous health services and cultural safety initiatives in each of the four countries were analyzed and compared. The analysis and comparison revealed that awareness of cultural safety concepts and applications of cultural safety practices were irregular, demonstrating that the cultural competencies of the Indigenous public health workforce are inconsistent or inadequate. This limits the workforce's ability to effectively and uniformly address the cultural health needs of Indigenous peoples. It is recommended that public health scholars and policymakers from all four countries establish a formal collaboration to design core competencies that will serve as a guide for Indigenous public health education, training, practice, evaluation and governance. Developing an international set of core competencies for Indigenous public health is an innovative and necessary next step in the process of improving cultural safety standards for Indigenous health services and health disparities interventions.