Department of Health and Human Services
Administration on Aging

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Addressing Diversity

Cultural Competency

This guidebook is designed for use by providers of services to racially and ethnically diverse older populations. There is growing interest in learning how effective, culturally appropriate services can be provided by professionals who have mastered culturally sensitive attitudes, skills, and behaviors. We hope you will find this document a helpful introduction. However, it is only an introduction and not intended to substitute for more rigorous and on-going study. We hope that you will find each chapter both enlightening and useful. For readers who have taken more formal courses to acquire cultural competence, this guidebook might serve as a review--a tool to engage you further and to enable you to evaluate current programs with a critical eye towards your staff achieving cultural competence.

In designing service programs, we cannot assume that methods designed for majority group older persons will automatically apply to minority elders. This poses a challenge and opportunity for all of us to design culturally appropriate interventions that are responsive to the needs of minority communities and to offer support that withstands the changing needs of diverse populations over time.

Racial and ethnic minorities face many barriers in receiving adequate care. These include difficulties with language and communication, feelings of isolation, encounters with service providers lacking knowledge of the client's culture and challenges related to the socio-economic status of the client. Often, service providers have a responsibility to provide a voice for clients who cannot speak for, or represent, themselves.

The guidebook is divided into six chapters and five appendices. Each of the first three chapters takes a particular perspective or point of view critical to understanding cultural competence. For example, in Chapter Two we explore the meaning of cultural competence. Part A provides a definition of culture and discusses the intervening factors that determine the impact of culture. Part B provides a definition of cultural competence, Part C outlines the barriers to accessing services experienced by minority elders, and Part D gives an overview of research accomplished in this area.

Chapter Three examines the importance of cultural competence, and is divided into three sections. Part A introduces the reader to the importance of providing services and programs that exemplify cultural competence. Part B evaluates demographic information pertaining to various racial and ethnic minorities, and Part C discusses the demographic information with relation to disparities among racial and ethnic minorities.

The focus of Chapter Four is to demonstrate the way in which agencies can conceptualize culturally competent practice within their organizations, set goals, and move on to the development and implementation of interventions by culturally competent professionals. Part A is a basic introduction to the principles of cultural competence. Part B explains the five elements essential in developing culturally sensitive programs.

In Chapter Five, the reader is given illustrative examples to gain a better understanding of individual and broad cultural differences between racial and ethnic groups and the process of acculturation. Part A presents profiles of people with regard to age, education, gender and geographic location. Part B provides profiles of programs, and Part C concludes the chapter with a discussion of the implications.

Appendix One summarizes the national laws relevant to cultural competency. Appendix Two provides a brief overview of executive orders related to the concerns of minority groups. Appendix Three describes the Healthy People 2010 effort to improve the health status of racial and ethnic minority populations.

No guidebook would be complete without accompanying hand­outs, and these are provided in Appendix Four. The hand­outs are intended as aids for providers during presentations in training workers to implement culturally appropriate programs within their agencies and can also be used as overhead slides.

Appendix Five concludes the guidebook with references for readers who would like to receive more in-depth information on culturally competent practice and how professionals can be culturally competent in their provision of services and programs for an increasingly diverse aging population.

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