Championing Cultural Competence

This month, athletes from around the world have converged upon Sochi, Russia, for the 22nd Winter Olympic Games.  For more than 100 years, the Olympics have embodied the spirit of diversity. Since the first modern Olympic Games were held in Athens, Greece in 1896, convening 14 nations and 241 athletes, it has grown to showcase the talents and variety of the entire world.1 The previous Winter Olympics in 2010 brought together 2,566 athletes from 82 nations, and the most recent Summer Olympics hosted 10,500 competitors representing 204 nations.2,3 Millions more from across the globe gather together to celebrate the Games as spectators.

Similarly, the United States food supply has undergone expansion and diversification over the past century. Today, on average, consumers can choose from more than 42,000 items in the grocery store. And, more than 20,000 new products are introduced into the food supply every year.4   This diversification is, in part, a reflection of the changing demographics of the U.S. population. By 2050, people from different cultural backgrounds will make up more than half of the U.S. population,5 thus creating a demand for a variety of foods that cater to the traditions and preferences of those backgrounds. As the population grows increasingly diverse, food and health professionals will be faced with the challenge of understanding the diet and health needs of many cultural, ethnic, and racial groups. Therefore, cultural competence is needed to address this challenge.

Defining Culture and Cultural Competence

The father of the modern Olympic Games, Pierre de Coubertin, envisioned athletic competition as a means to promote understanding across cultures and foster peace.6 In essence, de Coubertin foresaw an opportunity to improve cultural competence. To develop cultural competence, an understanding of the term "culture" is necessary. According to Goody, et al, "Culture can be defined as the accumulation of a group’s learned and shared behaviors in everyday life. It is the lens we use to view and understand people’s beliefs, customs, and knowledge."7

Culture plays a central role in what, when, and how people eat, and with whom.  Dr. Donna Gabaccia, history professor at the University of Minnesota and author of the book, We Are What We Eat, explains that “food and language are the cultural habits humans learn first and the ones they change with the greatest reluctance.”8 Much like certain sports are part of the fabric in specific cultures (e.g. long-distance running in Kenya and cross-country skiing in Norway), certain foods are also deeply embedded in specific cultures and have greater significance beyond fulfilling basic physiological needs. Foods are “powerful symbols of cultural identity,” often fundamental to religious and social events.7 As such, understanding underlying cultural attitudes, beliefs, practices, and values is a critical step for food and health professionals to comprehend the food choices and eating behaviors of different groups.

Self-Examination: A Key to Cultural Competence

Cultural competence, however, goes beyond simply understanding the beliefs and behaviors of different groups. Cultural competence is an ever-evolving process of examining one’s own attitudes and acquiring the values, knowledge, skills, and attributes that will allow an individual to interact with other cultures.9 Self-examination is essential to cultural competence in order to identify personal preconceptions we may have or generalizations we may make about others or other cultures, and to separate opinions from facts. As food and health professionals, this self-examination promotes both respectful behavior in cross-cultural situations and inclusive dialogue with audiences from all different backgrounds on food and health issues. 

Cultural Competence in Practice

How can food and health professionals incorporate cultural competence into their everyday work? There are several opportunities within communications, education and care, and food production:

  • Communications: Discussing food in a way that is respectful of differences among cultures can foster rich and constructive dialogue. Furthermore, messages containing culturally sensitive content tailored to the intended audience will be more relevant and influential.  For instance, Oomen, et al. describes family involvement as a fundamental component of the decision-making process (including healthcare decisions) in the Hispanic culture.10 Therefore, communicating food and health information in the context of family may improve the impact of the message.
  • Education and care: Some cultures are disproportionately prone to specific nutrient shortfalls or health outcomes. For example, a recent CDC report revealed African-Americans have the highest rates of vitamin D deficiency at 31%, compared to 12% for Mexican-Americans and 3% for non-Hispanic whites.11 Ethnic differences are also found in diabetes rates; approximately 13% of African-Americans, 10% of Hispanics, and 16.3% of American Indians and Alaska Natives have diabetes, compared to 8.7% of non-Hispanic whites.7 Therefore, it is important to create outreach materials, educational resources, and diet plans that address such health disparities, while maintaining the integrity of food and lifestyle traditions.
  • Food production: Providing a variety of choices that enable consumers to build a healthful diet that fits their cultural needs is key to meeting dietary guidance.  As a result of innovations in modern food production and increased globalization of the food supply, many foods with cultural relevance are made available year-round. For example, coconut milk often used in Asian cuisine may be produced from coconuts in Thailand or Indonesia, but it’s widely available in many supermarkets throughout the U.S. Need a tropical pineapple for a Caribbean recipe? It can be found fresh, frozen, or canned. Food and health professionals can support cultural preferences by promoting the diversity and choice available in the U.S. food supply.

As in sports, practice makes perfect. Thus, as the Winter Olympic Games come to a close, food and health professionals are reminded to practice cultural competence to address the nutrition and health challenges of the diverse population in America and help consumers build a healthful, “winning” plate.  

References

  1. The International Olympic Committee. Athens 1896. http://www.olympic.org/athens-1896-summer-olympics. Updated 2013. Accessed January 10, 2014.
  2. The International Olympic Committee. Vancouver 2010. http://www.olympic.org/vancouver-2010-winter-olympics. Updated 2013. Accessed January 10, 2014.
  3. The International Olympic Committee. London 2012. http://www.olympic.org/london-2012-summer-olympics. Updated 2013. Accessed January 10, 2014.
  4. Food Marketing Institute. Supermarket facts. http://www.fmi.org/research-resources/supermarket-facts. Updated 2013. Accessed January 10, 2014.
  5. Pew Research Center. Immigration to play lead role in future U.S. growth. http://www.pewhispanic.org/2008/02/11/us-population-projections-2005-2050/. Updated 2008. Accessed January 10, 2014.
  6. The Olympic Museum. Hope: When sport can change the world. http://www.olympic.org/Documents/Olympic_Museum/Education/DPHOPE/DP_Hope_EN_web.pdf
    Updated 2011. Accessed January 10, 2014.
  7. Goody, CM, Drago L, American Dietetic Association, Diabetes Care and Education Dietetic Practice Group. Cultural food practices. Chicago, Ill.: American Dietetic Association; 2010.
  8. Gabaccia DR. We are what we eat: Ethnic food and the making of Americans. Cambridge, Mass.: Harvard University Press; 1998.
  9. National Center for Cultural Competence. Definitions of cultural competence. http://www.nccccurricula.info/culturalcompetence.html. Accessed January 10, 2014.
  10. Oomen JS, Owen LJ, Suggs LS. Culture counts: Why current treatment models fail Hispanic women with type 2 diabetes. Diabetes Educ. 1999;25(2).
  11. Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, National Center for Environmental Health, Division of Laboratory Sciences. Second national report on biochemical indicators of diet and nutrition in the U.S. population. 2012.

(Main image courtesy of Kevin Pedraja, Flickr )