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The Importance of Cultural Humility in the Provision of Culturally Congruent Care

Carrie A. Pullen, EdD

California State University at Northridge

“Culture is the whole complex of distinctive spiritual, material, intellectual, and emotional features that characterized a society or a group” – United Nations World Commission

 

Learning Objectives

• Define diversity, culture, and cultural humility, and explain how cultural humility is required to help address health disparities.
• Describe the establishment of Culturally and Linguistically Appropriate Services (CLAS) and the included standards.
• Reflect on the topics of bias, ethnocentrism, cultural relativism, and cultural humility and how they impact the delivery of healthcare.
• Explain how cultural humility can be addressed at both the individual and organizational levels.
• Identify barriers to the cultivation of cultural humility.

Introduction

Diversity refers to the many ways that people are different, and those differences are important considerations in the delivery of healthcare. Some of the many ways people can differ include age, race, religion, sexual identity, gender identity and expression, body size, and neurological differences, just to name a few. Culture can be defined as the beliefs and behaviors shared by a group of people and is another important one of those differences, often shaped by some of the differences outlined above. Culture varies greatly within the diverse United States of America. Culture shapes much of what individuals think and believe and therefore how they behave. For instance, culture informs how groups and individuals think about, feel about, and take care of their health. It can also create barriers to providing competent and equitable care when caregivers and patients have different cultural views, experiences, and biases. The way that individuals relate to and feel a sense of belonging with a particular group is referred to as Cultural Identity (Chen, 2014). Important to note is that many people identify with one or more disparate or overlapping cultures. The term for that is Intersectional Identities (Bolding, 2020).

Cultural Congruence is a term that refers to the process of effective interaction between providers and clients based upon culture (Schim & Doorenbos, 2010). The numerous and intransigent health disparities currently experienced in the U.S. were covered in the previous chapter of this text. An approach that has been shown to positively impact cultural interactions is referred to as Cultural Humility. Cultural Humility is defined as a “process of self-reflection and self-discovery in order to build honest and trustworthy relationships” (Yeager & Bauer-Wu, 2013). It requires examination of one’s own culture and behavior with a critical eye. Someone who is developing cultural humility understands that no one culture can be better than another. The development of cultural humility can lead to a worldview that is broad and inclusive and therefore results in a more culturally sensitive individual. Cultivating cultural humility is one proven way to impact health disparities and is, therefore, an important topic to study and understand for those who seek to improve and provide equitable, high quality healthcare services.

Historical Perspective

The United States is a relatively young country and an especially diverse one. In the early days of the nation’s development those differences were addressed utilizing the concept of assimilation. Assimilation, in this context, means that people who came from other places were expected to give up their different languages and cultures and learn to fit in with, and be absorbed by, the dominant culture. The idea of the Melting Pot was just that; people from many different cultures that all melted into one single group that was expected to think about and see things in the same way. The problem with that idea is that research tells us that cultural diversity is an asset in many ways. Diverse organizations, for instance, are more successful than those that are not (Reynolds, 2022). Eliminating variations in culture might make some things easier, but it would also erase the varied richness of experience and thought diversity brings. Who would want a world with only one language or one kind of food? Today, we understand that the goal is not to erase differences in people or diverse cultures, but rather to preserve, appreciate, celebrate, and harness them.

The ways in which people are different are many, and diversity has been increasing again in the US in recent decades. People have different incomes and levels of education. They are of different races, have different genders or gender identifications, different sexual orientations, different religions, different body shapes, ages, and reside in different settings. Those differences, however important to preserve and protect, can also create barriers to people getting along, making joint decisions and, most relevant to this text, to providing culturally relevant services such as high-quality healthcare. One way to address the barriers that diversity presents is for individuals to work at cultural humility and to strive to make organizations supportive and create safe spaces for all stakeholders.

The Impact of Culture

Culture is a very powerful influencer. People are ingrained with cultural perspective from the time they are very young, as families and communities shape how an individual comes to view and understand the world. Culture drives much of how people think and behave, and yet many people are unaware of the breadth of its influence. One way to think of culture is like an iceberg floating in the ocean. You can only see a small portion of an iceberg above water; the much more significant portion is below the water line and therefore out of sight. Similarly, some aspects of culture such as food, music, clothing, and celebrations are easily visible, but they are only a small part of what makes up a culture. The deeper impacts of culture include things like thoughts, beliefs, and values that are not immediately visible.

Reflection: What aspects of your culture do you think other people can easily see? What

aspects might they not understand until they knew you well?

The deeper influences drive behaviors that, among many other things, impact health and healthcare delivery. For instance, what is considered proper versus rude behavior is very much driven by culture. A physician unfamiliar with a patient’s culture could easily and unintentionally offend them. Even the way an individual expects to be greeted or conversed with impacts trust. For example, a patient who doesn’t trust their doctor is less likely to follow medical directions (Greene & Ramos, 2021.) Similarly, providers and patients who have different views of time can experience resentment and confusion related to appointments and the expected length of consultations. These are only a couple of examples. The number of difficulties that can arise when individuals fail to understand and appreciate each other’s cultural differences is endless.

Reflection: If someone invites you to dinner at their home at 7pm, what time would you arrive? Why? If you ask this question of people from a variety of cultural backgrounds, you will get answers that vary widely. Of course, there is no correct answer to the question as what is expected is often culturally driven. So, the best answer is arguably at the time your host would expect you.

Culturally and Linguistically Appropriate Services

Among the first national efforts in the U.S. to acknowledge and address health disparities caused by cultural differences emerged from a work force established by former Health and Human Services Secretary, Margaret Heckler (NIH, 1985). The committee’s initial report, published in 1985, documented the pervasive substandard care among people in the U.S. who are not white or from the dominant culture. One important outcome of the report was the establishment of the Office of Minority Health under the Department of Health and Human Services (OMH, n.d.). In 2001 that office published the first National Standards for Culturally and Linguistically Appropriate Services (CLAS). The CLAS Standards set out to decrease inequities in healthcare by mandating culturally and linguistically appropriate care. Linguistics refers to language and established the requirement for medical facilities to provide appropriate translation services to patients who are not fluent in English. Prior to the establishment of this standard, translation duties often fell to family members and even children of patients. This caused many issues, as these individuals were not qualified and often not capable of accurately and adequately conveying technical and nuanced information such as is essential between doctor and patient. CLAS is not just about language, however. The standards also require that facilities provide culturally competent care, or care that is informed by cultural knowledge, understanding, and respect.

The original CLAS standards were updated in 2013 to include a broader definition of culture, as well as to address organizations other than those providing healthcare, such as education and community-based organizations. This produced the set of 15 standards that organizations in the U.S. operate under today. The first and overarching standard states that organizations must “provide effective, equitable, understandable, respectful, and quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs” (Federal Register, 2013, p. 58543). The remaining standards are organized under three themes. The first is Governance, Leadership, and Workforce. The second is Communication and Language Assistance. The third is Engagement, Continuous Improvement, and Accountability. Together these standards provide a framework to implement the needed changes to create and maintain culturally and linguistically appropriate care.

The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations to:
Principal Standard:
1. Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
Governance, Leadership and Workforce:
2. Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources.
3. Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area.
4. Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.
Communication and Language Assistance:
5. Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
6. Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
7. Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
8. Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.
Engagement, Continuous Improvement, and Accountability:
9. Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations.
10. Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities.
11. Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery.
12. Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.
13. Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness.
14. Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints.
15. Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public.

Retrieved from: (https://thinkculturalhealth.hhs.gov/clas/standards)

Thought Processes that Impact how Diverse People View One Another: Bias, Ethnocentrism, and Cultural Relativism

In order to impact intercultural understanding and communication among individuals and care provided within organizations, it is important to first understand the different views and perspectives that people may have toward those who are different from themselves. In fact, many factors impact attitudes and how one individual or group of individuals views another group. Historically, humans were tribal. In prehistoric times, distrust of other groups was important to maintain safety. While the need for this protective behavior has diminished, oftentimes in practice the thought process has not. Bias therefore refers to the preference of an individual for one group of people over another (U.S. Department of State, 2021). Biases tend to be negative as well as inaccurate. They are also harmful, as biases cause individuals to treat others based on preconceived and errant views. We know that all people have biases, but also that they are not always aware of them. Explicit bias refers to a bias an individual is aware of, whereas an Implicit bias refers to one they are not consciously aware of (National Center for Cultural Competence at Georgetown University, 2022). Both types of bias are harmful, especially in the delivery of healthcare (Fitzgerald & Hurst, 2017). While a physician who is aware that they have a bias against overweight people is likely to treat them differently than people of normal weight, so too is a physician who also has the bias but is unaware of it (Chapman, Kaatz, & Carnes, 2013). Being aware of your biases is important, however it is very difficult to acknowledge and work to change something you do not even know is there. Therefore, taking assessments related to implicit biases is recommended. One such assessment is provided free online through Harvard’s Implicit Bias Project (Project Implicit, 2022). The research conducted through this site has been ongoing now for over 30 years and looks at many different types of implicit bias including race, gender, religion, and many other factors.

(https://implicit.harvard.edu/implicit/)

Ethnocentrism is a term that refers to a tendency to view all cultures solely through the lens of one’s own culture (Worthy, 2020). That would include the thinking that one culture does things “right,” and other cultures do them “wrong.” This way of thinking leads to intolerance of differences. Intolerance on a large scale can lead to mistreatment of groups of people up to and including genocide. Ethnocentrism therefore is a dangerous construct. An alternative and preferred world view is referred to as Cultural Relativism. Cultural Relativism is the ability to view an individual’s actions based upon that person’s own cultural norms and experiences (Worthy, 2020). In other words, to be able to see that while in one culture a behavior might be considered undesirable, in many others it may not. This view helps to eliminate inappropriately judgmental thoughts and associated actions. An example here might be the topic of time. Perhaps you were taught that being on time is a sign of respect, and therefore being late is rude. It would be important to know, however, that many other cultures view time differently, as more fluid. Cultural relativism then would allow you to understand that while being late to you is rude, to another it is not, and that neither point of view is inherently right nor wrong; they are just different.

Strategies for Impacting Cultural Humility

Impacting views of other cultures at the individual level involves increasing knowledge, building skills, and impacting attitudes that should be seen as a journey. It cannot be accomplished in one class or workshop. The first step in the journey should be the establishment of goals related to the three prongs of building knowledge, establishing skills, and improving attitudes. Building knowledge can be accomplished at both a broad based and a culture-specific level. A logical place to begin is learning about and understanding your own culture and how it shapes what you believe, how you think, and how you behave. Then, it is advised that you begin building an understanding of cultural differences on a broad level. This could include the importance of culture in shaping behaviors, general differences in eastern versus western cultures, northern versus southern hemispheres, etc. Formal training sessions, workshops and courses can be effective ways of obtaining broader cultural knowledge, and those that include role playing and other interactive participation can also improve skills and help health care providers navigate cultural differences (McDermid & Worden, 2018).

Next, knowledge can be built at the individual cultural level, which is an important aspect of providing care to a specific patient population. While there is no way to understand everything about a culture that is different from your own, a lot can be learned that can improve interactions with individuals of diverse cultures. It is important to know, for instance, how a patient or patient group in your practice tends to understand their relationship with the medical community, what they believe constitutes healthy behaviors, the type of diet they are likely to have, and their beliefs about privacy and modesty, etc. Increased knowledge in these areas, and many more, can aid in the development of new skills, or ways of behaving when faced with cultural differences. An example of this would be when you find out that involving family is especially important in the culture of a patient you are providing services to. This will ideally lead you to communicate with the patient regarding their wishes and create a care plan that includes family as desired. Similarly, understanding about specific religious beliefs of a patient can help a caregiver provide appropriate communication and options when discussing end of life care.

Perhaps more important than obtaining knowledge and building skills, is doing the work to create an adjustment of attitude. This can prove particularly difficult as our own cultural beliefs are deeply ingrained. Viewing other cultures from only our own cultural point of view is called a Monocultural Mindset. Time and concerted effort are required to allow us to view situations not only from our own cultural point of view but rather through multiple cultural lenses, referred to as a Multicultural Mindset. Research tells us that experiences shape attitudes, and therefore efforts to improve attitudes necessitate experiential learning. Proven strategies include travel, learning another language, exposure to literature, films, and cultural events, as well as more formal types of training that have experiential components and reflections or journaling.

Finally, Cultural Humility requires a close examination of one’s own cultural background and beliefs. How has what you were taught, and your own personal experiences shaped your attitudes and beliefs? How much of what you believe is because you were taught to do so? Cultural Humility focuses on listening and learning over knowing. Keeping an open mind and a focus on learning helps to address the biases we all have and that have been proven to negatively impact the provision of quality care in our health systems. It also helps to fight the stereotypes that can arise from assuming one can become competent in another person’s culture. Focusing on cultural humility can help us believe in and rely on each patient’s lay expertise. This leads to the potential for shared power and more individualized care (Lekas, Paul & Fuller, 2020). The following strategies have been demonstrated to help individuals learn about other cultures, but also to help foster a culturally humble approach to otherness.

Travel

Travel is a tried-and-true method of improving cultural knowledge, skills, and attitudes (De et al., 2015). Mark Twain said, “Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.” There is much literature that supports Twain’s statement. In fact, that literature also supports the traditional semester long study abroad experiences that a portion of college students participate in, finding almost exclusively that students who participate in these types of experiences show improved levels of cultural competence (de Diego-Lázaro, Winn, & Restrepo, 2020). However, we also know that all travel is not created equal when it comes to impacting levels of cultural understanding. Simply the act of traveling to another country, or being a tourist there, won’t substantially improve cultural understanding in and of itself. Five-star hotels are similar all over the world, as are hostels. Living or staying with a local family, however, and choosing to purposefully immerse yourself in a new-to-you culture will result in new cultural understanding, and will therefore improve knowledge, build skills, and impact attitude. Global travel, however, is not easily accessible to everyone. Alternatively, in most urban areas of the U.S. there are many cultural educational experiences that can be accessed without leaving the area you live in.

Language

Learning another language is another well documented way to gain insight into another culture. If you have ever taken a language class, you know that it will invariably include information about culture. That is because while learning a language does help you to understand a culture, being able to conjugate verbs and perfect pronunciation are not sufficient to create effective communication without understanding the culture of the people that speak the language.

Cultural Events, Literature and Media

Additionally, as the U.S. continues to become more diverse, and there is an increased focus on maintaining cultural identity rather than assimilating, communities are enriched with cultural festivals that are fun and easy ways to learn about another culture. Access to culturally specific films, books, and media is also readily available. If you want to know how another culture views a particular current event, for example, try watching their news broadcasts. If you wish to understand a war from the other side, visit their history museums. Try reading translated tweets that were written in another language. These strategies are guaranteed to enlarge your view and create insight regarding the views of other groups.

Creating Relationships

Still another proven effective method to improve cultural understanding is to create personal relationships with people who are different from yourself. This can be at a professional level, such as working with someone from a different culture, or it can be a social relationship. Individuals who develop relationships with people from different backgrounds tend to be more receptive to views that are different than their own and tend to understand and appreciate differences. An example of this is a recent study that found that emergency department physicians who had close interactions with representatives from other cultures scored higher on cultural awareness assessments (Majda et. al., 2021).

Reflection: Think about your circle of friends. Are you a homogeneous group? Do you have any close friends that come from a very different background than you do? Interacting with others with different points of view regularly, on more than a superficial basis, creates opportunities for learning and growth.

Journaling

Finally, another strategy to improve your personal level of cultural competence is to journal. Journaling about your own culture, as well as your experiences as you work to educate yourself about other cultures and others’ experiences, has been shown to positively impact individual levels of cultural understanding (Taliaferro & Diesel, 2016). This is because journaling can help you to make sense of your thoughts, cement learning as you have new experiences, and even help you to challenge previously held assumptions.

Addressing Cultural Competence in Healthcare Organizations

Addressing cultural humility must occur not just at the individual but also at the organizational level (Truong, Paradies, & Priest, 2014). This is true not just because doing so has been proven to address disparities in care but also because doing so can reduce costs by making organizations more effective and efficient (Betancourt, et al., 2003). Therefore, the need for substantive organizational change is not driven only by ethics but also by practical concerns. It is in everyone’s best interests to address the need to create and maintain more diverse and inclusive organizations and to provide healthcare that is based upon the identities and lived experiences of the individual.

The Need for Committed and Engaged Leadership

Effective and lasting change, such as is required to positively impact care within healthcare organizations and result in the desired increases in efficiencies, necessitates an organizational wide plan, effort, and adequate support (Wilson-Stronks et al, 2008). First, a foundation must be built that will enable and sustain the changes needed. Effective leadership at the top levels of the organization in support of associated goals is vital (Glenngård & Anell, 2021). Organizations that strive for cultural congruence must have leaders who value diversity, embody cultural humility, and hold others accountable to the same. They must also ensure their organizations include Safe Spaces for collaboration, that is spaces that are comfortable to, and inclusive of, its members (Homawoo et al., 2017). Finally, leadership is also vitally important to ensure adequate resources and support are allocated to create effective and ongoing initiatives.

Improvement begins with Assessment

Addressing cultural congruity at the organizational level should also begin with a thorough assessment. This assessment should include a close examination of the existing attitudes and practices within the organization, supported with both initial and ongoing collection of data, as well as surveys and interviews. Next, creating collaborations that are both internal and external are pivotal to ensure inclusivity. Finally, to truly ensure that an organization consistently provides culturally sensitive care, a continual ongoing process is required (Brownlee & Lee, n.d.).

Assessing the level of cultural sensitivity that an organization exhibits, however, can be a complex process. Significantly more than a single questionnaire is called for. It is first recommended that a task force be created to identify important stakeholders, establish a timeline, select an initial assessment tool and to oversee the process (Andrulis et al., n.d.). Incorporated stakeholders should include all impacted groups, from staff in all departments to patients, physicians, community leaders and the board of trustees. It is also recommended that interviews be conducted to follow up on concerns flagged in questionnaires and to further investigate identified areas of concern. A report with conclusions should be distributed to all stakeholders and a plan should be prepared to establish goals to address and improve specific findings and improve levels of competence in the provision of care.

Designing Education and Training Programs

It is expected that the need for targeted training and education will arise out of a competently conducted organizational assessment. Studies have shown that educational interventions in organizational groups should seek to build awareness, improve knowledge, and allow the practice of skills (Young & Guo, 2016). Training should help individuals examine their own personal attitudes and reflect upon the impact of potential biases. Knowledge provided should be both global and specific to all cultures represented in stakeholder groups. Skill development will help individuals know how to respond to common cultural related difficulties such as knowing when and how to obtain the services of a translator. Finally, an effective improvement program must be ongoing and include regular evaluation against established goals and reassessment and adjustments as needed.

Barriers to Cultural Congruence and Humility

Even the most well-planned initiatives for improvement will confront barriers. Barriers, as referenced here, refer to existing circumstances that get in the way of a desired goal or outcome. Identified barriers to improving cultural competence can be divided into systemic, organizational, and individual categories. Systemic barriers refer to those found in society at large. Organizational barriers are specific to individual organizational groups, and personal barriers are those found within individuals themselves. These barriers must be understood and addressed to ensure improvement in competence and therefore quality of care.

Organizational Barriers

There are many barriers at the organizational level that serve to prevent the improvement of cultural congruence. One of those barriers would include a lack of diversity among staff, administrators, and care providers that fail to reflect the make-up of an organization’s patients. According to research, diversity within individual healthcare organizations is directly related to the quality of care received by diverse patients seeking care from that organization (Eisenberg et al., 2020). An obvious example of this would be a failure to ensure individuals on staff that speak the native languages of patients. Less obvious, but still important, is staff that has an appreciation for common cultural views and experiences. Another organizational barrier that is frequently cited is lack of, or scarcity of, resources. Lack of resources to devote to training, translation services etc. prevents optimal care levels from being achieved. As resources are known to be limited, organizational commitment to dedicating scarce resources to activities necessary to establish and reach goals related to cultural competence is imperative.

Systemic Barriers

Systemic Barriers include those large and difficult to right injustices that remain in society, such as racism and oppression. These barriers have continued to exist despite our awareness of them and decades of efforts to impact them. Privilege references special rights that one group has that another does not (Justin, 2020). Entitlement is the belief by the privileged group that they deserve those rights (Hillock, 2012). Oppression, then, is what is experienced by the group that lacks privilege and is controlled by the dominant group (“Social Identities”, 2021). Discrimination and lack of justice lead to distrust among disenfranchised populations that then negatively impact relationships between physicians and patients. Similarly, poverty and other socio-economic conditions create gulfs that can be difficult to navigate.

Personal Barriers

Finally, barriers also exist at the individual level in the form of bias and ethnocentricity and even basic lack of knowledge about the cultures of the patients an organization serves. These barriers are responsible for assumptions that are incorrect, breakdowns in communication, as well as discrimination that occurs at the individual level. An example of this would be the subtle statements or actions of discrimination, intentional or not, that people of color or those with other differences regularly experience, referred to as Microaggressions (Parikh & Leschied, 2022). Even though these barriers related to individual bias are well established, research suggests that individual healthcare providers tend to focus on systemic and organizational barriers, such as lack of time or identifiable socio-economic barriers, rather than reflecting on their own biases when confronted with failures to provide culturally competent care (Shapiro et al., 2002). Education and training are the key to overcoming personal barriers and must be tackled in a systemic manner in order to effect change.

Summary

This chapter addresses the importance of understanding, identifying, and improving the provision of culturally relevant care by addressing cultural congruence and humility at the level of individuals, as well as the functioning of organizations to positively impact healthcare disparities and improve the efficiency and efficacy of healthcare organizations. CLAS dictates that organizations provide culturally competent healthcare. Healthcare professionals must therefore seek to address their biases by practicing cultural humility and leaders must ensure their organizations support this work. Doing so requires leadership engagement, commitment of time and resources, creating an overarching plan based upon evidence-based research, as well as follow through and subsequent assessment and evaluation of outcomes. Cultural lenses such as ethnocentrism and cultural relativism are important concepts to consider when seeking to improve the provision of culturally congruent care. It is also crucial to shine light on the concepts of both explicit and implicit bias and resulting behaviors, such as microaggressions, and to understand their impact on the provision of healthcare. Many strategies are recommended for individuals seeking to improve their own cultural humility levels, including travel, learning of a new language, exposure to diverse media, developing relationships with people from different cultures, and journaling. Finally, barriers at the organizational, individual, and systemic levels should be acknowledged and understood to limit their impact and not allow them to impede needed progress.

Key Words

Assimilation: when individual cultural groups are absorbed into the dominant culture

Bias: preference of an individual for one group of people over another

Culture: beliefs and behaviors shared by a group of people

Cultural Competence: a set of attitudes, behaviors and policies that improve interactions among cultures

Cultural Congruence: the process of effective interaction between providers and clients based upon culture

Cultural Humility: self-discovery and reflection aimed at improving intercultural relationships

Cultural Identity: the way an individual relates to and feels a part of a group of people

Cultural Relativism: viewing another person’s behavior keeping in mind their culture

Diversity: the many way individuals or groups of people differ from one another

Entitlement: the expectation of a person or group to rights not given to all

Ethnocentrism: looking at other cultures only from the perspective of your own

Intersectional Identities: When an individual identifies with one or more disparate or overlapping cultures

Microaggressions: subtle statements or actions of discrimination, intentional or not, that people of color or those with other differences regularly experience

Monocultural Mindset: viewing other cultures from only our own cultural point of view Multicultural Mindset: the ability to view situations through multiple cultural lenses

Oppression: the control of a privileged group over those who lack privilege

Privilege: the special rights of one group of people or individual

Safe Spaces: Areas where there is complete safety and inclusivity for all group members

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