What is Cultural Competence?

According to the National Center for Cultural Competence, Cultural Competence is a “set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations”. 

Culture is more than race or ethnicity – it also refers to other characteristics that make up the whole person such as gender, age, sexual orientation, gender identity, disability, religion, income level, education, geographical location, or profession.  How effectively we work within this paradigm refers to our Competence.

What does it mean to be Culturally Competent?

Whether an individual or an organization, according to SAMSHA, to be Culturally Competent is to be “respectful and responsive to the health beliefs and practices—and cultural and linguistic needs—of diverse population groups”.

The Cultural Competence Continuum

How do you know if you are Culturally Competent?

Developing cultural competence (either as an individual or organization) is a continuous and purposeful process that occurs along a continuum. The National Center for Cultural Competence at Georgetown University describes this Cultural Competence Continuum in six stages.


Cultural Destructiveness

This stage is characterized by attitudes and practices (as well as policies and structures in organizations) that are destructive to a cultural group.

Culture Incapacity

This stage reflects the lack of capacity systems and organizations necessary to effectively respond to the needs and interests of diverse groups. This can include institutional or systemic bias, practices that may result in discrimination in hiring and promotion, or disproportionate allocation of resources that may benefit one group over another. This can also include subtle messages that certain groups aren’t valued or welcomed.

Cultural Blindness

This stage describes a philosophy of “fairness” that views and treats all people as the same. This philosophy, however, can be problematic because people are different and have different needs. People deserve approaches that acknowledge and celebrate differences, while addressing these needs. Cultural blindness can in fact, negatively influence system policies by encouraging assimilation, ignoring cultural strengths, fostering institutional attitudes that blame consumers for their circumstances, and failing to hire a diverse workforce.

Cultural Pre-Competence

This stage highlights the growing awareness of strengths (and areas for improvement) to respond effectively to culturally and linguistically diverse populations.

Cultural Competence

In this stage, acceptance and respect for culture becomes consistently demonstrated in policies, structures, practices, and attitudes. This can include an organization’s commitment to human and civil rights, hiring practices that reflect a diverse workforce, and increased efforts to improve service delivery for racial, ethnic, or cultural groups.

Cultural Proficiency

In stage six, culture is held in high esteem and used as a foundation to guide all endeavors. Organizations that do this successfully continue to add to their knowledge base. They support and mentor other organizations seeking to improve their cultural competence and they advocate with and on behalf of populations who are traditionally underserved or not served at all. They also partner with other diverse constituency groups to help reduce and eventually eliminate racial and ethnic disparities.


Organizational Cultural Competency

Understanding where you fall on the Continuum allows you to plan how to move your organization forward.  SAMSHA identifies a set of administrative steps organizations must take to become Culturally Competent.  They are:


Invests in building capacity for cultural competency and inclusion: Organizations should have policies, procedures, and resources in place that make ongoing development of cultural competence and inclusion possible. It must also be willing to commit the resources necessary to build or strengthen relationships with groups and communities. Including representatives of the focus population within the organization’s ranks is especially useful.

Practices strategic planning that incorporates community culture and diversity: Organizations are urged to collaborate with other community groups. Its members are also encouraged to develop supportive relationships with other community groups. When these steps are taken, the organization is seen as a partner by other groups and their members.

Implements prevention strategies using culture and diversity as a resource: Community members and organizations must have an opportunity to create and/or review audiovisual materials, public service announcements, training guides, printed resources, and other materials to ensure they are accessible to, and attuned to their community or focus population.

Evaluates the incorporation of cultural competence: Community members must have a forum to provide both formal and informal feedback on the impact of all prevention interventions.