Written by: Kristen DiFilippo, PhD, RDN
Food is many things to many people. At its core, food is fuel that nourishes us and keeps our bodies running. Food is used to celebrate, to socialize, to mourn, to share, and to comfort. Food brings people together. The ways we go about eating, both for nourishment and for connection, are deeply rooted in our cultural experiences. As nutrition professionals, considering cultural influence on food decisions is crucial to providing supportive care. Developing cultural competence and integrating cultural humility into our lives can help us approach patients with respect and empathy.
Cultural Competence (American Psychological Association) includes:
- The possession of the skills and knowledge that are appropriate for and specific to a given culture.
- The ability to collaborate effectively with individuals from different cultures in personal and professional settings. This usually involves a recognition of the diversity both between and within cultures, a capacity for cultural self-assessment, and a willingness to adapt personal behaviors and practices.
With an emphasis on skills and knowledge, cultural competence implies that it is something that we can achieve through learning and practice. This is encouraging, as it suggests that we all have the capacity for growth. In nutrition care, it is crucial to consider the role that culture plays in the food we eat. The CDC describes culturally preferred foods as “safe and nutritious foods that meet the diverse tastes and needs of customers based on their cultural identity” (Centers for Disease Control and Prevention). This can include food that respects religious traditions. Learning about the preferences and requirements of various cultures can help us guide patients toward meeting nutrient needs and goals.
However, we need to be cautious that we do not assume that we can become completely competent in a culture, particularly one that is not one’s own. It is important to keep in mind that one person does not represent a culture, and each individual will have unique preferences. This is where cultural humility plays a role.
Cultural Humility (Tervalon & Murray-Garcia) incorporates a lifelong commitment to:
- self-evaluation and critique
- redressing the power imbalances in the physician-patient dynamic
- developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations.
Cultural humility is a process. Rather than a set of skills we can master, it is an ongoing process. It requires us to consider the role our own culture may have in our judgments and recommendations. It pushes us to look beyond broad stereotypes about cultures to the individual needs and preferences of a patient. A patient is never just a culture. While cultural experience provides a foundation through which we view the world, each individual varies based on intersectionality and individual experiences and preferences. Cultural humility reminds us not to make assumptions when providing care.
By combining cultural competence with cultural humility, we are better able to provide sensitive nutrition care that is more likely to meet the nutritional needs of the patients we serve. Cultural competence lays a foundation that reminds us to consider the cultural background of each patient as we support their nutritional needs. Cultural humility reminds us to move beyond base-level assumptions we make based on our own culture and broad generalizations about other cultures, to acknowledge that with each patient we encounter we need to address their individual goals and preferences.
References:
American Psychological Association. APA Dictionary of Psychology. Accessed. 3/6/2024. https://dictionary.apa.org/cultural-sensitivity
Centers for Disease Control and Prevention. Cultural Food Preferences for Food Service. Accessed 3/6/2024 https://www.cdc.gov/nutrition/food-service-guidelines/strategize-and-act/cultural-food-preferences.html
Tervalon, M., Murray-Gracia, J. Cultural Humility Versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education. Journal of Health Care for the Poor and Underserved; 1998;9(2):117-25.
