At the conclusion of this educational activity, participants will
be able to:
1. Describe key trends in the demographics of culturally
2. Discuss the evolution of cultural competence in health care
3. Define cultural competence terms and ideas about health
4. Describe communication issues associated with working
with diverse populations
5. Explain oral practices and oral health disparities of diverse
Cultural competence is a vast topic of great importance to
the field of dentistry. In an increasingly diverse society, it is
necessary for dental professionals to be culturally competent
healthcare providers. A dynamic process, attaining cultural
competence includes awareness and understanding of the many
factors that influence culture and how that awareness translates
into providing dental services within clients’ cultural parameters. Multiple resources are available for dental professionals
to become culturally competent healthcare providers, ensuring
delivery of the best possible care for all clients.
As the US population becomes increasingly diverse, health-care providers are charged with developing the knowledge
and skills to adequately serve clients from multiple population
groups. Dental providers are no exception and it is necessary
to embrace the wealth of information available for serving clients from diverse backgrounds and cultures. This course will
provide an overview of cultural competence as it has evolved in
health care and dentistry.
On the journey toward cultural competence, it is important
to recognize that no individual can know every aspect of any
group, and though society tends to categorize by race, diversity includes more than racial and ethnic characteristics. Many
types of population groups can be viewed as a culture.
We are experiencing a rapidly increasing elderly population, with significant implications for health-care policy and
delivery of care. The disabled and other groups with lifestyle
characteristics bring accompanying health issues and needs to
the health-care system. The complexities of treating patients
of low socio-economic status continues to challenge systems of
care as we strive to provide health services for all Americans.
Health disparities have existed for centuries. These disparities have run through all races and ethnicities but are overrepresented in the racial and ethnic minority populations.
The Office of Minority Health and Health Disparities at the
Centers for Disease Control and Prevention states: “
Compelling evidence that race and ethnicity correlate with persistent,
and often increasing health disparities among US populations
demands national attention.”
2 An understanding of health disparities must be intricately woven into the tapestry of cultural
competence in health care just as much as the knowledge of the
characteristics of diverse populations.
US Demographics Concerning Race and Ethnicity
The 2010 Census revealed that the United States is more culturally diverse than ever before.
3 The once mainstream white
majority is shrinking as minority populations consistently
increase. In her cultural competence text, Patti R. Rose identified the new replacement term for minority populations as the
3 Specter uses the term as well.
4 One of the
most significant changes in the administration of the 2010 Census was in the wording of questions concerning race and Hispanic origin. The Office of Management and Budget (OMB)
sets the standards on race and Hispanic origin and has determined that Hispanic or Latino is not a race but an ethnicity due
to the multiple countries of origin included in the designation.
As a result, these questions were asked of all persons living in
the United States, and people were free to define themselves as
belonging to many groups.
Data on race has been collected since the first census was
conducted in 1790. There are five race categories that were
used in the 2010 Census (see figure 1). Additionally, a “some
other race” category was added for both the 2000 and 2010
censuses. Census data revealed in 2010 that while the white-only population remains the largest at 63.7%, it grew the least of
any population group from 2000 to 2010. The Hispanic ethnic
group constituted the largest minority population group, at approximately 16% of the total population and experienced the
largest increase from 2000 to 2010. Hispanics predominantly
identified as either white or some other race. The Asian population group grew faster between 2000 and 2010 than any other
major race group and represented 4.8% of the total population.
While all minority groups increased, the black/African American group had not exhibited the percentage increase as much
as the other population groups and remained relatively stable
at 12–13%. American Indian/Alaska Native and Native Ha-waiian/Pacific Islanders represented .9% and .2% respectively
of the total population. Those who identified as two or more
races was 2.9% and the most common combination of races was
Before discussing cultural competence in health care and
dentistry, it is necessary to define some commonly associated
• Culture: While there is no single definition, the term is
generally defined as nonphysical traits, such as values,
beliefs, attitudes and customs that are shared by a group of
people and passed from one generation to the next.