Equity Exchange June 2022

What is cultural humility? How does it affect healthcare and what can we do to promote human dignity for all? These questions and more are discussed in this short video with UCSD Professor Dr. Dredge Kang.

For those of you who’d rather read through the content (or you’re in a quiet place not conducive to video-watching) we’ve got you covered:

My name is Dredge Kang and I’m a professor at UCSD.

The Global Health Program at UCSD is housed in the anthropology department, and so I think that helps students a lot with how to think about health issues. Part of our perspective is always to understand the world from the perspective of the people that you’re working with. So, kind of the old adage of, you know, walk a mile in other people’s shoes.

In the past, the term that was typically used was cultural competence. Cultural humility takes a different stance because cultural competence implies that you can know a culture and then be competent in it and then you can deal with people, for example, from that cultural background. Whereas cultural humility emphasizes this idea that we’re always learning culture, and cultures are always changing, too, and everybody within a culture is not going to be the same.

Just because somebody is Mexican or just because somebody is from Somalia doesn’t mean that they’re going to have the same beliefs, have the same attitudes, have the same behaviors, or react to you in the same way based on how you’re coming to them and what you know about their background.

So cultural humility takes a stance of asking more questions of the patient and not making the assumptions that people often do about the patient. For me, the baseline is human dignity, treating everybody as if they have value in the world, whether other people think they do or not.

The first job that I got where I was provided with healthcare, they automatically enroll you into an HMO and you just go to the doctor and see them. The first appointment that I had with the doctor, I went, and during the first appointment, where we’re, you know, doing our introductions and stuff, I told the doctor, I’m gay. And he literally jumped back. Right? And it made me feel so like, am I like a monster or something?

So, a lot of people just fall out of care, right? They’re just not going to go back to the doctor again, and that’s where issues of things like stigma and discrimination come up in terms of access, retention and trust of the healthcare system. Medical schools have changed a lot in terms of how they’re doing curricula and residency and things like that, and you would be, I think, hard-pressed now to find a medical school that doesn’t do something around cultural competence. That doesn’t do something around care for different populations. And I would say probably the majority of them now have something around LGBTQ issues.

I think it’s also a general cultural shift, right? I didn’t think that in my lifetime I would see same-sex marriage, and then that happened. Might not be around for that much longer, but it happened. So, I think there are huge cultural shifts in terms of social acceptance, and even if there’s not social acceptance, there’s social tolerance, that’s increased, right?

So, obviously, there’s still violence, obviously, there’s still bullying, obviously, there’s still a lot of hate and discrimination. But I think social attitudes have changed a lot over the years to make it much more livable for LGBTQ+ people. I don’t want to say it gets better because things always change, but it has gotten better for a lot of people, and I think that’s something that we can be proud of.