Advancing Cultural Competence in the Public Health and Healthcare Workforce
Advancing Cultural Competence is advancing the field of cultural competency by offering the first
structural competency certificate program in the country. In a nutshell, structural competency introduces the social determinants of health and reflection about the culture of medicine and related issues into cultural competency discussions.
Each webinar covers these four “beats,” or themes:
Historical frames of oppression
Present day sociopolitical barriers and challenges to health
Engagement with activist and advocates within the community around health
Clinical cases and practical tools for advancing cultural competence
Leading Article on Structural Competence
Hansen, H., & Metzl, M. J. (2014).
Structural competency: theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133.
Additional Readings on Structural Competence
The May 2016 issue of the Journal of Bioethical Inquiry 3(2), is a Symposium Edition on Structural Competency.
Angoff, Nancy R., Duncan, L., Roxas N, & Hansen, Helena.
Power Day: Addressing the Use and Abuse of Power in Medical Training. Celermajer, D, Saul, J.
Preventing Torture in Nepal: A Public Health and Human Rights Intervention. Conley, D and Malaspina, D
. Socio-Genomics and Structural Competency. Drucker, E., K. Anderson, R. Haemmig, et al. 2016. Treating addictions: Harm reduction in clinical care and prevention.
Drucker, E, et al.
Treating Addictions: Harm Reduction in Clinical Care and Prevention. Hansen, H and Metzl, J.
Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice. Reich, A, Hansen, H & Link, B.
Fundamental Interventions: How Clinicians Can Address the Fundamental Causes of Disease. Thompson Fullilove, M. Cantal-Dupart, M.
Medicine for the City: Perspective and Solidarity as Tools for Making Health.
Alisha, A., & Sichel, C. (2014).
Structural Competency as a Framework for Training in Counseling Psychology. The Counseling Psychologist, 42(7), 901-918.
Behforouz, H., Drain, P., & Rhatigan, J. (2014). Rethinking the Social History. The New England Journal of Medicine, 371(14), 1277-1279.
Gottlieb, L. M., Tirozzi, K.J., Manchanda, R., Burns, A.R., Sandel, M.T., (2015). Moving electronic medical records upstream: incorporating social determinants of health . American Journal of Preventative Medicine, 48(2), 215-8.
Hardcastle, L.E., K.L. Record, P.D. Jacobson, and L.O. Gostin. 2011. Improving the population’s health: The Affordable Care Act and the importance of integration. The Journal of Law, Medicine & Ethics 39(3): 317–327. CrossRef
Manchanda, R. (2013). The Upstream Doctors: Medical Innovators Track Sickness to Its Source. TED Conferences, 38.
Metzl, M. J. (2014). The Case for Structural Competency. Nashville Post, June 30.
Metzl, M. J., & Roberts, D. (2014). Structural competency meets structural racism: race, politics, and the structure of medical knowledge . AMA Journal of Ethics, 16, 674-90.
Metzl, M. J. (2012). Structural Competency. American Quarterly, 64 (2), 213-18.
Metzl, J.M. (2010). . Boston: Beacon Press.
The Protest Psychosis
Tsevat, R.K., A.A. Sinha, K.J. Gutierrez, and S. DasGupta. 2015. Bringing home the health humanities: Narrative humility, structural competency, and engaged pedagogy. Academic Medicine 90(11): 1462–1465. Woolf, S.H., and P. Braveman. (2011). Where health disparities begin: The role of social and economic determinants—and why current policies may make matters worse. Health Affairs 30(10): 1852–1859.
Links to Resources on Structural Competency
Structuralcompetency.org (website by Dr. Helena Hansen)
Structural Competencies in Migration Health (webinar by the Migrant Clinicians Network)
What Makes Us Get Sick? Look Upstream (TED Talk by Dr. Rishi Mashada)
National Center for Medical Legal Partnership
You Tube Videos on Structural Competency
Medicine Health and Society (Vanderbilt University) Director Jonathan Metzl and NYU Professor Helena Hansen on Structural Competence
Structural Competency: New Medicine for the Inequalities that are Making us Sick Dr. Helena Hansen, NYU.
A Room of One’s Own: Moving Towards Structural Competency. Jennifer Tsai, Medical Student, Brown University MEDTalk
BIF 6: Sayantani DasGupta – Stories are Good Medicine.
Clinical Tools Discussed in the Advancing Cultural Competence Certificate Series
From the American Indian Series: Adverse Childhood Experiences ACE tool, from the
ACES Too High website.
Adverse Childhood Experiences study description, and additional resources from the CDC website. (Tool from the webinar: “Resilience from Our Roots.”)
From the Latino/a Series:
Structural Vulnerability Domains and Potential Sample Questions by Dr. James Quesada, SFSU (Tool from the webinar “Being Structurally Vulnerable: “Deservedness,” Latino Migrant Laborers and Health.”)
Selected Readings on:
Cultural Competence and CLAS Standards
Structural Vulnerability and Structural Violence
Social Determinants of Health and Health Equity
American Indian Health
African American/Black Health
Asian American Health
Lesbian, Gay, Bisexual, & Transgender Health Links to Additional Web-based Resources
Cultural Competence and CLAS
Health Disparities and Health Equity
African American and Black
Refugees and Human Trafficking
Films and Videos