Field Epidemiology
 

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. 

This FREE online program offers free continuing education credits and free certificates of completion for the American Indian, Latino/a, African American/Black, and Asian American populations in New York State.  Each certificate series contains four webinars on issues specific to that population.

What People are Saying about Advancing Cultural Competence

"An emerging concept."

"A paradigm shift in how I look at competency."

"More effective approach than what is commonly called cultural competency."

"Clear, personal, multidisciplinary"

"Strategies shared are useful and meaningful."

"So riveting. The presenter's discussion was very thoughtful yet it was easy to grasp the concepts she was presenting."

"Speakers were very knowledgeable and it's great that their own personal experience guides their work. Excellent!"

"Historical context was incredibly helpful and I look forward to that in future webinars".

Watch a 9-minute webinar on structural competency and the certificate program.



More on the Free Advancing Cultural Competence Certificate Program

Each certificate series consists of four webinars. To earn a certificate, you will need to watch all four along with two prerequisite courses on cultural and structural competency.
Each certificate series covers these four “beats,” or themes:

  1. Historical frames of oppression
  2. Present day sociopolitical barriers and challenges to health
  3. Engagement with activist and advocates within the community around health
  4. Clinical cases

If you earn all of the series certificates you may also obtain a certificate of completion for the entire Advancing Cultural Competence program. 

Please note that we have created the sets of webinars to be watched as a series; if you cherry pick the individual webinars you will not obtain a complete understanding of structural competency or a complete understanding of the structural issues affecting the health of each population. Since the continuing education credits and the certificates are all FREE, why not take them all?

More on Structural Competency

Structural competency refers to the capacity of practitioners to recognize and respond to the ways in which broad social, political and economic structures contribute to the vulnerability and ill health of the individuals and communities we serve. 

The move toward structural competency marks a shift in cultural competency training away from focusing only on individual cross-cultural understandings toward an emphasis on the larger forces that affect the health of vulnerable populations, while not discounting cultural factors that impact health. 

We have designed this certificate series around an influential article on structural competency by Jonathan Metzl and Helena Hansen, both physicians and cultural critics. This program uses their definition of structural competency: the “trained ability to discern how a host of issues defined clinically as symptoms, attitudes or diseases (e.g. depression, hypertension, obesity, smoking, medication “non-compliance,” trauma, psychosis) also represent the downstream implications of a number of upstream decisions about such matters as health care and food delivery systems, zoning laws, urban and rural infrastructures, medicalization, or even about the very definitions of illness and health” (Metzl and Hansen 2013).  Members of the public health workforce will recognize these issues as the social determinants of health.

Structural competency includes elements of self-reflection, now common in cultural competency trainings, while it promotes narrative humility and critical thinking about the culture of medicine itself. 

Narrative Humility and Structural Competency
Humility is integral to structural competency, since it requires practitioners develop the skills necessary to truly listen to their patients and determine the impact of those stories on their health.
We have adopted the term, “narrative humility,” as coined by pediatrician Dr. Sayantani DasGupta, who teaches in Columbia University’s Narrative Medicine program and developed the introductory webinar on structural competency. Dr. DasGupta he coined the term after recognizing that all stories have an element of the unknowable, and that some stories are heard and others are silenced or marginalized in hospitals and other institutions.

Dr. DasGupta advocates that we adopt narrative humility towards everyone walking through our doors, not just those who are “others” in relation to ourselves.

For more information on structural competence and related topics, see the Resources tab.

Funding for this project was supplied by a grant from the New York State Department of Health.

This page is for enrolling in the webinars archived in the NYS Department of Health’s Learning Management System (LMS) and for obtaining a certificate after you have completed all of the requirements. 

The courses for the American Indian and Latino/a series have been archived in the LMS. The two pre-requisite courses and the webinars presented in February and March of 2016 are available directly on our website under the Course Descriptions tab.

Enrollment

  • To obtain a certificate or to just take one of the archived courses in the American Indian and Latino/a series, you must register through the NYS Department of Health Learning Management System (LMS). 

  • For step-by-step enrollment instructions, including a link to the LMS, open and read the Quick-Start Guidebook.

  • If you have seen some of the courses live and want to enroll in the certificate program, you will receive credit for those courses once you are registered in the LMS.

Certificate Request

  • You must be registered in the LMS before you apply for your certificate.
  • After you have completed all of the required courses, you must fill out a program evaluation, which serves as your request for a certificate.
  • Page 12 of the Quick-Start Guidebook provides the links to the evaluation and certificate request.

Frequently Asked Questions (FAQs)

If you have questions about the program that are not answered on the FAQ link above, or have any difficulty registering, please contact us at: advancingcc@albany.edu.

 

The Advancing Cultural Competence Program begins with two pre-requisite courses. For a description of the courses, click on the individual titles.


Pre-Requisite Course

Format

Credits

Bridging Gaps: The Vital Role of Cultural Competence in Healthcare

Webcast

1.0 CNE, CME, CHES

From Cultural Competency to Structural Competency: A Narrative Humility Approach

Webinar

1.0 CNE, CME, CHES


After you have taken both pre-requisites above, you may begin the courses within a certificate series. For a description of the webinars, click on the individual titles.


Certificate Series

Course Titles

Credits

Asian American

Community Health Workers Advancing Population Health Equity & Promoting Structural Competence

1.5 CNE, CME, CHES, CPH

Asian American

Violence Against South Asian Women: Understanding Cultural "Competency" of Structures that Heal

1.0 CNE, CME, CHES, CPH

Asian American

Trauma and the Refugee Patient: Barriers and Strategies for Care

1.5 CNE, CME, CHES, CPH

Asian American

Structural Competency and Health Equity: Asian American Experience in New York City

1.0 CNE, CME, CHES, CPH

African American/Black

Structural Competency: Engaging Stigma and Inequality in Medicine and Medical Training

1.5 CNE, CME, CHES, CPH

African American/Black

Structural Competency: A New Medicine for the Inequalities That Are Making Us Sick

1.5 CNE, CME, CHES, CPH

African American/Black

Mass Incarceration and Its Impact on Community Health

1.0 CNE, CME, CHES, CPH

African American/Black

African American History for Healthcare Providers

1.0 CNE, CME, CHES, CPH

American Indian

Multigenerational Trauma: Effects of the Indian Boarding School Era

1.0 CNE, CME, CHES, CPH

American Indian

Women As First Environment – Bodies Telling Her/stories

1.0 CNE, CME, CHES, CPH

 American Indian

Resilience from Our Roots

1.0 CNE, CME, CHES, CPH

 American Indian

Urban Indian Issues in New York City and Buffalo

1.5 CNE, CME, CHES, CPH

Latino/a

Latino/a Health Disparities: Beyond the CulturaAnswer

1.0 CNE, CME, CHES, CPH

 Latino/a

Addressing Suburban Structures: Health and Latino Communities on Long Island

1.0 CNE, CME, CHES, CPH

 Latino/a

Being Structurally Vulnerable: “Deservedness,” Latino Migrant Laborers and Health

1.5 CNE, CME, CHES, CPH

 Latino/a

Structural Competency and Latino Health in Upstate NY

1.5 CNE, CME, CHES, CPH

Leading Article on Structural Competence


Metzl, M. J., & Hansen, H. (2014). Structural competency:  theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133.

Additional Readings on Structural Competence

Alisha, A., & Sichel, C. (2014). Structural Competency as a Framework for Training in Counseling PsychologyThe Counseling Psychologist, 42(7), 901-918.

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.

Behforouz, H., Drain, P., & Rhatigan, J. (2014). Rethinking the Social HistoryThe New England Journal of Medicine, 371(14), 1277-1279.

Manchanda, R. (2013). The Upstream Doctors: Medical Innovators Track Sickness to Its Source. TED Conferences, 38.

Metzl, M. J. (2014, June 30).  The Case for Structural CompetencyNashville Post.
Metzl, M. J. (2012).  Structural Competency.  American Quarterly, 64 (2), 213-18.

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.

Links to Resources on Structural Competency

Structuralcompetency.org  (website by Helena Hansen)
Structural Competencies in Migration Health  (webinar)
HealthBegins (nonprofit)
HealthLeads (nonprofit)
What Makes Us Get Sick? Look Upstream (TED Talk by Rishi Mashada)
National Center for Medical Legal Partnership 

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
Latino/a 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
American Indian
Latino/a
African American and Black
Asian American
Refugees and Human Trafficking
LGBT
Films and Videos