Key Conceptual Issues in the Forging of “Culturally Competent” Community Health Initiatives: A South African Example

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Many cultural competency efforts in healthcare stress the importance of cultural diversity and difference. This emphasis is necessary and well justified. It has helped sensitize healthcare systems to the differences among people and their health-related attitudes, preferences, and behaviors. However, the emphasis on diversity and difference has, unfortunately, also detracted from serious consideration of the things that cultures have in common and the possibility that socioeconomic differences are today far more important than cultural ones in determining healthcare outcomes.We thank the Comprehensive Cancer Center at Case Western Reserve University and University Hospitals of Cleveland, Ohio, for supporting the research on which this paper is based. We are also grateful to the wonderful people of Masidaal, our project coordinator, Debbie van Stade, and our large team of research assistants for making the research possible.