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Of Goldfish Tanks and Moonlight Tricks: Can Cultural Competency Ameliorate Health Disparities?

Drevdahl, Denise J. PhD; Canales, Mary K. PhD; Dorcy, Kathleen Shannon MN

doi: 10.1097/01.ANS.0000311526.27823.05
Original Article

Within nursing, cultural competency is seen as an important mechanism for reducing racial and ethnic health disparities; however, after years of attempted implementation of “cultural competence,” minimal evidence exists demonstrating a relationship between culturally competent interventions and improved health outcomes or reduced disparities. We examine how cultural competency as an intervention for tackling health disparities is undertheorized and misguided, and deflects attention and efforts needed to address broader social determinants of health. We provide a historical overview of cultural competency, critiques of the concept, and recommendations for moving beyond cultural competency as a means of diminishing health disparities.

University of Washington Tacoma (Dr Drevdahl); Mashantucket Pequot Tribal Nation, Mashantucket, Connecticut (Dr Canales); and Fred Hutchinson Cancer Research Center, Seattle, Washington (Ms Dorcy).

Corresponding Author: Denise J. Drevdahl, PhD, University of Washington Tacoma, 1900 Commerce St, Campus Box 358421, Tacoma, WA 98492 (

We thank Bronwyn Pughe and the 3 anonymous reviewers for their comments on an earlier draft of this article.

© 2008 Lippincott Williams & Wilkins, Inc.