Health literacy, equity, cultural safety and competence

Health literacy

‘Health literacy’ is being able to obtain, understand and use basic health information to navigate health services and make appropriate health decisions. It is the responsibility of health care professionals to present health information in a way that consumers and whānau can understand. Our resource Three steps to meeting health literacy needs | Ngā toru hīkoi e mōhiotia ai te hauora is useful and provides a process to follow with every person in every health care discussion.

Health equity

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.[1]

This page on our website provides a number of strategies to help address inequities in the Aotearoa New Zealand health sector.

Cultural safety and cultural competence

Cultural competence

Cultural competence has been defined by the Medical Council of New Zealand as a doctor (or any health care worker) who ‘has the attitudes, skills and knowledge needed to function effectively and respectfully when working with and treating people of different cultural backgrounds’. While it is important, cultural competence is not enough to improve health outcomes. Evidence shows that a competence-based approach will not deliver improvements in health equity.[2]

Cultural safety

Cultural safety requires health care workers and their associated health care organisations to examine themselves and the potential impact of their own culture on clinical interactions and service delivery. This requires individual health care workers and health care organisations to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, structures and characteristics that may affect the quality of care provided. In doing so, cultural safety encompasses a critical consciousness where health care workers and health care organisations engage in ongoing self-reflection and self-awareness, and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. Cultural safety requires health care workers and their associated health care organisations to influence health care to reduce bias and achieve equity within the workforce and working environment. This is a modified definition taken from Aotearoa New Zealand-based literature.[3]

Find out more on the Healthify (formerly Health Navigator) website.

We also encourage you to complete our learning modules on understanding bias in health care, which provide further information on cultural awareness.

He Ako Hiringa has produced a webinar discussing ideas on culturally safe consultations which also may be of interest.

References

1. Manatū Hauora. 2019. Achieving equity. URL: www.health.govt.nz/about-ministry/what-we-do/work-programme-2019-20/achieving-equity. Return to place in text

2. Medical Council of New Zealand. 2019. Statement on cultural safety. URL: www.mcnz.org.nz/assets/standards/b71d139dca/Statement-on-cultural-safety.pdf. Return to place in text

3. Curtis, E., Jones, R., Tipene-Leach, D. et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health 18, 174 (2019). https://doi.org/10.1186/s12939-019-1082-3. Return to place in text