Diversity and cultural competence seems to be more essential as one moves from the bottom of the public health pyramid to the top. At the bottom of the public health pyramid is infrastructure building services such as planning and policy development (Frieden, 2010). At this level, although it is prudent for diverse populations or people with different cultures to be involved in helping to develop policy, it is not always necessary because any well-meaning professional, who is not biased, can identify problems facing various communities, and subsequently develop policies to address them. At the population-based services such as immunization and screening, almost every population uses these services, and therefore, cultural competence and diversity may not be needed. Cultural competence and diversity would only be needed if these services are foreign to some cultures, and in the event that there are some skepticism among some cultures to embrace such services.
At the enabling services level of the public health pyramid, cultural competence and diversity is inevitable. Some of the services provided at this level include, health education, and family support services (AMCHP, n.d). In this case, people have different cultural practices, especially in relation to family systems and interactions, beliefs, and attitudes. It will, therefore, only be prudent that people who are familiar with these differences try to provide these services. People who are not culturally competent may cause conflicts, and consequently, poor health outcomes. Similarly, the top level on the public health pyramid, which is direct services, requires a lot of knowledge in diversity and cultural competence. At this level, the staff provides basic health services to patients, who may obviously comprise of different cultural and ethnic backgrounds (White et al., 2019). The differences may be in the form of language, beliefs, and attitudes. Therefore, the staff must have the required knowledge to address the health issues of the diverse groups.
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References
AMCHP. (n.d). Essential Public Health Services. http://www.amchp.org/AboutTitleV/Resources/GuideforSeniorManagers/Pages/GuideforSeniorsChapter1Framework.aspx
Frieden, T. R. (2010). A framework for public health action: the health impact pyramid. American journal of public health , 100 (4), 590-595.
White, J., Plompen, T., Tao, L., Micallef, E., & Haines, T. (2019). What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting. BMC public health , 19 (1), 1096.
