Scope and Elements of Comprehensive Multicultural Health Interventions

MCH programs, public health organizations, and communities should be encouraged to apply the frameworks and concepts described above to develop multidisciplinary, multistrategy interventions to improve the health, well-being, and environmental conditions of multicultural populations. Key decisions will center on the scope and elements of training to be used, depending on the mission of the individual organization or program.

Suggested components of a comprehensive strategy are outlined below. Curricula and practice opportunities should prepare students, faculty, and practitioners to develop, implement, and evaluate these components within the context of multicultural communities.

Comprehensive public health interventions require the following elements:

Structural

• Collect and track data according to race, ethnicity, socioeconomic status, language use, non-ethnic cultural groups, etc.
• Track political and public policy affecting the health of diverse populations.
• Collect and track data of epidemiological patterns of disease and disorders across population groups.
• Conduct community assets and needs assessment.
• Conduct organizational self-assessment of cultural and linguistic competence.
• Develop a business case, rationale, and vision for multicultural health interventions.
• Address root causes including institutional and individual racism and discrimination.
• Increase and assure for a culturally and linguistically diverse workforce.
• Manage the dynamics inherent within a multicultural workforce.
• Create structures, policies, and practices, and allocate resources to ensure effective communication among multicultural staff and multicultural populations.

Social and Economic

• Improve social, economic, and environmental community conditions through social action and advocacy to effect policy change.
• Engage communities in educational efforts and initiatives as a way to support political empowerment (e.g., promotion of health and mental health, impact of racial and ethnic disparities within communities, development of community leadership, and community-based participatory research).
• Include communities in planning, priority setting, and interventions.
• Ensure the engagement of communities in evaluating the efficacy of interventions.
• Advocate for increased research funding to address health and mental health disparities among multicultural populations.

Services and Supports

• Eliminate barriers and ensure access to public health, medical care, and mental health services for multicultural populations.
• Provide culturally and linguistically competent services and supports.
• Create and provide community-specific and/or disease-specific prevention and interventions for multicultural populations.
• Engage communities in the design and implementation of quality assurance for and evaluation of services and supports.
• Prepare and support a workforce that has the knowledge and skill sets necessary to provide and/or manage services and supports to multicultural populations.

Research

• Conduct research that employs culturally and linguistically competent and community-based participatory action methodologies.
• Research and evaluate disease factors that impact multicultural health.
• Contribute to the body of knowledge of evidence-based practices that are culturally and linguistically competent, for multicultural populations.
• Add to the research base of effective interventions that help achieve elimination of health and mental health disparities.
• Conduct evaluation of interventions through both process and outcome assessment.
• Use evidence-based findings to effect policy change and guide interventions.
• Prepare and support researchers who have the knowledge and skill sets necessary to design and conduct research in collaboration with multicultural populations.

Policy Change

• Make recommendations and advocate for health, social, environmental, and political policy change at the community, state, and national levels.
• Use research findings to inform policymakers regarding social inequities and other factors that contribute to health and mental health disparities.
• Prepare and support individuals who have knowledge and skill sets necessary to provide public health leadership for policy change within a multicultural environment.

Transformative Leadership

• Cultivate the capacity of individuals and groups to transform systems and organizations at the community, local, state, tribal, and Federal levels.
• Acknowledge and support leadership, at all levels, within systems, organizations, and communities with special emphasis on informal leaders and natural networks of support within culturally and linguistically diverse communities.
• Prepare and support individuals who have the knowledge and skill sets necessary to advocate for and contribute to the transformation of both the health care and mental health care systems in the United States.
• Promote systems change in a multicultural environment to eliminate health and mental health disparities.

This multifaceted, interdisciplinary listing of public health interventions may appear daunting; however, systemic change is required—in each of these areas, on multiple levels—to improve multicultural health. Students, faculty, and practitioners must be knowledgeable about how these elements can contribute individually and collectively to improving multicultural health and organizational cultural and linguistic competency.

It is essential for public health systems and organizations to:

This approach allows the public health system or organization to focus on one or more elements that are most compelling or feasible, given the goals, expertise, community-identified assets and needs, capacity, and resources.

See selected suggested reading and resources for in-depth information that has relevance to this section of the module.