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Cultural Competency is the trained ability to identify cross-cultural expressions of illness and health, and to thus counteract the marginalization of patients by race, ethnicity, social class, religion, sexual orientation, or other markers of difference.
Racial trauma, also known as race-based traumatic stress, refers to the stressful impact or emotional pain of one’s experience with racism and discrimination. Common traumatic stress reactions that reflect racial trauma include increased vigilance and suspicion, increased sensitivity to threat, sense of a foreshortened future, and maladaptive responses to stress such as aggression or substance use. Further, racial trauma can have a negative impact on individuals’ physical and mental health, including negative mood and depressive symptoms, and hypertension and coronary heart disease.
Structural Competency is the trained ability to discern how a host of issues defined as symptoms, attitudes, or diseases (e.g., depression, trauma) also represent the downstream effects of a number of upstream decisions. These are decisions about such matters as health care and food delivery systems, zoning laws, urban and rural infrastructures, medicalization, or even about the very definitions of illness and health.