Unlike traditional diversity approaches that focus on acquiring knowledge about others, Cultural Humility shifts the focus inward, emphasising ongoing self-reflection, addressing power imbalances, and building equitable partnerships. First introduced by Tervalon and Murray-García (1998), cultural humility represents a powerful framework for dismantling systemic inequities in healthcare and creating true health justice. 

Beyond Cultural Competence: The Case for Transformation

Traditional cultural competence approaches, while well-intentioned, often reinforce problematic dynamics in healthcare. When we position healthcare providers as potential “experts” in others’ cultures, we create a false sense of mastery that can perpetuate stereotypes and power imbalances rather than resolving them. The NHS Race and Health Observatory (2023) has identified critical distinctions that demonstrate why transformation is necessary:

• Cultural competency is a finite learning process positioning providers as “experts” on others
• Cultural humility is a lifelong commitment to self-critique that actively neutralises power dynamics
• Competency often reinforces provider-recipient power differentials
• Humility improves safety and fosters trust essential for effective care

As Curtis et al. (2019) explain, cultural competency often presents a “totalising view of culture” that essentialises complex identities and reinforces stereotyping. Cultural humility acknowledges that no amount of study can make us experts in another’s lived experience. Instead, it creates space for continuous reflection, openness, and power-sharing—essential elements for addressing the structural racism embedded in healthcare systems.

Evidence for Change: Why Cultural Humility Works

The evidence supporting cultural humility as a transformative approach continues to grow, providing a solid foundation for systemic change:

Research by Hook et al. (2013) validates that cultural humility—measured through respect, lack of superiority, and critical self-examination—directly correlates with improved therapeutic outcomes. Mosher et al. (2017) demonstrated that healthcare providers receiving cultural humility training showed significantly better patient-centred communication and lower implicit bias compared to those receiving standard diversity training. The compelling evidence extends to measurable health outcomes. A comprehensive meta-analysis by Jongen et al. (2018) examining 31 studies found significant positive effects on patient satisfaction treatment adherence and health outcomes. These findings provide robust evidence that cultural humility approaches deliver superior results to traditional cultural competency training—not merely theoretically, but in tangible improvements to people’s health and wellbeing.

Real-World Impact: Transforming Healthcare Delivery

Cultural humility approaches have demonstrated remarkable capacity to address longstanding healthcare inequalities across various settings:

In primary care, Chang et al. (2021) showed that implementing cultural humility frameworks led to significant reductions in health disparities, including improved diabetes management among ethnic minority patients. Lewis et al. (2018) documented substantial positive impacts on therapeutic outcomes across diverse client populations when therapists practiced cultural humility. Perhaps most compelling is research by Rosenthal and Lobel (2020) revealing significant improvements in birth outcomes for minoritised women in programmes emphasising cultural humility principles. Their work documented reduced preterm births and increased breastfeeding rates—tangible evidence that cultural humility can literally save lives by addressing the systemic racism that produces maternal health disparities. 

Addressing Healthcare Inequalities: A Systemic Approach

Cultural humility directly confronts key structural factors perpetuating healthcare inequalities:

• Power imbalances: By actively addressing power differentials in clinical encounters, cultural humility tackles a fundamental driver of healthcare disparities
• Medical mistrust: Through patient-centred care and recognition of historical harms, cultural humility helps rebuild trust with communities who have experienced discrimination
• Systemic racism: As Lekas et al. (2020) note, cultural humility effectively addresses structural racism by promoting awareness of systemic issues and encouraging critical self-reflection
• Intersectionality: The approach acknowledges the complex intersection of multiple identities and social determinants of health, moving beyond simplistic categorisations

This multi-level approach makes cultural humility particularly effective for addressing the complex factors driving healthcare inequalities.

From Individual Practice to Systemic Change

Transforming healthcare requires more than individual commitments to cultural humility—it demands systemic change. Fisher-Borne et al. (2015) found that cultural humility approaches produced more sustained behavioural changes among healthcare providers than cultural competence models. Shepherd et al. (2019) demonstrated improved outcomes at 12-month follow-up, including higher treatment completion rates and patient satisfaction scores.

For organisations committed to health equity, cultural humility offers a pathway to transform healthcare systems from the inside out. By embedding these principles throughout organisations—from frontline staff to executive leadership—we can create systems that truly serve all communities with dignity and respect. This transformation isn’t easy and may initially feel uncomfortable. For professionals trained in traditional approaches, shifting toward more equitable models may initially seem challenging. But as Tervalon and Murray-García (1998) emphasised, cultural humility creates the foundation for lasting change that advances social justice and equity—benefiting not only marginalised communities but enhancing healthcare for everyone.