Embodying cultural humility

In 1998, Melanie Tervalon and Jann Murray-García published a groundbreaking article1 that challenged the concept of “cultural competency” with the concept of “cultural humility.” Cultural humility is committing to lifelong learning, critical self-reflection, and personal and institutional transformation. Accepting cultural humility means accepting that we can never be fully culturally competent. Cultural humility is the foundation for establishing trust and respectful relationships, and for managing differences and conflict. Cultural humility means

  1. committing to lifelong learning and critical self-reflection;
  2. realizing our power, privileges, and prejudices (biases) (includes conscious and nonconscious [implicit] biases);
  3. redressing power imbalances for respectful partnerships; and
  4. promoting institutional accountability.

Power is the capacity or ability to direct or influence the behavior of others, the course of events, or the allocation of resources. Power comes from positional, moral, or relational authority. Authority is granted by appointment or earned by trust and credibility. It is exercised by embodying universal values (humility, compassion, equity, dignity), or by persuasion, manipulation, or deceit. The dynamics and impacts of power are multi-dimensional, context dependent, cumulative, and can be subtle. For example, the mere presence of a boss can unintentionally shut down subordinates.

Privilege is a form of unearned power that comes from social advantage. All of us have some form of privilege. Privilege exists because of sociopolitical systems and cultural norms that create, reinforce, and amplify power inequities, explicitly or implicitly. For example, in the US, if you are like me: male, heterosexual, cisgender, or have lighter skin color, you have more privilege. You do not choose privilege, but you can acknowledge it, and, more importantly, you can make “the noble choice to forgo your status, [and to] use your influence for the good of others before yourself” — this is humility.

For our purposes, biases are preferences, cognitive processes, or inferences that shape our mental models, knowledge, attitudes, beliefs, and behaviors in ways that cause or contribute to inequities in power, privilege, opportunities, or outcomes for ourselves and/or others. Biases can be known to you and others (open), known to you and not others (hidden), known to others but not you (blind spot), or not known to you and others (unknown).2

Implicit biases account for the unknown and blind spot biases, and are the most challenging type of bias because we all have them, and they are difficult to identify, measure, and mitigate. For example, ambiguous hiring criteria are susceptible to implicit biases. Without unambiguous, objective criteria, hiring someone you “trust” is driven, unintentionally, by implicit biases.2

Cultural Humility video (edited to 6 min)

Cultural Humility video (complete 30 min)


  1. Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Under- served. 1998 May;9(2):117–125. ↩︎

  2. To learn more study “JoHari Window in Interpersonal Communication”: Video lecture by Dr. Lori Zakel, Professor and Chair of the Communication Department at Sinclair College, Dayton, Ohio. Available at https://youtu.be/-7FhcvoVK8s. ↩︎

Tomás Aragón
Tomás Aragón
Health Officer, City & County of San Francisco; Director, Population Health Division

I exercise legal authority to protect and promote equity and health, and I direct core public health services.

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