Table 1

Basic definitions

Intercultural competence in epidemiologyThe ability to effectively address cultural and intercultural factors in the study design, data collection, data management, analysis and dissemination. Intercultural competence values the impact of cultural factors on both participants and researchers. In this sense, it includes both lay and expert systems.
CultureA culture is a set of values, meanings and lifestyles shared by a human group that is transmitted intergenerationally through a process of socialisation and learning. All human beings are cultural to the extent that we live in society. Each cultural system involves specific norms, values, canons, aesthetic forms and models of personhood, among other aspects, that shape a worldview. This particularity or specificity does not contradict the existence of an internal diversity in each culture. Culture is a dynamic reality, the result of historical developments, and therefore changing over time.11 36
Biomedicine as cultureThe ‘culture of biomedicine’ is the Westernised idea of care, analysis and perception of health, illness, the body and healing processes. Any medical system can be considered a cultural system. Biomedicine, also called Western medicine, scientific medicine or allopathic medicine, is the hegemonic medical system worldwide.37 38
RaceAnthropology and population genetics indicate that the notion of race is not useful in accounting for human biological variation and that it results in reproducing non-existent biological differences.39–41 Alternative use of this term implies considering it a social construct, as a social variable related to discrimination and racism.
RacismRacism can be understood as the exclusion of specific individuals and groups due to phenotypical and/or cultural traits (cultural racism). These traits may be imagined, but they have a real effect in the life of people. In this sense, it is a structural factor of vulnerability and vulnerabilisation.
EthnicityThe notion of ethnicity or ethnic group refers to a set of individuals who share a sense of common origins, claim a common and distinctive history and destiny, and feel a sense of collective uniqueness and identity. This identity may be based on similarities in outward appearance (ie, phenotype), customs, language, religion or other identity elements.
Structural competence in epidemiologyThe ability to recognise in the study design, data collection, management and analysis of data, and dissemination of the results the ways negative health outcomes and lifestyle practices are shaped by larger socioeconomic, cultural, political and economic forces.
Structural vulnerabilityBourgois et al12 define structural vulnerability as follows: ‘An individual’s or a population groups’ condition of being at risk for negative health outcomes through their interface with socioeconomic, political and cultural/normative hierarchies.’
Following these authors, some structural vulnerabilities are:
  • Discrimination (ie, stigma, racism)

  • Lack of financial security (ie, income, rent)

  • Lacking safe/stable place (ie, housing, residence)

  • Exposure to environmental risks (ie, climate change, toxins)

  • Difficulty in food access (ie, proximity, price)

  • Lack of social network (ie, isolation)

  • Problems with legal status (ie, undocumented migrants, refugees)

  • Lack of education