Culturally safe practices are essential to providing high-quality, effective care and support. They are ensure tāngata whaiora and their whānau receive care that acknowledges and respects their individual cultural values and needs. When people feel that their cultural identity is acknowledged and respected, they are more likely to use and benefit from health and wellbeing services. If they don’t feel safe about using these services they won’t use them, and their health could deteriorate.

Culturally safe practices encompass several key elements:

• Awareness of cultural diversity: This involves understanding and respecting the diverse cultural values and principles of tāngata whaiora and their whānau, recognising how cultural traditions shape care preferences and expectations.
• Focusing on the individual needs of tāngata whaiora and their whānau: This involves providing care that is person-centred and tailored to the specific needs and preferences of individuals, ensuring that their cultural values and personal preferences are integrated into their care plan.
• Awareness of own bias: This involves health and wellbeing workers being aware of their own biases, attitudes, and assumptions. These personal biases can affect the quality of care and interactions with the people they support.
• Awareness of institutional bias: This involves health and wellbeing organisations reflecting on their own cultural practices and policies to ensure they do not disadvantage or exclude any group.

By incorporating these culturally safe practices, support workers and organisations can create a more inclusive and respectful environment.

In the following sections, we will explore how understanding and addressing biases is integral to maintaining cultural safety in your practice.

Understanding bias is a strategy for ensuring culturally safety. As a support worker this culturally safe practice is crucial for contributing to a professional, safe and inclusive environment within your health and wellbeing organisation.

What is Bias?

Bias refers to a tendency or preference for or against a particular person, group, way of thinking or thing, often resulting in unfair judgment or discrimination.

Bias can be personal or institutional.

• Personal bias: The individual prejudices, thoughts and feelings that affect how we perceive and interact with others. These biases are shaped by personal experiences, beliefs, and values. They influence our behaviours, decisions and actions.
• Institutional bias: The ingrained and established practices within organisations and institutions that reinforce inequality and disadvantage certain groups. This type of bias is seen in policies, procedures, and behaviours that favour one group over others, leading to unequal treatment and opportunities.

Examples of bias include the following:

• Cultural bias
  Personal: This might lead someone to misinterpret behaviours and traditions different from their own as strange or inferior
  Institutional: practices or polices that favour one cultural group over others, leading to unequal opportunities and resources or the development of services that do not consider the needs of diverse cultural groups.
• Sexual orientation
  Personal: This bias can manifest in the form of homophobia or personal assumptions about sexuality leading to unfair treatment or exclusion of LGBTQ+ individuals.
  Institutional: Laws or organisational policies that discriminate against LGBTQ+ individuals such as lack of inclusive health benefits or discrimination in hiring practices
• Gender bias
  Personal: This often results in stereotyping roles and abilities based on gender, affecting how individuals are perceived and treated.
  Institutional: Practices that favour one gender over another, affecting hiring, promotion, pay and underrepresentation in leadership roles.
• Religious bias
  Personal: This might lead to prejudice against individuals who practice a different faith, spiritual belief system or no faith at all.
  Institutional: Policies or practices that fail to accommodate religious practices or discriminate against individuals based on their religious beliefs, such as not providing flexible leave for religious observances.
• Socio-economic status bias
  Personal: Assumptions about a person’s capabilities or character based on their financial situation, leading to unfair judgments or discrimination.
  Institutional: Practices that disadvantage individuals from lower socio-economic backgrounds, such as barriers to accessing services, limited support for educational advancement, or biased bank loan approval processes.
• Age bias
  Personal: Involves assuming individuals of certain ages are less capable, resistant to change, or have diminished intelligence or value. This can lead to expectations that people of certain ages should behave in stereotypical ways or be capable of only certain things
  Institutional: Policies or practices that disadvantage individuals based on their age such as hiring practices, promotions, or training opportunities
• Disability bias
  Personal: Assuming individuals with disabilities are less competent, overly focusing on their limitations rather than their abilities, or feeling pity instead of recognising their autonomy and potential.
  Institutional: Practices that do not adequately accommodate or support individuals with disabilities, such as inaccessible workplaces or lack of reasonable adjustments in job roles.
• Mental Illness bias
  Personal: This leads to stereotyping individuals with mental illnesses as being dangerous, unreliable, less intelligent or incapable of making decisions
  Institutional: Policies that fail to support mental health needs, such as inadequate mental health resources, lack of accommodations, or discriminatory practices in employment and health service provisions.

Becoming aware of how bias presents itself allows you to be more intentional and empathetic in your support work, ensuring you contribute to a fairer and more culturally safe environment.

Types of Bias

There are various types of personal and institutional bias, including:

Explicit Bias:

• Explicit bias is the conscious belief, attitude, or stereotype toward a specific person, group, or thing. It is intentional and can be openly shown or stated.
• Example: A support worker consciously avoids assigning a particular task to a person from a specific ethnic group because they believe that group is less likely to adhere to treatment plans. This behaviour is deliberate and based on a conscious stereotype.

Implicit Bias:

• Implicit bias refers to the automatic attitudes or stereotypes that influence our understanding, actions, and decisions without us being aware of them. These biases are not intentional and often go against our conscious beliefs.
• Example: A support worker unintentionally spends more time and shows more warmth towards tāngata who share their own cultural background, while being less engaged with patients from different cultures. This happens without the support worker's awareness and contradicts their belief in treating all patients equally.

Unconscious Bias:

• Unconscious bias, which is similar to implicit bias, refers to the automatic judgments and stereotypes we form about certain groups of people without even realising it. Everyone has these biases because our brains naturally categorise people and things to make sense of the world.
• Example: A support worker unknowingly assumes that a younger patient is less knowledgeable about their condition and, as a result, provides overly simplistic explanations. This judgment occurs automatically and without conscious intent, stemming from a subconscious stereotype about age and the ability to understand health information.

Our biases can significantly influence how we interact with others and the way we approach our work. This can impact the quality of care and the experiences of those we support.

Read and flip the cards to better understand how bias can influence as support worker

H5P here

Becoming aware of your own biases is a key component of practising cultural safety. As we discussed earlier, biases—whether implicit, explicit, or unconscious—can shape the way you interact with tāngata whaiora (people seeking health support), colleagues, and others in your workplace. When you actively work on recognising and addressing your biases, you enhance the quality of care and contribute to a more inclusive and equitable environment for everyone.

Hopefully, you were able to come up with some useful strategies in the previous reflection activity. Now, let’s take a look at a list of strategies designed to help you uncover and address any potential biases that could affect your interactions with the people you work with. Click on each section below to expand and read more about each strategy.

What did you think of those strategies? Did they align with some of the ideas you came up with during your reflection, or did they spark new thoughts? If you have strategies that weren’t mentioned, consider sharing them with your classmates and listening to their suggestions. Collaborative learning is a great way to deepen your understanding and continue building your skills in culturally safe practices.

End of Topic

Well done on completing this topic! We've covered key concepts around cultural safety and explored how you, as a support worker, can practice in a way that honours and respects cultural differences. Building this awareness is essential for creating trusting and inclusive environments for those you support. In the next topic, we’ll dive into another crucial area—interpersonal skills and relationship-building. These skills are fundamental to effective support work and will help you connect meaningfully with tāngata whaiora and their whānau. Keep up the great work and let’s continue building on these foundations!