The Toolkit for Cross-Cultural Collaboration was created as a
result of a study of collaboration styles of African American, Asian American,
Native American, Hispanic American, and Anglo American communities. While some
similarities were found across communities in styles and markers of success, a
great chasm separated each minority community from the Anglo American
Communities. The chasm was created by differences in expectations, styles,
assumptions, values, body language, and privilege. Each minority community
understands that great differences separate them from the Anglo American
mainstream cultures. In contrast, Anglo American communities do not have much
awareness of the magnitude of differences. Occasional events open a small portal
to this awareness, but Anglo Americans do not experience cultural differences as
a central concern in their lives. For minority communities, the differences are
not only central, but vast and inescapable.
The consequences of gaps in collaboration and communication styles are
devastating to each minority community and to the nation as a whole. For
minority communities, some consequences are: health services are underutilized,
and many children do not complete their education. The resulting economic
disadvantages are passed from generation to generation.
Following are examples of differential at-risk behaviors and outcomes for
ethnic minorities, from the Centers for Disease Control and Prevention Web site
(1998, 1999) and the Department of Health and Human Services Public Health
Services Web site (1998, 1999):
Asian American and Pacific Islanders: The number of Hepatitis B
cases among Asian American and Pacific Islander (API) children is two to three
times greater than the rates for all children in the United States;
tuberculosis rates for APIs is five times higher than the rates for the
total population; 36 percent under the age of 65 have no health insurance; and
for Southeast Asian men, smoking prevalence is 34% to 43% compared to
27.6% for Anglo American men (Department of Health & Human Services, Public
Health Service (1998).
Hispanic Americans: Tuberculosis prevalence is twice the rate for
the total population; Hispanic Americans are almost twice as likely to have
diabetes as Anglo Americans; and among Hispanic American youth ages
15-24, homicide was the leading cause of death (Department of Health
& Human Services, Public Health Service, 1999).
African Americans: Through 1997, over one third (36%) of AIDS
cases were among African Americans, who represent only 13% of the U.S.
population; 60% of all women reported with AIDS in 1997 were African American;
62 percent of all reported pediatric cases for 1997 were African American; 63
percent of HIV diagnoses for young people ages 13 to 24 were among African
Americans; African Americans are 1.7 times as likely to have diabetes as
Anglo Americans; over 20 percent of poor African American children have high
blood lead levels compared to 8 percent of poor Anglo Americans; African
American children have twice the infant mortality rate of Anglo American
children and four times the rate for causes related to low birthweight;
and among African American youth ages 15-24, homicide was the leading
cause of death (Centers for Disease Control and Prevention, National Center for
Disease Control and Prevention. (1999).
Native Americans: Diabetes prevalence is 70 per 1,000 compared to
30 per 1,000 for the total population and cirrhosis deaths are 21.6 per
1,000 compared to 8 per 1,000 for the total population; the rate for Sudden
Infant Death Syndrome is 2.5 times higher than for Anglo American infants
(Centers for Disease Control and Prevention, 1999).
What is the cost of failing to prevent at-risk behaviors or reduce
poor health outcomes through collaboration with ethnic minority communities?
Diabetes alone was estimated to cost $98 billion in direct and indirect
health care costs for 1997 for the total population (Centers for Disease Control
and Prevention, 1998). If the rate of diabetes for ethnic minorities matched
Anglo American rates, billions would be saved each year in health care
In terms of human suffering:
- Risk of stroke is 2 to 4 times higher in people with diabetes
- Sixty to sixty-five percent of people with diabetes have high blood
- Diabetes is the leading cause of blindness in adults 20 to 74 years old
- Heart disease death rates are 2 to 4 times higher for persons with
- Diabetes is the leading cause of end-stage renal disease (dialysis, kidney
- Sixty to seventy percent of people with diabetes have mild to severe forms
of nervous system damage
- More than half of lower limb amputations occur among persons with diabetes
Starting the Collaboration Process
This toolkit brings a new set of perspectives to the study and practice of
collaboration between and across ethnic groups. A similar perspective has not
yet been found in the collaboration literature, especially in cross-cultural
collaboration. Studies in the past have been built primarily upon the
disciplines of speech communication, sociology, anthropology, and psychology.
What the authors bring to this study is the perspective of intercultural
communication, and methods to evaluate the effectiveness of programs. This
process can lead to improved communication and collaboration between agencies
and ethnic minority groups.
While persons in minority communities know that differences separate them
from the Anglo American communities, they do not understand the exact nature of
the differences in communication styles and values. Instead of understanding
these differences, persons from minority communities perceive that they are
treated disrespectfully. (Sometimes they are, by individuals displaying
prejudice). Because of behaviors they experience as disrespectful from the Anglo
American communities, minorities often withdraw from participation in services
designed on an Anglo American model. Cross-cultural collaboration to improve
services for members of other cultures then becomes very difficult.
Some members of minority communities move away from their own traditions and
adopt the values and styles of the mainstream or Anglo American community; such
individuals may have frequent communication gaps when dealing with both
traditional and mainstream communities. They may find they are not trusted
within their own minority communities and they are not fully accepted within the
mainstream community. Since they usually work and associate with Anglo
Americans, such individuals are more accessible to mainstream organizations and
are most often asked by mainstream agencies to represent minority communities.
This further expands the gap in communication.
Minority communities perceive it as an act of disrespect when a
mainstream agency appoints someone to "represent their interests." Instead,
communities believe that they should choose their own
In these circumstances Anglo Americans are frustrated because they have
chosen persons of high visibility-to them-from minority communities in an
attempt to bridge gaps and increase involvement of the community. They then find
that participation or service utilization from those minority communities is
still lacking, even after the agency's good-faith (but uninformed) effort to
correct the situation.
If persons from a minority background have high visibility within the Anglo
American community, such as administrators within mainstream organizations, it
does not mean that they also have high credibility or visibility within a
minority community. Their adoption of values and styles of the Anglo American
community may have simultaneously discredited them within their communities of
origin. Persons who have high visibility within the Anglo American communities
are usually not the best people to choose as representatives for minority
The best choices for representatives for minority communities are found by
asking those who actively serve within those communities. For example, leaders
within the African American communities may found by contacting leaders of some
of the larger churches serving primarily African Americans. Leaders of Native
American communities may be found through contacting members of the tribal
governments, who can consult with traditional leaders. For Asian Americans,
contact the faith communities serving primarily Asian Americans; also, contact
neighborhood associations where Asian Americans predominate. For Hispanic
Americans, contact the faith communities and the Hispanic advocacy groups.
Each of the above organizations may help identify the most respected leaders
within the communities they serve. Such respected persons, however, may not be
particularly effective, or interested in communicating with, the Anglo American
communities. The community leaders may have had a history of frustration and
perceived or actual disrespect.
Finding respected minority community leaders to represent a community is a
necessary, but not sufficient, condition for effective cross-cultural
collaboration. A person with training in bicultural competence may also be
necessary to bridge communication gaps before and during the collaboration
process. Having a respected representative and a culturally competent
facilitator are two necessary elements for effective cross-cultural
collaboration. For long term success, however, much more is needed.
The Cross-Cultural Collaboration Toolkit identifies areas of
miscommunication that defeat attempts at cross-cultural collaboration. The
Toolkit is designed to help administrators and community leaders become
more culturally aware and therefore more effective at collaborating
Issues underlying the gaps in cross-cultural collaboration, however, are
deep, systemic, and even global. A toolkit cannot, of course, solve the problems
alone. Training to increase cultural competence must be incorporated into our
national and local infrastructures. We need to work with schools and media, as
well as politicians and administrators. Our current and future leaders need
specific training to increase their cultural competence.
The problem of insufficient cultural competence for cross-cultural
collaboration goes back to the earliest beginnings of humanity. Every human
culture teaches its members to value their beliefs, mores, and views of reality
as the best, as the ideal; in some cases, cultures teach that their beliefs are
the ONLY acceptable way to be or think. The resulting lack of cultural
interchange and adaptation is pervasive and severe. However, given the wide
diversity present in modern societies, cultural competence is a necessary skill,
allowing us to provide appropriate services to all citizens. Given our modern
technologies, it is also a skill we need for global survival.
Bias in Terminology
It is difficult to discuss issues of diversity or multiculturalism. Many of
the words related to this issue have unintended connotations, leading to
inaccurate communication and the furthering of unintended biases. Finding an
appropriate term for the non-minority population is especially challenging.
"Whites" is the official term used by the federal government. However,
referring to a group based on skin color rather than ethnic affiliation is not
supportable on the basis of biology, anthropology, or any science. As Jared
Diamond points out in Race Without Color:
…it's easy then to distinguish almost any native European from any native
sub-Saharan African; we recognize Europeans and sub-Saharan Africans as distinct
races, which we name for their skin colors: whites and blacks, respectively.
What could be more objective? As it turns out, this seemingly unassailable
reasoning is not objective.
For example, "…races defined by body chemistry don't match races
defined by skin color." Based on biological systems of
classification, "…many anthropologists today conclude that one cannot
recognize any human races at all."
If "race" is based on DNA rather than body chemistry, another
conclusion is reached. "If so, the primary races of humanity may
consist of several African races, plus one race to encompass all peoples
of all other continents."
If we were just arguing about races of nonhuman animals, essentially the same
uncertainties of classification would arise. But the debates would remain polite
and would never attract attention outside the halls of academia.
Classification of humans is different 'only' in that it shapes our views of
other peoples, fosters our subconscious differentiation between 'us' and
'them,' and is invoked to justify political and socioeconomic
discrimination. On this basis, many anthropologists therefore argue that
even if one could validly classify humans into "races", one should
Diamond concludes with "The last thing we need now is to continue
codifying all those different appearances into an arbitrary system of racial
classification." (Diamond, J. 1994, p. 1).
"White" also seems to mean "normative" or "non-minority." Why? If one
examines recent federal reports from many of the most authoritative sources,
such as the Centers for Disease Control, one finds that each "minority" group is
identified in terms of ethnicity; the majority group, in contrast, is identified
by skin color.
If one views "whites" as one more ethnic group, instead of the "normative"
group, then the proper term would be "Anglo American" or "European American."
One therefore has to ask, "Do key policy makers not recognize that Anglo
Americans are also an ethnic group, not just the normative group
for the culture?
Why would one group be identified by skin color and every other group
in terms of ethnicity or geographic origin?
If the ethnicity and geographic origins of Anglo Americans are
unnoticed, taken for granted, and invisible, then we can understand why an
older term, referring solely to skin color, has been maintained.
Unfortunately, this practice only serves to maintain a lack of cultural
A noted national expert on multicultural communication, Carlos Cortes, asked
a number of experienced trainers in multicultural communication to divide
themselves into groups by ethnicity. The "white" participants (other than those
who were Jewish) said they did not know where to go because they 'weren't really
a part of any ethnic group.' Dr. Cortes says this is what happens every time he
requests a group to divide itself this way (Cortes, C., 1997).
Anglo Americans rarely understand that they also are an ethnic/cultural
Cortes also pointed out that this phenomenon is one of the central barriers
to intercultural communication in the U.S. If a group does not understand that
it is an ethnic group, what is their alternative concept of themselves? Do they
unconsciously consider themselves the "human norm" group, in contrast to others,
who are "culturally different?"
Skin color is not a useful classification. It does not predict behaviors or
values. In contrast, knowing a person's ethnicity can help improve
communication, the foundation for effective collaboration.
A compelling argument against the use of "white" to describe the majority in
the United States is from the pioneering study of A. G. Greenwald and M. R.
Banaji (1995) in which an assessment was made of the terms "white" and "black"
in reference to people. They found strong bias associating the term "white" with
what is desirable and good in people (by persons who consider themselves
"white") compared to bias against the word "black."
For more information on why skin color or race should not be used as a way of
defining groups, see Geometer of Race (Gould, 1994), which provides a
history of the development of our current classification system for human
Given all the reasons mentioned above, the authors therefore prefer the
ethnic term "Anglo Americans" or "European Americans" to refer to the majority
population. The term "Anglo Americans" is commonly used and understood as
referring to persons who are not ethnic minorities. However, it literally refers
to people of English origin or descent, so it is not inclusive. The term
"European American" is preferred by many specialists in multicultural
communication, but is not yet common in everyday language. It is not even
included in Merriam-Webster's Collegiate Dictionary (1993). In addition,
"European American" can also refer to citizens who are immigrants, such as those
who have recently arrived from Eastern Europe and the former Soviet Union.
The term "Anglo American" was also chosen to help clarify the invisible
privilege associated with this ethnic group in comparison to others. We
found that this invisible privilege, and an associated lack of cultural
awareness, is a central barrier to effective multicultural
McIntosh (1988) outlines the invisible nature of "white" privilege. Included
in her article are forty-six questions Anglo Americans can ask themselves.
Answers to those questions serve to raise the reader's consciousness of unearned
We had difficulty with the term "Collaboration" also. The Multnomah County
Strategic Plan (1998) defines collaboration as "a mutually beneficial and
well-defined relationship between two or more entities for the purpose of
increased outcomes, enhancing the probability of greater achievements together
than separately." Although the Plan was designed by people with cross-cultural
experience, the definition subtly supports Anglo American values more than the
values of some ethnic minorities. For example, "greater achievement" may not be
a central reason for many ethnic minorities to agree to collaborate; rather,
ethnic minorities may meet primarily to form a foundation for trust, at least
In addition, we found that ethnic minorities tend not to use the term
"collaboration." In fact, we were advised by community leaders not to use the
term because its use would indicate we had an Anglo American perspective. This
document will use the expression "multicultural collaboration" to mean
"effective communication across ethnic communities, created by adapting to the
expectations, communication styles, and values of the participants. The purpose
of that communication is to work together and build trust."
While the word "respect" never arose among the Anglo American mainstream
agency representatives we interviewed as an issue that affected collaboration,
it was perhaps the central term each of the ethnic minority communities focused
on as the problem. Being treated disrespectfully by agency staff was seen as a
central barrier to collaboration by the ethnic minorities.
"Respectful" interaction includes treating others in a way that supports
their feeling of being valued as individuals and as members of their cultures.
The words "ethnic," "culture," "cultural sensitivity," and "cultural
competence" are used throughout this document. Please see the Glossary at the
end of this document for definitions of these terms.
We have used the expression "ethnic minority communities" to refer to
minority individuals or cultures. We are defining "ethnic minority community" as
those persons who share membership within a group because of history, values,
expectations, social experience, religion, nationality, language, traditions,
culture, communication styles, self-identification, and/or physical appearance.
Individuals are often identified as members of an ethnic group solely because of
their appearance and/or dialect, but this is not a sufficient basis for
A person's ethnicity is a combination of
- self definition
- shared values
- shared norms for behavior
- group acceptance
If any of these four elements are missing, the individual should
not be considered an adequate or appropriate representative for that
For example, individuals could be chosen to represent "persons of color"
because of their appearance, but they may not identify with, associate with
persons from, or operate according to the values of, the ethnic minority they
appear to represent. They may have assimilated Anglo American cultural values,
despite the fact they may sometimes experience discrimination from that
Although persons may be discriminated against because they appear to be
an ethnic minority, experiencing discrimination does not translate into an
ability to represent the values of the minority
The following chapters provide a framework for understanding and adapting to diversity in
communication. They can assist in avoiding barriers to trust that are invisible
and ethnically based. The comparison may also permit better diagnosis of where
trust has been violated in the past, so an appropriate mending of the
relationships can begin.