Cultural Humility in Healthcare ________________________________________________________________
Self-Assessment Question
OPPRESSION, PRIVILEGE, AND MARGINALIZATION
5. When discussing oppression and privilege, healthcare professionals should know that: A) Privilege is the commission of an unjust or cruel exercise of authority or power. B) Privilege is a guarantee of success for groups receiving it. C) Oppression’s foundation is in the “me too” movement. D) Oppression leads to a condition of privilege for the person or the group that is the oppressor(s). Marginalization is an important concept in the delivery of patient care. Marginalization is the “act of placing a person or group in positions of lesser importance, influence, or power” (Dictionary.com., 2025). Examples of groups that have been, and are being, marginalized include ethnic and racial minori- ties, immigrants, the LGBTQ population, persons who are disabled, and the economically disadvantaged. Some experts have identified the following three themes of marginalization (Chim, 2022): 6. Creation of Margins: Margins act as barriers and connections between a person and the environment. Margins construct physical, emotional, and psychological boundaries that people experience during interactions with society. Enforcement and maintenance of boundaries divide the political and socioeconomic resources in an uneven fashion. This also facilitates the unbalanced distribution of critical resources such as healthcare (Chim, 2022). This illustrates the concept of social determinants of health (SDH), which is defined as “the circumstances in which people are born, live, work and age and the systems put in place to deal with illness” (World Health Organization [WHO], 2025). 7. Living between Cultures: Living between cultures is another factor that links marginalization to SDH. Although the boundary or margin separates the dominant and peripheralized group, incomplete integration leads to a person or group that lives between cultures. Incomplete integration creates a situation where a person or group relinquishes characteristics of the marginalized group in order to bond with the dominant society but is unable to do so. Examples of living between cultures are the ways of life of most immigrants, migrant farm workers, and other vulnerable groups. People living between cultures tend to live in areas characterized by limited employment and educational opportunities (Chim, 2022). 8. Creation of Vulnerabilities: Creation of vulnerabilities are created by the cumulative impact of the creation margins and living between cultures. Vulnerability is defined as a state of being exposed to and unprotected from health-damaging environments (Chim, 2022).
Understanding the concepts of oppression, privilege, and mar- ginalization is essential for practicing with cultural humility. There are various aspects of individual identities that oppress or privilege people and their marginalization or empowerment. Oppression can be defined as an “unjust or cruel exercise of authority or power” (Merriam-Webster, 2025). This can be a person or group that knowingly or unknowingly abuses a specific group. Oppression is a pervasive system. It has its foundation in history and is maintained via individual and institutional systematic discrimination, personal bias, bigotry, and social prejudice. Oppression leads to a condition of privi- lege for the person or the group that is the oppressor(s). See the National Conference for Community and Justice (NCCJ, 2025). Privilege is a central concept within the healthcare professions. The concept of White privilege and male privilege was clearly articulated and widely disseminated through McIntosh’s work in the 1980s. McIntosh articulated White male privilege as “an invisible package of unearned assets which he can count on cashing in each day, but about which he was ‘meant’ to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, assurance, tools, maps, guides, codebooks, passports, visas, clothes, compass, emergency gear, and blank checks” (McIntosh, 1998, p. 1). Privileging is “a process where chances or odds of being offered an opportunity are altered or skewed to the advantage of members of certain groups” (Minarik, 2017, p. 55). Essentially, privilege functions by providing some groups of individuals (e.g., White, male, heterosexual, abled, middle class) with preferred treatment in the form of special opportunities and advantages, while with- holding that preference from other individuals (e.g., African American, female, LGBTQ, disabled). Privilege can include many advantages including being given the benefit of the doubt and feeling a sense of belongingness (Minarik, 2017). Individuals who are not privileged experience the opposite – such as being an automatic suspect or having to prove belong- ing (Minarik, 2017). Privilege is not a guarantee of success for those groups who receive it; however, it is an advantage that other groups do not receive and allows for opportunities that others are denied (Minarik, 2017). A final key aspect regarding privilege is that it is not necessarily visible to those who receive it. The invisibility of privilege is the key component that allows it to continue. More simply, when those who receive privilege do not recognize it, they are unable to take actions to change it. Once people become aware of privilege, they choose to use the benefits of privilege to advocate for marginalized populations.
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