The Culture-Structure Framework: Beyond the Cultural Competence Paradigm Mimi E. Kim School of Social Work California State University, Long Beach This article provides a framework for understanding the distinctions between culture and structure in its application to the human services. Using intimate partner violence (IPV) as a case study, this article builds upon the contributions of intersectionality, which was first introduced as a critique of white-dominated IPV interventions. It also follows the development of the concept of cultural competence to demonstrate the ways in which it both opened opportunities to discuss cultural differences but also suppressed the analysis of racialized hierarchies of power, which are often muted by the elevation of culture over race. Finally, this article proposes a general culture-structure framework that more clearly distinguishes the differences between culture and structure and provides analytical categories for looking at how culture and structure organize along lines of categories of identity and experience such as race/ethnicity, gender, class, sexuality, immigration status, ability, age, and religion. The framework also centers hierarchies of power, demonstrating how dominant individuals and groups often have both cultural dominance and greater control over and access to structural resources. Keywords: cultural competence, structural analysis, race, intersectionality, intimate partner violence Journal of Sociology & Social Welfare • December 2019 • Volume XLVI • Number 4 5 6 Journal of Sociology & Social Welfare The language of culture in the human services is polyglot. Those of us who regularly weave between the worlds of theory and the less pristine categorical boundaries of on-the-ground human intervention constantly seek new frameworks to bring clarity not only to how we think about our work but how we do our work. With those frameworks comes the obligatory manufacturing of words and phrases used to name new concepts and their operationalized set of practices. For those of us specifically addressing marginalized populations, such tasks as naming problems and proposing solutions are imperative and also daunting in the face of today’s growing inequities and human-caused catastrophes. The term cultural competence has been used to address racial/ ethnic disparities and to improve interventions in public health, social work, education and other arenas of human services. While the influence of culture is ubiquitous across human life, the term is generally reserved in the context of the United States for individuals and communities that are non-dominant and non-white (Sakamoto, 2007; Sue, 1998). The concepts of culture and, hence, cultural competence, have also become umbrella categories used to demarcate a multitude of distinctions or characteristics associated with a non-dominant race or ethnicity (Gallegos, Tindall, & Gallegos, 2008). These may include factors such as beliefs, values, customs, traditions and language, which are usually considered distinctly cultural (Bennett, 2015). But culture and cultural competence often address conditions that are not within the purview of culture, but may be better described as structural, referring to the material conditions that shape the life opportunities and barriers faced by individuals and communities. Using the field of intimate partner violence (IPV) as a case study, this paper examines the conflation between cultural and structural factors, the distinctions between the two sets of explanations, and a proposal for a culture-structure framework with implications for analysis of social problems and for interventions to address them. The paper builds upon the applications and critiques of the conventional use of culture and cultural competence in reference to IPV. It also references the contributions of Metzl and Hansen (2014) and their proposal for the notion of structural competency as applied to medical education. Based upon my experience in a culturally specific Chapterthe Title Beyond Cultural Competence Paradigm 7 IPV organization and research in the field of IPV intervention and prevention, I argue for a rigorous distinction between cultural and structural factors, offering a general culture-structure framework to guide practice, policy and research across the human services and which also may be relevant to broader social movements. Clarifying and refining these conceptual domains will promote better understanding of the complex conditions underlying social problems, improve policy and practice (especially for marginalized communities), and contribute to social change strategies that can more effectively address the root causes of social problems. This conceptual paper employs the case study of IPV, relying primarily upon secondary literature addressing culture, cultural competence, and culturally specific programming as related to human services, generally, and more specifically to interventions to IPV. I also use my own experience as a long-time advocate in immigrant-specific domestic violence programs and as a proponent of alternative community organizing intervention models to inform the paper’s organization and analysis. Culture and Cultural Competence Emergence of Cultural Competence in the Human Services The history of social work is rooted in the racial/ethnic and class differences between the “provider” and the “client.” This is evident in the settlement house movement that established the foundations of social work and the distinctions between settlement workers, primarily white, middle-class, educated women, and immigrant settlers (Lissak, 1989). During this period, settlement workers mostly neglected African Americans. Instead, they primarily served European immigrants during a time when “new immigrants,” such as Irish, Italian and Russian populations who settled in urban centers in the late-1800s, were considered to be “racially” different than Northern European white populations (Hounmenou, 2012). It was not until the 1980s that the concept of cultural competence emerged as a way to deliver sensitive and effective social services to ethnically and racially diverse communities (Gallegos et al., 2008). The concerns arose from the broader civil rights and racial justice movements of the 1950s and 1960s, as 8 Journal of Sociology & Social Welfare well as in response to the increasing numbers of non-white immigrants entering the United States. As the U.S. population became more diverse, cultural competence also represented a way to manage anxieties about these changes. Cross, Bazron, Dennis, and Isaacs (1989), whose early handbook on cultural competence set new standards across human services, were cognizant of changing demographics as well as the new and differentiated organizational contexts, including: “1) mainstream agencies providing outreach services to minorities; 2) mainstream agencies supporting services by minorities within minority communities; 3) agencies providing bilingual/bicultural services; and 4) minority agencies providing services to minority people” (Cross et al., 1989, p. vii). They recognized that many human service organizations were not only serving non-white populations, but were also run by them. By 1996, the National Association of Social Workers (NASW) adopted a policy statement on cultural competence, raising this as an ethical responsibility of social workers (NASW, 2001). NASW codified the features of “knowledge,” “competence” and “sensitivity” that had already served as the foundations for policies, protocols, and curricula underlying cultural competence. The 1990s similarly witnessed an expansion of diversity trainings and multicultural programming within the broader arena of human services spurred by these same concerns (Gallegos et al., 2008; Kohli, Huber, & Faul, 2010; Warrier, 2008). Despite the rise in culturally specific organizations, which were often established by and staffed by representatives of the target communities (Hung, 2007), human service organizations still grapple with many of the same assumptions that characterized the formation of social work as a profession. Specifically, human service organizations are typically run by administrators and providers from more privileged and culturally dominant positions than service users. As Stanley Sue (1998), a prominent psychological researcher on Asian American communities, chronicles, “[o]ne of the most frequently cited problems in delivering mental health services to ethnic minority groups [in the 1990s] is the cultural and linguistic mismatches that occur between clients and providers” (p. 441). Since that time, mandates for cultural competence have raised the promise of relevance and recognition for those deemed to be the cultural “other” (Sakamoto, 2007), while simultaneously imposing Chapterthe Title Beyond Cultural Competence Paradigm 9 the oppressive practices that so often accompany these demands (Abrams & Moio, 2009; Kumagai & Lypson, 2009). One of the primary critiques of applications of cultural competency is that it provides a manageable compendium of how-to’s, sets of instructions cuing providers on fixed characteristics of “cultural” groups, and “sensitive” service delivery to African Americans, Latinos, Asian Americans, Native Americans and, more recently, Muslim Americans (Kumagai & Lypson, 2009; Warrier, 2008). Practices of inclusion are also accomplished through the selection of tokenized representatives in the name of cultural diversity (Beckwith, Friedman, & Conroy, 2016). Despite the sensitivity to contextual variation grounding the application of cultural competence in some of the earliest formulations of the concept (Cross et al., 1989), it has become more common in the cultural competence literature to assume cultural “mismatch” (Sue, 1998), thus normalizing differences in provider and client that may replicate relations of power from a century earlier. This assumption further disregards or minimizes the option for human services designed and delivered by providers who may actually share common racial/ethnic (and other), hence, cultural attributes with their service users or constituents. This narrow cultural competence lens suggests that sufficient knowledge and corrected provider attitudes and behaviors can remedy what might be more accurately understood as deeper structural conditions such as lack of resources for services provided by and for people from specific marginalized communities. At the same time, the suppression of such categories as race and class yield to the more neutral term “culture” and a more digestible reference to differences in values, customs and language, rather than differences in power and access to resources (Abrams & Moio, 2009; Sakamoto, 2007). Defining Structural Competency Through the lens of cultural competence, barriers to access or health disparities too often elide cultural explanations with structural causes. Metzl and Hansen (2014) sought to disentangle the notions of culture from those of structure, maintaining the significance of the cultural while delineating characteristics or behaviors more accurately tied to structural factors. Metzl and Hansen begin with a more concrete material definition of 10 Journal of Sociology & Social Welfare structure, which they describe as “the buildings, energy networks, water, sewage, food and waste distribution systems, highways, airline, train and road complexes, and electronic communications systems that are concomitantly local and global” (p. 128). This definition provides welcome specificity synthesized from the contributions of classic social scholars and applied to the contemporary field of medical education. More familiar perhaps to those arguing for structural analysis is the emphasis on ways in which access or lack of access, control over or lack of control shape inequities in society—inequities that often follow the contours of race/ethnicity, gender, class, sexuality, immigration status, ability, age, religion and other categories. Using this definition of structure, Metzl and Hanson (2014) advocate for an alternative concept, to both disentangle from and connect cultural considerations to the practice they name structural competency. Building upon the language of cultural competence, structural competency reflects a set of skills used to “discern how a host of issues defined clinically as symptoms, attitudes, or diseases (e.g., depression, hypertension, obesity, smoking, medication ‘non-compliance,’ trauma, psychosis) also represent the downstream implications of a number of upstream decisions” (p. 128). While they focus on the medical industry, this definition and the five skill sets they advance to operationalize structural competency are relevant across human services. Using case studies, they deconstruct clinical interactions that may benefit from a structural analysis of individual behavior. For example, they describe the situation of “Mrs. Jones…an African American woman in her mid-60s who comes late to her office visit and refuses to take her blood pressure medications as prescribed” (p. 128). These behaviors can be interpreted as typical of older African-American women or, alternatively, can be viewed through an understanding of structural factors such as lack of access to insurance, exposure to toxins, or a lifetime of exposure to racism. The example of Mrs. Jones illustrates how a facile turn to cultural attributes to explain individual or group behavior may obscure a more accurate appraisal based upon structural barriers tied to poverty, sexism and racism. Chapter Title Beyond the Cultural Competence Paradigm 11 Intersections of Culture and Structure in IPV IPV, Cultural Competence and Intersectionality Following a historical chronology embedded in the broader evolution of social work, the history of IPV interventions in the United States first addressed domestic violence as witnessed among immigrant families by late nineteenth century social workers who were at the time almost completely made up of white, educated women and men, primarily of northern European ancestry (Gordon, 1988). However, the field of IPV has also been driven by feminist social movements, not only advocating for the safety and integrity of others, but also self-organizing for the self-determination of girls and women. Emerging from civil rights, labor rights, welfare rights and anti-war movements, the contemporary feminist movement was primarily made up of white women who espoused a continuum of political positions (Schechter, 1982). Race-specific organizing and culturally specific programs have been present, if poorly documented, since the beginning of the contemporary anti-violence movement. The names of the earliest shelters, such as La Casa de Las Madres in San Francisco in 1974 or Harriet Tubman Women’s Shelter in Minneapolis in 1976, belie the prominence of women of color in the earliest moments of the battered women’s movement. Their contested origins also reflect racial struggles that underlay these histories (Schechter, 1982). An increase in government funding for IPV services followed the passage of the federal Family Violence Prevention and Services Act in 1984 and continued with the Violence Against Women Act (VAWA) in 1994. This rise in funding coincided with increased demands for culturally relevant programming. Cultural relevance referred not only to race or ethnic specific services but also increased immigrant, lesbian-gay-bisexual-transgender-questioning-intersex-2-spirit (LGBTQI2S) and disability access. As a result, the 1990s, in particular, opened up a new era of “culturally specific” IPV programs, many of which were initiated and run by members of marginalized communities (Kim, Masaki, & Mehrotra, 2010). These shifts were made at a time when the language of cultural competence informed policy mandates and local governmental and private funding initiatives. As a service delivery 12 Journal of Sociology & Social Welfare field, practitioners and policymakers, even among programs established by those from marginalized populations, often acquiesced to a less critical adoption of the discourse of culture (Munshi, 2011; Sakamoto, 2007). However, the social movement’s origins and continued influence also fueled critiques that illuminated multiple and intersectional categories of identity, while also pointing to the problematic use of culture and cultural competence. Those leading culturally specific programs within the IPV field struggled with the limitations of the category of culture, the pragmatics of new culturally specific funding, and the urgency to provide some sort of basic cultural education to uninformed mainstream providers and policymakers (Kim, 2018; Kim et al., 2010). Tendencies towards acquiescence matched political decisions made early in feminist social movement development. Struggles over racial equity within the anti-violence movement were contained by the gender essentialist position adopted early in movement history in the 1970s and 1980s (Goodmark, 2013). In the United States, feminist anti-violence movements had made formative decisions to suppress race and class differences in favor of an every woman analysis of domestic and sexual violence that emphasized the vulnerability of all women to gender-based violence, regardless of race, ethnicity and class (Kim, 2019; Richie, 2012). During the time of the formation of this enduring trope, same gender IPV within LGBTQI2S communities remained invisible (Kanuha, 1990). In the 1990s, people of color began to emphasize that vulnerability to IPV was related to the intersection of race/ethnicity with gender, gender identity, class, language, sexuality, immigration status, religion, ability, age, size and other categories (INCITE!, 2016; Kim, 2018). The term intersectionality, first coined by legal theorist Kimberlé Crenshaw (1991), emerged from her critique of the negligent or negative effects of gender-based violence remedies on women of color, particularly African American and immigrant women. These remedies made explicit the inadequacies of undifferentiated notions of gender. Crenshaw’s nuanced critique of the symbolic and material consequences—not only of gender-based violence, but also of white-dominant responses to these forms of violence—did not reproduce rigidly compartmentalized categories of race within the construct of gender. Rather, the introduction of intersectionality made conceptual space for indeterminacy Chapterthe Title Beyond Cultural Competence Paradigm 13 and contradictory tensions stemming from the multiple identities that constitute each person and community. It also demonstrated the ways in which structural conditions such as chronic poverty, language barriers, and vulnerability to immigration control are tied to gender, race, and class, categories that would later expand across other identities as the concept of intersectionality rapidly diffused across movements and disciplines. Abuses of cultural competence frameworks prevail and persist despite the insights of intersectionality; however, Crenshaw’s powerful analysis also opened the way towards a more robust framing of the relationships and distinctions between categories of identity and structural conditions. Conceptual Reframing: A Culture-Structure Framework Introduction to a Generalist Culture-Structure Framework The proposed culture-structure framework articulates more clearly the distinctions between culture and structure raised in these critical debates on culture and cultural competence with a focus on the contributions raised in response to IPV. It also acknowledges the limits of these critiques and the lack of attention that IPV-related practice, policy and scholarship have paid to the breadth of structural factors that influence vulnerability to IPV. The culture-structure framework turns to Metzl and Hanson’s (2014) synthesis of structural concepts derived from social theory as a foundation for a comprehensive definition and conceptualization of the various components that constitute structural factors. I begin the framework with general definitions of culture and structure (see Table 1) drawn from the literature on culture and structure, respectively. The framework follows with three intervening categories, or domains, through which I argue that both culture and structure must be further analyzed. Figure 1 illustrates these domains as categories of: (1) identity and experience (e.g., race/ethnicity, gender and class); (2) location (e.g., domestic, local and national spheres); and (3) hierarchies of power (e.g., dominant versus subordinate). 14 Journal of Sociology & Social Welfare The following section describes the primary categories, that is, culture and structure, further divided by three intervening domains: identity/experience, location, and hierarchies of power. Within each category, examples will be used to illustrate how the complex lives of individuals and groups require this more intersectional frame for understanding the relationship between cultural identities and structural conditions. Defining Culture and Structure Culture. To define culture, I turn back to a rather conventional, ethnographic definition dating back to the late 19th century that defines culture as a set of knowledge, beliefs, morals, and customs held by a defined group of people (Bennett, 2015). There is the sense that culture is shared, often unconsciously held, and tends to organize relationships among a set of people who identify as a common group. Table 1. Defining Culture and Structure CULTURE Definition Categories A set of knowledge, beliefs, morals, and customs held by a defined group of people. Included in definition. This list can be expanded to include language and other factors. STRUCTURE Economic, political, social and ecological conditions and systems that shape control over and access to material goods and resources necessary for individual and collective life. (a) Basic necessities such as income/employment, housing, food, education, health/mental health services, communication, transportation; (b) Political rights such as personal and political decision-making power, rights to assemble, rights to freedom of expression (including gender identity, sexuality and religion), reproductive rights, rights to citizenship, rights to homeland; and (c) Safety from harm such as interpersonal violence, community violence, state violence, surveillance, incarceration, war, displacement, forced migration, forced separation from family and community, and natural and human-made disasters. Chapter Title Beyond the Cultural Competence Paradigm 15 Structure. In this framework, structure is defined as the economic, political, social and ecological conditions and systems that shape control over and access to material goods and resources necessary for individual and collective life. Because the breadth of these material conditions is so great in contemporary society, I expand the framework to discern categories to consider. I identify these categories as: (a) basic necessities such as income/employment, housing, food, education, health/mental health services, communication, transportation; (b) political rights such as personal and political decision-making power, rights to assemble, rights to freedom of expression (including gender identity, sexuality and religion), reproductive rights, rights to citizenship, rights to homeland; and (c) safety from harm such as gender-based violence, interpersonal violence, community violence, state violence, war, displacement, forced migration, and natural and human-made disasters. While this is not a comprehensive list, it includes categories that impact one’s ability to live and thrive as individuals and as a collective group. Three Intervening Domains: Identity/Experience, Location, and Hierarchies of Power Viewed through an intersectional lens, a simple distinction between culture and structure is insufficient. Rather, culture and structure are made meaningful by the categories that shape individual and collective perceptions, experiences, and access to resources. I name these categories as: (1) identity and experience; (2) location; and (3) hierarchies of power. Identity and experience. First, categories of identity or experience are those that have always been critical to the life opportunities and trajectories of individuals and groups. Although this list is not conclusive (nor does it reflect significant categories outside of a U.S. context or within all geographic areas of the United States), I highlight the categories of race/ethnicity, gender, class, sexuality, immigration status, ability, age, and religion. Because the term identity tends to be associated with some sort of fixed qualities that are thought to attach to the bodies of individuals, I also include the term experience to emphasize that some of these categories may also be the result of experiences 16 Journal of Sociology & Social Welfare Figure 1. Culture and Structure: Categories of Identity/Experience, Location, and Hierarchies of Power Identity/Experience (intersecting identities may also be expressed as subcultures) c,\\.;,e, ,,,t~j ..,.,0 A 0 .3 Race/ Ethnicitv Domestic/ Home Local Communitv Local Institutions National Global I Gender I Class I Sexuality I 1~ifi:!ion I Ability I CULTURE --- ,.;. 'e.,--Q: c>r,i, -- -------Subordinate ---- - -- ·~e in~e!':c~t ... ... - - - -- --- Hierarchies of Power I Contested/Shifting I Age I Religion ------- -- -- -- -- STRUCTURE Dominant that can then take on meaning as identities in specific contexts. For example, immigrants may have been born into geographic communities where their families had lived for generations; however, it is their experience of migration from home countries that creates a new identity as immigrant. Furthermore, the word culture tends to be associated with one’s race/ethnicity alone. It is important to highlight these various categories of identity/experience, as culture can vary among what we might call subcultures, constituted among people who may share a particular race or ethnicity, but who may also be organized by another category of identity or experience. For example, those who identify as LGBTQI2S within a specific ethnic community may also organize as a subpopulation sharing certain cultural norms and practices distinct from the broader ethnic community. Hence, it is necessary to distinguish intersectional identities in order to challenge the inaccurately simplified assumption of uniform cultural traits within a specific race or ethnicity. Location. This framework further distinguishes locations in which culture and structure operate. I categorize these as (1) domestic/home; (2) local community; (3) local institutions; (4) national; and (5) global. The domestic or home sphere (also often referred to as the private sphere) is that of intimate or family relationships that may be centered in the home; these can include biological family members, family members through marriage or domestic partnership, or chosen family. The local community may extend outside of the home, but be inclusive of communal Chapterthe Title Beyond Cultural Competence Paradigm 17 relationships that may be important in one’s daily life, such as extended family, neighbors, workplace, one’s faith institution, or other close-knit community members that are influential in defining and shaping culture and access to material goods and resources. I distinguish this from local institutions, as the latter may be less intimate or familiar, but may be influential in the ways in which they govern opportunities or challenges/barriers in cultural life and structural systems. These might include local commercial systems, educational institutions, medical institutions, or local systems of governance. The national level describes the system of national laws and governing institutions that regulate broad levels of material goods and resources and that further influence local and domestic spheres. They also include national level commercial systems. Finally, the global level may include global systems of regulation, commercial flows, security and conflict, and systems of migration. Hierarchies of power. Central to the culture-structure framework are hierarchies of power. The exercise of power is not only overt; it can operate through the heightened visibility of some individuals and groups over others. That visibility can be positive or negative in terms of their associated levels of status and power. I further use the categories of (1) dominant; and (2) subordinate to distinguish in more stark terms the ways in which power is distributed and the relationships between those who are dominant and, conversely, those who are subordinate. I also add another more liminal category, that is, contested/shifting, to emphasize that the definition of dominant and subordinate is always shifting and subject to struggle. Interaction Between the Three Domains While these domains are presented as conceptually distinct, in the real world, they interact. In the following sections, the framework will expand to illustrate how culture and structure, respectively, can be seen through the individual categories of identity/experience, location, and hierarchies of power. As with any conceptual framework, categories are meant to provide greater analytical clarity in order to disentangle the complexities and ambiguities of the real world. They provide conceptual elements that can be scaffolded in order to build a more comprehensive understanding of individual and 18 Journal of Sociology & Social Welfare collective situations. They are to be understood as intersecting elements, not to entrap and encase into more distinct, but still static stereotypes. Rather, the framework is constructed to illuminate and guide towards a richer and more comprehensive understanding of our social world. Culture and the Three Domains Culture and identity/experience. In the United States, culture has been strongly identified with the categories of race, ethnicity, and religion. Stereotypical views of culture still hold these as immutable over time and as uniformly held within a geographic boundary or among a specific race/ethnicity. However, contemporary interpretations of culture are no longer so rigid and stable. Early definitions of culture were established in relationship to Western anthropological notions of culture attributed to pre-modern societies (Bennett, 2015). While these views still persist, culture is now understood to be flexible, indeterminant, and shifting due to unstable territorial boundaries, diasporic migrations of people, and changing economic, political, social, and ecological conditions over time. Furthermore, one can see that cultures, even within a specific geographic location, are often complex. Intersectional identities within any group of people, that is, by race/ethnicity, gender, class, sexuality, immigration status, ability, age and other categories, may yield distinct forms of knowledge, beliefs, morals, and customs that can also be understood to represent a subculture. Subcultures may be recognized, such as youth culture or hip-hop culture. They may also be unrecognized, especially if they are held within a subordinate group with little visibility, status, or power. Culture and location. While culture is considered to include multiple aspects of life, we can also think of specific locations or spheres in which culture operates. How does culture operate in domestic life or the private sphere? How might this be different than cultural expressions at the level of the community? How is culture performed within organizations and workplaces? How are local cultures defined as compared to national cultures? At the global level, what is the influence of culture associated with globalization, such as cosmopolitan bourgeois culture or a global culture of proletarian solidarity? Chapter Title Beyond the Cultural Competence Paradigm 19 Culture and hierarchies of power. Simplified categories of hierarchies of power in this framework are divided into those that are dominant, subordinate/marginalized or shifting/contested. However, these different cultural forms are subject to complex and often contradictory relations of power. For example, a working class young adult Latinx woman who is an undocumented migrant from Guatemala may carry a set of knowledge, beliefs, morals, laws and customs from her village in Guatemala. She may feel a sense of pride and connection to the religious customs with which she was raised in her home country. She may also suffer from IPV in a patriarchal relationship with her husband who comes from the same locale. In her home country, she may also have been culturally different if she were from an indigenous community marginalized within a Spanish-language-dominated country with a history of violent discrimination against indigenous people. As an immigrant to the United States, she may be subject to a dominant white, patriarchal, xenophobic, elite U.S. culture that considers her to be uneducated, intellectually inferior, and even criminal. From a human services standpoint, an anti-violence provider may view her through a dominant cultural lens that casts her as someone ignorant about her rights or oppressed by her female passivity due to cultural norms. Conversely, she may also be “appreciated” within this same dominant culture, but for aspects defined by and valued by the dominant culture. For example, she may be viewed as exotic, a good cook, or desirable as a lover. While perhaps perceived as positive cultural traits, the definitions of these traits and the presumed consumption of these traits by the dominant culture render these subordinating to the woman and the presumed “culture” to which they are ascribed. Structure and the Three Domains Structure and identity/experience. Structures are also often organized along the contours of categories of identity/experience such as race/ethnicity, gender, class, sexuality, immigration status, ability, age, and religion. Individuals and communities falling under a certain category or intersection of categories are organized in such a way that they have access to these materials and resources or, alternatively, do not have access. In this way, structural conditions are also often defined by broader terms such as racism, sexism, 20 Journal of Sociology & Social Welfare classism, and ableism because control of and access to material goods and resources are often significantly organized according to these broad categories and their intersections. Structure and location. Structural conditions can also be categorized by location. It may be useful to think of the ways in which the domestic sphere or families/households distribute resources according to categories of identity/experience such as gender and age. Each geographic level organizes material goods and resources in distinct ways, with lower and more local levels often subject to the greater authority and control over resources wielded at higher regional or national levels. Finally, global systems also determine access to material goods and resources. The control of international monetary institutions, trade agreements, and military alliances are all examples of the influence of global systems over national and local structural conditions. Each location shapes and is shaped by the control and distribution of material goods and resources through regional, racial/ethnic, class, religious, and other hierarchically organized categories. Structure and hierarchies of power. Structural relationships clearly determine control over and distribution of material goods and resources via hierarchies of power that operate at the levels of the domestic or private sphere, local communities, local institutions, national, and global levels. These sources of power are also controlled by those within dominant categories of identity/ experience; accordingly, those in subordinate or marginalized positions often suffer from lack of control and access to material resources. As relations of power reflected in culture are subject to constant shifts and contestations, so too are structural systems in flux and subject to struggles over control and distribution. Interaction between Culture, Structure, and the Three Domains While this framework distinguishes culture and structure, delineating differences so often erased or misunderstood, culture and structure also interact. The dotted line between culture and structure in Figure 1 denotes the permeability and interaction between these two conceptual categories. Similarly, there is interaction between the category of identity/experience and the column representing location, and the bottom row of the figure represents hierarchies of power and indicates interaction between these domains. Chapterthe Title Beyond Cultural Competence Paradigm 21 To return to the example of the Latinx woman who may have migrated to the United States from rural Guatemala, cultural distinctions that may become apparent in her migration to the context of the United States are also influenced by structural conditions tied to her migration. For example, conditions of chronic poverty, economic neglect and extraction from rural areas, and international trade agreements that further exacerbate economic and political inequities may have contributed to her migration. The resulting isolation from family and cultural institutions that may have provided support could also worsen her situation of IPV as she becomes more geographically separated from these assets. While it is important to separate culture and structure, it is also important to recognize that culture and structure interact in the complex lives of individuals and communities. Using the Framework to Understand Struggle and Change The framework further includes the dynamic of ambivalence, contention, contradiction, struggle, and change. The hierarchies of power under culture and structure all assume dominance and subordination; however, they also assume that these relationships of power are always subject to fluidity and struggle. Using another example, a 22-year-old college-educated Hmong American woman may have status and power within her small Hmong community but have little status among white, elite faculty on campus. Her status may be questioned among male Hmong leaders at a clan meeting but may be elevated when the community leaders are attempting to negotiate with officials at a city council meeting, as they find it beneficial to take advantage of her greater knowledge of English and U.S. systems of governance. She may move between these locations or spheres several times in a given day, at times subject to the greater authority of males in her clan or family, and at other times, subject to dominant forces on campus. Her identity and position may appear flexible compared to elder males who may appear to hold static views of culture. However, every individual and group is subject to shifting levels of visibility, status, and access to resources. For older Hmong males, in this example, their position of power may depend upon whether they look internally within their family or clan where they may exercise dominance or outward to white-elite dominant systems of civil society, market, and governance, where they may have little power. 22 Journal of Sociology & Social Welfare As the category of hierarchies of power indicates (Figure 1), relationships of power are not static; they are subject to negotiation and struggle. The struggles for a 22-year old educated Hmong woman may be different than those for a Hmong male elder. At times, these parties may come together to suppress differences in order to join in strategies that have a greater chance of success; they may take advantage of specific forms of power and resources each subculture may have in certain contexts in order to achieve greater collective goals. These struggles may attempt to shift relationships of power between the broader Hmong community and the greater dominant neighborhood, city, or state structures. At the same time, young Hmong women may also demand greater respect and decision-making within their local Hmong families and clan structures; these struggles may aim to change cultural notions of gender, age, and their relationships to status and power. Discussion and Conclusion Culture, Structure, and Lessons from IPV The contemporary history of the feminist anti-violence movement demonstrates how the dominance of a gender essentialist position suppressed differentiation based upon race/ethnicity, class, sexuality, immigration status, ability, and other categories of identity and experience. While the movement included strong leadership from women of color from its beginning, the rise of race and ethnic specific programs throughout the late 1980s and 1990s increased the presence of women of color, immigrant and LGBTQI2S-led programs. Their growing numbers, constituencies, and cumulative experiences created more visibility and power to diversify the movement/field and to demand changes. At the same time, the IPV field was constrained by an often conservatizing language of culture and cultural competence. While attention to culture opened opportunities for greater inclusion of formerly invisible communities of color that expanded to LGBTQI2S communities and individuals with disabilities, narrow focus on identity without attention to structural conditions constrained the types of interventions to those defined by dominant white feminist leaders (Richie, 2012). Crenshaw (1991) Chapter Title Beyond the Cultural Competence Paradigm 23 directly critiqued the consequences of the gender essentialist framework, pointing to the material effects the suppression of race, class, and immigration status had on the lives of women of color. The introduction of the concept of intersectionality further strengthened the distinction between categories of identity and the structural conditions that are shaped by and through these categories. Implications for Policy and Practice The culture-structure framework attempts to clarify a rich, manifold, and often muddied field in order to provide a more systematic guide to inform practice, policy, and future research across the human services with implications for broader social movements. In a human services field that tends towards flattened and simplified cultural tropes as a way to diagnose social problems that marginalized communities face, the culture-structure framework reminds us that that which might present itself as “culture” may more accurately be understood as a result of the very real opportunities and constraints of structure. It turns our attention from the often “othering” frame of cultural competence towards a more action-oriented mandate to change the structural conditions that deprive entire communities of the material goods and resources necessary for a robust individual and collective life. It reminds us that human life is, indeed, complex and that the role of engaged scholarship is to honor the lived experience of those most marginalized and to shine a light on those in struggle to illuminate a way forward. 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