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Home health care organizations striving to effectively serve their clientele may be experiencing barriers, one of which is serving a culturally and linguistically diverse population. The National Center for Cultural Competence (NCCC) identifies seven salient reasons in this article for incorporating cultural competence into organizational policy. The article provides an examplary definition that can be adapted and useful to home health care organizations. A checklist, developed by the NCCC, is also included to facilitate policy making that supports culturally and linguistically competent health care delivery.

A new, simplified anthropometric field tool for detecting nutritional stunting, the "tallstick, " has been developed in community-based pilot programmes in Nicaragua and Nigeria. The folding stick, marked to indicate height-forage cutoff points for ages from birth to seven years below which the child is considered nutritionally stunted, is compared with arm circumference measurements as a simplified field tool. Sensitivity-specificity analyses contrasting the ability of height-forage and arm-circumference cutoff points to detect malnutrition showed height for age to be as good as arm circumference for detecting low weight for age, weaker for low weight for height, and stronger for a composite score of any degree of malnutrition in 1,070 children 0-72 months old in urban Managua with a prevalence of wasting of 0%-4%, of stunting of 17%-38%, and of underweight of 4%-22%. The importance of detecting stunting, the likelihood of reducing stunting rates, and the feasibility of using the tallstick and its variants are discussed.

This article outlines some of the barriers to health care experienced by Asian and Pacific Islander Communities. The authors then describe a number of strategies the Washington State Department of Health has used to reduce cultural and linguistic barriers to health care. As a state health agency, the Department has promoted accessible programs through mechanisms such as improved data collection, culturally competent staff, targeted outreach, and development of partnerships with community organizations and other agencies to promote culturally accessible health care delivery.