CCBENCH: Assessing LLM Cultural Competence via Implicitly Signaled Norms using Health Queries

To interact with users fairly and without stereotyping, AI models must display cultural competency, i.e., the ability to infer and adapt to a user's implicitly signaled cultural values, rather than relying on static demographic traits. We introduce CCBENCH, a framework for evaluating cultural competency in large language models (LLMs), treating culture as a continuum of norm adherence states rather than as a binary state of cultural belongingness. As a case study on health, we create CCBENCH-Health, which includes 60 theoretically grounded personas exhibiting varied norm-adherence states across six cultures, each engaging in 18 realistic dialogues. Each persona is evaluated on 52 authentic healthcare questions drawn from real user forums, yielding 3,120 unique interactions. Benchmarking five leading models reveals that even the best achieve culturally appropriate responses only 20-30% of the time. When explicitly prompted to focus on culturally relevant cues from the conversational history (CoT), performance improves modestly by 3-5% on average. We find that models perform best when personas avoid cultural norms rather than follow them, revealing a persistent asymmetry, suggesting a preference in the models to align with built-in biases than adapt to cultural cues. This is especially observed in the Afghan context (Avg: 8.8%), where cultural cues rarely yield appropriate health advice. Finally, we find that models sometimes adapt more readily to implicit, cultural conversational styles than to explicitly stated cultural practices, though this varies across cultures.