Is a Lack of Cultural Diversity in Healthcare Harming Our Patients?
By the time the 2020 census is conducted in the U.S., it’s projected that more than half of the nation’s children will belong to a minority race or ethnic group, according to a 2015 report from the U.S. Census Bureau. In fact, the report also predicts that by 2060, just 36 percent of all children will be single-race, non-Hispanic white.
With our country growing more diverse each year, natural progression would suggest that so too should our fundamental institutions, such as our government, our schools and our healthcare facilities. While all undeniably important, the latter of the three has arguably the most potential for negative community-wide impact when lacking in cultural competency.
Assertions like this have led many to ask some pivotal questions: How important is cultural diversity in healthcare? Could a lack of diversity truly harm patients?
In search of answers to those questions, we interviewed healthcare professionals to gather some insight. Just like in any workplace, maintaining a medical facility that is open to and unbiased toward any culture is integral to maintaining a positive reputation. This is true both in the medical world and also within the public sphere, explains Dr. Faisal Tawwab, a family practice specialist currently practicing at MultiCARE Physicians.
“While it is medical skill that truly matters most, patients feel comfortable with doctors who appear similar to them at first,” he adds. “It’s just human nature.” As our nation becomes more diverse in ethnicity, so should our medical providers, Dr. Tawwab asserts.
Diversity in healthcare: The facts
Medical professionals nationwide echo similar sentiments in support of the important task to further diversify our healthcare workforce. “We are transitioning to a values-based, patient-centered care system in which patients are demanding more personable service, open communication and higher levels of rapport,” explains Dr. Kristy Taylor, President of Heka Healthcare Consulting, LLC. “They want to feel comfortable with their healthcare providers and care teams.”
Numerous studies have shed light on the disparities that exist in the quality of healthcare received by minority populations in our country. Consider the following facts from the Health Professionals for Diversity Coalition:
- The average waiting time for African Americans needing kidney transplants is almost twice as long as that of white patients.
- African-American women with breast cancer are 67 percent more likely to die from the disease than are white women.
- The mortality rate for African-American infants is almost 2.5 times greater than it is for white infants.
- Hispanic and African-American youth are substantially more likely to die from diabetes than white youth.
- African-American, Hispanic and Native-American physicians are much more likely than white physicians to practice in underserved communities and to treat larger numbers of minority patients, irrespective of income.
- African-American and Hispanic physicians are more likely to provide care to the poor and those on Medicaid (this also holds true for female physicians).
- Racial and ethnic minority patients who have a choice are more likely to select healthcare professionals of their own racial or ethnic background.
- Racial and ethnic minority patients are generally more satisfied with their care, and are more likely to report receiving higher-quality care, when treated by a health professional of their own racial or ethnic background.
While there are many statistics that paint a harrowing portrait of the current state of our healthcare system as it relates to diversity, the report also revealed some encouraging facts about potential solutions:
- By encountering and interacting with individuals from a variety of racial and ethnic backgrounds during their training, health professionals are better able to serve the nation's diverse society by having broadened perspectives of racial, ethnic and cultural similarities and differences.
- Growing evidence shows that diversity in education environments can improve learning outcomes for all students, improving such skills as active thinking, intellectual engagement and motivation, as well as certain social and civic skills, such as the ability to empathize and have racial and cultural understanding.
“In many cases, healthcare professionals are only exposed to diversity principles as a component of their academic studies or as a requirement for the job,” Dr. Taylor explains. “They are not taught how a lack of cultural diversity within the organization can affect its bottom line.”
She believes the solution lies deeper than simply promoting diversity as a form of policy. Instead, it should be incorporated as a principle within a healthcare facility’s organizational culture. “It must be done through a process of policy, principle and proactive educational initiatives,” she adds.
The importance of cultural competency
In the world of medicine, the term cultural competence refers to the knowledge, skills, attitudes and behavior required of a healthcare professional to provide optimal care and services to patients from a wide range of cultural and ethnic backgrounds.
“When healthcare organizations fail to incorporate cultural diversity into their organizational culture, the organization also fails to provide the patient with comprehensive quality, patient-centered care,” Dr. Taylor argues. She adds that while healthcare should not primarily be viewed as a business initiative, it can be helpful to think of it in such terms when weighing the importance of a diverse workforce.
“Patients value their relationships with providers as much as they do the medical advice that they receive,” Dr. Taylor says. While a patient-provider relationship is much deeper than a traditional business-consumer relationships, she believes it should be viewed the same. Patients are essentially customers, and if you fail to connect with them, they will look elsewhere for care.
“Healthcare facilities should operate like any other business in the sense that we want our patients to be repeat customers if they need our services again in the future,” Dr. Taylor explains. “If healthcare organizations want to stay in business, they must learn to engage patients in a culturally competent manner.”
Diversity can take on many different forms, but studies have uncovered just how important racial, ethnic and cultural diversity is in healthcare specifically. Health disparities have been traced to numerous causes, including language and cultural barriers which can result in minority patients not seeking proper care for their ailments.
With the number of minority citizens on the rise, future healthcare professionals will be tasked with caring for many patients whose backgrounds differ from their own. It is becoming more and more critical that providers maintain a firm understanding of how and why different systems of belief, cultural biases, ethnic origins, family structures and other culturally determined factors influence the way patients experience illness, heed medical advice and respond to treatment plans. The outcome of care is dependent on cultural factors such as these.
The forecast for a diversified future
A recent report from the U.S. Agency for Healthcare and Research Quality noted that while the overall health of the country’s population has steadily improved over the last few decades, not all Americans have benefited equally from this growth. So what can we expect for the future of healthcare?
The foremost step is for healthcare organizations to proactively commit to not only increasing the diversity of their workforces, but to investing in the continued cultural competence and education of their providers. This is in the best interest of the patients, the healthcare facility and individual medical professionals.
“Healthcare teams that lack diversity might only bring in a patient base that is also lacking in diversity. This could have implications on the doctor’s resume in the long run,” Dr. Tawwab says. The doctors would have no exposure to certain genetic conditions, disorders or treatment plans that are specific to a particular ethnicity.
“Over time, as the nation becomes more diverse, these doctors will be ill-equipped to treat our population and therefore may struggle to maintain a thriving practice 30, 20 or even 10 years from now,” he explains. “At the end of the day, it is our duty as physicians to be aware of a patient’s needs—medically, personally and linguistically.”
Deepen your impact as a nurse
The most effective healthcare professionals are those who maintain a steady commitment to continually learn and progress in their field. Some impactful first steps toward a more diverse healthcare workforce have been taken, but the work has only just begun. It will take active participation from all involved to ensure the outcome is a diversified, more culturally competent team of caretakers and providers.
If you’re looking for other ways to improve your healthcare practice on a daily basis, check out the tips in our article, Teamwork in Nursing: How to Be a Key Contributor in Your Unit.