Improving Healthcare Diversity to Meet Diverse Patient Needs

Last Updated May 29, 2019

America is a rapidly diversifying nation. According to U.S. Census estimates, no single ethnic or racial group will represent a majority of the U.S. population by 2055. This demographic shift is creating a diverse patient population with unique care needs and challenges for healthcare professionals and leaders. How can physicians be a bridge between one culture’s traditional remedies and modern medicine? How do they ensure a patient is comprehending a diagnosis when there’s a language difference?   

For healthcare leaders, providing inclusive care, equipping healthcare professionals with diversity and cultural competency training and proactively looking to ways to diversify the healthcare ranks is vital to meeting the needs, expectations and desired patient outcomes of a diverse, multicultural population.   

Breaking Down Language Barriers  

For a sick patient, the ability to communicate with and relate to a healthcare provider that sounds like, looks like and culturally relates to them can make all the difference in their health outcomes. Latino patients in particular are often left to navigate a healthcare system that is short on Spanish-speaking providers. Over the last 30 years, the Spanish-speaking patient population has expanded by 243%, while “the Latino physician rate per 100,000 of the Latino population” has dropped by over 20%, based on a study of U.S. Census data.

In California, Latinos surpassed whites as the largest single racial group in 2014, with state demographers projecting Latinos will account for about 49% of California’s population by 2060. When the Los Angeles Times profiled the Harbor-UCLA Medical Center’s family medicine clinic, Dr. Gloria Sanchez shared how chronically ill Latino patients need providers who understand them, both linguistically and culturally, to be “that critical piece of healthcare communication.”

In many instances, clear doctor-patient communication can be the difference between life and death—from the seven-year-old boy who suffered organ damage due to physician miscommunication with his Spanish-speaking family, to a Vietnamese girl who died due to her parents misunderstanding medication instructions.   

Under federal civil rights law, bolstered by provisions in the Affordable Care Act, hospitals and healthcare providers that receive federal funding must take reasonable steps to accommodate non-English speaking patients by informing them of language services and translating provider and medication information into the 15 most frequently used non-English languages spoken in their state. However, a 2016 study published in Health Affairs found that about 30% of all hospitals nationwide were not offering translation services.

Impacting Patient Care and Outcomes

Beyond the communication challenges posed by language differences, a more diverse patient population means health practitioners may see an increase of certain cases or conditions, often with research studies and training lacking or underfunded.

For example, people born in Asia are more likely to have been affected by Hepatitis B, a disease preventable via vaccination, with Asian Americans having up to a 13 times higher risk of developing liver cancer as a result of a Hepatitis B infection than white Americans, according to National Cancer Institute research published by Medscape Gastroenterology.

Sickle-cell anemia, an inherited blood disorder primarily found in African Americans, affects an estimated 100,000 people in the U.S. While the genetic mutation causing the disorder was discovered more than 60 years ago, researchers and specialists have argued that effective treatments have been slow to materialize (the first new drug treatment in nearly two decades was recently approved for use) due to a lack of research interest and funding.

Communication challenges, cultural differences, access to equal care, and even unconscious bias and stereotyping can all combine to create imbalanced care for minority patients. The Health Professionals for Diversity Coalition has gathered striking numbers from various research studies on the treatment of ethnic and racial minority populations:

• African Americans who need kidney transplants wait almost twice as long as white patients.
• African-American women with breast cancer are 67% more likely to die from the disease than are white women.
• Hispanic and African-American youth diagnosed with diabetes are more likely to die from the disease than are whites.

When it comes to patient treatment, the Coalition shared that minority patients are more likely to report receiving higher-quality care when treated by a healthcare practitioner of their own racial or ethnic background.

Diversifying the Healthcare Ranks

More diverse healthcare providers provide a relatable voice and face for their diverse patients, helping to augment language needs, understand cultural norms, and even advocate for underserved populations to secure research funding. Yet, racial and ethnic minorities are underrepresented in healthcare, from physicians and researchers to C-level leaders.  

To transform the landscape of healthcare diversity, the Association of American Medical Colleges (AAMC) advises a holistic effort, from revisiting medical school recruitment and admissions policies to overhauling outreach programs to better engaging underrepresented communities, such as building up minority student enrollment in undergraduate STEM (science, technology, engineering, and math) programs.

Besides recruiting and training more minority students, medical schools need to emphasize cultural competency training for all students so they examine their own biases to be more sensitive to differences in race, ethnicity, culture, sexual orientation or socioeconomic status, as recommended in a Pew Trust report.

With this in mind, many healthcare organizations are applying the National Standards for Culturally and Linguistically Appropriate Services (CLAS). Developed by the U.S. Department of Health and Human Services Office of Minority Health, CLAS provides as “blueprint” for healthcare organizations in educating and recruiting a diverse workforce, ensuring translation services and language assistance for patients, and advocating for multicultural/multilingual goals and policies. 

Leading Through Diversity

Nationwide, racial or ethnic minorities represent only 14% of hospital board members and 9% of CEOs, according to a 2016 report by the American Hospital Association’s Institute for Diversity and Health Equity. To foster diversity throughout organizations and better serve diverse patient populations, healthcare leaders can start by leading by example, rethinking their approach to people management leadership development.  

In a three-year plan to elevate leaders who better reflect the multicultural patients the hospital serves, the Robert Wood Johnson University Hospital “embedded diversity and inclusion in its operating strategy” through staff and patient data analysis, mentorship programs, and succession planning, resulting in the leadership team’s diversity growing from 4% in 2012 to 32% in 2015 and from 17% of board members in 2011 to 22% in 2015.

Experienced healthcare professionals of all backgrounds are eager to answer the call to leadership. The Association of University Programs in Health Administration found in a 2017 survey of 43 healthcare administration and management programs that 47% of applicants identified as a racial or ethnic minority.   

MSU’s Master of Science in Healthcare Management program is designed to prepare these future leaders for the diverse healthcare landscape. Housed in the Broad College of Business, the program encompasses healthcare-specific courses in such areas as Human Resources, Strategic Decision Making and Organizational Behavior, grounding participants with the skills and business acumen vital to strategic leadership, team development and organizational management.