By Shane L. Lloyd & Christopher S. Morin | May 14, 2019
While many workplaces across the nation are making inroads in their diversity and inclusion efforts surrounding gender, race, sexual orientation, religion, and physical ability, we still have a long way to go. Daily news feeds are filled with stories of employees saying or doing something that harms groups of employees within their organization or members of the communities their organizations aim to serve. The far-reaching consequences can range from public embarrassment to outright physical harm.
The healthcare industry is one sphere in which unchecked biases can be fatal and compound long standing health disparities that disproportionately impact people along identity markers such as race, sexual orientation, gender, and ability. The National Institutes of Health define health disparities as “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.” Yet health disparities often go unnoticed because of the lack of continued documentation of data and limited channels for patients to provide feedback on their encounters with medical staff. However, there is a growing body of evidence and data that show health disparities are something that cannot be ignored.
The #healthcare industry is one sphere in which unchecked #biases can be fatal and compound long standing #healthdisparities that disproportionately impact people from underrepresented groups. Click To Tweet
According to the Center for National Healthcare Statistics, “For racial and ethnic minorities in the United States, health disparities take on many forms, including higher rates of chronic disease and premature death compared to the rates among whites…While national infant mortality rates decreased overall by 14 percent from 2004 to 2014, disparities among racial and ethnic groups persisted…In 2013, infants born to African American mothers experienced the highest rates of infant mortality (11.11 infant deaths per 1,000 births), and infants born to Asian or Pacific Islander mothers experienced the lowest rates (3.90 infant deaths per 1,000 births).” Since 2013 the trend has not changed significantly and in some areas in America has increased. This unfortunate trend reveals that in some parts of the United States, white clinicians in a hospital delivery and prenatal ward tend to have a bias that favors whites over African Americans.
A prime example of this is that of Alia McCants. “She had given birth to healthy twins. She and her husband had brought the babies home to their apartment in Harlem, and everything seemed all right — until complications from her cesarean section caused her to hemorrhage…She recalled that her obstetrician was dismissive of her desire to avoid a C-section. While cesareans are common when delivering twins, McCants, who had a complication-free pregnancy, had hoped for a natural birth. And most crucially, while McCants was still only semi-lucid after delivering her twins, a doctor was short with her while explaining warning signs of hemorrhaging, a known risk of C-sections.” More widespread attention to this phenomenon came to light when tennis champion, Serena Williams, reported that she nearly died due to complications following childbirth. Especially startling about this disparity is that it impacts Black women of all class backgrounds, which suggests that the cumulative impact of racial bias poses a threat to the health of Black women. These are just two of numerous examples that bias, when left unchecked, negatively impacts the experiences of many diverse patient populations.
With the advent of the Affordable Care Act (ACA) which contains some provision to help start to reduce race and other health related disparities, things are on the right path. However, progress is slow and not enough is being done to reduce, let alone eliminate, health disparities among racial and ethnic minorities. Advancing health equity requires disrupting entrenched bias in the healthcare system by providing health care professionals with the tools and resources that will aid them in providing culturally competent care to their patients.
Barriers to attaining quality care also need to be eliminated where possible. The ACA has provided healthcare coverage to approximately 20 million more Americans, but healthcare access still remains a challenge. In an article published by Center for American Progress, “Even with health insurance, accessing timely, culturally appropriate, quality care can often be difficult. Many women, especially those in rural or underserved areas, lack physical proximity to doctors or hospital maternity wards to receive pregnancy care or deliver a baby.” This lack of access or the cost in time and money to gain critical access has a disproportionate affect on minorities and the poor.
As a society, we must strive to become aware of these disparities and do our part as citizens to break the chain of inadequate healthcare. At Cook Ross, we work tirelessly to raise awareness about diversity and inclusion for healthcare providers and build the capacity of organizational leaders to build a strategic ecosystem that supports diverse constituents. By improving awareness and equipping managers and healthcare professionals with tools and techniques, healthcare organizations learn to mitigate their biases and raise their cultural understanding. Culturally aware workers in a clinical setting ask better questions that can often save lives, ease suffering, and reduce healthcare costs. CultureVision™ is one such tool that provides culturally sensitive awareness.
But tools and cultural awareness training alone are not the complete solution. Unless organizations and the broader society recognize and increase action regarding health disparities, change will be slow. Our awareness raising efforts must also be coupled with ongoing strategic planning and capacity building. We need to continue to elevate awareness of the issue and increase data collection to identify trends in health disparities, so we can one day avoid the issues that Alia McCants and Serena Williams went through and perhaps help their daughters live in a world where health disparities are a thing of the past.
Shane L. Lloyd is a Consultant with Cook Ross. His extensive experience in diversity and inclusion includes work with Brown University, Yale University, and the Rhode Island Department of Health’s Health Disparities and Access to Care teams.
Christopher S. Morin is a Portfolio Lead with Cook Ross. He holds over fifteen years of experience managing diversity and inclusion initiatives, including work with Dr. Jane Jarrow on the American Disabilities Act and leading teams of content and design specialists at CareFirst BlueCross BlueShield.