By Linda Perkins

Health disparities continue to disproportionately affect minority populations despite improvements in overall health for most Americans. In Michigan, minority groups have a higher rate of chronic disease than average, so improving healthcare for these groups is critical. Unfortunately, cultural differences and societal biases often impact the quality of care these individuals receive. To improve outcomes, healthcare organizations must do more to deliver culturally competent, judgement-free care that addresses bias and provides tools for every patient to be fully engaged.

According to recent surveys, nearly half of Hispanic Americans said they have had negative healthcare experiences or difficulties getting care due to language and other cultural differences. A study of Black and Hispanic adults over age 65 found a variety of factors affecting the quality of care these groups received, including lack of individualized care, poor communication, feeling rushed or ignored, and harmful assumptions that were made based on their race and socioeconomic factors. These patient experiences may not typically be driven by intentional malignant behavior, but if left unchecked, they can plant seeds of fear and mistrust of the healthcare system.

Linda Perkins

As a nurse for CCA Health Michigan, and as an active member of my community and church, I’ve seen first-hand how cultural differences and societal barriers impact the health of individuals with significant needs, especially members of minority groups. In my experience, individuals who mistrust the healthcare system struggle to embrace their care plans. They may see a medical expert’s guidance as one option of many, which requires discussion with family, friends or religious leaders.

To provide good healthcare and improve outcomes for minority groups, we must appreciate the richness of backgrounds among patients that may impact compliance with clinical guidelines. For example, while mammograms are considered to be an important preventive screening, some Arab American women cite concerns about modesty that prevent them from seeking these life-saving tests. By actively listening and addressing these concerns, we can deliver high quality care that considers the needs, values and preferences of every individual.

Through intentional practices outlined below, the healthcare system can take important steps to support our diverse communities:

• Foster trust by recognizing the importance of human relationships when delivering care. We do this by addressing all patients respectfully, which includes using their preferred name, title or pronoun.
• Respect and acknowledge a patient’s preferences and beliefs. For example, if a patient wishes to discuss the recommended treatment plan with their family or spiritual leader, give them the chance to do so and offer to connect in a few days to discuss their concerns and preferences.
• Meet individuals where they are on their healthcare journey. My team at CCA Health Michigan starts by talking to our members about their health goals. Together, we come up with an action plan they fully endorse. Patient-centered care should prioritize an individual’s medical needs while considering their personal circumstances and what is important to them. This might mean treating someone’s depression before other physical conditions so we can have more successful outcomes, for example.
• Create judgment-free zones by honoring where each person is emotionally, spiritually or financially. Taking the time to get to know each patient and their challenges allows you to work with them to set realistic goals. This approach empowers patients to follow through on treatment plans rather than striving for a health standard that may be unrealistic. Celebrate small achievements and milestones to build momentum toward shared goals.
• Assess health literacy, including a patient’s ability to understand their conditions and treatment plans. Consider the accommodations they may need and prioritize offering information that is appropriate for their language, culture, age and other socioeconomic factors that can impact health literacy. By doing this, you empower them to make informed decisions, ensuring they’re able to retain their independence.

Everyone should have access to quality healthcare regardless of their cultural, religious or social background. By building trust with our patients and by addressing their barriers to care, we can achieve better health through better understanding and meet the diverse needs of our communities.

—Linda Perkins, is a registered nurse and director of clinical operations at CCA Health Michigan