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Reduce inequalities in minority health care by providing culturally sensitive education
View every patient encounter as a cross-cultural interaction.
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As a health care professional specializing in diabetes, you’ve probably noticed an influx of patients in the last several years, the majority of whom are from minority backgrounds.
It is no secret that chronic illnesses like diabetes disproportionately affect black, Hispanic, Native American/Alaska Native and Asian patients. It was, however, shocking to many health care professionals to learn about the discrepancies in the quality and nature of care that these minority patients receive in the American health system.
The 2002 Institute of Medicine report — Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care — found that the discrepancies in minority care were not wholly attributed to their socioeconomic status, cultural differences, attitudes toward health care, or treatment preferences. In fact, the study showed that “bias, prejudice, and stereotyping on the part of health care providers may contribute to differences in care.”
Recommendations for change
The IOM made several recommendations for decreasing the discrepancies in care revealed in the report. One recommendation encouraged all current and future health professionals to undergo cross-cultural training so that they will be more aware of how cultural and social factors influence the care provided to patients and their health outcomes.
In a 2002 position statement entitled “Cultural Sensitivity: Definition, Application, and Recommendations for Diabetes Educators,” the American Association of Diabetes Educators recommended that: Health professionals should develop and deliver diabetes education in a context that recognizes how groups of people self-identify their culture and express their beliefs, a perspective that underscores the importance of moving beyond simple associations of cultural identity with race or ethnicity.
 Amparo Gonzalez |
The position statement reinforces the idea that “cultural identity is based on any combination of collectively shared historical, linguistic, and psychological lineage; these sets of factors influence the social and spiritual perspectives of ethnic groups, particularly in establishing priorities for daily living.”
Diabetes, in particular, requires significant changes in a patient’s lifestyle, which is informed by one’s cultural and social identity. In order for minority patients to understand, accept, and implement the behavior changes needed to control their diabetes, educators and other health care providers must be aware of a range of cultural factors that impact compliance with their recommendations.
It is difficult to confront one’s own bias, prejudice, and stereotypes and objectively evaluate how they influence one’s treatment recommendations to minority patients. However, it is essential that health care providers take the necessary steps to ensure that they minimize their own biases, educate themselves about other ethnic and racial groups, and strive to provide culturally-appropriate health education.
It is a good idea to view every patient encounter as a cross-cultural interaction, even if their skin is the same color as yours. People are an amalgamation of their experiences, family heritage, socioeconomic levels, gender, sexual preferences, and lifestyle choices.
To address the diverse needs of each patient, health care professionals must increase their cultural awareness and learn techniques and strategies that make patients feel understood, respected and cared for. Ultimately, this will translate into better health outcomes for minority patients and help close the gaps in quality of care that they experience.
Amparo Gonzalez, RN, BSN, CDE, is President of the American Association of Diabetes Educators.