Authors: Felecia D. Sheffield Ph.D., and Mary E. Ray, M.D.
- The United States has a long and well-documented history of systemic discrimination. These are evident in a myriad of areas, including education, employment housing, health, and housing. associated with the economic or social or environmental disadvantage.
- Health disparities negatively impact populations of people who are more likely to face barriers to health due to their race or ethnicity and religion, socioeconomic status, gender; age and mental health; sensory, cognitive physical, or sensory impairment sexual orientation, or gender identity; geographical place of residence; or any other characteristic traditionally associated with the discrimination of or exclusion.”
- Women and minorities of racial or ethnic origin have been found to receive more inaccurate diagnoses, fewer treatments, and less control, and suffer from worse outcomes in clinical care. Pregnancy-related deaths are between 3 and 4 times higher for women of non-Hispanic African descent as compared to white counterparts who are not Hispanic Caucasian. In 2014, researchers discovered it was true that Native Americans and Alaskan Natives have a rate of infant mortality 60 % higher than whites.
- The two groups of Black, as well as Hispanic females, have also been found to have higher unintended pregnancies rates than their Caucasian counterparts. This is also proven to be connected to a range of adverse prenatal outcomes. Outside of the healthcare system for civilians, the disparities have been seen in the military veteran population in relation to access to healthcare, the utilization of healthcare, and the higher rates of prevalence of certain chronic illnesses. Like healthcare in general access to mental health care and the absence of health insurance are associated with significant gaps in the treatment of mental illness in ethnic minorities.
- Based on the preceding healthcare providers need to make sure that they do their part to raise awareness of social injustices as well as acknowledge the impact they influence on the delivery of treatment, self-management by patients, and the collaborative planning of treatment between the patient and the provider. The suggestions below do not provide a complete solution to a problem that is systemic just a few suggestions for first actions to open up dialog, encouraging assessments of the system, and stressing the importance of constant monitoring and improvement of processes.
- Keep an eye on our implicit biases towards groups that are different from our own. Promote cultural competence as a requirement through regular staff development, training for employees, and expert consultation with subject matter experts in anti-racist education, peer reviews.
- Don’t be shy to respectfully inquire about your patients and friends instead of thinking that certain customs or beliefs are the same for everyone in the same ethnic or racial group.
Collaboration in Treatment Plan:
- Take note that treatment planning is a process that involves the patient and healthcare professionals. Let the patient provide feedback and be attentive to their concerns.
Problems with Medication Adherence
Review the medication adherence of your patients regularly. Consider factors that could be hindering compliance, such as history or cultural mistrust, or obstacles to treatment.
Family Dynamics and Relationships:
- Let patients discuss their concerns privately, without the spouse, or relative being in their presence. Discuss the treatment plan in detail with patients only with their permission. If a teenager is a minor, ask parents to permit a split appointment during which their child can be seen by themselves prior to inviting the parent or guardian back at the conclusion of the appointment.
- Let professional translators be employed, and schedule beforehand. Don’t suppose that patients wish for the family member or friend to have access to their medical information simply because the person brought them into the appointment. Make it clear that this isn’t an inconvenience to lessen self-consciousness regarding a lack of English knowledge.
- When describing treatment suggestions be aware of any costs associated with the treatment which could hinder follow-up or drug adherence. If possible, assist patients to avail discount drug programs. Don’t believe that every patient is insured through health insurance.
- Discuss with patients the possibility to attend scheduled follow-up appointments or other referrals to a medical professional. If you can, discuss options to make multiple appointments on the same day, to limit the cost of gas, tolls, or the patient’s dependence on other people for transportation.
- Take advantage of a survey from patients to gather feedback from patients about the treatment they receive. Be aware of the patterns and areas that are consistently lacking. Make a plan for corrective action to address the areas of concern or complaints.
- It is recommended that organizations ensure that their staff is regularly educated about cultural competence as well as how diverse demographics affect the care provided to patients. Make sure that staff is aware of expectations regarding cultural competency in routine procedures and processes.
- Dr. Sheffield is a Licensed Clinical Psychologist, with an extensive background in clinical, treatment, and program management expertise with people of diverse ethnic and socioeconomic backgrounds and children. She provides consultations both nationally and internationally in non-profit organizations hospitals, schools, and clinics. Dr. Sheffield has written over three dozen parenting and self-help pieces for people of all ages. Her involvement in volunteer activities includes being a member of Science Cheerleaders, a national non-profit 501(c)3 organization made up of former and current professional NFL/NBA cheerleaders who have STEM degrees who inspire in encouraging, empowering, and energizing youngsters or young girls to explore engineering, science, and math-related careers.
She is an expert in the field of family medicine. She has vast experience working with people of different ages and ethnic backgrounds. In her role as an educator, she is interested in