The last 30 years have witnessed incredible advancements in medicine. Revolutionary care has improved the prospects on many conditions once thought fatal. However, one thing that hasn’t changed is the disturbing health disparity throughout populations in the United States. The U.S. continues to become increasingly diverse, but the intersection of healthcare and medicine has yet to catch up in many cases. Diversity and population health go hand in hand. That’s why it’s crucial for providers to understand diverse patient needs and improve medical care across communities.
What do diversity and population health mean?
Today’s health workforce faces numerous challenges when it comes to caring for the diverse communities they serve. These challenges often relate to language and staffing. When hospital leaders commit to “culturally and linguistically appropriate care highly visible to hospital staff and patients,” staff members are more likely to prioritize providing this level of care.
While public health highlights improving health through policy, population health connects practice to policy. It’s the lens that brings “significant health concerns into focus and addresses ways that resources can be allocated to overcome the problems that drive poor health conditions in the population.”
So how does promoting diversity tie into population health? Let’s take a deep dive into that question:
According to Georgetown University Health Policy Institute, “having a regular doctor or a usual source of care facilitates the process of obtaining health care when it is needed.” If your organization serves communities that do not have regular care providers, they are less likely to get preventive care let alone receive diagnoses and treatment for more complex and/or chronic health conditions.
When your organization’s patients don’t have health insurance coverage, they face another layer to their lack of access. According to the Kaiser Family Foundation:
- Most people who are uninsured are in low-income families
- Adults are more likely to be uninsured than children
- People of color are at higher risk of being uninsured than people who are white and non-Hispanic
- Many adults do not have access to employee sponsored health insurance
- Many adults in states that did not expand Medicaid are ineligible for financial assistance for health insurance coverage
Understanding diverse communities and their needs
The U.S. Office of Personnel Management notes that hiring a diverse workforce is not enough. According to the organization, “when we draw on the wisdom of a workforce that reflects the population we serve, we are better able to understand and meet the needs of our customers: the American people.” This means consideration of a workforce and of patients in regard to traits and experiences such as:
- sexual orientation
- gender identity
- veteran status
- socioeconomic reality
- where people are from
- where they’ve lived
- how they express their personal beliefs
The United States is expected “to become a majority-minority in 2045, thereby increasing the need to prepare and train health care professionals who are culturally responsive and equipped to provide quality care in a multicultural society.” But as of now,
- under 10% of physicians identify as black or African American, Native American or Alaska Native, and Hispanic or Latino
- the number of women physicians going part-time or leaving medicine has skyrocketed
- there are less than 170 medical school faculty members who identify as American Indian and Alaska Native
- only a fraction of U.S. healthcare facilities participated in the 2018 Healthcare Equality Index voluntary online survey, an initiative that measures LBGTQ patient care and workforce inclusion
When patients experience a lack of diversity in your organization, it may be intimidating. If they’re intimidated, they may not receive the care they need. They may also be a part of a culture that views health services, diseases, and treatments differently than your organization.
Reaching out to underrepresented minority groups
“We run the risk of becoming short-sighted or boxed in to a particular way of thinking when everyone is the same,” according to Dr. Lisa Doggett, co-founder of Texas Physicians for Social Responsibility. “We lose a certain richness and opportunity to learn from one another. We, as individual clinicians, are certainly affected when there is a lack of diversity, but our patients are impacted even more.”
Reaching out to groups who are racially and ethnically underrepresented to attend medical school has proven valuable to underserved communities. Research has shown that people in such groups are more likely to practice in underserved communities, “thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide.” Extending that reach to a larger variety of diverse traits and experiences may very well yield similar results.
Reaching out to diverse patient populations means understanding not only their health concerns but also how organizational messaging speaks to communities. Improving health literacy and connections to diverse communities means more than translating brochures into different languages. To connect with a community, your organization must collaborate with the community. Technology may be a critical tool as your organization builds relationships with a variety of communities, including how you provide access to messaging and medical information.
How can you promote diversity and population health?
Diversity in the professional development of the health workforce is fundamental. You organization’s success depends on it as does the health of populations it serves.
It’s just as important that your organization’s workforce be representative of and able to effectively engage with the communities they work with.
Here are some ways your organization can improve its connection to diverse communities:
Start with a diversity and inclusion statement.
These statements are more than just symbols: they represent an organization’s commitment to providing excellent care to everybody regardless of ethnicity, religion, race, age, socioeconomic status, and background to thoroughly implement diversity and institutionalize inclusion efforts.
Be more inclusive from the top down.
CEOs and members of leadership who “actively work to learn more about these issues, who are aware of the diverse needs of their patient population, and who demonstrate their commitment through involvement in cultural and linguistic programs are more likely to have staff follow their lead.”
Hire a diverse workforce.
Create diverse hiring committees, leadership teams, and patient teams. “Having a workforce that reflects the diverse cultures and ethnicities and the diverse lifestyles of the community has helped us formalize strategies to be a much more inclusive health system,” according to Jennifer Mieres, MD, senior vice president and chief diversity and inclusion officer for Northwell Health.
Create metrics on how to reach these your goals.
Maximize your organization’s investment into inclusion by remembering that what gets measured gets done.
Evolve and analyze.
Institutions need to understand what’s working and what isn’t. This will help your organization understand where there’s room for growth. Take a two-fold approach:
- identify the best national public healthcare training and education practices that foster inclusivity
- keep track of your organization’s local communities and specific needs
Share this with your colleagues in population health:
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