Patient-Physician Racial Concordance Associated with Improved Healthcare Use and Lower Healthcare Expenditures in Minority Populations

Jetty, Anuradha; Jabbarpour, Yalda; Pollack, Jack; Huerto, Ryan; Woo, Stephanie; Petterson, Stephanie C.

doi:10.1007/s40615-020-00930-4

Cited by 184 publications

(110 citation statements)

References 40 publications

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“…Increased access to Native Hawaiian practitioners may increase the ability of the kūpuna to make connections, as providers with similar cultural backgrounds may have an intuitive understanding of their patients' contexts, worldviews, and values through their own lived experiences. Evidence from a secondary analysis of data from the 2010–2016 Medical Expenditure Panel Survey, suggests that patient-provider racial “concordance contributes to a more effective therapeutic relationship and improved healthcare” ( 54 ). Expanding the pool of Native Hawaiian practitioners should also support the integration of Western and Hawaiian healing practices.…”

Section: Discussionmentioning

confidence: 99%

The Lives of Native Hawaiian Elders and Their Experiences With Healthcare: A Qualitative Analysis

Kawakami¹,

Muneoka²,

Burrage³

et al. 2022

Front. Public Health

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Native Hawaiians are proud and resilient people who have endured significant impacts from colonization. Despite being in a time of vibrant cultural revitalization, Native Hawaiians have a shorter life expectancy than other racial and ethnic groups in Hawai‘i. The primary aim of this paper was to share data from the first year of a 5-year study with Native Hawaiian kūpuna (elders) on their experiences with healthcare, along with barriers to accessing healthcare. Ten kūpuna living in rural areas of Hawai‘i participated in three interviews each, which were held in an informal, talk-story style. The first interview focused on establishing rapport. The second interview focused on the kūpuna's strengths, resiliencies, and what they would like to pass to the next generation. The third interview focused on the elders' experiences with healthcare, which is the focus of this paper. All ten kūpuna reported growing up with limited access to Western healthcare; rather, their families successfully treated many illnesses and injuries with lā‘au lapa‘au (Hawaiian herbal medicine) and other traditional healing practices, as they had done for generations. As Western medicine became more prevalent and accessible, they used both, but many preferred holistic treatments such as prayer, a return to the traditional diet, and lā‘au lapa‘au. As a group, the kūpuna rated their health as fair to good; two had diabetes, two had cardiovascular disease, four had neuropathies, and five were cancer survivors. The kūpuna reported high turnover among providers in rural communities. Limited access to specialists often required them to travel to Honolulu for care, which was costly and especially difficult during coronavirus disease 2019 (COVID-19). Regardless of provider ethnicity, the kūpuna appreciated those who took the time to get to know them as people and respected Hawaiian cultural practices. They advised that Western providers speak honestly and directly, have compassion, and build connections to patients and their communities.

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Section: Discussionmentioning

confidence: 99%

The Lives of Native Hawaiian Elders and Their Experiences With Healthcare: A Qualitative Analysis

Kawakami¹,

Muneoka²,

Burrage³

et al. 2022

Front. Public Health

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“…93 Because medical system trust plays a role in cancer care engagement, 58 it is important to consider interventions to increase comfort and trust for marginalized populations. Research shows that patientprovider racial or ethnic concordance can improve patient-provider communication and increase patient health care engagement, 94,95 highlighting the importance of ongoing interventions to increase research and medical workforce diversity and the need to increase patientprovider racial or ethnic concordance in genetics care. [96][97][98][99] Additional interventions might include (1) specialized case managers to streamline care and address patient questions, a model that has been successful in the diagnostic pathway, 100 and (2) leveraging celebrity hereditary cancer syndrome diagnosis disclosure, which has correlated with enhanced genetic testing usage and genetics knowledge seeking in the past, to create accessible and relatable interventions aimed at reducing stigma and increasing information access for lower health literacy populations.…”

Section: Discussion: the Future Of Equitable Care Delivery In Hereditary Cancer Syndromesmentioning

confidence: 99%

Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities

Mittendorf

Knerr

Kauffman

et al. 2021

JCO Precision Oncology

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“…Racially or ethnically concordant patient-physician relationships are associated with more effective communication, increased patient satisfaction, better adherence to treatment, and improved health care outcomes, 16-18 all of which are essential to lessen the gap in disparities. 16,19-23 Other industries recognize the importance of creating, promoting, and sustaining a diverse work force, 24,25 yet medicine lags behind.…”

Section: Current State Of Diversitymentioning

confidence: 99%

Tackling the Minority Tax: A Roadmap to Redistributing Engagement in Diversity, Equity, and Inclusion Initiatives

Faucett

Brenner

Thompson

et al. 2022

Otolaryngol.--head neck surg.

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Academic medical centers striving to implement diversity, equity, and inclusion (DEI) and antiracism initiatives often ask faculty to volunteer substantial time to committee work, recruitment, mentoring, community, and administrative responsibilities. These requests are not in lieu of current workload and seldom count toward scholarship; the service may go unrecognized, unrewarded, and uncompensated. URiM faculty (underrepresented in medicine) providing such service thus pay a minority tax when precious time is syphoned away from career-advancing activities and personal growth. The resulting strain on available resources has social, psychological, and monetary ramifications that can undermine the long-term objectives of DEI initiatives. We examine the facets of the minority tax, consider the current state of diversity, and present a roadmap to redistribute, reform, and reduce URiM taxation through shared engagement in DEI initiatives. Key interventions include ascribing value to DEI efforts, implementing evidence-based policies to reduce bias, and promoting mentorship, sponsorship, and allyship.

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Patient-Physician Racial Concordance Associated with Improved Healthcare Use and Lower Healthcare Expenditures in Minority Populations

Cited by 184 publications

References 40 publications

The Lives of Native Hawaiian Elders and Their Experiences With Healthcare: A Qualitative Analysis

The Lives of Native Hawaiian Elders and Their Experiences With Healthcare: A Qualitative Analysis

Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities

Tackling the Minority Tax: A Roadmap to Redistributing Engagement in Diversity, Equity, and Inclusion Initiatives

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