Transforming Clinical Practice to Eliminate Racial–Ethnic Disparities in Healthcare

Abstract

Racial-ethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racial-ethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racial-ethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racial-ethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices.

Treating and Precepting with RESPECT: A Relational Model Addressing Race, Ethnicity, and Culture in Medical Training

“…17 In the RESPECT model, the provider actively conveys empathy to the patient rather than simply collecting data. Since so much of trust-building is affective and relation- 18,19 Providers need skills to counterbalance power differentials through verbal and nonverbal behaviors, actively seeking patients' concerns, potential disagreements, and barriers to treatment. Accumulating evidence supports the validity of the RE-SPECT components as critically related to disparities in care (see Table 1: refs 16,[20][21][22][23][24][25][26][27]36 ).…”

Health disparities in Chinese Americans with hypertension: A review

“…Culturally appropriate interventions, including addressing the need for linguistically and culturally competent healthcare providers, are important for reducing these health disparities. However, evidencebased interventions to eliminate disparities in healthcare for minority groups are still underdeveloped [9,24,32,37]. Sociocultural factors and health literacy must be considered when tailoring interventions, particularly for Chinese Americans, which involves reducing barriers, such as language difficulties, cultural variation, lack of available and accessible preventive services, and addressing perceptions about healthcare.…”

Getting to Equal: Strategies to Understand and Eliminate General and Orthopaedic Healthcare Disparities

“…Weaving the concepts of equitable cross-cultural care into the larger scope of ethics of caring reduces healthcare disparities, particularly when addressing issues that are especially sensitive or important to the patient's health or well-being [8,11] Translate principles and recommendations for reduction of healthcare disparities into specific interventions that providers can use in their own clinical practices ''Blueprints'' can assist healthcare providers in translating principles for the elimination of racial and ethnic healthcare disparities into specific actions that are relevant for individual clinical practices [71] Expand leadership efforts of academic medicine Academic medicine must make the elimination of healthcare disparities a critical part of its mission and provide national leadership by identifying quality improvement innovations and creating disparities solutions; examples include collecting and reporting data on patients' race/ethnicity, integrating cross-cultural education into health professions training (eg, the Harvard Medical School Culturally Competent Care Education Committee), promoting diversity in research, recruiting and training greater numbers of minority health professionals and faculty [9,73] Expand culturally competent care education in graduate, postgraduate, and continuing medical education activities…”