MINORITY HEALTH: Experts Want Cultural Competence Care
Despite new technology and advances in medicine, health care for minorities still lags behind that of whites, according to an Alliance for Health Reform briefing held Wednesday in Washington, D.C. Reducing the racial disparity in health care is one of the central goals for the administration's "Healthy People 2010" initiative. As part of the initiative, HHS will target community-based organizations through its REACH -- Racial and Ethnic Approaches to Community Health -- program in an effort to raise awareness and combat infant mortality and HIV/AIDS -- among other illnesses that disproportionately affect minorities. Experts report that there are cultural differences in perceptions of health care-related issues, including access and quality of care. Speaking at the briefing, Dr. Marsha Lillie-Blanton of the Henry J. Kaiser Family Foundation said, "For the last 20 years, the gap between whites and blacks without a source of regular care remains the same." She noted that many minorities anticipate being treated unfairly when seeking medical care. To better serve minority health care needs, Lillie-Blanton advocated for a more culturally sensitive system. Echoing Lillie-Blanton's statements, Dr. Deborah Gould, chief of pediatrics at the Permanente Medical Group and the chair of pediatrics for Kaiser Permanente-Fremont, stressed the need for culturally competent care. The Kaiser Permanente National Diversity Council has designed provider handbooks that offer important and often overlooked information regarding minority health issues and concerns. Gould said that as the country's demographics shift and the minority population grows, cultural competence becomes extremely important to ensure that all citizens have access to quality health care.
According to a report commissioned by the Henry J. Kaiser Family Foundation, "A Synthesis of the Literature: Racial & Ethnic Differences in Access to Medical Care," prepared by the Morehouse Medical Treatment Effectiveness Center, pregnant white women tended to seek prenatal care earlier in their pregnancies than black or Hispanic women. Black women were more likely to be admitted to the hospital after child birth than whites, and black infants, regardless of birth weight, were admitted to neonatal intensive care more than two-and-a-half times more often then white infants (MMEDTEC survey, 10/99). A Henry J. Kaiser Family Foundation survey "Race, Ethnicity & Medical Care: A Survey of Public Perceptions and Experiences," released in October, found that 54% of white respondents said they were unaware of the racial differences in infant mortality, compared to 58% of African Americans. Fifty-one percent of African Americans said they are worse off than whites when it comes to receiving needed medical treatment, while 62% of whites believe that blacks receive the same necessary care. Forty-seven percent of Latinos said they are worse off than whites when it comes to getting routine medical care, compared to 66% of whites who say there is no difference. There are differing perceptions between blacks and whites when it comes to access to HIV/AIDS treatment, as 43% of whites agree that they are more likely than African Americans to receive the newest treatments for the disease, compared to 64% of blacks who believe whites receive better treatments. In addition, 60% of African Americans and 56% of Latinos say that race affects the ability to obtain health insurance compared to 47% of whites who said race as a factor (KFF survey, 10/99). Another problem facing many minorities is the lack of a regular physician or a regular source of health care. When it comes to accessing health care, Lillie-Blanton concluded that for minorities, "getting through the door remains a challenge because they lack the key" (Melissa Keefe, American Health Line, 11/19).