Story Highlights
- Monitor your data to find potential problems and targets for improvement
- Get proactive to prevent new problems and avoid exacerbating existing ones
- Steadfastly treat known DEI issues
The theme of Black History Month 2022 is Black health and wellness. For leaders at healthcare systems, that theme is a reminder to improve the awareness and understanding of health and wellbeing for Black Americans, consider the sources of health disparities, and strive for improvements. This year's theme is also a reminder that a diversity, equity, and inclusion (DEI) checkup may be in order.
These questions are key to your healthcare system's annual exam:
- Is your system providing truly equitable and inclusive healthcare to the communities you serve?
- How is your system working to close long-standing racial gaps in health and wellbeing?
- Do system policies and processes help or hinder DEI outcomes?
- How are you holding system leaders accountable for DEI progress, and how will you ensure these initiatives remain priorities?
- What are you doing, personally, to contribute?
If you are less than satisfied with any of your answers -- or have no answer -- it might be time to recommit to your system's DEI "health." While every system's approach will be unique, a three-point regimen can help you get back on track.
Monitor Your DEI Health
Your physical and emotional health indicators highlight potential problems and identify targets for improvement. Your healthcare system's DEI indicators serve an analogous function.
Think through the best indicators across a range of KPIs. Simple quantitative variables are important, so monitor things like caregiver demographics across roles, variance in the caregiver experience of wellbeing and engagement across demographic groups, and important career outcomes like participation in development opportunities and advancement. Select the factors that directly influence patient experiences and outcomes.
Most health systems track data of this sort, but far fewer actively monitor and act on those data. To move from awareness to action, establish processes to routinely review the data through a DEI lens.
To ensure your system is meeting the needs of its entire patient population, ask hard questions about variance in quantifiable data and the perceptions of traditionally underserved groups. These processes should be designed with clear accountability and expectations for acting -- and repercussions for not acting -- on the data.
Health system leaders may well find performance gaps. A recent Gallup Center on Black Voices study, incorporating survey results from more than 13,000 Americans, revealed that Black and Hispanic Americans reported poorer patient experiences across various dimensions and were more likely than White Americans to report negative experiences with providers.
| White Americans | Black Americans | Hispanic Americans | |
|---|---|---|---|
| % | % | % | |
| I am satisfied with the amount of time healthcare providers spend with me during visits | 32 | 26 | 22 |
| Healthcare providers explain things in a way I can understand | 38 | 33 | 28 |
| Healthcare providers tell me what medicines or treatments are for before prescribing them | 38 | 34 | 28 |
| Healthcare providers listen carefully to my concerns about medicines or treatments | 33 | 28 | 23 |
| Gallup | |||
| White Americans | Black Americans | Hispanic Americans | |
|---|---|---|---|
| % | % | % | |
| Assumed something about you without asking | 32 | 35 | 37 |
| Didn't believe you were telling the truth | 17 | 23 | 24 |
| Refused to order a test or treatment you thought you needed | 12 | 15 | 19 |
| Gallup | |||
Prioritize Preventative Care
As any good doctor would recommend, being proactive helps you avoid developing new problems or exacerbating current ones. DEI is no different. There are many steps you can -- and should -- take to maintain or improve your organization's basic DEI health.
Increasing the diversity of your own workforce is critical for the overall DEI health of your organization. A doctor with the same background, experience and frame of reference as the patient can help the patient feel more comfortable sharing personal or sensitive information, which helps providers better direct their questions or recommendations. That common experience can be foundational to the patient experience.
However, many Black and Hispanic Americans struggle to access doctors who share their race or ethnicity. Approximately one in five Black Americans say it is "very difficult" to find a doctor of their race or ethnicity, and another 35% say it is "somewhat difficult." Similarly, Hispanic Americans are more likely to say that it is "very difficult" (15%) or "somewhat difficult" (24%) to find doctors of their race or ethnicity than are White Americans (5% and 8%, respectively).
A doctor with the same background, experience and frame of reference as the patient can help the patient feel more comfortable sharing personal or sensitive information, which helps providers better direct their questions or recommendations.
Like expanding diversity in your workforce, upskilling the cultural competency of employees at all levels is an important step toward healthier DEI.
Cultural competency helps your workforce interact appropriately and effectively with a diverse patient population -- helping to minimize the presence or perception of bias, stereotyping or unequal treatment. Currently, 65% of Black Americans and 48% of Hispanic Americans say that healthcare systems treat people unfairly based on race or ethnicity "very often" or "fairly often." Forty percent of White Americans say the same.
Apply Treatments
It's clear that some conditions are already in dire need of treatment when it comes to DEI in healthcare.
At the top of the list is addressing disparities in access to quality healthcare. A number of groups report disparities in access, including rural Americans and low-income Americans. Gallup finds that Black and Hispanic Americans are less likely than White Americans to report having easy access to quality healthcare where they live (31%, 32% and 47%, respectively).
Expanding telehealth and virtual care options are a solution. Healthcare access via a mobile phone, computer or tablet can provide a feasible option for patients who are distant from a physical location, lack transportation or childcare, can't leave work, or have other barriers.
Importantly, when it comes to telehealth and virtual care, Black, Hispanic and White Americans report similar levels of quality: 41% of Black Americans rate it as "good" or "excellent," as do 37% of Hispanic Americans and 38% of White Americans.
Gallup finds that Black and Hispanic Americans are less likely than White Americans to report having easy access to quality healthcare where they live (31%, 32% and 47%, respectively).
Of course, the cost of healthcare is a central barrier, and it affects certain groups disproportionately. Consider, for example, that 60% of White Americans are "living comfortably" on their present income, but only 43% of Black Americans and 45% of Hispanic Americans say the same.
In fact, 30% of Black Americans and 32% of Hispanic Americans say there have been times in the past 12 months when they did not have enough money to pay for healthcare they or a family member needed, compared with 23% of White Americans.
Treating that problem may require personnel or online systems to address financial concerns, such as questions about charges or insurance and options for payment plans (i.e., monthly payments).
Systems to address financial concerns will be most effective if you consider the patient's perspective -- are these services easy to find and use? Are inquiring patients treated with respect and compassion?
For whatever solutions you apply as treatment, monitor progress or improvement to create accountability and maintain your treatment adherence, noting what really works and what doesn't so that your organization can make the best possible investments.
Finally, everyone needs a little motivation to maintain their health. So, as you focus on this DEI health regimen, keep in mind that the health of your systems is integral to your ability to achieve your core mission and purpose: improving the health and wellbeing of the diverse people in the communities you serve.
