Racial, ethnic, and linguistic concordance between healthcare providers and patients is low for people of color, a new report says.
Lack of diversity in the healthcare workforce risks undermining trust and patient health, according to a new report published by the Urban Institute.
Past medical mistreatment of people of color such as ignoring patients’ health concerns has resulted in mistrust of healthcare providers in these populations. “Perceptions of a shared identity between patients and their healthcare providers could be one way to improve the patient-provider relationship and foster trust and better communication,” the new report says.
Earlier research has shown benefits of having healthcare providers of the same race as patients or who speak the same language as patients. These kinds of concordances have “been associated with a greater likelihood of patients agreeing to and receiving preventive care, better patient experience ratings, and higher ratings on patient-reported measures of care quality,” the report says.
The report, which received funding from the Robert Wood Johnson Foundation, includes two key findings.
- Only 22.2% of Black adults reported being of the same race as their healthcare providers compared to 73.8% of White adults.
- Only 23.1% of Hispanic/Latinx adults reported racial, ethnic, and language concordance with their usual healthcare provider.
“Trust is part of the foundation of good patient-provider relationships and is especially important for communities of color, who have long been discriminated against in healthcare. Having a provider who looks like you and shares your experiences builds trust. Diversifying the healthcare workforce and increasing access to culturally competent care are significant opportunities to promote health equity and reduce disparities,” Jacquelynn Orr, DrPH, Robert Wood Johnson Foundation program officer, said in a prepared statement.
Addressing healthcare workforce diversity
Medical education should be a focal point in efforts to increase diversity in the physician workforce, the report says. “Because Black medical institutions play a key role in training Black providers and other providers of color, creating and supporting medical schools at historically Black colleges and universities and other minority-serving institutions could help increase the diversity of the healthcare workforce,” the report says.
Barriers for people of color who apply to medical school include the high cost of medical education programs, inadequate guidance in navigating admissions, and insufficient support systems to make sure people of color have the resources necessary to pursue a medical education, the report says.
“Cost barriers are particularly salient, given that the median cost of attending an in-state four-year medical school is about $260,000 for public institutions and more than $350,000 for private ones. … Tuition-free programs, debt-free medical education programs for students qualifying for financial aid, and scholarships and grants for underrepresented students are promising strategies for lowering the price of medical education and increasing the representation of Black students and other students of color,” the report says.
Importance of language
Earlier research has shown that patients for whom English is not the primary language have worse health outcomes than patients with English proficiency.
There are two primary strategies to address language gaps, the report says.
First, healthcare providers can offer interpretation services. “Most Medicaid programs reimburse for professional medical interpretation, but reimbursement ranges from $30 to $50 per visit, and interpretation for an encounter could cost up to $200; private insurers seldom reimburse for interpretation services. Stronger enforcement of language access regulations and higher reimbursement for medical interpretation services by health insurance payers could improve language access in healthcare,” the report says.
Second, healthcare providers can be encouraged to be multilingual. “Although some medical schools recommend students be fluent in a language other than English, making this a requirement or a heavily positively weighted factor for medical school admissions could also help diversify the languages spoken in the healthcare workforce. Offering bonuses and higher pay for healthcare workers who speak multiple languages could also incentivize providers to add staff who speak languages other than English,” the report says.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Only 22.2% of Black adults reported being of the same race as their healthcare providers compared to 73.8% of White adults.
Only 23.1% of Hispanic/Latinx adults reported racial, ethnic, and language concordance with their usual healthcare provider.