Cultural diversity is one of this country’s defining characteristics. And yet, cultural bias and discrimination in health care is an unfortunate reality. Patients often feel underrepresented when it comes to their own care or the care of their family members.
Clinicians and health care professionals need to understand the mindset that contributes to bias in care and what can be done to curb instances of discrimination. Dr. Alissa Erogbogbo, Medical Director of Operations with Ob Hospitalist Group, has witnessed these issues firsthand in her career as an OB/GYN and physician leader.
Listen to Dr. Erogbogbo discuss this topic on the Obstetrics Podcast:
“I had a patient who needed help with prenatal care, who was very shy, very nervous to give the information she needed to give. It took a few coaching moments with her, and helping her understand she can trust me, for her to be able to give me some true background information,” says Erogbogbo.
“The first thing she said was, ‘I really felt I was going to be judged by the nursing staff, by the physicians.’ It brought on a different spin of how we, as clinicians, welcome patients and talk with patients.”
Clear communication is key
One way to prevent bias in care is to maintain a direct line of clear communication between patients and health care staff—whether clinicians, nurses or front-office personnel.
Erogbogbo cites another example where an African American women pregnant with twins experienced judgment based on an insurance versus cash payment misunderstanding. The woman was covered by her own insurance, but care costs were being covered by a third party.
Unfortunately, she was met with bias that could have been avoided had there been better communication on the part of the staff. “After things cleared, the patient was fine. She understood. But, those are the types of situations where there’s prejudgment and not knowing the whole backstory before making a comment,” says Erogbogbo.
“As clinicians, as caregivers, we always need to take a step back and ask questions first before we proceed with any type of judgment or course of action for that patient.”
Statistics reveal disparities
Research comparisons between African American women and caucasian women during pre-pregnancy, pregnancy, and post-pregnancy reveal clear disparities in infant mortality rates, death due to complications related to low birth weight, and more. The U.S. Department of Health & Human Services published the most recent statistics available to be:
- African Americans have 2.3 times the infant mortality rate as non-Hispanic whites
- African American infants are 3.8 times as likely to die from complications related to low birth weight as compared to non-Hispanic white infants
- African Americans had over twice the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2017
- In 2017, African American mothers were 2.3 times more likely than non-Hispanic white mothers to receive late or no prenatal care
Erogbogbo also notes that language barriers can be a contributor to underlying bias, in communities where there are large non-English speaking populations.
Awareness & education
Education is the foundation for ensuring that clinicians become aware of their own implicit bias, and many platforms offer surveys and diversity training for medical staff – but it should extend to the community as well.
Erogbogbo suggests holding town hall meetings to ensure community members are well-informed about the services provided, or pairing hospitals with clinics to help staff better understand the area’s demographics and accompanying need.
“We want people to understand and see that the hospital is really working towards making sure everyone is taken care of. That we’re really looking at what can be done in that community for each and every citizen, and no one is going to be left behind.”