Conversations in Cultural Competency

Why Being Black in America is Bad for Your Health

After more than a year of in-depth reporting in Baltimore, The Atlantic has published a long read that explores why, as a group, black Americans are significantly less healthy than white Americans. The piece follows a woman named Kairra, who is 27, black, very overweight, and suffers from a host of health problems that are usually associated with people three times her age. In Baltimore, as well as other segregated cities like Chicago and Philadelphia, the low-income, mostly black neighborhoods have a life expectancy that is 20 years lower than more affluent, whiter neighborhoods. The gap can be attributed to several factors, including violence, diet, environmental hazards, substance abuse, and stress.

In this week's News Roundup:

• Creating Financial Success at a Small Rural Hospital
• Gender Bias Hinders Research in Chronic Disease
• The Business Case for Racial Equity

Creating Financial Success at a Small Rural Hospital

An in-depth piece from Politico Magazine explores how a small, rural hospital in Kansas has become an economic powerhouse by serving the local refugee/immigrant population and specializing in labor and delivery. Ben Anderson, the hospital's CEO, relies on community partnerships, infrastructure grants, and targeted recruiting. His recruiting model is especially interesting: He attracts young physicians who are interested in helping Third World populations. "You can do that work right here in Kansas," he says. Having a staff that actively seeks to work with diverse populations improves patient experience and outcomes.

• Health Equity Bill Introduced in Congress
• Medical Schools Must Do More to Combat Racism
• Experiment with Barbershop Clinics is Succeeding
  
  

Health Equity Bill Introduced in Congress

The Congressional Tri-Caucus, made up of the Congressional Asian Pacific American Caucus, Congressional Black Caucus, and Congressional Hispanic Caucus, has introduced the Health Equity and Accountability Act of 2018 (HEAA), a bill that attempts to address health disparities based on race and ethnicity. The authors note several reasons for these disparities, including language and cultural barriers to care.

In this week's News Roundup:

• Near-Miss Mothers: For Every Woman Who Dies Post-Childbirth, Thousands More Come Close
• Surging Opioid Overdose Rate in Latinos Tied to Language Barriers
• More Transgender-Inclusive Healthcare is Essential

Near-Miss Mothers: For Every Woman Who Dies Post-Childbirth, Thousands More Come Close

The maternal mortality rates in the U.S. are grim, but the number of women who suffer postpartum complications that nearly cause death are even worse. For every woman who dies after childbirth, at least 70 come close. Some estimates put the number of women who suffer "severe maternal morbidity" at around 80,000 per year. A report by NPR/ProPublica finds that many of these complications are preventable, and there's a common theme that postpartum mothers don't feel their concerns are taken seriously by healthcare providers.

In this week's News Roundup:

• Unconscious Bias Training Can Ease Crisis in Black Maternal Mortality
• Stigmatizing Language in Medical Records Affects Patient Care
• Discrimination Causes Latinas to Be Less Satisfied with Contraception
• Documentary Explores Desegregation of Healthcare System

Unconscious Bias Training Can Ease Crisis in Black Maternal Mortality

We've reported extensively on the dismal maternal mortality rates in the U.S., and the crisis in black maternal mortality in particular. A new piece by NBC News follows the stories of two black mothers who experienced serious complications with their deliveries. Both women felt their medical teams were dismissive and brusque, and that their health problems may have been avoided with better communication. They are among the 32% of black women who feel they’ve been discriminated against in physicians’ offices. Unconscious (or implicit) bias on the part of healthcare providers has very real consequences for patient outcomes. Bias training may not be the complete solution, but it is part of the solution, and should become a standard practice in all medical schools and healthcare organizations.

In this week's News Roundup:

• How Empathy Keeps People Out of the Hospital
• Gender Bias Diminishes Women's Health Concerns
• University of Chicago Reopens Trauma Center
• Black Patients with Heart Failure Less Likely to See Cardiologists

How Empathy Keeps People Out of the Hospital

Growing evidence shows that more empathetic care can keep people healthier and reduce hospital visits. A new piece by NPR's Marketplace profiles Philadelphia's Penn Center for Community Health Workers, which pairs community health workers with patients who frequent hospitals due to chronic illness, poverty, or mental health problems. The community health workers visit patients at their homes and help them navigate their health issues. The Penn Center makes an effort to match its staff with patients who share a similar background, in order to inspire trust. A randomized, controlled study showed the Center reduced hospitalizations by 30%.

Asian Americans Undertreated for Mental Health Disorders

Racial Bias Isn't Just a Problem at Starbucks

A video of two black men getting arrested at a Starbucks in Philadelphia has sparked widespread outrage directed at both Starbucks and the police. In response, Starbucks announced that it will close 8,000 stores in May so employees can engage in racial bias training. "While this is not limited to Starbucks, we're committed to being a part of the solution," said CEO Kevin Johnson. The problem certainly isn't limited to one company, or one industry, or one region of the country. There are any number of examples of white Americans calling the police on black Americans without real justification. Deeply ingrained and unconscious racial bias routinely leads to instant, often fear-based judgements about people that can have dire consequences. The question is, what can we do to break this cycle?  

Unconscious Bias in Healthcare Impacts Bottom Line

Unconscious bias leads to health disparities for patients, and has a negative effect on healthcare workers as well. Unconscious bias can cause both patients and staff to be treated differently based on gender, race, language spoken, lifestyle choices, and more. This results in higher staff attrition and and lower patient satisfaction—and in turn, it negatively effects healthcare organizations' bottom line.

We're Failing Dr. King's Legacy in Healthcare

This past week marked the 50th anniversary of Dr. Martin Luther King Jr.'s death. Dr. King famously said, "Of all the forms of inequality, injustice in health is the most shocking and inhumane." He said that in 1966. In 2018, the US still struggles with pervasive health inequality that weakens our overall healthcare system, and reduces our standing compared to other developed nations. The city of Atlanta, where Dr. King grew up and went to college, is a national healthcare hub, boasting world-class healthcare facilities. It is home to the Centers for Disease Control (CDC), the American Cancer Society, the Arthritis Foundation, and several schools of medicine and public health. But Atlanta also has some of the widest gaps in black and white health outcomes in the country. Among these disparities are: