Abstract
Studies of inequalities in health care have documented 13 groups of patients who receive disparate care. Disparities are partly due to socioeconomic factors, but nonsocioeconomic factors also play a large contributory role. This article reviews nonsocioeconomic factors, including unconscious bias, stereotyping, racism, gender bias, and limited English proficiency. The authors discuss the clinician’s role in addressing these factors and reducing their impact on the quality of health care. They indicate the significance of cultural humility on the part of caregivers as a means of amelioration. Based on a review of the clinician’s role as well as background considerations in the health care environment, the authors put forward a set of 18 recommendations in the form of a checklist. They posit that implementing these recommendations as part of the patient clinician interaction will maximize the delivery of equitable care, even in the absence of desirable in-depth cross-cultural and psychosocial literacy on the part of the clinician. Trust, mutual respect, and understanding on the part of the caregiver and patient are crucial to optimizing therapeutic outcomes. The guidelines incorporated here are tools to furthering this goal.
Highlights
Health care organizations shall Bprovide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.^ This statement is from the National Standards for Culturally and Linguistically Appropriate Services (CLAS) [1]
Racial and Ethnic Health Disparities (2017) 4:472–479 of health care than non-minorities^ [2] which means that some of us are delivering a lower quality of health care to certain groups
The sources of health and health care disparities are Bcomplex and involve many participants at several levels.^ [2] This paper focuses on the level of the individual clinical encounter—where it is you, the clinician, and your partner, the patient, battling against common enemies: disease and poor health
Summary
Health care organizations shall Bprovide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.^ This statement is from the National Standards for Culturally and Linguistically Appropriate Services (CLAS) [1]. The sources of health and health care disparities are Bcomplex and involve many participants at several levels.^ [2] This paper focuses on the level of the individual clinical encounter—where it is you, the clinician, and your partner, the patient, battling against common enemies: disease and poor health. There are factors in every patient clinician encounter that can lead to unequal treatment; there are measures you can take to combat those factors
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