“To eliminate disparities, we must know enough (research); do enough (deliver the outcomes); care enough (commitment); and persevere enough (do not get discouraged).”
David Satcher, MD, PhD, Director, Morehouse School of Medicine
April is National Minority Health Month and this year’s focus is on “Partnering for Health Equity.” This month offers an opportunity to learn more and raise awareness about the health status and disparities in healthcare provided to racial and ethnic minority populations in the United States. Racial and ethnic disparities exist in surgical outcomes and care as well. Patients of lower socioeconomic status have increased complication, mortality and failure-to-rescue rates after major cancer surgery (Reames et al. 2014). African American and Hispanic patients have increased odds of mortality after trauma, as do uninsured patients (Haider et al. 2008).
Multiple factors at the patient, provider, and organization level influence surgical disparities. We must understand surgical disparities in order to help mitigate them (Hisam et al. 2016). As a surgical community we can help address these disparities by learning about cultural competency, focusing on our doctor-patient communication and encouraging our institutions and professional organizations to provide the necessary assistance services to the patients who receive care there.
Cultural competency can take many forms. It entails trying to understand the patient’s culture, which is not static. Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients (Betancourt et al 2002). A patient’s culture is shaped by myriad things, including where they were born, raised, live, and work. All of these factors impact their health. Providing culturally competent medical care is one strategy that can help reduce racial and ethnic health disparities.
Minority patients and individuals from lower socioeconomic backgrounds tend to receive less health-related information from their providers compared with non-minorities and individuals from higher socioeconomic backgrounds due to barriers in communication. These communication hurdles lead to patient dissatisfaction and poor comprehension, negatively affecting patient compliance with treatment plan and, in our case, affecting surgical outcomes.
As an individual what can you do to address health disparities?
- Read the American College of Surgeons Statement on Optimal Access
- Learn more about National Minority Health Month resources and activities by visiting: https://www.minorityhealth.hhs.gov/nmhm18/
- Join the conversation on Twitter, Facebook & Instagram by using the hashtag #NMHM18
- Explore resources for providing culturally and linguistically appropriate health services on the Think Cultural Health website: https://www.thinkculturalhealth.hhs.gov
- Encourage your organization to provide effective communication and language assistance services to culturally and linguistically diverse individuals receiving care and services from your organization. https://hclsig.thinkculturalhealth.hhs.gov
Everyone plays a role in reducing healthcare and surgical disparities. Collaboration between individuals, organizations and healthcare systems is necessary to advance health equity and help improve the health of our patients and communities. The first step we can take as physicians is to ensure culturally competent patient–provider communication, always have shared decision-making, and build trust as this will enhance the quality of care of all patients, not just racial and ethnic minorities. Through collaboration we can work toward achieving health equity.
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
Martin Luther King, Jr.
Patricia Martinez Quinones is a general surgery resident at the Medical College of Georgia at Augusta University. She was born and raised in Ponce, Puerto Rico. Dr. Martinez received her M.D. from the University of Puerto Rico School of Medicine. She hopes to continue her career path in academic trauma and critical care surgery. Patricia is an AWS Communications Committee member. You can find her on Twitter at @PMartinezMD.
Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.