Race significantly impacts the quality of health care patients receive in the United States, as well as the ultimate outcomes. While the impact of COVID 19 on diverse communities heightened the public’s awareness of health disparities, this phenomenon is present in so many different areas of medicine and has been for a long time. Infant mortality rates, as an example, are two to four times higher among Black babies than their white counterparts and the average life expectancy for Black people is almost six years less than for white people.
What contributes to these differences in health care and outcomes? A whole host of factors — including poverty, lifestyle and inadequate access to essential medical resources — play a role. These are societal issues that extend beyond the health care system and its providers and while hospitals and the health care system find themselves grappling with these challenges, they cannot tackle these issues alone.
However, a key contributor to health care disparities that providers may be able to address is the lack of trust in the medical establishment felt by many in minority and culturally unique communities.
This mistrust is partially rooted in the underrepresentation of minorities within the medical profession which can breed doubts about health care advice and result in patients not following medical recommendations. When patients feel their providers don’t really understand or relate to them, they may feel alienated and wary of complying.
So what can be done to foster trust between patients and their doctors to mitigate disparities that have devastating consequences on health? Working to nurture diversity among health care professionals so people can begin seeing doctors that look and act like them is one important first step. Cultivating positive relationships between health care providers and their communities can also enhance health outcomes.
Trust is enhanced when individuals connect with those treating them because they have shared life experiences. Unfortunately, doctors and other health care professionals often do not mirror the diverse makeup of the communities they serve. Representation does matter. It fosters rapport between medical professionals and patients. It creates environments where patients are more transparent and honest about their lifestyle choices because they can better relate and feel that they will be heard.
Increasing racial diversity in the medical profession has the potential to save lives. Recent studies reveal that Black people with longer lifespans live in communities with a higher concentration of Black physicians.
Researchers at Stanford University found that Black men who were seen by Black doctors were more likely to consent to immunizations and cardiovascular screenings. The study further noted that those who were most distrustful of the medical system benefited most when they were able to be seen by physicians of the same race. They estimated that this approach can potentially reduce the mortality gap between Black and white patients due to heart disease by 19%.
Research also underscores that patients, particularly women, tend to embrace preventive measures more actively when cared for by physicians who share their racial or gender identity. This revelation supports an urgency to address the barriers that prevent students of color and women from pursuing medical careers.
That change can start in higher education. Encouraging students from culturally unique communities and continuing the cultivation of women to pursue careers in medicine requires addressing systemic inequalities in education and mentorship opportunities. It requires developing opportunities for minority and all high school students to interact with medical students, shadow doctors and conduct research so they can envision their own medical careers.
Working within the guidelines set forth by the recent Supreme Court decision, universities and health care educators can nurture a pipeline of future health care professionals from diverse backgrounds by ensuring that their journey is supported and their potential maximized. In addition to fostering careers in medicine, higher education institutions can help build trust in the medical system by nurturing minority students to pursue careers that will enable them to become part of the health care team — as nurses, technicians, medical assistants, respiratory therapists, dietitians and more — who will deliver care to minority patients.
Building trust in health care goes hand in hand with embracing diversity and representation within the medical profession. Today’s health care educators can stand at the forefront of this, equipping students with the knowledge, compassion, and cultural competence to make a lasting impact in their communities. By fostering a positive relationship between health care providers and the communities they serve, we take a significant step towards a healthier, more equitable future for all.
Together, let’s create a health care system where diversity thrives, and the power of compassionate care leads to better health outcomes for everyone.
Kadish, a physician, is president of Touro University.