Last week, I began this a series of posts on a new “business case” for diversity, equity and inclusion in healthcare: When we don’t get diversity, equity and inclusion right in our hospitals, in our clinics, in our coverage policies, and in our communities, people die.
Last week’s post explored the issue of maternal and infant mortality. This week, I will explore disparities in the way we screen and the impact this has on marginalized communities.
Changing the Way We Screen
Screening for disease such as breast cancer, colorectal cancer, or other health indicators can be life-saving for patients. And yet, the racial identity of patient populations can have a profound impact on this process. Unconscious bias can turn a good thing like health screenings into a vehicle for disparities.
Unconscious bias can turn a good thing like health screenings into a vehicle for disparities. Share on XFor example, research by the Annals of Family Medicine shows Black women are 1.5 times more likely to be given a universal screening, which tests for illicit drug use in pregnant women, than their white counterparts, even though there has been no positive correlation between race and the likelihood of substance use.
In other instances, we need to fundamentally change the way that healthcare is provided in order to reach patients who need us but who may never come through our doors. Take colorectal cancer screening as an example. A study by the Annals of Family Medicine offers that colorectal cancer is one of the leading causes of cancer death in the United States and that potentially life-saving screening rates in non-white, low income, immigrant, and non-English speaking individuals is significantly lower than other populations. Part of the reason for this is that our standard process of screening – patients come in and have a test performed – is not effective across these populations where a combination of access (financial, transportation, or otherwise), language barriers, or medical or cultural awareness impact the likelihood that these patients will engage with the standard process as it has been designed.
And yet, we cannot ignore them and focus only on those who have the means to engage with the system on our terms. Going back to the business case for diversity, our communities are changing, and each of these populations – communities of color, low income, immigrant, and non-English speaking patients – are increasingly becoming a large percentage of the communities in which many of our hospitals and clinics exist. And I’m proud that this is an area where healthcare is making progress.
And yet, we cannot ignore them and focus only on those who have the means to engage with the system on our terms. Share on XBy administering alternative tests in the mail to patients that can be completed in the comfort of their own homes and by providing culturally conscious outreach services so that patients understand the importance of this screen, promising research indicates that the disparities in screening rates is declining. These results matter because every screen is an opportunity to detect and prevent the spread of a life-threatening cancer, which is ultimately a matter of life or death.
[Note: This forms part of a 3-post series; check out Part 1 and Part 3.]
