Advantages and Disadvantages in Diversity, Equity, and Inclusion (DEI) in Healthcare
Guest Blog Author: Manasvi Khullar, 3rd Year Medical Student, Touro University. Blog came after continuing education workshop seminar discussion with Colorado licensed therapists, physicians, psychologists, and social workers.
Denver Psychotherapy Group’s private workshop provided 4 continuing education (CE) hours for Colorado licensed therapists, provisional and candidacy therapists, psychologists, chiropractors, massage therapists, and licensed clinical social workers.
In recent years, there has been more attention on diverse and inclusive workplaces. In healthcare clinics, this dynamic also affects interactions with patients. Historically, patients from minority groups have a distrust of the healthcare system due to systemic injustices. As a result, many in the healthcare world are becoming more mindful and practicing trauma-informed care. Systemic inequalities are now looked at as part of a patient’s health, under the umbrella of social determinants of health.
Advantages
Improved access and outcomes - A diverse healthcare workforce helps provide care to an equally diverse patient population in a culturally sensitive way, improving access, quality of care, and health outcomes.
Better communication - Staff who speak the languages of minority groups and understand cultural backgrounds can more effectively communicate with patients to understand their needs.
Increased trust - Minority patients are more likely to trust and feel comfortable with practitioners of similar backgrounds, improving care-seeking behavior.
Broader perspectives - Diverse teams bring different viewpoints, experiences, and ideas, fueling innovation and problem-solving.
Representation as a social good - Promoting diversity promotes equal opportunities and social justice.
Disadvantages
Discrimination - Minorities may still experience prejudice from colleagues or patients. Strong leadership must actively foster inclusion.
Communication barriers - Language and cultural barriers can still impede care if robust interpretation/translation services are unavailable.
Tokenism - Focusing on numbers alone without meaningful inclusion and support can lead to poor retention of diverse staff.
Mistrust - Minority patients may have a historical mistrust of the healthcare system and be less likely to seek care. Building trust requires cultural competence from staff.
Racial disparities - Even with diversity efforts, racial gaps in healthcare access, quality of care, and health outcomes may persist. Ongoing analysis and reform is needed.
What are the social determinants of health?
Social Determinants of Health are factors and conditions that affect the daily lives of people, with effects on their overall well-being and measurable health outcomes. These include factors such as a person’s employment status, number of social connections, housing, proximity to parks, education status, access to healthy produce, and the quality of healthcare available to them. When a patient arrives at a healthcare provider’s office seeking care, they are provided with standard medical care, and their social determinants of health are often ignored. Yet, medical care is only able to account for 10-20 % of the modifiable contributions to healthy outcomes. Inversely, social determinants of health are 80-90% of the modifiable contributions to healthy outcomes. Although many healthcare providers do not feel prepared to address this aspect of a patient’s health, we must start to educate ourselves on what our patients are experiencing. One step is by screening patients for social determinants of health with a form, such as the American Academy of Family Physicians Social Needs Screening Tools, then connecting patients with resources such as social workers, peer navigators, or support groups in their community.
What is trauma-informed care?
Trauma is an event that causes physical or emotional harm to an individual, with long term effects on their ability to function at a social, mental, emotional, physical, or spiritual level. Trauma-informed care is the practice of engaging with patients without retraumatizing them. In the medical setting, there are many ways that patients can be retraumatized: the use of physical restraints, being asked to undress, seeing blood, waiting in a room with the door closed, or undergoing invasive procedures.
Here are some tips for healthcare providers on how to incorporate trauma-informed care:
Use warm, calming colors in your physical space.
When walking into a room, make sure the whole room is visible and the exit is not blocked by furniture.
If body parts need to be exposed as part of a physical exam, try and make sure that the body parts are exposed for the minimum amount of time required.
If a patient needs to wear a gown, allow them to change into it during the exam and not be sitting in the gown the whole length of the appointment
Take a second and ask patients if you can make them more comfortable by getting them a glass of water, if the temperature in the room is comfortable, or if they would like a support person in the room.
Overall, incorporating trauma-informed care and social determinants of health into your healthcare practice is beneficial in creating a more welcoming and inclusive space for your patients. By creating an atmosphere of physical and psychological safety, your patients will feel more comfortable sharing and addressing the root causes of their diseases and poor health.
