U of U Health Internal Medicine Grand Rounds
This article is an excerpt from the Department of Internal Medicine Grand Rounds, “Applications of Patient Race and Ethnicity in Medical Education, Research, and Healthcare Delivery,” presented on April 18 2024, at University of Utah Health.
ealth equity, according to the CDC, is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving health equity involves taking actions today to ensure that future generations have the opportunity to achieve optimal health.
1. Recruit and retain a diverse workforce
This may be the single most important thing we can do to ensure a more equitable future. A workforce comprised of people from many different races, cultures, religions, geographic regions, and backgrounds can provide higher quality care to patients. Numerous studies show that a diverse workforce increases creativity, productivity, and flexibility in the workplace. Studies also show people feel more comfortable receiving care from providers who are from a similar background. A diverse workforce can also better recognize issues that may be affecting different populations of people.
2. Be wary of race-based treatment algorithms
These algorithms often use race as stand-in for a more specific factor, such as family history or genetics. Because race is a social construct, “adjusting” a clinical result for race may mean that patients don’t receive important diagnoses or care they should receive to reduce poor outcomes.
3. Recognize the power of community engagement
Community engagement means giving community members a seat at the table, such as inviting them to join advisory boards. It means listening to the community’s needs and finding ways to be equal partners with existing organizations who understand the needs, concerns, and solutions in their communities.
4. Raise the bar for journals and funding agencies
We can only improve when we hold each other accountable. When evaluating grants, reviewing papers or looking at studies that are examining race, look for mentions of racism.
5. Learn and use inclusive language
Inclusive language acknowledges diversity in respectful and sensitive ways. Using this language in your practice, in your lab and in your studies impact how people see our work. It makes patients feel more welcome, improve their engagement and empower them to be a partner in their healthcare.
Taking these five steps within your lab or your clinic can help shift equity in healthcare and increase justice in your community. Some changes will happen quickly; others will take time, but making these efforts will bring us closer to health equity.
The Power of Inclusive Language
When using inclusive language, you’ll want to follow these tips:
- Avoid vague and stigmatizing adjectives. For instance, calling a community “high-risk” or “hard-to-reach.” This language places blame or responsibility on the community and doesn’t explain why a given community lacks equitable access to better health.
- Avoid dehumanizing language and use person-first language. For instance, we are not treating cancer or treating a diabetic. We are treating a patient with cancer or a patient with diabetes.
- Be specific about groups you are talking about in research and educational settings. Avoid general terms like “minority” and instead name the race, culture or background you are actually referring to. Be specific as possible; also, be thoughtful about the reasons for including this information in clinical notes – is it a proxy for something else? Or are you addressing structural barriers based on race in the clinical setting?
- Avoid violent language, such as “war on cancer.” These words aren’t clear and can be triggering for people who have a lived through violence.
- Avoid unintentionally blaming language, such as "non-compliant". Be clear about why a patient is having difficulty following a care plan. Do they have trouble getting transportation? Do they have financial struggles? Avoid labeling or stereotyping patients, especially in the EMR.
- Keep learning. Inclusive language is always changing. Do your best to stay up-to-date on the latest language and terms.
View the complete Grand Rounds:
Gita Suneja
Michelle Debbink
Physician colleagues provide a basic understanding of the impact of using race and ethnicity in academic medical education, research, and healthcare delivery to develop shared language and understanding.
Accurate, self-reported race and ethnicity data is necessary to create visibility of health disparities, provide inclusive care, and improve equity of health outcomes. Community engagement director RyLee Curtis, Chief Quality Officer Sandi Gulbransen, Project Manager Kimberly Killam, Patient Experience Director Mari Ransco, Chief Medical Informatics Officer Michael Strong, and Health Sciences Equity, Diversity, and Inclusion Librarian Donna Baluchi explain how University of Utah is improving data quality.
Accurate, self-reported race and ethnicity data is necessary to create visibility of health disparities, provide inclusive care, and improve equity of health outcomes. Redwood Health Center’s Patient Relations Specialist Nichole Misner shares how to respectfully discuss this needed health information with patients.
