The Healthcare Industry Must Operate with Cultural and Community Competency
The population of the United States is becoming more diverse by the year. Population growth among the African-American, Hispanic-American, Asian-American and Pacific Islander communities are on pace to enable those groups to collectively outnumber Caucasians by 2050.
According to Forbes' contributor Glenn Llopis, this, coupled with a shift toward a consumer-driven model of healthcare, means that providers and hospital systems should be taking a close look at their delivery models and making sure that they have well-defined patient engagement strategies for those communities. Unfortunately, many providers do not.
Do US healthcare providers suffer from a lack of cultural competency?
That's what Llopis cautions. Many providers and systems lack insight into the shifting demographics and cultures of the communities they serve.
Even as "an increasing percentage of individuals from fast-growing minority groups become insured and gain access to healthcare through the Affordable Care Act," he asserted, "the ratio of those who are culturally competent enough to serve them is on the decline."
For any healthcare organization seeking to realize excellent return on engagement, this lack of cultural competency does not bode well. For example, as Llopis noted, even though persons of Hispanic descent will likely number about one-third of the US population by 2050, currently only 5 percent of US physicians are Hispanic.
It may be that we not only need better patient engagement strategies, but need also to diversify the provider base. And that means more proactive recruitment.
But it follows, then, that the industry has a vested stake in exciting students within what are, today, minority communities about science, math and careers in healthcare. If we want better future returns on engagement within growing communities, we need to be grooming a generation of providers who can better serve those communities' needs. We need a generation of providers who possess — innately — those cultural competencies that we, in many cases, lack at the moment.
In short, part of our larger patient engagement strategy for minority patients should include providing more career opportunities in healthcare for members of minority communities — through scholarships, through outreach programs in the schools and through community-based health initiatives. We can't effectively serve a given population if we are culturally isolated from it.
Do we need more boots on the ground on Main Street?
American healthcare has traditionally holed up in citadel institutions: hospitals, clinics, doctors' offices. But if we want to improve our consumer engagement, we need to expand out of those hubs and get into the communities — particularly in those places with minority majorities.
That's exactly the example CVS is setting. Having launched its store-based primary care "MinuteClinics," dropped tobacco sales and acquired high-visibility lines like Target's pharmacy operation, Caremark and Omnicare, CVS is making a concerted push to expand away from "corner drugstore" to "neighborhood health care partner."
Imagine a one-stop health care shop that is actively engaged with its constituency, that is located among its constituency and that serves the bottom-to-top needs of daily care, including nutrition, medication, screening and prevention programs and convenient primary care?
“Consumers are saying, 'I want all of that at a place near my house that’s open on Saturdays, when it’s convenient for me,'" Health Research Institute managing director Ceci Connolly told the New York Times. "It’s in CVS’s interest to pull in more and more pieces of that puzzle.”
Patient engagement isn't something that begins and ends at the clinic or hospital door.
And for many communities, it's not something that can simply be accomplished through minimal efforts over social media or paid advertising. Gaining a better return on engagement will require getting out in our communities and getting our hands dirty.
The health care industry, as a whole, must recognize that public health is something that doesn’t just happen in hospitals, clinics, and physicians’ offices. Rather, health—and health care—is rooted within the families and communities that these organizations serve.
"There are social determinants that come into play where health is concerned, be it culture, the economy, the school system, even the system of sanitation in your neighborhood. These all can have a powerful impact on the health and well-being of the community," Llopis said, "so in addition to reflecting the patient population we have to create systems that are representative of community needs."
We've already seen holistic models of community-centered care instituted — and achieve significant success — in education. Are similar models the wave of the future in health care?