Advocate for Culturally Responsive Care in Illinois!
This legislative session, Howard Brown Health and a group of advocates and providers are supporting a legislation (SB 2427/HB 2280) that would establish cultural competency requirements as part of continuing medical education (CME) for healthcare providers. There is a strong need for increased cultural competency training among providers to help improve patient experiences and health outcomes, especially for patients from historically marginalized and underserved communities. You can help ensure that providers in Illinois are trained to provide inclusive and affirming care by telling us your health care story!
Many people face barriers to healthcare that stem from discrimination based on race, religion, sexual orientation, gender identity, and disability. For example, transgender and nonbinary (TNB) patients are often misgendered or called by the incorrect name due to lack of provider education and training on gender identity and affirming care. In a national survey conducted by the Center for American Progress, 3 in 10 transgender or nonbinary (TNB) respondents reported that they had to “teach [their] doctor or other health care provider about transgender or nonbinary people in order to get appropriate care.” For example, TNB patients may not receive important and appropriate health screenings such as cervical, breast, or prostate exams because providers make incorrect assumptions and do not ask about gender identity or history of gender affirming care. This lack of understanding of TNB health leads many TNB patients to avoid or delay necessary and preventative care, resulting in worse health outcomes. With more and more legislative attempts to ban gender-affirming care introduced and passed across the country, it is more critical now than ever to use tools such as cultural competency training to help reduce and eliminate discrimination patients may face in healthcare.
Lack of education and training also leads to poorer health outcomes for other marginalized communities. For example, far too many providers still believe the racist myth that Black people possess thicker skin or experience less physical pain than their White counterparts. One study asked patients to report how much pain they were experiencing and compared that to providers’ perception of how much pain the patients were in. Results showed that providers are more likely to underestimate Black patients’ pain (47%) relative to nonblack patients (33.5%). These incorrect beliefs result in suboptimal care: Black patients are 22% less likely than White patients to receive any pain medication. These negative experiences often result in Black patients avoiding or delaying care due to not being believed or being given care that doesn’t address their healthcare needs. Patients with disabilities also often experience suboptimal care due to lack of knowledge and training amongst providers. A study by National Disability Rights Network and Disability Rights Washington chronicled instances where physicians recommended denials of needed transplants; withheld medical treatment, and even sterilized people due to provider misperception of disabled patients’ quality of life. Providers in this study noted a lack of sufficient knowledge, experience, and skills when it comes to providing care for people with disabilities.
Cultural competency training would help providers to deliver better care to marginalized communities by addressing generalizations, misunderstandings, and gaps in knowledge. However, this training isn’t a requirement for all providers. Currently only seven states require providers to engage in cultural competency or implicit bias training as part of their CME criteria for licensing. CME around cultural competency and working with varied patient populations is especially necessary given that these topics are still inadequately covered in medical schools and other formal education settings for healthcare workers. According to a 2016 National Academies of Science report, 40% of first- and second-year medical students endorsed the belief that Black people’s skin is thicker than that of White people. Furthermore, research shows that LGBTQ+ focused curriculum was “scant” and highly varied among U.S. medical institutions. Findings show medical students only received an average of 2.22 annual curricular hours of LGBTQ+ related education, leaving students feeling unprepared to treat LGBTQ+ patients.
Given the lack of cultural competency education in formal education and training curricula, CME courses are necessary to help providers become more affirming and knowledgeable when treating their patients. There is evidence to show cultural competency training helps increase provider knowledge about culturally, linguistically, and socio-economically diverse patients. Patient attendance and adherence to provider advice improved significantly among providers who had engaged in cultural competency training versus providers who had not (Horvat et al., 2014). Research has also shown that cultural competency training resulted in increased satisfaction by BIPOC patients. You can help ensure that providers in Illinois are trained and educated to provide inclusive and affirming care by telling us your health care story! Please provide your stories of instances of discrimination or bias in healthcare and how it affects health outcomes. For anyone who speaks or would prefer to, you can provide your story in Spanish.
To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage. To stay up to date with advocacy and policy news like this, sign up for the Center for Education, Research, and Advocacy (ERA)’s newsletter.