Cultural Differences and Healthcare

When looking at differences among patient populations and finding the best ways in which to customize treatment options, we as physicians need to take a step back to understand the varying racial, ethnic and cultural differences from which our patients come.

Trust between patients and their providers is critical to building good health, yet it’s an issue for many minority populations. And it’s no surprise given what patients often report. Many Black women reported that they expressed concerns to their doctors while pregnant, but felt they were not heard or that they were ignored by providers. According to the Center for Disease Control, for Black women, pregnancy-related mortality rates are over three times higher than their white counterparts.

Blacks and Hispanics are at a higher risk for dementia yet often aren’t diagnosed in later stages. Controllable factors such as high blood pressure and diabetes often play a role in the progression of dementia, yet these contributing conditions have a higher rate of going undiagnosed.

Concepts of race, ethnicity and culture are blended. Ethnicity shares ancestry, cultures and history while culture is a learned, shared belief. Cultural competence for a physician is critical in meeting patients where they’re at, not based on pre-conceived beliefs of who they are.

Considering our own personal motivations, self-awareness, and cultural knowledge will prevent expectations of patient assimilation.
Cultural assessments from around the world take into consideration disease models and etiology. Different cultures have different thoughts, ideas and practices related to health and wellness, and these are not always grounded in science:

• Understand that in many cultures, illness is seen as a punishment for transgression and given by gods or supernatural forces.
• For other cultures, a holistic model keeps balance within the body and metaphysical universe. Health is a positive state of well-being. In these cases, germs upset this balance, resulting in soul loss or theft, spirit possession or object intrusion.
• Build trust with the patient by asking about their family and not rushing into business. Understand the role a patient’s extended family may play in their healthcare. Recognize that women can be the medical decision-makers even if they aren’t the head of finances or the household.
• Many cultures rely on curative herb gardens for plants with analgesic and antibacterial properties. Ask about home remedies, as they often reduce the effectiveness or interfere with Western pharmaceuticals. Some patients are private about sharing this information, so build the foundation of trust and at a minimum, ensure you’re mentioning the potential complications of prescribed medications when paired with herb use.
• Understand the importance of masculinity, slang terms, taboos against certain words and topics, and when it’s inappropriate to discuss reproductive health between genders.

Taking the time to get to know your patients and understanding their backgrounds helps to build a connection and foundation of trust that is necessary to provide the best care and treatment for them.

This information was presented at the ACOFP 60th Annual Convention and Scientific Seminars. We are pleased to offer more than 40 hours of AOA Category 1-A CME and (new this year!) AMA PRA Category 1 Credit(s)™ to watch on-demand from the convenience of your home or office! Learn more: https://www.acofp.org/acofp23