If you’ve put off going to the doctor, you’re not alone. But have you ever skipped a medical appointment because you don’t think the doctor will accept you or understand your health needs?
Unfortunately, avoiding the doctor can be common for people in diverse communities. Some people don’t want to be judged for identifying as LGBTQ+ (lesbian, gay, bisexual, transgender or queer). For others, it may be a fear that their care needs won’t be understood because of their race or ethnicity. People with disabilities may be concerned that there aren’t appropriate accommodations in place for effective care.
These fears aren’t completely unfounded – it isn’t always easy for people of all races, ethnicities, gender identities and abilities to find health care that respects their specific needs and culture. HealthPartners is hoping to change that.
Below, we look at ways that cultural differences affect health care and how people of all races, ethnicities and gender identities can get the personalized care they need to stay happy and healthy.
Cultural differences in health care
Culture is a core part of your identity, shaping your personal identification, language, thoughts, communications, actions, customs, beliefs, values and participation within institutions and organizations. Differences in culture can also shape the health care experience. Here are just a few examples of cultural differences in health care:
Language differences in health care
Understanding health information can be hard for people of all ages, races, ethnicities, incomes and education levels, even if the information is provided in your first language. When there are language differences, it can be even more difficult for people to find and understand health information – and make the right decisions for their health.
If instructions on a prescription label are confusing, a person may take unsafe amounts of medication. If they don’t understand the benefits and risks of different treatment options, they may choose one that doesn’t line up with their life goals. For example, a woman may choose a hysterectomy to treat bleeding in her uterus without realizing she would not be able to get pregnant in the future.
Differences in how people seek health care
People seek healing in different ways. For example, people in some cultures may start with traditional or folk healing methods before going to a medical doctor. It’s important to remember that just because practices are different, they’re not necessarily wrong.
The goal of health care is to keep people as healthy as possible to live a quality life. And there can be different ways for people to get there – though some of those ways may mean delaying treatment.
For instance, in some cultures, it can be a point of pride to suffer through pain and other symptoms. But if people only see a doctor when their symptoms are too much to bear, the condition may be in an advanced stage and harder to treat.
Differences in health care communications
Culture can affect who can communicate with the health care system and how. In some cultures, a woman may not be able to make health care decisions without input from her husband – she may not even be able to talk directly to her doctor. Understanding these differences is critical to being respectful and ensuring that patients get the best care.
Bias in health care
All of us come from different backgrounds. And seeing the world through our personal experiences can make us biased. While some forms of bias are obvious stereotypes that people have of others, many types of bias are unconscious. Overcoming bias is necessary to providing the best care.
How cultural barriers in health care affect patient care
Differences in culture are cause for celebration. But sometimes these differences can create barriers for people trying to get the necessary care to stay healthy.
Timing of health care
When you get treatment for sickness and medical conditions, timing matters. However, if there are cultural differences, people may not get the right care at the right time. Instead, they may experience:
- Delays in care – Instead of getting preventive care, people only seek care when the problem is serious and less treatable. People of color and people who are LGBTQ+ are less likely than others to have a primary care doctor. This means that they’re more likely to wait until their care needs are severe, then go to urgent care or the emergency room.
- Ineffective care – People may not understand and follow the necessary directions for medications, health screenings, treatment preparation and follow-up appointments.
- Avoided care – Some people may avoid going to the doctor all together. For example, according to the Rainbow Health survey, about 35% of Minnesotan adults identifying as LGBTQ+ said they didn’t go to the doctor when they needed to because they thought they would be mistreated or disrespected.
Differences in maternal and infant care
The care you get before and after your baby is born can make a huge difference in your health and the health of your baby. But unfortunately, patients of color are less likely to get prenatal care or postpartum care between 7-84 days after delivery.
Also, only 71.7% of patients of color visited the doctor in their first trimester compared to 89.9% for white patients. Patients of color are up to five times more likely to have late or no prenatal care compared to white patients, according to the Kaiser Family Foundation (KFF).
Additionally, some pregnant women of color experience bias and discrimination that can lead to a lower quality of care and worse health outcomes for both them and their child.
Differences in childhood immunizations and vaccines
Childhood immunizations help protect kids from vaccine-preventable diseases as early and as safely as possible. But immunization rates aren’t equal across races and ethnicities. For example, African American infants are less likely than others to receive all recommended childhood immunizations, according to national survey data collected between 2009 and 2018.
Differences in vaccination rates aren’t only seen in infants. More white people get the flu shot on a yearly basis. And early in the COVID-19 pandemic, there was a large gap in vaccine rates between white people and people of color. While vaccines can’t always keep you from getting sick, they can help an illness stay mild. Which means that if people of color don’t get vaccines as preventive medicine, they may be more likely to have severe symptoms from illnesses such as COVID-19 or the flu.
Differences in chronic conditions
Chronic conditions are more common for people of diverse ethnicities and races, and for people within the LGBTQ+ community.
People of color are up to two times more likely to have chronic medical conditions, based on information collected as part of the All of Us research program. In particular, there are notable differences in the rates of diabetes, high blood pressure, cancer, asthma and heart disease.
People who identify as gay, lesbian or bisexual are more likely to get diabetes, asthma, headaches, allergies, cancer and cardiovascular disease, according to KFF.
It’s important to note that, with very rare exceptions, the differences in rates for chronic conditions have nothing to do with genes or biology. Instead, they are the result of the timing and type of medical care someone receives. For instance, people in diverse communities are less likely to get preventive care or specialized care for their health conditions.
Differences in trauma and emergency care
Anyone can be in an accident or experience trauma or violence. But LGBTQ+ and people of color are more likely to suffer physical violence and sexual trauma. For many of these people, getting treatment for trauma and emergencies can be a challenge.
This may be due in part to feeling uncomfortable seeking care or not knowing where to turn. But the locations of treatment facilities can be a problem too. Communities of color are more likely to be located farther than five miles from the nearest emergency room compared to white communities.
Differences in mental health care
Populations that experience bias, discrimination and violence have higher rates of mental health concerns. The All of Us research project reports higher rates of mental health disorders among Asian American and African American people. There are also significant mental health challenges within the LGBTQ+ community, including higher rates of substance abuse and suicide.
But within these communities, mental health needs aren’t always prioritized – getting therapy may be seen as unnecessary or too expensive. It can also be difficult for people of diverse communities to feel they can trust medical professionals with their problems.
Customs and attitudes that affect health care outcomes
There are some cultural traditions and customs that are dangerous and can affect a person’s health and well-being. For example, female genital cutting (FGC) involves removing or damaging female genitals for nonmedical reasons. This painful practice – usually performed on young girls between infancy and age 15 – can cause severe bleeding, problems urinating and, later in life, cysts, infections and complications in childbirth.
Still, it’s important to be respectful when talking about these practices while working toward change. HealthPartners and organizations such as Isuroon, a nonprofit organization focused on improving the well-being of Somali women, work to respectfully educate parents of the potential harmfulness of FGC.
The best health care is personalized – something that’s easier to do if you have a diverse workforce. Our goal at HealthPartners is to make everyone feel welcome, included and valued so they’re comfortable and confident in getting the health care they need.
Embracing cultural diversity in health care
HealthPartners has a goal of being an anti-racist organization. Here are some steps we’re taking to ensure that our care providers appreciate and reflect your culture and values:
- Addressing language barriers – HealthPartners has doctors that speak one or more of 19 different languages. We also offer language interpreters to make sure you don’t miss important information.
- Understanding our bias – We’re committed to addressing all forms of bias and provide ongoing training to employees to help them identify bias and change behaviors so they can provide more inclusive care.
- Providing gender-affirming care – We’ve been providing gender-affirming care for people who identify as LGBTQ+ for longer than most – over 25 years.
- Creating opportunities – We know that increasing diversity in health care doesn’t just happen. So we proactively look for ways to bring about change, such as offering scholarships to women of color who’d like doula training.
Increasing access to important health care
If people get health care when they need it, they’re more likely to have better health outcomes. Here are a few ways we’re making health care more available for everyone:
- Preventive care – We’re increasing access to preventive care and same-day appointments for important health screenings like mammograms.
- Children’s health – Health and well-being in childhood is linked to health and well-being in adulthood. Our Children’s Health Council focuses on early brain development, family-centered care and stronger communities.
- Mental health – We want to end the stigma around mental illnesses and provide education through our Make It OK program. We’re also addressing disparities in mental and behavioral health treatment through partnerships with organizations like the Minnesota State Baptist Convention, which includes 28 African American churches.
- Vaccine equity – Early in the COVID-19 pandemic, there was a large gap in vaccine rates between white people and the African American and Latin communities. HealthPartners took deliberate steps to ensure COVID-19 vaccine equity in diverse communities.
Find a doctor who meets your unique needs
Fear shouldn’t get in the way of getting the care you need to live a long and healthy life.
We’re working hard to ensure that our doctors reflect the races and ethnicity of our patients. So chances are you can find a primary care doctor or specialist who shares your cultural or gender identity.
If you’d be more comfortable with a doctor who shares your cultural background, use our online tool to find a doctor based on your preferences for language, race, ethnicity and gender. You can also find a gender medicine expert to provide tailored support and services, including providing hormone therapy and surgeries for gender affirmation.
Please let us know how we can support you.