UHCO Series Addresses the Need for Cultural Competence in Health Care

UHCO Series Addresses the Need for Cultural Competence in Health Care

A growing array of studies and news reports have established that racial and cultural biases among health care providers contribute to health disparities. Here are some eye-opening facts from the U.S. Centers for Disease Control and Prevention (CDC):

• African American, Native American, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than White women.
• African Americans ages 18-49 are twice as likely to die from heart disease as Whites in the same age range.

Can anything be done to reduce such disparities and provide quality care across the board?

Dr. Lucy Kehinde, clinical assistant professor at the University of Houston, College of Optometry believes the solution lies in cultural awareness and training as well as a more diverse health care workforce.

In an effort to improve patient outcomes, Dr. Kehinde is hosting a series of talks and interactive workshops on topics including cultural competence, implicit bias in health care, and mitigation strategies.

The series, “Cultural Competence and Community Engagement,” is for UH faculty, staff and students involved in the health professions.

“This is important to me because as a provider and an educator, I have seen breakdowns in communication tied to patient-provider differences in clinical settings,” Dr. Kehinde said. “These instances are less likely to occur if there was a better understanding of someone's background or a sincere and deliberate effort to do so. Better yet, when minority patients receive care from providers from the same race or ethnic group, there is a better understanding of perspectives, which often enhances the quality of care.”

Dr. Kehinde’s project is based on the idea cultural competence can be taught and learned. In fact, she said, it is an integral part of a provider’s skill set when working with the highly diverse population of patients in the greater Houston area and beyond.

Health profession programs at UH are committed to advocating excellence in patient care, leading health sciences research, providing students with an innovative and quality education and providing support for community well-being initiatives.

In addition, UH is located in Houston’s Third Ward – a predominantly African American neighborhood with a rich cultural history, but one that continues to experience educational, economic, and health challenges.

Dr. Kehinde’s project aligns with the Third Ward Initiative, a collaborative partnership between UH and the Third Ward community. 

“One of the goals of the Initiative is to transform the community’s health care resources by addressing health disparities of underserved residents,” she said. “The series will add to the cultural intelligence of UH faculty and students by providing an understanding of the history, demographics, culture, and concerns of the surrounding community and its residents.”

The project, which is funded through the UH Provost’s Multicultural Success Initiative, will run from now through August.

Outreach, engagement and building a pipeline

Dr. Kehinde said another key contributing factor to the imbalance of care and health outcomes is that minorities rarely encounter providers who share similar cultural or ethnic backgrounds and who can instinctively navigate many of the nuances in patient communication, belief systems, and culture that impact delivery of care.

For example, in optometry 78.4% of practicing optometrists identified as White, 13.7% as Asian, 3.9% as Hispanic and 1.8% as Black, according to the U.S. Department of Health and Human Services.

Increasing the number of underrepresented minority groups in the health care workforce is key to narrowing the gap in disparate health outcomes, she added.

An important part of the solution is understanding what factors influence students from underrepresented groups when deciding whether to pursue STEM careers made up of the highly-valued fields of science, technology, engineering, and mathematics, she added.

Employment in STEM occupations has grown 79% – from 9.7 million jobs in 1990 to 17.3 million in 2016, vastly outpacing employment in non-STEM sectors, according to the Pew Research Center. The U.S. Bureau of Labor Statistics projects employment of optometrists will grow by 10 percent from 2018 to 2028, faster than the average for all occupations.

Yet, the minority representation in optometry and other STEM fields remains glaringly low.

“It is plausible students from underrepresented groups have little awareness and exposure to STEM careers by the time they have to decide what courses to take in high school and what path to pursue in higher education,” Dr. Kehinde said. “Children need to be exposed and continually engaged in STEM activities and opportunities from primary school onwards.”

She is putting this idea into action.

Following the lecture series, a multidisciplinary team of UH health professions students from pharmacy, optometry, social work and nursing will engage in community outreach and engagement. Together with Houston Independent School District administrators, teachers, and parents as well as Third Ward community members they will work to understand perceptions, challenges, and concerns regarding minority student pursuit of STEM and health care careers. 

This team of health professions students, largely made up of individuals from underrepresented minority groups so they can serve as role models, will design a summer school program for students at Hartsfield Elementary, a magnet school for animal and environmental sciences located in the Third Ward.

“The team will create and implement hands-on activities, showing the students what nurses do, what optometrists do, and what it’s like to be one of these professionals,” Dr. Kehinde said.

The goal is for the elementary students to actually experience the STEM possibilities, not just hear about them.

“I want the kids to know that Black and Hispanic doctors and nurses are right here training in their community and that they (the kids) can choose to come to UH and learn to become one too,” she said.

Looking to the Future

Dr. Kehinde wants cultural awareness and competence education to be eventually integrated into ongoing training for all health care professionals. “My hope is that we increase our cultural competence to improve access to care and health outcomes of under-served populations,” she said.

She also wants to improve cultural competence in the classroom setting. 

“I would like to see that we are making a concerted effort to minimize bias in the recruitment and admissions process, while increasing awareness of how some of our behaviors as educators may unintentionally isolate or overlook students from diverse backgrounds in learning environments,” Dr. Kehinde said. “My long-term hope is to build a skilled and diverse health care workforce equipped to deliver quality care to all patients.”