Questions for Emily P. Terlizzi, M.P.H., Lead Author on “Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity”
Q: Why did you choose to look at this topic?
ET: As we mention in the report, the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care, or the CLAS standards, were released from OMH in order to provide guidance to health care organizations in order to practice more culturally competent care. Previously though, there weren’t a lot of sources of nationally representative data to measure progress towards these standards. So to address this, there were several questions added to the NHIS in 2017 about patients’ perceptions of cultural competence of their health care providers. This report takes a look at two of these questions, and is one of few which provides nationally representative data on perceptions of cultural competence in the health care setting.
Q: How do you measure how well a provider “understands” their patient’s culture?
ET: The questions asked on the NHIS that are analyzed in this report are asking about patient’s perceptions of their providers. The question asks “Some people think it is important for their providers to understand or share their race or ethnicity or gender or religion or beliefs or native language. How important is it to you that your health care providers understand or are similar to you in any of these ways? Would you say… very important, somewhat important, slightly important, or not important at all”? We don’t know specifically what the respondents were thinking of when they answered these questions, just what they were asked and how they answered.
Q: What were some of the more interesting findings you uncovered?
ET: Among adults who had seen a health care professional in the past 12 months, the percentage of non-Hispanic white adults who thought it was very important to have a health care provider who shared or understood their culture was significantly lower than that among all other race and Hispanic-ethnicity groups. Among those who thought it was at least slightly important to have a health care provider who shared or understood their culture, minority groups were generally more likely to report never being able to see a culturally similar health care provider compared with non-Hispanic white adults, and this pattern persisted regardless of sex, age group, or urbanicity.
Q: So would you say that the “lack of understanding” or sharing of culture is a problem in the U.S.?
ET: I can’t speak to the implications of these findings, but what I can say is that per our 2017 data, there are racial and ethnic differences in reported importance and access to health care providers who share or understand their culture.
Q: What will this information do to improve health care quality in the U.S.?
ET: This study examined racial and ethnic differences in patients’ perceptions of the importance and frequency of seeing providers who share or understand their cultural characteristics. Our study isn’t looking at the effects on health care quality, but is just the start of measuring progress towards the CLAS standards.
Q: Any other things about this study that you’d like people to be aware of?
A: I think the take home message of the report is that racial and ethnic minorities were more likely to find it important that their provider share or understand their culture, but were less likely to be able to see a provider who met these criteria.