Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity

October 8, 2019


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.

QuickStats: Percentage of Adults Aged 18–24 Years Who Currently Smoke Cigarettes or Who Currently Use Electronic Cigarettes, by Year — National Health Interview Survey, United States, 2014–2018

October 4, 2019

From 2014 to 2018, the percentage of adults aged 18–24 years who currently smoked cigarettes decreased from 16.7% to 7.8%. The percentage of adults in this age group who currently used electronic cigarettes increased from 5.1% to 7.6%.

Source: National Health Interview Survey, 2014–2018 data.

Fact or Fiction: Are multiple births in the U.S. are on the decline?

October 3, 2019

Is Twin Childbearing on the Decline? Twin births in the United States, 2014-2018

October 3, 2019

Questions for Joyce Martin, Lead Author of, “Is Twin Childbearing on the Decline? Twin births in the United States, 2014-2018.”

Q: Is this the first time you have published a report on this topic?

JM: General information on twin births is published annually in the National Vital Statistics Report series “Births: Final Data.”   A number of special reports have also been published on the topic in the past.

Q: Why did you decide to do a report on trends in twin births?

JM: There appears to be a reversal in the direction of trends in twin childbearing in the US. After increasing for decades, the number and rate of twin births trended downward for 2014-2018.  This is important to public health because of the greater risk of poor pregnancy outcome, such as preterm birth and infant death, for babies born in twin pregnancies compared with those born in single pregnancies.

Q: How did the data vary by maternal age, race and Hispanic origin and state of residence?

JM: Trends differed by all of these characteristics.  Rates for women in their 30s and over declined by 10%-12% and rates for women 40 and over by more than 20%.  In contrast, there was no significant change in trends for women in their twenties.  Among the three race/Hispanic origin groups studied, twin childbearing declined for 2014-2018 among non-Hispanic white women but were essentially unchanged among non-Hispanic black and Hispanic women. Rates declined significantly in 17 states and increased in only three states.

Q: Was there a specific finding in your report that surprised you?

JM: The steady decline in twinning from 2014 through 2018 after many years of increases was surprising as was the fairly large declines among women aged 30 and over.

Q: Do you foresee the decline in twins continuing?

JM: As fertility procedures continue to improve, twin births, and especially higher-order multiple births, would be expected to continue to decline.  However, it is important to note that older mothers, those aged 35 and over, are more likely to have a twin delivery without the use of fertility therapies.  The older age of women at birth may also affect twining rates.

Fact or Fiction: Was the death rate from firearm deaths in 2017 the highest rate recorded in the U.S. since 1968?

October 1, 2019

Source: National Vital Statistics System, 1968-2017, CDC WONDER