Many physicians who work with predominantly Black American populations do not understand our beliefs and behavior because they haven’t educated themselves on the history
When filling out forms, I have always dreaded the infamous “race box.”
You know, the one that gives you a standard list of choices to pick from? This guy? ↓↓↓
Please select your race:
☐ Black or African American
☐ American Indian or Alaska Native
☐ Native Hawaiian or Other Pacific Islander
Source: The United States Census Bureau
For some people, this box is just another field they fill out on forms. But for others, it can represent something of an identity crisis.
As a biracial woman, I never know what to put in that box. My mother is white, and my dad is Vietnamese. A million thoughts run through my head when I’m asked to fill out that box — especially on medical forms.
“Do I just put white? Do I just check Asian? Do I check both? Can I check both? What if there’s a really specific disease specific to one of those races, but I put the other one and they don’t test for it?”
(I tend to overthink in general, if you couldn’t tell).
It took me a long time to realize that these are valid questions — and they may be ones your patients ask themselves as well. But as healthcare marketers and professionals, a better question might be: Does it have to be this way? And, can we be doing something better?
We Unpacked The Race Box: What Happened
In the fall of 2021, CareContent partnered with a client who, like us, was pushing back on the idea of the race box. They were interested in attracting a diverse audience to their residency program. Like, a genuinely diverse audience, not just one that looked diverse on paper.
In order to accomplish this, our partnership included many different points of growth and development. It included strategies like revamping their website, putting their commitment to diversity front and center, showcasing their already diverse graduate students, and focusing on SEO so the right candidates could find them.
Another element of this focus on inclusion was to reconsider the race and ethnicity questions on one of their interest forms. Potential applicants would have the opportunity to chat with a current resident in the program, and they wanted to know a little bit about the individuals who were interested.
Rather than just do what’s always been done, both their team and ours saw this as an opportunity to rethink some of those questions we take for granted — including the questions about race and ethnicity.
What We Did
To get a better sense of who was considering applying — and to communicate to them that the program was committed to accepting those residents’ whole identities — we decided to rewrite the race data-collecting question entirely.
When we went about crafting this question, our first goal was to remove the burden of the options. In making this question open-ended with a text entry box — instead of a checkbox — applicants could feel empowered to provide an answer that felt more accurate and authentic.
We also considered potential results of making the question encompass race, ethnicity, and cultural identity — instead of making these separate questions. In doing so, the question recognizes that our identities are not made up of disparate variables, but rather that we sit at the intersection of multiple identities that are all pushing and pulling on our sense of self.
Lastly, we wanted to communicate our intentions for making the choice we did. When collecting demographic data, there can be a lack of transparency. “What do you need my race for? Are you immediately going to sell my email to the highest bidder?” In deviating from the expected, this form chose to explain why.
What We Found Out
By asking this question in this way, we opened ourselves up to the wide range of responses we might get. Over 100 potential applicants filled out the “Chat With a Residency Leader” form — and of those, nearly 75% answered the question on race, ethnicity, and cultural identity.
Open-Ended Identity Question Findings
10% indicated their status as first, second, or third-generation immigrants or college graduates.
6% shared the ways religion impacts their identity.
65% responded with two or more identity markers.
Others spoke of the places they were born or the places they call home now. Many spoke about their parents, the languages they speak, and how their identity drives their desire to pursue medicine. Some even expressed their gratitude about being asked this question in this particular way.
The results blew us away — we could not have expected the breadth of responses, and we couldn’t replicate them again if we tried. Each individual response encapsulated a specific person at a specific time, reflecting on their identity in a specific way.
Where Do We Go From Here?
Ultimately, what we sought to do was to remove the burden of a different box — the “other” box — where maybe you’re not 100% sure what to select, so you choose the write-in option under “other.” By reframing this as an open-ended prompt, we were able to address this “othering” of the other box.
As we continue to grapple individually and societally with questions of race and identity, there are many things we might come up against that could use some reimagining. How we ask people about their identity is just one of them.
The case shared here is just one potential approach — and it might not be the best one for every single situation. For example, if you want to know how many people receive a blood pressure screening at your hospital this quarter — and how many belong to a certain racial or ethnic minority — it may not be the best data-collecting option to ask people to identify in this open-ended way.
But if you’re running a grief support group — and you want to bring in experts with fitting cultural expertise — then maybe it does make more sense to ask group participants to answer an open-ended prompt instead.
Very rarely is there one “right answer.” More often, there are simply many potential approaches that offer different insights depending on the information we’re actually looking for.
When it comes to demographic data collection, the way you ask this question might be impacted by anything from geography to what data you’re trying to collect. But while there may not be one right way to ask this demographic question, how we ask it is worth questioning.
Are you looking to attract more diverse residents, physicians, or patients? CareContent can help you get there.
While many people think of Black History Month as a time to reflect on the past achievements of Black Americans, it can also be a time to amplify the great things nonprofit organizations are doing to improve the health of Black Americans today.
The 2022 theme for Black History Month is Black Health and Wellness. In addition to recognizing the work of Black Western scholars and medical practitioners, this theme also calls attention to other means of knowing (such as the work of birthworkers, doulas, midwives, naturopaths, and herbalists).
Source: Association for the Study of African American Life and History
Healthcare Access And Equity For Black Americans
CareContent is a Black woman-owned business, and we care deeply about healthcare equity for Black Americans. Even though Black Americans’ death rate has gone down by 25% since the early 2000s, they still experience more disease burden and worse outcomes for pregnancy, hypertension, and diabetes than that of white Americans.
Black Americans’ Healthcare Access And Outcomes Lag Behind
- By age 55, 75% of Black adults have hypertension compared to about 50% of white men and 40% of white women.
- Black adults are 60% more likely to be diagnosed with diabetes than white adults.
- Black women are 3 times more likely to die during pregnancy or childbirth than are white women.
Sources: American Heart Association, Centers for Disease Control and Prevention
The good news is that nonprofit and healthcare organizations are doing work to achieve healthcare access and equity while fighting bias in their content and strategy, which is important so that all groups can access the information they need to stay healthy.
Today, many organizations that promote Black health and wellness have developed mutual aid and social support initiatives to help their communities, such as building community clinics, hospitals, and medical and nursing schools. Some organizations are focused on creating diverse and inclusive healthcare content that promotes nutrition, body positivity, physical health, and mental health. Others are promoting specific initiatives, like better maternal healthcare outcomes and increased breastfeeding rates in the Black community.
Within some hospitals and traditional healthcare settings, medical practitioners are taking the lead by implementing programming to give their Black patients more healthcare access and better healthcare outcomes.
When community and healthcare organizations work together, the results can be even more impressive.
Here are 5 organizations making a positive impact on Black health and wellness.
1. National Black Leadership Commission on Health (Black Health)
Equity often begins with community leaders taking initiative. Originally focused on developing Black leadership to fight HIV/AIDS, the National Black Leadership Commission on Health (Black Health) updated its mission and name in 2019. It expanded its focus to include Hepatitis C, cardiovascular disease, breast cancer, prostate cancer, sickle cell, diabetes, and mental health.
In addition to working on making policies more equitable and organizing local communities, this organization offers many online informational handouts on diseases that affect Black Americans as well as educational programs like The Leadership Training Institute.
2. Center for Black Health
Organizations that want to provide equitable healthcare don’t always have the tools or know where to begin. The Center for Black Health has a website filled with resources to get your organization started. They work to promote policies, community-led programs, and public health campaigns that benefit people of African descent.
Community members and healthcare professionals can find a health justice training guide and links to the Black Body Health Podcast on the website. Their blog also has a wealth of information on healthcare issues affecting Black Americans.
GirlTrek is the largest nonprofit public health organization for Black women and girls in the US. They also have a podcast, Black History Bootcamp. Listeners can follow the daily meditations while they walk.
4. Black Mamas Matter Alliance
Pregnancy should be a happy and healthy time for all women. That’s why Black Mamas Matter Alliance performs advocacy for and research on Black maternal health.
They host conversations with Black maternal healthcare professionals and keep the community updated with information about local resources. They also offer a toolkit for those interested in advocating for the health and well-being of Black women and girls.
5. Black Mothers Breastfeeding Association
Breastfeeding is so important for infant health, but most infants in the US aren’t breastfed as long as recommended by the Centers for Disease Control. Black infants are even less likely to be breastfed than white infants.
Black Mothers Breastfeeding Association’s goal is to reduce racial inequities in breastfeeding by providing breastfeeding support for Black families. They offer virtual classes, an online club, and culturally appropriate literature for Black families. Healthcare workers can become leaders for Black healthcare equity by joining the leadership institute planned for 2022.
Healthcare Access And Equity For Black Americans
These organizations are making real changes by involving local communities, educating healthcare workers, and offering resources to patients and physicians alike. Nonprofits that work within the Black community can inspire your organization to create programming for healthcare access and better healthcare outcomes for Black Americans all year long.
CareContent can ensure your organization has a healthcare content strategy that promotes Black health and wellness. Contact us if you would like help with content strategy and creation.
In the United States, healthcare is not equal.
There are any number of factors that can impact your ability to receive the care you need — socioeconomic status, geographic location, sexual identity and orientation, race. These factors can all play a role in which resources you have access to, which can influence your health and generally lead to poorer health outcomes.
Racial health disparities, in particular, are staggering.
Racial Health Disparities In The US
- In 2017, more than double the amount of Hispanic Americans were uninsured compared to white Americans.
- In 2018, less than half the amount of Black adults received mental health services compared to white adults.
- In 2017, American Indian and Alaska Native adults were nearly 3 times more likely to have diabetes compared to white adults — and 2.5 more times likely to die from it.
- Compared to any other racial or ethnic group, Black Americans continue to have the highest mortality rate for all cancers combined.
Source: Center for American Progress
These are just a few of the many statistics that highlight the very real problem of racial health disparities in the US. While no solution can fully address this problem on its own, one has recently made its way to the forefront of the healthcare system — diversity in the healthcare workforce.
Many studies point to the fact that when healthcare professionals look like their patients, it enhances the quality of care for patients and the overall health status of community members — many of whom are impacted by health disparities.
The case for diversity in healthcare is airtight. And it’s exactly why healthcare organizations around the country are stepping up their Diversity, Equity, and Inclusion (DE&I) efforts, including hiring, retaining, and promoting a diverse staff.
The problem is — talking the talk and walking the walk are two different things. And unfortunately, too many organizations are all talk.
- Nearly 90% of all hospital CEOs were white — even though just 60% of the population was white.
- Just 5% of physicians were Black — despite nearly 13% of the population being Black.
Sources: American College of Healthcare Executives, Association of American Medical Colleges, US Census Bureau
With these disheartening statistics — and the fact that not much progress is being made — not all healthcare organizations can flaunt a diverse and inclusive healthcare workforce in good faith.
Unfortunately, many still do.
Being transparent about the diversity of your healthcare organization is key. But it’s also important not to be deceitful in the process, whether that’s in your marketing efforts, on your website, or in conversations with your community members.
As you amp up your DE&I efforts in your healthcare organization, here are 3 factors to keep in mind.
1. Actually Build A Diverse Healthcare Organization
Step one should be obvious, but just in case it’s not — everything starts with building a diverse workforce.
Our country is a diverse one, and it’s becoming even more so. In fact, according to projections from the US Census Bureau, patient populations will move to a majority-minority balance by 2045.
And yet, our healthcare system does not reflect that.
Now is the time to recruit, build, support, and retain a workforce that looks like and understands your patient population. When patients interact with clinical staff members who share their gender, race, ethnicity, or language, they’re more likely to build a strong rapport.
This leads to stronger interpersonal care, enhanced medical comprehension, and higher chances of sticking with follow-up appointments — all of which can help address health disparities.
2. Be Transparent About Where You Are
As a healthcare organization, it’s critical for you to come to a common understanding of your organizational values. Who you are, what you stand for, and what you believe in are key aspects of whether or not a patient will want to come to you for care.
If that includes a commitment to diversity and inclusion, make that known — within your organization, to your patients, within your community, and on your website.
At the same time, if you are not at a place where you can truly say you have a diverse workforce, don’t be dishonest.
For instance, don’t build a website using stock images that depict a diverse staff when that’s not the case. And don’t release statements of support that contain plenty of buzzwords but loads of empty promises. These actions are not only deceitful, but they are also misguiding for the patient experience.
3. And Be Transparent About Where You’re Going
Whether you have a diverse workforce or not, be honest about your organization’s goals for the future.
If your healthcare organization is already diverse, talk about how you are going to utilize those diverse perspectives to better serve your patient population and reduce health disparities. Be open about how you are supporting the people of color within your organization, including their growth toward leadership positions.
If your workforce is not yet diverse, discuss the concrete steps you are taking to get there. For instance, if you have a DE&I Committee, who’s on it? What do they do? Who is holding them accountable? Or, if you’re implementing hiring practices that support diversity, what are those exactly? What progress have you made so far? Who is overseeing this process?
Diversity and inclusion are no doubt an essential part of healthcare that must be enhanced, supported, and talked about.
As with all factors within your healthcare organization, be transparent — but be honest.
Do you have questions about how to align your healthcare organization’s website with your values? We can help.
Diversity has been a buzzword for a while now. In every field, every mission statement, and every strategic plan, common goals of “diversity,” “equity,” and “inclusion” are often found.
And they absolutely should be.
Efforts toward creating more inclusive spaces, more equitable opportunities, and more diverse representation are needed. In healthcare especially, these efforts are not only important, but critical — they can mean the difference between someone receiving life-saving and affirming care, or not. But what happens when these buzzwords are just that — words?
Making Equity, Inclusion & Diversity In Healthcare Actionable
In a study, 85% of physicians agreed that social needs impact health, but only 20% said they were confident in their ability to address the social needs of their patients.
Source: American Academy of Family Physicians
Saying your organization is committed to diversity or accessibility isn’t the same as actually working towards it, and equity efforts require more than just putting some new words in your mission statement.
If you want to be intentional about making your healthcare organization a more inclusive space for patients and providers, there are many ways you can start. Here are three places to review that can help you assess — and if needed redefine — your commitments.
1. On Your Website
Even before the pandemic, between 75 to 80% of patients were using Google search before booking health appointments.
This means that the first place new patients may be getting to know you is not through their experience in your clinic, but through your website. And for returning patients, they may be returning to your website in between clinic visits for information or scheduling.
The landscape of healthcare websites is competitive, and yours has the opportunity to communicate your commitments and values. Patients want to know whether your clinic will be welcoming, accepting, and knowledgeable about their particular needs and life experiences.
Questions To Ask Yourself
- What values are communicated by our website, either explicitly or implicitly?
- Do the people — patients and staff — pictured on our website look like the patients we serve?
- Does our website offer information in multiple languages or in the local English used by our community?
- How easy is it to find information about things like pricing, affordable financing options, or other accessibility programs?
- Is our website ADA compliant, meaning it is accessible to people with disabilities?
2. In Your Programs
Part of your diversity and equity efforts may already include assistance programs that help your patients overcome obstacles to healthcare. While often including considerations for other determinants of health — like race, economics, and various social factors — it isn’t always simple to determine how successful these programs actually are.
In the same way that you want to be sure you’re getting honest feedback from your team, you also want to seek out honest feedback from your patients.
Knowing if existing programs are or aren’t working can help pave a path — not only for more successful programs — but for more diversity and equity in your organization.
Questions To Ask Yourself
- What are the obstacles to care that our patients are facing?
- How do we know that?
- What assumptions might we be making about what our patients need or want?
- What effort has our organization made recently to hear from patients directly regarding what is working or what could be more effective?
3. On Your Team
Every day, your team brings to life your vision and mission, all while bringing care and comfort to the communities you serve. You want to be sure you have a great group of people, and you want to provide them the tools to be the most successful they can be.
But sometimes our biases — whether they are personal or structural — can impact who gets a seat at the table. This, in turn, can impact the level of care provided by your organization.
Ensuring that your team of healthcare professionals is diverse isn’t just about creating a “look” of diversity. It also isn’t just about organizational success — though recent studies have found that more diverse businesses consistently outperform their less diverse competitors.
With a wider range of experiences, your healthcare team can provide more personal, informed, inclusive, and — simply put — better care to your patients.
Questions To Ask Yourself
- Who is on our board? Do they reflect the community we serve?
- Do the medical practitioners at our clinic speak the languages spoken by our patients?
- How are we soliciting honest feedback from our team?
- Does our team feel comfortable and safe discussing the challenges they may be facing in the workplace, like microaggressions or sexual harassment?
- What hiring practices or internal biases might be impacting who is hired at our organization?
You probably don’t have the answers to all of these questions. That’s okay.
Diversity, inclusion, and equity efforts must constantly be changing and improving — the work will always be ongoing. Asking yourself or your team some of these questions means you have an opportunity to look critically at the way your organization is operating and how that work can improve.
Don’t just assume you know all the answers, and don’t assume that your answers are reflective of the other people on your team or in your community. Diversity work isn’t something that can be done alone — it is stronger when we do it together.