Hospitals in New York, Other Cities Increase Culturally Competent Care, Particularly Among Minorities With Diabetes
Medical professionals across the nation are "beginning to bone up" on culturally competent health care, in particular with diabetes, "given the rising incidence of the disease, its prevalence among minority groups and the changes in diet and lifestyle that treatment often entails," the Wall Street Journal reports.
In New York City, nearly 50% of Asian-Americans have diabetes or pre-diabetes and about one-third of blacks and Hispanics have one of the conditions, compared with roughly 30% of whites. According to the Journal, the 50,000 diabetes patients at the city's 11 public hospitals speak "scores of languages" and are accustomed to "varied cuisines." Area hospitals have begun to tailor treatment and educational materials to minority populations, including making print information available in several languages, providing on-site cooking classes that focus on ethnic-specific recipes and offering a range of translation services. The public hospitals' electronic health record system is the "backbone" of the city's effort, the Journal reports. It allows providers to track clinical indicators, check when patients are due for certain exams and alert patients to missed appointments in their native languages.
Many of the efforts are not directly reimbursed by the government or private insurers, according to the Journal. The New York City public hospital system estimates that it spends about $10 million annually on cultural competency efforts and an additional $50 million to $60 million on health care information technology.
Similar efforts are occurring in other cities. A Massachusetts hospital offers a computerized diabetes registry that tracks Haitian and Hispanic patients; a San Diego center offers healthy cooking classes for Hispanics, Filipinos and Vietnamese; and California, New Jersey and New Mexico require health professionals and medical students to receive some form of cultural competency training.
Alan Aviles, president of the New York City Health and Hospital Corporation, said that over time, the efforts will save money by preventing the onset of chronic diseases. He added, "It doesn't take too many (averted) cardiac surgeries before you have the money needed to start a demonstration kitchen."
Jeannette South-Paul, chair of the University of Pittsburgh Department of Family Medicine, said the goal of cultural competency is not to provide different care to patients based on their ethnicity and religion but rather to make health care more accessible to individuals of various backgrounds. "It's imperative that you get this information across to patients and help them treat these ailments, because they result in increased mortality," she said, adding, "If you can be creative in how you approach that population, that is good" (Francis, Wall Street Journal, 10/23).