Culture issues impede minority healthcare

WASHINGTON, Jun 28, 2005 (United Press International via COMTEX) -- Healthcare providers face cultural challenges developing and improving care for minorities, industry representatives told the 2005 Minority Health Conference Tuesday.

Joy Wheeler, president and chief executive officer of FirstGuard Health Plan, said even controlling statistics for gender, age and socioeconomic status, minorities have higher morbidity and mortality rates for various diseases than do whites and are more likely to have conditions such as strokes, diabetes and cardiovascular disease.

There also are gaps in cultural understanding between doctors and their patients.

"We're just beginning to scratch the surface with regard to cultural norms," said Karen Ignagni, president and CEO of America's Health Insurance Plan.

For instance, many Medicaid users prefer to hear rather than read health information, said Medicaid Health Plans of America Chairman Emeritus Clyde Oden.

Carlos Olivares, executive director of Yakima Valley Farmworkers Clinic, described his experiences working with migrant farmers in Oregon and Washington. He said language barriers often cause problems for farmers trying to obtain medical care -- with 12-year-old children providing translation services during their parents' colonoscopies. A man from a South American native tribe languished in an Oregon mental institution for a year and a half, Olivares recounted, because no one understood his language.

"You need to realize that, in the state of Oregon, if you are a migrant farm worker ... you don't quite exist," Olivares said. "The state does not recognize you as a human being."

"Just because a doctor looks like you isn't a guarantee of cultural competency, either," said Fredette West of FDWest Network Associates, who added doctors of all races go through the same flawed training system.

Ignagni said she has given workshops in Albuquerque, Chicago and other cities to discuss the need for the health industry to collect data on medical treatment of minorities, analyze it and find ways to improve care. She said many people who attended her workshops thought they were prohibited from collecting such data, when, in fact, only six states prohibit it and there is no such federal law.

One healthcare issue soon to affect people of all races is the Medicare Modernization Act of 2003. Beginning in January 2006 it will provide prescription drugs for seniors previously covered by Medicaid.

Mark McClellan, administrator at the Centers for Medicare and Medicaid Services, described the upcoming switch as one of the "biggest changes ever in the Medicare program" and said efforts already are underway to notify Medicaid users of the transition.

McClellan said elderly minorities are disproportionately likely to benefit from coordinated care opportunities that will be offered under the new Medicare system.