Typically, medical students get a few days of training about communicating with diverse patient groups, and they may take occasional continuing education courses on the subject as providers, Friedland said. Usually, the training focuses on people of different ethnicities or religions, though sometimes training about LGBTQ people and people with varying disabilities is available, he said.
When patients trust their doctors, they’re more likely to follow medical advice, whether that’s getting a vaccine or taking steps to manage their chronic conditions, King said. And they’re more likely to trust providers who understand where they’re coming from and are trying to meet their needs, he said.
“When you look at (COVID) vaccine adoption rates… the key factor is trust,” Friedland said.
A better relationship with patients is only one part of the solution, though, King said. Patients won’t get better care if the office is only open when they’re at work, isn’t accessible for people with disabilities and doesn’t offer help navigating the complex systems surrounding elder care, he said.
“Training is about 20% of the equation,” he said. “If the system doesn’t change, if the structure doesn’t change… any effect is going to be marginal.”
Cultural gaps in vaccine rollout
Maria Gonzalez, CEO of Commerce City-based Adalante Community Development, said the need for cultural competency became clear during the pandemic.
The state and local health departments’ initial efforts to get COVID-19 vaccines out didn’t focus on the Latino community’s needs, and asking for identification at some sites raised suspicion among people who didn’t trust the government with health information or were worried about their immigration status, she said.
Some sites didn’t have bilingual staff who could answer people’s questions, and it could be difficult to even find Spanish versions of the forms that vaccine recipients fill out, Gonzalez said.
In the first months of the vaccine rollout, recipients were disproportionately non-Hispanic white Coloradans, though the disparity has narrowed somewhat since then as the state hosted clinics in underserved areas. People of color were disproportionately likely to catch COVID-19 and die of it nationwide, though it’s difficult to know to what extent Colorado saw the same pattern, because so many cases lacked data on race and ethnicity.