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Colorado moves to fund “culturally responsive” health care training. What does that mean?

Meg Wingerter, The Denver Post on

Published in Health & Fitness

“There have been so many barriers,” she said.

Practical considerations, like whether a medical site is as accessible, has convenient hours and offers interpretation services at every point in the interaction can be as important to cultural competency as having a well-trained staff, according to guidance from Georgetown University’s Health Policy Institute. So can working with people who know a community well, whether that’s staff members who share the patient’s background, community health workers or traditional healers (when possible without compromising care).

Adalante normally doesn’t get involved with health issues, focusing on economic development and assisting Latino business owners. But the staff is part of the community and knew how to talk to people about their concerns, Gonzalez said, estimating they facilitated about 15,000 shots through a partnership with Colorado Access, which provided staff and funding.

They also knew that setting up at the weekly Mile High Flea Market and at apartment and mobile home complexes would bring in people who weren’t opposed to being vaccinated but hadn’t been able to get the shot easily, she said.

“We didn’t have to beg,” she said.

Patients who feel supported seek more care

While race and language come up most often in discussions of cultural competency, some of the biggest supporters of the bill to fund the training are organizations representing the LGBTQ community.

In a 2018 survey commissioned by One Colorado, about one-third of people identifying as LGBTQ said they didn’t have adequate access to health care providers who understood their needs, and 36% said they weren’t open about their gender identity or sexual orientation because they worried about discrimination in the provider’s office.

 

Dr. Jude Harrison, a recently retired family medicine physician in Durango who identifies as transgender, said even having options other than “male” and “female” for patients to mark on their intake forms can be helpful.

So can getting rid of gendered language when it’s not necessary, such as asking about the patient’s parents, rather than mother and father, when taking their health history. With a few exceptions, a relative’s sex doesn’t matter when figuring out if family history puts a patient at risk for an illness, he said.

“A lot of it comes down to practices not assuming that someone is heterosexual and cisgender,” he said. “When people are treated respectfully… that significantly increases the odds that someone will seek care and they will seek it promptly.”

Transgender people have a particularly difficult time getting health care, even when the reason they’re seeking care has nothing to do with their gender identity, Harrison said. It doesn’t matter if a patient is transgender if they have strep throat or a broken wrist, but a significant percentage of providers still say they can’t treat those patients, he said.

The One Colorado survey found that when respondents thought their health care provider understood and was supportive of LGBTQ people, they were more likely to have had a medical visit in the past year, and to have received routine care like flu shots and cancer screenings. About 78% of people who said their provider understood their needs had a primary care visit in the previous year, compared to 52% of those who didn’t feel comfortable with their provider.

“You don’t have to comprehend someone’s sexual orientation or gender identity to treat them with compassion and respect,” Harrison said.

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