April marks the Department of Health and Human Services’ Minority Health Month for 2016, focusing on “Accelerating Health Equity for the Nation.” As a critical piece of the health care system, home health care is a vital ally in the mission of improving health equity.
Data from the Alliance’s 2015 Home Health Chartbook shows that home health care already serves a disproportionate share of racial and ethnic minority patients as compared with the general Medicare population. However, there are still plenty of areas of focus with regard to health equity in home health care. Black and Hispanic home health users are more likely to have an income under 100 and 200 percent of the federal poverty level compared to all Medicare home health users, as well as being half as likely as all Medicare home health users to have an income over $25,000 per year. On top of that, both black and Hispanic home health users are more likely to have two or more activity of daily living limitations.
Work is being done to improve home health care for all, and a number of providers are already utilizing innovative programs to improve care for minority patients. In 2014, the Alliance released a Faces of Home Health profile highlighting the racial and ethnic diversity of home health patients and how one agency is meeting the needs of such patients. The profile featured Asian American Home Care, an agency based in Oakland, California, serving a diverse array of patients. Staff at AAHC speak nine different languages and have extensive knowledge of, and sensitivity to, cultural, ethnic, and racial diversity. Staff undergo training courses and are offered teaching materials in a variety of languages, meeting once a month to coordinate patient care. It’s not just languages in which AAHC staff are fluent. Emphasis is placed on being sensitive to unique considerations for minority patients in many areas of communication, including non-verbal communications, dietary customs of various cultures, understanding political and natural disasters that patients may have endured, and financial and socioeconomic barriers to care. Taken in combination, these specialized skills and tailored approaches help provide more well-rounded care to minority patients, improving overall health care and increasing the likelihood of adherence to care plans and improved outcomes.
Specifically, the profile shares the story of a 91-year old native Chinese speaker being treated by AAHC who prefers Traditional Chinese medicine (TCM) to Western medicine. The patient’s nurse utilized a series of tools to help improve the patient’s care, including making flash cards for her patient to use with doctors to address the language barrier, and finding dietary substitutions that improve the patient’s condition while still maintaining a sensitivity to the customs of the patient’s culture. These small things had a tremendous impact on the patient’s overall health, while still maintaining empathy for the patient’s culture and preferences.
Tailoring care to include cultural, ethnic, and racial sensitivities is vital to not only achieving better clinical outcomes, but to truly providing patient-centered and patient-preferred care. In doing so, home health care can continue to strive toward health equity, and improved patient outcomes and experience. The quicker health equity is achieved for all, the better we all are.
More information on National Minority Health Month is available online at: http://minorityhealth.hhs.gov/nmhm16/. Follow on Twitter using #NMHM16.