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Race, Ethnicity and Patient Engagement

flying cadeuciiA few years ago, I was upgraded to First Class on a flight from California back to Chicago. Not long after I settled in, a tall, muscular man easily four inches taller than me walked up to my aisle seat in the first row and prepared to sit by the window.

I envisioned him spending hours hemmed in by the bulkhead and offered to switch places. We began to talk, and soon he shared that his seatmates often hesitate to engage him in conversation. Women and even some men will turn or stiffen in their seats in order to send a clear body-language message.

That’s what happens when you’re a large, physically imposing black guy. People make assumptions. When it comes to patient engagement, we often make assumptions, too.

We minimize the influence of race, gender and ethnicity, or we confuse it with socio-economic status. We assume that “people like us” have communication preferences like us. We downplay the doctor-patient relationship and overemphasize technology.

Race and Ethnicity Matter

In truth, race and ethnicity matter as much in medicine as in the rest of the society. For example, whites, African-Americans and Latinos share the same expectations of their physicians, a study in Health Services Research found, but “patients from different racial and ethnic groups report differing experiences…when using well-validated measurement tools.” Translation: the perception reflects reality.

Continue reading…

Health is Life

Alex-Drane We’ve all experienced the crushing agony of a heartbreak, or the deep foundational stress of worrying about how you’ll pay all your bills, or the isolating and bleak reality of a mum or dad or loved one whose health is failing in a way you can’t figure out how to stop – or fix. Life is hard. Now – how hard is all relative … but for most of us, our days are consumed on some level with a pretty significant level of worry. Did you overextend when you bought that house? Is so-and-so gunning for your job? Is it wrong that you secretly and deeply resent your partner because you’re sick of them “never doing anything”?

And how about the real worries – will you have food, electricity, heat, clothing, safety…the worries that consume more people than any of us would care to imagine (The Shriver Report has 1 out of 3 women living ‘on the brink’ – in other words, right smack dab in this reality). For fun – let’s try an exercise marriage counselors use for marriages that are in trouble…they have each of you sit down and write on a piece of paper what matters to you, and what you think matters to your partner. Then they compare the two. And what do you think stands out in stark testament to the current state of the relationship? Pretty much zero overlap. You don’t understand what matters to me, and I don’t understand what matters to you.

Let’s extend that analogy to the healthcare space…picture a typical day for many of us in the health communication space, for example. How are we spending our days? Dreaming up new and more imaginative ways to lecture about the importance of getting a colon cancer screening, or eating well, or taking your blood pressure medication, or getting in for your annual Medicare wellness visit, or or or…

And a question for those of us working on this stuff. If you turned all that passion and intensity you bring with you to work, and to the task of telling others how to live in a way that complies with HEDIS this or STAR that or [insert any other traditional health quality metric here]…if you turned that lens on yourself – how are you doing? Do you eat the way you should? How’s your weight? Do you sleep the recommended 7 to 8 hours of sleep a night? How are you on your preventive screenings – are you up to date? Did you exercise at all in the last week?

I’d bet the answer to all those questions is “no”. Continue reading…

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